5

Context

I am a alien living in the UK (England, more precisely). I have right to permanent residency, (so) I benefit from the NHS.

As background for those not familiar with the UK, all health expenses are paid for by the (tax-funded) National Health Service (NHS). So you go to the NHS, you pay nothing out of your pocket. The same to the hospital, if you call an ambulance, etc.

I have stumbled upon some Private Health Insurance documentation. In their disclaimer, they state that (not like-for-like copy-past, but you'll get the gist of it):

Significant Limitations:

  • the services of a GP or dental GP,
  • sight testing
  • pregnancy and childbirth
  • any dental conditions not involving in-patient oro-surgical operation
  • health screening, routine monitoring, allergy testing or treatment

[…]

Significant Exclusions

  • Accidents or emergency admission
  • Treatment of chronic conditions
  • HIV/AIDS
  • Sleep disorder
  • Organ transplant
  • Treatment arising from […] war, civil disorder, riots.

My understanding is that the rest (going to the GP, visits to the A&E, dentist check-up) is covered by the NHS (well, I believe it costs £25–50/visit for dental care).

Question

My very naive first reaction is why pay £900/year (childless couple in their 30s, £250/year excess, full cancer cover) for something that doesn't pay for neither the daily stuff nor the big ones (that would be free anyway through the NHS?)?

Thus, I wonder what is the point of a private healthcare insurance in the UK if they don't cover extra-ordinary events or things that aren't covered by the NHS?

In other words, in which case would be a private health insurance worth it? (Or at least "actionable", the worthiness depending on each personal risk aversion)


Note: I believe my poor knowledge of UK health system is the reason I can't really see the point. But my question assumes there is something I don't understand. (There must be a value somewhere, otherwise they wouldn't sell such insurance, would they?).
In addition, I have to ability/possibility to come back to my western-European home-country where I can still benefit from subsidised healthcare (should NHS waiting time be too long).

  • 3
    It's a very good question. I believe the main benefits would be speed of treatment, comfort and choice of facilities. But I will leave it up to better-informed people to answer… – marktristan Jan 14 at 16:55
  • @marktristan yeah, "speed" and "comfort" were my first thoughts, too. – RonJohn Jan 14 at 23:37
9

Health Insurance/Private Medical Insurance in the UK is a luxury not a requirement

The NHS in the UK is funded through National Insurance and general taxation that is taken from pay at source (generally), the amount of which varies by earnings of the individual. Access to NHS services is based on residency (if you live outside the UK but use NHS services you may need to pay for your care).

For the majority of people the NHS will be sufficient for their needs, as the NHS provides, either free of charge, or for a nominal fee the following services:

So what is Health Insurance good for then?

Health Insurance in the UK is primarily there to cover non-routine tests and treatment. It enables the policyholder to do the following:

  • Access some tests or surgery as an inpatient or day patient (including some elective surgeries)
  • Get hospital based accommodation that is private and/or of a slightly better standard
  • Access drugs that are not available via the NHS (usually due to decisions the NHS has made on cost vs benefit)
  • Get treatment slightly faster for the early stages of potentially chronic conditions
  • Outpatient tests, consultations and therapy

Some health insurers in the UK also give their policyholders "perks" or "rewards" (at the time of writing VitalityHealth is a primary example of this, at present an Apple Watch is one of the rewards they offer). As a result:

  • Young and healthy individuals may take out this policy and actively use as many of the rewards and perks to get more value than they are paying in premiums (most policyholders don't make use of the full suite of benefits), and have the additional benefit of having some additional flexibility if they do get sick
  • Older, weathy individuals may have Health Insurance to get treated faster

To address some of the specific exclusions you mention directly

Significant Exclusions

  • Accidents or emergency admission
    • Covered by the NHS directly
  • Treatment of chronic conditions
    • NHS treatment is generally free for chronic conditions
  • HIV/AIDS
    • Would be classified as a chronic condition and would be included in your standard NHS cover for free
  • Sleep disorder
    • Would be classified as a chronic condition and would be included in your standard NHS cover for free
  • Organ transplant
    • Covered by the NHS directly
  • Treatment arising from […] war, civil disorder, riots.
    • treatments arising from war will generally only be experienced by members of the armed forces and the Armed Forces in the UK have their own special NHS services and MoD provided care
    • for non military personell this would be classified as A&E style care and is covered directly
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    "Get treatment slightly faster for the early stages of potentially chronic conditions" - NHS waiting lists are the longest they have ever been, and many operations get cancelled at short notice. The biggest advantage of private insurance is avoiding the waiting lists. – Simon B Jan 14 at 21:51
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    @SimonB it really depends on the specific condition on how long waitings lists are and the specific area you live in. Also no they aren't, they are the longest since 2007/08 (fullfact.org/election-2019/ask-fullfact-nhs-waiting-lists) – illustro Jan 14 at 21:56
  • According to the Nov 19 waiting times, 50% of patients got treated within 8 weeks, and 84.4% of patients were treated within 18 weeks (which is the NHS maximum target) (england.nhs.uk/statistics/wp-content/uploads/sites/2/2020/01/…) – illustro Jan 14 at 21:58
  • @illustro back in 2018, I saw a dermatologist for a spot on my nose. Two weeks later, I saw a specialist for it, a month later had surgery to excise a (non-life threatening) basal cell carcinoma. Is that a reasonable speed in the NHS? – RonJohn Jan 15 at 2:18
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    The issue is the waiting time for non-urgent non-life-threatening treatments, such as hip operations. Looking at 'RTT Overview Timeseries Nov19 (XLS, 93K)', in November 2019, there were 690000 people who were waiting more than 18 weeks, and a total of 4.42 million people waiting for operations. It's then that you really want health insurance. – Simon B Jan 15 at 23:08

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