Private medical insurance is a valuable benefit for many people across the UK. By providing faster access to non-emergency healthcare, it helps to ease pressure on NHS services while ensuring individuals can get the care they need, when they need it.
Designed to work alongside the NHS rather than replace it, private medical insurance offers shorter waiting times and quicker access to diagnostics, specialist consultations, and planned treatments.
This allows the NHS to focus on emergency care, long-term conditions, and essential support services while patients benefit from greater choice and speed in their healthcare journey.
So, what does private medical insurance cover?
What private medical insurance covers
The range of services covered by private health care is becoming more and more important. Whilst not a replacement for the NHS, it can aid quicker access to consultant opinion, diagnostics, and planned interventions.
Consultations and diagnostics
Private medical insurance generally covers specialist consultations following referral, along with diagnostic tests, such as scans and blood tests. Many patients experience shorter waits for these services through private pathways. And less time waiting for diagnosis, means faster access to treatment.
Mental health support
It’s no secret that mental health is difficult to manage on the NHS, which means many people are looking to private healthcare for this specifically, especially when it comes to therapy.
For instance, services like Vitality offer up to eight Talking Therapy sessions including CBT and counseling, with no need for a GP referral. This is significantly ahead of most NHS services as, according to The BMA, nearly 1 in 8 planned roles in the mental health workforce need urgently filling.
Cancer treatment
When it comes to what private medical insurance covers, most policies include cancer care from diagnosis through surgery, chemotherapy, and radiotherapy, though this is often subject to policy terms. Some insurers may also provide access to cancer support services alongside medical treatments.
Menopause support
While the NHS offers support throughout menopause, it can be a difficult time to navigate for many women. That’s why having dedicated private support services can help with consistency, providing support throughout an incredible time of change.
Physiotherapy
Many healthcare insurance options, offer physiotherapy sessions within their own networks.
Private hospital treatment
If surgery or other hospital treatments are a part of your needed healthcare, most private healthcare companies will cover the cost of appointments, stays, and any medication needed. This means no worrying about hefty bills for necessary treatment, helping to remove stress from an already difficult time.
Dental cover
As the Oral Health Foundation have noted, there are positive changes ahead for the NHS in this space, but these do not help tackle the bigger problems faced by this sector.
Adding dental care to private healthcare packages makes sense: It means no stress trying to get an NHS dentist space. Instead, you’re covered to see emergency dentists and get hygiene treatments whenever needed.
Other optional features and add-ons
Depending on the provider and level of cover selected, private medical insurance policies may include extended outpatient cover, digital GP consultations, broader hospital networks, and flexible excess options. These can broaden coverage but may increase premiums.
What private medical insurance typically does not cover
While private medical insurance can provide faster access to treatment, it does not cover all healthcare needs and is not a replacement for NHS services. Key exclusions typically include:
- Pre-existing conditions: Most policies exclude conditions that existed before cover began, though some insurers may offer coverage after a symptom-free period.
- Emergency and chronic care: A&E treatment, ambulance response, and ongoing chronic care remain under the NHS.
- Maternity, routine, and preventative care: Standard private medical insurance usually excludes pregnancy, childbirth, routine GP appointments, vaccinations, and preventive health checks.
Supporting your healthcare planning
Private medical insurance can form part of a broader approach to health and financial planning, especially where NHS waiting times for diagnostics, specialist opinions, and planned treatment are lengthy. It makes an ideal option for busy professionals and those looking to plan their retirement alike.
At Rigby Financial, we support clients in understanding how private medical insurance fits within personal and business planning. If you would like to review your options or discuss existing cover, please contact our team for personalised guidance.