The Ultimate Health Insurance Guide

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by shieldwise

In the UK, most citizens are entitled to free healthcare under the NHS. Though this is a benefit envied by many countries across the world, the recent presence of the COVID-19 pandemic has diminished the accessibility of this benefit. With hospitals filled and patient contact time limited, the current pandemic has been used as an example to highlight the potential benefit and importance of investing in health insurance. While it may seem easy to simply type “Good Health Insurance” in Google, it is important to know how health insurance works and what features of a policy best suit your needs.

To help you gain a better understanding of the key attributes that make up health insurance, we at ShieldWise have composed an easy-to-read health insurance guide. Hopefully, after reading this health insurance guide, you will have a clear understanding of health insurance policies and how they operate.

What is health insurance?

Sometimes referred to as private medical insurance, health insurance is a policy set in place to cover the cost of private medical care in the event an individual gets ill. Working alongside the NHS, this insurance plan offers access to benefits attributable to private medical, including, shorter waiting times, location options and specialist treatments. Whether it is a broken leg or stomach pains, health insurance can provide you with the necessary support to address the medical issue at hand.

How does health insurance work?

When investing in a health insurance policy, clients are required to pay an agreed premium rate that guarantees coverage. The size of this premium rate is dependent on a variety of factors, including, insurance provider, health status, age, policy type, and the agreed excess paid before each claim. In the event a medical incident occurs, the policyholder is 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 requires you to assess the types of medical conditions and services you want to have cover for in the future.

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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.

What types of health insurance policies are there?

As previously mentioned, when dealing with health insurance, there are different options to choose from that come with different premium prices and benefits. Some of the health insurance policy types you can find in the UK include:

Individual Health Insurance

Available at most insurance companies, individual health insurance provides medical coverage to one person. Providing financial coverage to cover the cost of private medical care, the use of this policy allows an individual to avoid lengthy NHS waiting times and receive necessary treatment as soon as possible.

Joint Health Insurance

Designed for couples, joint health insurance provides private health care cover to you and your partner under a single policy. While on the surface this may seem no different from two individual plans, making use of a joint health plan can be a significantly cheaper alternative that allows both members to split the cost of their monthly premium. As a result of this benefit, most people who apply for health insurance opt for a joint private health insurance policy over a single plan.

Children’s Health Insurance

Simply put, children’s health insurance is an insurance policy that provides private medical care cover to children. Due to the relatively low monthly premium cost attributed to this insurance plan, children’s health insurance is only available up to a certain age determined by the insurance provider. Once a child exceeds the age criteria, their policy type is changed into a normal individual health policy.

Family Health Insurance

As the name implies, family health insurance is a policy designed to provide private health care cover to an entire family. Placing family members under a single umbrella policy, family health insurance can offer the same perks as individual health insurance but at a cheaper price. Depending on the insurance provider, some policies can offer access to a private ambulance, home nursing, dedicated virtual GP consultation and hospital accommodation for parents if a child is required to stay overnight.

Over 50’s Health Insurance

Ideally, health insurance is a policy you should be able to invest in at any age, however, this is not the case. Most health insurance providers have a maximum age where clients can take out their cover, this is normally between the ages of 60 and 80. Due to the increased risk of illness and death that comes attributed with older ages, some insurance companies offer over 50’s health insurance. Typically, this policy variation charges a higher premium rate when compared to the other health insurance types.

Health insurance coverage levels

Alongside different health insurance policy types, most insurance providers also offer different coverage levels:

Basic Health Insurance

Normally the cheapest of the three categories, basic health insurance policies focus on providing cover for the cost of inpatient treatment. Inpatient treatment is when a policyholder receives treatment that requires them to stay in a hospital bed for the day or overnight.

Medium Health Insurance

Juxtaposing the basic type, medium health insurance policies generally cover outpatient care as well as inpatient support. Outpatient care is typically when policyholders have access to consultancy and treatment that do not require an overnight stay. The amount policyholders can claim for outpatient treatment is normally capped.

