In-patient vs. out-patient cover

Everything you need to know about in-patient and out-patient cover

When it comes to health insurance, there are terms you’ll often come across that you may not fully understand. A good example of this is the difference between in-patient and out-patient cover.

We think it’s important to understand these terms as they can have an impact on your policy. That’s why we’ve provided all the information you need to understand what the terms mean, what they cover and how they can affect your policy.

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What is in-patient cover?

To put it simply, in-patient cover will cover the costs of any treatment you would receive when admitted into a hospital or clinic for at least one night.

This can cover a wide range of things, including:

  • diagnostic tests, such as MRI, CT and PET scans or blood tests prior to surgery
  • consultant fees for surgeons, anaesthetists or physicians
  • fees for the treatment itself, including any medications you may require
  • your stay in hospital and any care you may require
  • private cancer treatment, including radiotherapy, chemotherapy and bone marrow and stem cell transplants

What is out-patient cover?

Out-patient cover is for when you need to attend a hospital or clinic for diagnostic tests, treatments or therapies but you don’t occupy a bed or stay overnight.

This mainly covers:

  • minor diagnostic tests such as X-rays, blood tests and ultrasound
  • conditions that are treated as an out-patient, such as physiotherapy

It is possible that after you’ve been diagnosed you could be referred to a hospital or a clinic for treatment, which would then be defined as in-patient cover.

When it comes to health insurance, what is the difference between inpatient and out-patient treatment?

Usually in-patient cover is included in most health insurance policies as standard, meaning you’ll be covered for any treatments you may need.

Sometimes out-patient cover may not be included on basic health insurance policies. If it is included there may be limits applied, meaning you’ll only be covered up to a chosen amount per year. Once you’ve reached your annual limit you’d need to pay for any further out-patient treatment yourself or use the NHS. That’s why it’s worth checking your policy to see if out-patient cover is included and if any limits apply.

Is in-patient and out-patient cover included on Bupa policies?

We have two different levels of private health insurance cover. Each of our policies include full in-patient cover for all eligible treatment as long as you use a facility from your chosen Bupa network and a Bupa recognised consultant who agrees to charge within Bupa limits (this is called a fee-assured consultant).

With our Comprehensive cover you’ll be able to choose an annual limit of £500, £1000 or unlimited cover. If you choose unlimited all of your out-patient fees will be fully covered, however your premium may increase as a result. As with in-patient treatment, we’ll only fund eligible treatment when you use Bupa-recognised facilities and consultants.

Learn more about private health insurance

Our useful guides are here to help you understand the fundamentals of health insurance. We also cover a number of key health topics – such as looking after yourself as a parent and taking care of your children’s health.

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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.