Inpatient vs. outpatient cover

What is the difference between inpatient and outpatient cover?

The main difference between inpatient and outpatient cover for your health insurance policy is whether your treatment requires you to stay overnight. If you’re required to stay overnight after you’ve had your procedure, you’ll need inpatient cover. Outpatient cover won’t require you to stay overnight or occupy a bed.

It’s important to understand these terms, as they can have an impact on your health insurance policy. Below is all of the information you need to understand these common health insurance terms, and how they may affect your policy.

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What is inpatient treatment?

Inpatient treatment is any treatment that requires you to stay overnight in a hospital or clinic for at least one night.

Inpatient cover on your health insurance policy 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 outpatient treatment?

Outpatient treatment is when you don’t need to stay overnight in hospital for your treatment, but you will still attend a hospital or clinic for any diagnostic tests, treatments or therapies you need.

Outpatient treatment on your health insurance policy 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.

Is inpatient and outpatient cover included on Bupa policies?

We have two different levels of private health insurance cover. Each of our policies include full inpatient 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 health insurance cover you’ll be able to choose an annual limit of £500, £1000 or unlimited cover. If you choose unlimited all of your outpatient fees will be fully covered, however your premium may increase as a result. As with inpatient treatment, we’ll only fund eligible treatment when you use Bupa-recognised facilities and consultants.

Sometimes outpatient 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 outpatient treatment yourself or use the NHS. That’s why it’s worth checking your health insurance policy to see if outpatient cover is included and if any limits apply.

Usually inpatient cover is included in most health insurance policies as standard, meaning you’ll be covered for any treatments you may need. You should check your health insurance cover to find out exactly what’s covered, and what isn’t.

Whether you need outpatient cover is entirely up to you. Think about what you’d like to get out of your health insurance cover – if outpatient cover is something that is important to you, add it on. Our health insurance is flexible and fits around your individual needs and lifestyle.

Everything you need to know about health insurance

Our useful guides are here to help you understand the fundamentals of health insurance. Not only that, but 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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Families save 10% with Bupa:

10% saving applies to family cover which includes one adult or more and one or more children. The savings apply to family cover with children on their policy compared to the price of individual cover for each family member. Savings only apply to Bupa By You core insurance. We reserve the right to amend or withdraw our family rate at renewal.

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.