Comprehensive Health Insurance

The most expensive of the three versions, comprehensive health insurance policies are likely to cover for a range of conditions and treatments. Additionally, some comprehensive insurance plans offer cover for mental health conditions, such as, depression and body dysmorphic disorder (BDD).

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The benefits of having health insurance

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

Options to add more cover

With some insurers, applicants have the option to add extra cover policies to their health insurance plan. These optional covers can include, dental care, eye care, physiotherapy, homeopathy mental health support. While these services can be beneficial, it does bear mentioning these optional cover plans are not free and can lead to increased health insurance quotes.

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.

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.

Potential drawbacks of health insurance

While health insurance comes with many benefits, there are two main drawbacks that often influence an individual’s decision to opt against acquiring it. These drawbacks include:


In many cases, health insurance is an investment that people consider too expensive to own. While the price of health insurance can vary from company to company, the average household is expected to pay between £600 and £1,800 a year for health insurance cover. Due to the lack of a fixed premium rate, this cost continues to rise every year until the policyholder decides to opt out of their plan. For this reason, it is recommended to only invest in health insurance if you have the necessary financial security needed to address this ever-growing fee structure.

Alternative options may be better

While access to private hospitals can provide you with the resources to receive high-quality treatment, in some cases it is possible to find better care on the NHS. For patients dealing with serious diseases like cancer or heart disease, the NHS provides priority treatment. The NHS offers this same level of priority to sick and injured children to ensure they are nurtured back to health.  

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. This outcome means that many clients may benefit from using the services offered by the NHS which guarantee consistent medical care and support at a low cost.

What factors affect your health insurance quote?

While health insurance can be a great tool to aid you during times of illness, its relation to your health means there are multiple factors that can affect your health insurance policy. In some cases, an applicant’s age and lifestyle habits can be the key decider on the amount of premium a customer has to pay to receive cover.

To help you understand what aspects of your life might be affecting your quote, the following section of this guide will explore some of the key factors that insurance providers take into consideration when giving a quote.


As previously mentioned in the Over 50’s health insurance section, age is one of the biggest factors to influence premium quotes. With illness and mortality rates more prominent in older demographics, insurance companies are normally more inclined to offer cheaper premiums to younger applicants. Recent reports suggest that clients over the age of 60 could be charged premium rates three times higher than someone in their 30’s. Additionally, policy premiums are not fixed and increase along with the holder’s age. Most health insurance policies are reviewed annually and can increase in price every year.

Medical history & health

Most health insurance companies want to know about any pre-existing medical conditions before they are willing to give you a quote. Depending on the provider, some insurers may require you to complete a medical test that assesses your blood pressure, heart rate and cholesterol levels. If an applicant is considered unhealthy for their age, they will be met with a high premium rate.

Where you live

This may sound a bit odd, but where you live can play a huge role in how much an insurance provider is likely to quote you. Since health insurance is a service used to cover the cost of private medical care, being established in an expensive area like London can lead to higher fees. It is important to remember that the private hospitals you choose for your policy do not share the same service fees. The more expensive the area, the more money a private hospital will charge for its services.


Drinking with friends can be fun, but it’s not much fun on your wallet or insurance quotes. Depending on the risk associated with certain lifestyle habits, most insurance companies are likely to increase or decrease the price they offer. Habits such as occasional drinking and smoking can increase an applicant’s quote by 80%, while frequent exercise could reduce it by up to 30%. In some cases, insurance companies also enquire about an applicant’s job role to assess whether there is a substantial chance a claim will be made because of a workplace incident.

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How to get cheap health insurance

While it may seem costly to invest in health insurance, there are avenues you can take to make health insurance cheaper and accessible. These avenues include:

Increase the excess you pay

As previously touched upon, one of the avenues you can take to reducing the cost of health insurance is to increase your excess. Typically, when dealing with insurance companies, the higher the excess a client pays, the lower the monthly premium they will quote. This approach is normally the easiest option people can take to reduce the cost of any type of insurance policy. However, it is important to remember that once you make a claim, you are required to pay this excess.  

