Do You Need Health Insurance?

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by shieldwise

In the UK, most residents are entitled to free healthcare under the NHS. So do you need health insurance? Though this is a benefit envied by many countries across the globe, the recent presence of the COVID-19 pandemic has diminished the accessibility of this benefit. With hospitals filled and patient contact time spread thin across doctors, the current pandemic has been used as an example to highlight the potential benefit and importance of investing in health insurance.

As the UK sits in its third national lockdown, many people have been made redundant and unable to allocate a large portion of funds towards insurance policies. With the average UK household owning at least one insurance policy, the cost of acquiring health insurance has left many questioning whether they need it in the first place. To facilitate a level of awareness, this blog article was devised to highlight the key elements of health insurance that often decide its necessity.

What is health insurance?

In layman’s terms, health insurance is a policy set in place to cover the cost of private medical care in the event an individual is afflicted by an illness or injury. Occasionally referred to as private medical insurance, health insurance works alongside the NHS to provide benefits, such as, shorter waiting times, location options and specialist consultation services commonly found in private medical care. Whether it is a broken leg or back pain, health insurance can provide you with the necessary support to address the medical issue at hand. Now that you know what it is, we can dig deeper and determine do you need health insurance.

How does it work?

When investing in a health insurance policy, you are required to pay an agreed premium rate that guarantees coverage. The size of this premium depends on the insurance company, your current health status, and the agreed excess payment. In the event a medical incident occurs, you are entitled to receive a payout to cover the cost of any consultation or treatment administered at a private hospital.

What does it cover?

Typically, health insurance is designed to cover non-routine tests and treatments needed for acute conditions that start after a policy begins. These covered conditions normally include musculoskeletal problems (e.g., short-term neck pain), digestive system conditions (e.g., appendicitis), cancer, heart diseases and ear conditions.

Like most insurance, the cover an individual will receive is dependent on the policy they invest in. Depending on the policy chosen, it is possible for health insurance policies to include, day-care surgery, specialist consultations and compensation pay for each night a policyholder spends in an NHS hospital.

Choosing the right health insurance policy and seeing do you need health insurance requires you to assess the types of medical conditions and services you want to have cover for in the future.

What is not covered?

Though health insurance policies can provide you with the necessary support to address most medical needs, it does not provide coverage for all treatments and illnesses. Adopting an approach that focuses on single claims reimbursement, many health insurances only provide coverage for the first initial tests of chronic disease and not the overall long-term treatment. In the event you are diagnosed with a chronic illness that requires continuous treatment, mediation or check-ups, health insurance coverage is limited, and you are likely to be transferred to the NHS.

Additionally, health insurance companies typically refrain from providing coverage for medical incidents that include organ transplants, normal pregnancy and childbirth fees, cosmetic surgery, medical conditions that existed before the policy began and injuries suffered from participation in a dangerous activity. However, depending on the insurance provider, you may have the option to request additional coverage for specific medical events.

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Advantages of health insurance

As previously mentioned, having health insurance can provide you range of benefits normally found in private medical care. These can include:

Specialist referral

Depending on the insurance company, you can request that your GP refers you to a specialist for a second opinion. Access to this service is ideal for policyholders who want to receive advice from experts in a particular field.

Easy scans

While this may seem trivial, there have been multiple reported cases of patient scan requests being delayed or denied by the NHS. For situations where you need scans urgent, having health insurance can help you bypass this issue and have the necessary scans at a private facility.

Reduce waiting times

Since every UK citizen has access to NHS services, it is not uncommon to deal with long waiting times for NHS treatment. Depending on the insurance company, if the waiting period for treatment exceeds more than 4-6 weeks, the treatment will be conducted at a private hospital. If you need frequent quick care it can help you answer the question of do you need health insurance.

Pick your hospital and surgeon

With health insurance, you can increase the number of private hospitals you have access coverage to. Having access to this service can allow you to establish coverage in every major city in the UK. In some cases, insurance companies actively restrict you to a network of hospitals that offer them advantageous rates. This approach to hospital access serves to reduce the cost a company would have to pay to cover your claim, resulting in cheaper premium rates.

Specialist drugs and treatments

With health insurance it is possible to receive treatment and drug prescriptions from a specialist in the field. In some cases, this can lead to you getting access to specialist drugs and treatments that are not available on the NHS due to financial reasons and/or disapproval from the National Institute for Health and Clinical Excellence (NICE). Having health insurance can open avenues to receiving effective treatment that you may not have been aware of in the NHS. When you are deciding do you need health insurance you will need to assess how much of your medications could be covered if you got additional insurance.

Quicker access to physiotherapy

Due to underfunding and increased clients, getting a physiotherapy session from the NHS can be quite time-consuming. Health insurance reduces this wait time and assigns you to a private hospital with an available physiotherapist. 

