Private Insurance Patients: What Are Their Expectations?

Private health insurance is a form of healthcare coverage provided by private companies, rather than the government. It is an alternative to public health insurance, which is available to most UK and US residents. Private health insurance covers the costs of treatment by private healthcare providers, which can be very expensive without it. Private insurance patients want to be able to pay for private medical care and treatment for short-term, curable conditions. They want to be able to choose the level of care they receive, when and how it is provided, and the hospital in which they are treated. Private insurance patients also want to reduce waiting times and have faster access to healthcare services.

Private insurance patients want to avoid the high costs of private treatment without insurance

Private health insurance is not compulsory, but it can be very expensive to seek private treatment without it, especially for serious conditions. The cost of private treatment without insurance can be prohibitive, and patients may end up paying more, either directly or indirectly, in the form of higher copays or out-of-pocket payments.

Private health insurance plans typically offer comprehensive benefits, including hospital stays, doctor's visits, preventive care, prescription drugs, and more. The exact details of what is covered vary considerably from policy to policy, so it is important to shop around and compare policies to find the right cover.

When deciding whether to purchase private health insurance, patients should consider the importance of the benefits of insurance to them, such as greater choice and flexibility in their treatment options. They should also weigh the costs and benefits to decide if insurance will make healthcare more affordable in the long run.

By having private health insurance, patients can reduce wait times for elective surgeries and specialised treatments, as public healthcare systems may have longer waitlists. Private insurance can also provide access to advanced treatments and technologies that may not be available through public healthcare programs.

Private insurance patients want to reduce waiting times for NHS treatment

Private insurance can be particularly useful for those who want to reduce waiting times for elective surgeries and specialised treatments. Public healthcare systems may have long waitlists for certain procedures, whereas private insurance can expedite access to these services.

In addition, private insurance often provides quicker access to healthcare services in general. Patients can typically schedule appointments with specialists and undergo medical procedures more promptly than if they were relying solely on public healthcare systems. This can be especially important when immediate care or consultations are needed.

Private insurance patients also benefit from a broader choice of healthcare providers. They can select doctors, specialists, and hospitals based on their preferences and healthcare needs, allowing them to receive care from professionals they trust and are comfortable with.

Furthermore, private insurance plans often offer additional benefits such as wellness incentives, gym memberships, health screenings, and discounts on health-related products and services. These extra perks can contribute to the overall health and well-being of patients.

The ability to reduce waiting times and access expedited care is a significant advantage for private insurance patients, ensuring they receive timely and personalised treatment.

Private insurance patients want to be able to choose their surgeon and hospital

The ability to choose one's surgeon and hospital is especially valuable for individuals who want to ensure they receive treatment from specific experts in their field or those who wish to be treated at a particular facility. This choice can be crucial for patients with complex or rare medical conditions who may require access to advanced or innovative treatments that are not available through public healthcare programs. Additionally, having the option to select their surgeon and hospital enables patients to make informed decisions about their health and well-being, taking into account factors such as location, availability, and the reputation of the healthcare providers.

In addition to the choice of doctors and hospitals, private insurance offers patients a range of other benefits. These include comprehensive coverage options, faster access to healthcare services, coverage for additional services such as chiropractic care and alternative therapies, personalized customer support, and wellness incentives such as gym memberships and health screenings. Private insurance also provides portability, allowing individuals to maintain their coverage even if they change jobs or move to a different location.

While private insurance offers the advantage of choosing one's surgeon and hospital, it is important to consider the associated costs. Private insurance patients may face higher health costs at hospitals, as hospitals often charge private insurers significantly more than what Medicare would pay for the same services. Therefore, while private insurance provides the freedom to choose healthcare providers, patients should also be aware of the potential financial implications and make informed decisions based on their budget and specific healthcare needs.

Private insurance patients want to be able to access specialist drugs and treatments

Private health insurance covers the costs of being treated by private healthcare providers. It is a contract between the patient and a private health insurance company that mandates the insurer to pay some or all of the patient's medical expenses as long as they pay their premium. The alternative is to pay for care themselves as the need arises.

The more basic policies usually pick up the costs of most in-patient treatments – such as tests and surgery – and day-care surgery. Some policies extend to out-patient treatments – such as specialists and consultants – and might pay a small fixed amount for each night spent in an NHS hospital.

Private insurance is particularly useful for those who want to be covered for drugs and treatments they can't get on the NHS, such as specialist surgery for sports-related injuries. Some drugs and treatments are not available on the NHS because they are too expensive or not approved by the National Institute for Health and Clinical Excellence in England and Wales (NICE) or the Scottish Medicines Consortium (SMC).

However, it is important to note that private insurance patients can sometimes face higher health costs at hospitals. A report by the research group Rand Corp. found that in 2022, the prices hospitals charged to private and employer-based insurance providers were, on average, 254% higher than what Medicare would have paid for the same services.

Private insurance patients want to be able to access advanced treatments

Private health insurance plans come in various tiers and coverage levels, allowing patients to choose a plan that suits their healthcare needs and budget. While basic policies typically cover inpatient treatments and day-care surgery, some policies extend to outpatient treatments, such as specialists and consultants. Patients can also opt for policies that cover mental health, depression, and sports injuries, which are not always included.

Private insurance patients also want the ability to choose their surgeon and hospital. This is a significant benefit of private health insurance, as it allows patients to select a surgeon and hospital that suit their time and place preferences, which is generally not possible with public healthcare. Private insurance often provides quicker access to healthcare services, allowing patients to schedule appointments and undergo medical procedures more promptly.

Additionally, private insurance can help reduce wait times for elective surgeries and specialized treatments, as public healthcare systems may have longer waitlists. Private insurance patients also have the option of choosing a policy with an approved list of consultants and hospitals, although this may not always include the expert consultant they want to see or a convenient location for treatment.

Overall, private insurance patients value the ability to access advanced treatments and the flexibility and choice that private health insurance offers in terms of healthcare providers, treatment timing, and specialized services.

Frequently asked questions