How does private medical insurance work?
We know that health insurance isn’t always the easiest thing to understand. Here we answer some common questions about how health insurance works.
How could private medical insurance work for me?
We’re often asked, is health insurance worth it? We think so, if you choose the right policy for you. Here, we explain some aspects of health insurance, to help you find a policy that ticks all your boxes.
How it works
You’ll usually pay a monthly or annual fee and then make claims for any private healthcare you receive. Your insurance will cover some, or all of the costs of private treatments. Health insurance is designed to cover new conditions which occur after your policy start date.
Benefits
The main benefits of private medical insurance are that you’ll get fast access to private healthcare and usually get treatment faster. Many providers offer access to GP appointments through digital GP apps, giving you fast access to medical support, as well as a referral to further private treatment. Some also offer direct access to physiotherapists or mental health specialists without the need to wait for a GP referral, which also gets you the treatment and support you need, quicker.
What’s covered?
This depends on the policy you choose. Some just cover private treatments, others also cover diagnosis and offer ongoing support for cancer, or for mental health issues.
How to choose health insurance
Think about your individual needs – what do you want to get from health insurance? Then compare health insurance policies to find one that provides the right cover for you.
What’s covered?
Most health insurance policies don’t cover emergency treatment, maternity care, or management of long term conditions like arthritis or diabetes.
Conditions you had before you took the policy out are not normally covered.
Some policies limit the amount you can claim for out-patient appointments each year, while others offer unlimited cover.
Will I have to pay an excess?
You can opt to include an excess on most health insurance policies. This is an amount you agree to pay towards the cost of claims each year.
Opting for a larger excess can reduce the monthly payments on your policy. But you will need to pay the excess amount if you make a claim.
How easy is it to make a claim?
Every provider has its own process. Most ask you to visit your GP first to get a referral. Then they’ll help you to find the private medical treatment you need.
You’ll usually choose from a list of approved healthcare providers. Your insurer will usually pay these directly, meaning you won’t have to claim money back.
Is health insurance worth it?
This is entirely up to you.
Health insurance can help you avoid wait times. With health insurance you can get access to new drugs or specialist treatments, and you'll often be treated faster.
Private healthcare can offer you choice, as well as comforts like a private room, or treatment in your local private hospital.
Does health insurance cover emergency care?
No - private health insurance only covers you for non-emergency treatment and care. If you have new symptoms which require emergency care, you should visit A&E or a private urgent care centre as normal and get the help you need.
How does Bupa health insurance work?
We offer a range of products so you can choose the cover that’s best for you. Bupa health insurance works differently depending on the options you choose.
See our other guides on health insurance
How to make health insurance meet your budget
Here we share useful tips on making health insurance suit your budget.
How to choose health insurance
Knowing what to look for in a policy will help you choose the right cover for you.
Health insurance cost
Find out how much health insurance costs and what you get for your money.
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^ We may record or monitor our calls. Lines are open Monday to Friday 8am to 8pm
Bupa health insurance is provided by Bupa Insurance Limited. Registered in England and Wales No. 3956433. Bupa Insurance Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Arranged and administered by Bupa Insurance Services Limited, which is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales No. 3829851. Registered office: 1 Angel Court, London, EC2R 7HJ.
