Private Medical Insurance – the Good, the Bad and the Uncovered


Many people are thinking about private medical insurance (PMI) nowadays, as they realize that paying more for healthcare gives them more choice and possibly better outcomes. Let’s take a realistic look at the ups and downs of PMI so that you can decide if it’s for you or not.

The ups

  • You won’t have much of a wait for your treatment – possibly just a matter of days. We all know about the waiting times for state hospitals, which can run into months. This can be annoying at best and scary at worst.
  • Some conditions will get worse very rapidly, so the short queue for treatment is a huge help, and could mean a better outcome. At the very least you’re not left fretting for weeks.
  • You can choose your surgeon, consultant and hospital, within reason. Some policies have a list of approved places and practitioners.
  • You’ll get a private room, and the better policies will probably give you an ensuite bathroom as well. There’s nothing worse than trying to sleep on a noisy ward.
  • Your loved ones can visit you as much as they like and at any time.
  • Your care will be more personalized. You’ll get to see your consultant more often, and for longer each time. If you don’t like medical students, you won’t have to see them.
  • You’re more likely to see the same consultant throughout your course of treatment.
  • Your policy might include cover for medical negligence. See here for information on medical negligence.
  • Your policy might have a specialist team that can deal with certain conditions, like cancer or sports injuries.

The downs

  • Not all illnesses are covered. Basic policies tend to cover short-term illnesses or injuries. You’ll pay more for serious conditions or for help with pre-existing ailments.
  • Some treatments aren’t covered. Once you get referred to a specialist, you’ll need to make sure that everything is covered. You might find that the appointment is covered, but that you’ll have to pay for the medication.
  • There are a bewildering number of policies out there, so you’ll need to take advice from an independent party. You won’t get an objective opinion from an insurance company, oddly enough!
  • If you want more cover, you’ll have to pay more. Simple.
  • Medical insurance premiums are getting more expensive every year. Treatments cost more, so insurers need to charge more. This rise is above inflation, too.
  • Illness is unpredictable. You might develop an illness you didn’t expect, and once you’ve got it, it’s pre-existing, so you might not get help.
  • Private hospitals might not have the same access to joined-up teams to experts like a state teaching hospital might have. If you have a problem with your inner ears, you might have to see an ENT (ear, nose and throat) team. This is great, but the team might be spread out between different hospitals.
  • Your consultant might also work for the national health provider, and so you may be sharing him or her with lots of other people. You will get appointments when he or she isn’t working for the state provider.