Inpatient and outpatient cover
We explain what inpatient and outpatient treatment means, and how these are covered by health insurance.
Edited by Hannah Ramsden, health insurance expert at Bupa Last updated 28 May 2024
3 minute read
What’s the difference between inpatient and outpatient cover?
Health insurance can offer different levels of cover for inpatient and outpatient care.
Inpatient
Inpatient means that you’re treated in hospital and you stay overnight. You’re admitted to hospital, and you would have a bed. Most health insurance covers inpatient care.
Outpatient
Outpatient means you’re not admitted to hospital for the day, and you don’t stay overnight. Some cover limits how much you can claim each year for outpatient care.
What’s included in inpatient cover?
Most health insurance doesn’t limit the amount you can claim each year for inpatient care.
Inpatient cover usually includes:
- Diagnostic tests, such as blood tests or scans.
- Fees for surgeons, doctors, or other specialists in hospital.
- Fees for the treatment itself, including any medicines you need.
- Your stay in hospital and any care you need while you’re there.
What’s included in outpatient cover?
Some health cover limits the amount you can claim each year for outpatient treatment.
Outpatient cover usually includes:
- X-rays, blood tests and ultrasounds you have when you’re not staying in hospital.
- Physiotherapy and other therapy sessions.
- Consultations with specialists.
- Outpatient MRI, CT and PET scans.
If you have tests as an outpatient and are then admitted to hospital, the rest of your care would be inpatient treatment.
Inpatient and outpatient cover for cancer treatment
Some health insurers limit the amount you can claim for outpatient treatment. This means there may be a limit on cancer treatments that you have as an outpatient.
Some health cover makes exceptions for outpatient cancer treatments. You may have cover for these treatments even after you've reached your limit.
So, if you need outpatient care for cancer treatments like radiotherapy or chemotherapy, your limit may not apply.
Cover for cancer treatments can vary a lot. So, make sure you fully understand any limits that apply to a policy before buying it.
Did you know?
At Bupa, we offer cancer cover as part of some of our health insurance policies.
Do I need outpatient cover?
This depends on what you want from your health insurance. Outpatient cover includes physiotherapy and appointments with other therapists and specialists.
So, for example, if you think physiotherapy might be important to you, a larger outpatient allowance would be a good idea.
If your policy has a limit on outpatient cover and you reach this limit, you’ll have to pay for any more treatment yourself. Or you’ll need to use the NHS.
Does all health insurance cover inpatient and outpatient care?
Most health insurance covers inpatient treatment. This means you’ll usually have cover for treatment where you need to stay in hospital overnight.
Outpatient cover isn’t always included in basic health insurance policies. Some policies include it but limit the amount you can claim each year. Some policies offer unlimited outpatient cover.
If you choose a policy that has a limit on outpatient cover, once you’ve reached that limit you’d have to pay for any more outpatient treatment yourself. Or you could use the NHS.
Tip
Check the outpatient limits carefully when you’re comparing policies.
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Bupa health insurance is provided by Bupa Insurance Limited. Registered in England and Wales with registration number 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 with registration number 3829851. Registered office: 1 Angel Court, London, EC2R 7HJ.
