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Can I have private health insurance and still use the NHS

Can I have private health insurance and still use the NHS?

Unlike countries where private care is the only option, UK residents are in the privileged position of being able to use the world-class NHS free of charge. But with ever-growing NHS waiting times, more people are turning to private healthcare for peace of mind.

Thankfully, if you take out private health insurance, you’re still eligible to use the NHS when you need to. It may be you need emergency treatment or you’re receiving treatment that doesn’t have a long waiting list where the NHS offers the best options. Additionally, if you have private health insurance and a specific condition isn’t covered by your provider, you’ll still be allowed to use the NHS as and when necessary, without being expected to subsidise it from your own pocket.

The NHS has published guidance for patients who choose to pay for additional private care, whether that be with private health insurance or self-funded. The good news is, your NHS care will continue to be free of charge and you won’t be asked to pay towards your care unless usual charges apply.

How private insurance and the NHS can work together

At Westfield Health, our policy differs from traditional private medical insurance. To keep the costs down, we don’t cover heart disease and cancer-related conditions.

This decision was made following thorough research into the performance of the NHS, who treat these conditions as a priority.

In cases where cancer has been confirmed, the NHS states you shouldn’t have to wait more than 31 days from the decision to treat to the start of treatment. This is much quicker than the 18-week target set for non-emergency treatment, which is often not met because of increasing NHS waiting times.

If a heart condition or cancer is suspected, we do cover you for referral appointments. If confirmed, the treatment will be provided by the NHS. Cancer-related surgical procedures are excluded, however, we will cover surgical procedures when cancer is suspected but not confirmed, such as biopsies.

Having the option to go private for these consultations will give you peace of mind during your diagnosis. By then utilising our national health service for treatment we can keep your premiums down, as these are some of the most expensive treatments. This allows you to have affordable cover for those non-emergency situations whilst safe in the knowledge that if you are diagnosed with a heart condition or cancer, your treatment will be treated as a priority by the NHS.

What are the benefits of having private health insurance?

  • Faster treatment, while still being able to rely on the NHS when needed.
  • The reassurance you can get private treatment without the large price tag and avoid long NHS waiting lists.
  • Immediate cover for new conditions once your cover has begun. This is any condition that you haven’t had symptoms of or received treatment/advice for in the 3-year period before your cover started.
  • We settle all bills directly with the hospital so you’re never out of pocket.
  • You can choose from any UK hospital where a fixed price package is available, allowing you to find the most convenient location for your treatment.
  • A dedicated case manager who will guide and support you through the process.
  • The price you pay isn’t affected by your location or number of claims, and no medical is required.
  • Payment from our NHS benefit if you do receive treatment you would be covered for from the NHS.

You can find out more about the different levels of cover available, the benefits and what operations are covered on our private health insurance page.

NHS benefit

If you choose to have NHS treatment while paying for your private health insurance, we'll pay a cash sum directly to you. This means you never need to worry about private health insurance not being worth your money, as if you do end up receiving NHS treatment you will still receive a benefit.

The amount you receive will depend on the classification of the medical procedures. Each medical procedure is classified into one of four bands according to its medical complexity. Band A contains the least complicated medical procedures and Band D the most complicated medical procedures.

We’ll pay the NHS cash payout if you have NHS treatment for an eligible medical procedure. You’ll still need to submit all the relevant information so that we can assess whether the claim is eligible for the NHS cash payout. The table below explains the various amounts you can get for the cash payout depending on the band of treatment you receive.

NHS benefit table

Private health insurance with Westfield Health

If you do get private treatment at any time you’re still fully eligible to receive care from the NHS for any other treatment you may get in the future.

The costs of private care can be high. Private health insurance is a great way to ensure you’re covered for when you need medical care, allowing you to have peace of mind and know if something does come up you’ll be seen quickly.

You can read more about the different levels of cover and what’s included on our private health insurance page.

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