Depending on the insurance company, it is possible to be charged an excess rate yearly, regardless of the number of claims made, or on a claim-by-claim basis. Raising your excess can be a great option to finding cheaper health insurance, however, we recommend only choosing this option if you can afford it, or if you are using health insurance for ‘worst-case scenario’ cover.

Check with your employer

In some cases, it is worth simply asking your employer if they offer some form of health insurance cover. What often goes unannounced 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 businesses, many employers can negotiate discount prices with insurance companies to provide health insurance cover for employees and their families.

Asking your employer about this potential avenue can save you spending hundreds of pounds for a service you have at your disposal. 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.

Reduce your optional add-ons

While on the surface, add-ons can seem valuable, most of them only serve to increase the overall monthly premium you are required to pay. If you believe the premiums you are being quoted are too high, you might want to consider reducing the number of add-ons you apply to your plan.

Health insurance in the UK was designed to act as a safety net for emergencies and not an absolute alternative to the NHS. Whether it is dental care or physiotherapy, the NHS offers a variety of medical services needed to address an issue at hand. Free and available to every UK citizen, make use of the services the NHS has to offer and only invest in add-ons you believe are important.

Reduce the number of hospitals

While this may sound counter-productive, reducing the number of private hospitals your insurance plan covers can significantly reduce the monthly premium you are required to pay. Though having access to a large number of hospitals can be considered crucial when the time comes, most insurance companies encourage this decision so they can increase the premiums they charge.

As previously mentioned, health insurance prices vary depending on what area you live in. For this reason, requesting access to multiple private hospitals in an expensive region like London can see your premium rate increase drastically. Not all private hospitals charge the same prices for their services and as such insurers must set a high premium to ensure they can cover any claim incurred. Unless you live in a rural area with few hospitals, we would recommend reducing your allocated hospital list to save some extra coin.

The ‘Multi-week’ option

As the name implies, some insurance companies offer cheaper premium rates if clients accept a multi-week alternative. Depending on the insurance provider, this alternative allows clients to reduce the cost of their policy by agreeing to accept NHS treatment if its available within 4-8 weeks of a claim. Making use of both NHS and private health care services, this approach is an easy compromise that reduces insurance costs and maintains policy coverage.

Consider critical illness cover

For individuals that plan to use health insurance as a ‘worst-case scenario’ safety net, they may benefit from looking at critical illness life cover. Similar in concept but different in approach, critical illness cover is a life insurance policy that provides support to users that contract or are diagnosed with a serious illness. Available at multiple insurance providers, this policy offers support in the form of a lump sum payment that can be used to cover the cost of treatment and bills.

In the event of the policyholder’s death, designated beneficiaries will receive an agreed lump sum payout from the insurance company. This cover plan is ideal for people who want to prepare for a life-threatening illness and the repercussions associated with it.

Health Insurance Guide: How do you find a provider that meets your needs?

Once you have determined that you want health insurance, you can begin searching for the one that meets your needs. While it may be more convenient to simply apply for the first insurance provider you see, it can often prove quite costly to invest in an insurance policy that can be considered overpriced for the coverage you want. In some cases, it is possible to completely miss out on health insurance policies that offer more benefits for the same price quoted for a basic policy.

With many policies containing a cancellation fee, the decision to change to a different provider or policy during a coverage term can be both expensive and time-consuming. To help you make the right choice we recommend making use of comparison sites to find the right provider for the right price. Making use of a comparison site can help you sift through several insurance policies and companies to find the one that meets your budgetary requirements.

While there many comparison sites available, we recommend using the comparison site we offer at ShieldWise. Driven by a commitment to develop an excellent platform that helps customers find the ideal insurance provider, here at ShieldWise we offer a comparison service that instantly locates insurance policies that meet your financial needs.

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Categories: Health Insurance