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What is private health insurance

What is private health insurance?

Although private health insurance is available in the UK, many people are unaware of what it is or how it actually works. We are fortunate enough to have the NHS which has been around since 1948, so a lot of people haven’t taken the time to understand how private healthcare policies could benefit them.

With the pandemic putting such a large strain on the NHS, more people have been turning to paying for their own private treatment rather than joining a lengthy waiting list. Although this method can get you seen faster, it doesn’t come cheap. Treated privately, a hip replacement surgery could cost you up to £14,050, while a cataract surgery on one eye will cost an average of £2,513. This is where private health insurance comes in.

Put simply, private health insurance is a healthcare policy you pay for monthly. Your monthly fee is calculated using your age, and for as long as you continue you'll be covered for private treatment, as set out in your policy. This gives you access to private appointments, tests and surgery if you are ill or injured during the policy's term, without the high price tag.

How is it different from private medical insurance?

Traditional private medical insurance has a reputation of being expensive, with the high costs feeling out of reach for a lot of people and adding more financial strain than people feel it is worth. Private health insurance is a much more affordable option, giving more people the opportunity to gain access to private healthcare.

At Westfield Health we’ve created a private health insurance plan that is cost-effective and accessible for all. Unlike traditional private medical insurance, we don’t ask for any medical history or if you are a smoker while applying, instead we base your premium on your age. For a 45-year-old, prices start from just £5.94 a month for Level 1 cover and £16.35 for Level 2, without outpatient benefit. We also offer private health insurance for businesses from just £6.12 per employee per month. Providing your employees with private health insurance helps to look after your staff and have them treated and back to full health quicker.

Your premium won’t increase if you do make a claim, so there’s no need to feel apprehensive about using the private health insurance that you pay for. You have immediate cover for any new conditions you may develop from the time your cover starts, and the price you pay won’t be affected by your location or the number of claims you make.

What does and doesn’t it cover?

For both levels of cover available, you can have 3 surgical procedures per policy year. Level 1 you have up to a maximum of £100k during a lifetime of cover with access to 61 common procedures, including both hip and knee replacement surgeries. Level 2 gives you a maximum of £250k during a lifetime of cover, covering you for all procedures excluding heart and cancer-related surgeries.

Some common surgeries that are covered are:

  • Slipped discs
  • Varicose veins
  • Hip replacement
  • Knee replacement
  • Abdominal hernias
  • Sinus problems
  • Cataracts
  • Tonsillitis
  • Prostate problems
  • Gynecological problems
  • Gallstones

Pre-existing medical conditions are not covered, unless you have been free of symptoms, treatment or advice for 2 continuous years from your commencement date.

One way we keep our private health insurance at a lower cost is by not covering heart disease or cancer-related conditions. Both of these are treated as a priority on the NHS so it is less likely that you would need to go private in order to get fast treatment for these.

According to the NHS website, in cases where cancer has been confirmed, you should not 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, making you a higher priority and unlikely to need to rely on private health insurance.

We do cover you for referral appointments if a heart condition or cancer is suspected, and then if confirmed your treatment will be provided by the NHS. Not covering surgery and treatment for these conditions helps us to keep your premiums down as these are some of the most expensive treatments. As research shows, these conditions will have you seen as a priority, so private treatment may not be as important.

How does private health insurance work?

As already explained, you pay a monthly fee which then covers you for a range of different private treatments. To actually use your insurance, the process starts the same as any medical journey, by visiting your GP. Once your appointment is complete, your GP may decide to refer you to a specialist. If they do, you can ask to go through private treatment and contact us to start the claims process.

You can choose any UK hospital where a fixed price package is available for your treatment, allowing you to find a location most convenient to you. Our dedicated team will guide and support you through the process to make it as simple as possible.

Our team will then assess your symptoms and ensure that you are covered for this condition. Once this is done, you will then be able to get a private appointment with the specialist. The invoice will come straight to us and we’ll pay it directly so you’re never out of pocket.

checking in for private appointment

What are the benefits?

Having private health insurance allows you to skip lengthy NHS waiting times. As reported in the NHS referral to treatment (RTT) waiting times data, 4.44 million patients were waiting for referral appointments in October 2020, with 162,888 of those patients waiting more than 52 weeks. Even before the pandemic, the NHS were already struggling to meet their 18-week referral target for non-emergency treatment, and the pressure they have been under throughout 2020 has just made this worse.

Though some of the treatments we cover are classed as non-urgent by the NHS, many of them are painful conditions or caused by injuries and can significantly impact your quality of life and overall wellbeing. There is always the option of getting private treatment, however, without insurance, this comes with an extortionate price tag.

If you prefer NHS treatment, we’ll pay a cash benefit directly to you. The amount paid is determined by the band for your surgical procedure.

Other benefits of private health insurance include:

  • £1,000 optional outpatient benefit to pay for specialist consultations, diagnostic tests and scans. This is an additional benefit that you can choose to include in your cover for either level of insurance at an added cost.
  • Immediate cover for new conditions once your cover has begun. This is any condition that you have not had symptoms of or received treatment/advice for in the 3-year period before your cover started.
  • Our dedicated team will arrange the treatment package for you.

Should I invest in private health insurance?

Investing in your healthcare is more important than ever right now. With NHS waiting times getting longer each year, having private health insurance can give you fast access to the treatment you need that you could otherwise be waiting over a year for. You can find out more about the different levels of cover available, what operations are covered and the optional outpatient benefit by reading our plan guides.

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