Potential drawbacks of health insurance

The price

For some people, health insurance can simply be too expensive to own. In cases where an individual wants to invest in a family plan, households could look at up to £700 to £1,800 a year in premium fees. This cost will only continue to rise every year until you opt out of your plan. Unless you have the necessary funds to invest in health insurance without it being a hindrance on your finances, health insurance could prove to be a financial headache.

Not always the best care option

Though many consider private medical care to be the best service, in some cases you might find better care on the NHS. For patients dealing with serious diseases like cancer or heart disease, the NHS provides priority treatment. Having previously mentioned how health insurance policies operate on a single claim basis, many plans are not designed to provide long-term support for cases dealing with a serious chronic illness.

Identifying do you need health insurance

Just like many insurance policies, having health insurance is something that you must weigh up before deciding if it is worth it. To judge whether it is worth your time getting health insurance, ask yourself these key questions:

Does the NHS meet your needs?

Arguably one of the most important questions to consider when dealing with health insurance, it is important to assess whether you believe the NHS would provide a sufficient level of support to meet your needs. As highlighted earlier, even with private health insurance, you will still utilise the NHS for services such as your GP or A&E. If you are opting to invest in health insurance to prepare for the worst, there is a chance that if the worst-case scenario is a chronic disease, you would likely be passed on to the NHS.

For this reason, it is vital to consider whether it is worth investing a monthly sum in a plan that does not provide sufficient cover for life-or-death cases. This is the best way to determine do you need health insurance other than what the NHS provides.

Would you be better off self-insuring?

Remember, you do not need health insurance to get private medical care, you can simply pay for the bill yourself. Health insurance is a policy plan set in place to cover the cost of private medical bills; they do not act as a special membership that prohibits you from having access to private hospitals if you are not covered.

For this reason, it is important to assess whether it may be better to place the money you would typically spend on monthly premiums into a savings accounts with an interest rate that would allow it to grow. Adopting this approach to self-insurance allows you to receive medical treatment from any private hospital when the need arises. As a bonus, you also get to keep your money if you do not claim.

However, it does bare mentioning that this method takes time to build up and the treatment for certain conditions can be quite expensive.

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Does your employer offer health insurance cover?

Sometimes it may be worth simply asking your employer if you have some form of health insurance cover. What often goes announced in the working world is the number of people that are unaware of the benefits that come alongside their salary. Due to the bulk-buying power of most business firms, some employers can negotiate big discounts with insurance companies to cover employees and their families.

If your employer does offer health insurance cover, this will normally come as a no-cost standard benefit or as an option to pay with your payslip. Having this option can allow you to compare the current cost and cover you get, with the cheapest plans that match your need.

Are you doing it for your children?

If the reason you are looking to invest in health insurance is for your children, you might want to explore other avenues. Many parents invest in a health insurance family plan out of worry that their children may get sick and not receive adequate care.

However, depending on the age of the children, the NHS provides immediate priority and care to children with medical conditions. In the event that your child suffers from a chronic disease, you are likely to use of the NHS and its services, making your family plan redundant.

Is there an alternative insurance policy you can explore?

Depending on what you want from your health insurance plan, it may be better to opt for a completely different insurance type. Similar in premise, investing in Critical Illness Life Cover could be ideal for individuals that want cover for ‘worst-case scenario’ incidents.

Normally available as an optional add-on to life insurance, critical illness cover provides support to policyholders in the event of a serious illness contraction, or a severe medical condition diagnosis. Depending on the insurance provider, this policy can cover several conditions, including, cancer, cardiac arrest, HIV infection, Parkinson’s disease, and body paralysis.

This policy was designed to provide financial support to the policyholder and their family so they can focus on dealing with the medical issues at hand. Typically, this financial support comes in the form of a small lump sum payment used to cover the cost of treatment or to pay bills. In the event of the policyholder’s death, designated beneficiaries will receive an agreed lump sum payout. This cover plan is more beneficial for any individual who wants to prepare for a life-threatening illness and the repercussions associated with it.

Do you need health insurance and is it worth it?

All in all, health insurance can be a good investment if you ever need expensive specialist treatment and consultation. For individuals that want to pursue a career in sports, access to these specialists could be ideal for injury rehabilitation and conditioning. However, due to the pricey nature, it is a venture that you must thoroughly assess before moving forward with.

Remember that most of the services offered by private medical facilities can be found at a cheaper rate in the NHS. For this reason, it is important to understand that if you wish to invest in health insurance, make sure it is a venture that does not completely drain your financial resources. Always view health insurance as an optional safety net that will pick up the tab for anything that the NHS cannot cover.

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Categories: Health Insurance