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Can you afford to skip NHS waiting lists and go private? Here’s what you’ll pay | Personal Finance | Finance

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Sales of private medical insurance (PMI) are seeing sustained growth for the first time in 15 years. Many who previously ruled out PMI have decided the price is worth paying as NHS waiting lists hit 7.8million.

Britons spent a thumping £5.3billion on PMI in 2022, according to health data provider LaingBuisson, plus another £1.4billion on other forms of private treatment such as dental insurance and cash plans.

PMI sales rose by an average of 6.1 percent a year between 2020 and 2022, up from just 1.7 percent a year in the previous 12 years.

Tim Read, director of research and content at health data specialist LaingBuisson, said there is a close relationship between NHS waiting list lengths and demand for health insurance.

While waiting lists remain this lengthy, more of us wil respond by going private.

It would be a no-brainer decision except for one thing. PMI is not cheap.

Cover can cost hundreds of pounds a month, depending on your age, postcode, insurer, medical history and level of cover you buy.

For man it’s a price worth paying, said Kyle Godden, managing director at independent PMI broker Clarity Health Insurance. “PMI is shedding its reputation as a luxury for the wealthy. Many now see it as essential protection product for all walks of life.”

PMI puts you in charge of your health. “It offers a flexibility choice of hospitals, avoids lengthy NHS wait times and lets you access treatments not readily available through public healthcare.”

It also offers fast-track consultations, diagnostic tests, surgeries, therapies and mental health treatment.

There are ways of managing the cost, said Dale Le Page, product manager at PMI brokers Howden Life & Health.

“You can save money by taking out a basic treatment and care policy, where you still use the NHS for GP services and diagnosis, but go private thereafter. Or you could go all the way and get a fully comprehensive plan, which includes private diagnosis, too.”

A 50-year-old couple can expect to pay around £63 per month for basic cover, rising to £109 for a comprehensive plan, Le Page said.

Unfortunately, PMI gets more expensive as you get older, as you are more likely to fall ill and make a claim. “At 70, the same couple might pay £129 for basic coverage and £251 for comprehensive,” Le Page said.

These figures are based on two non-smokers living in central London who have agreed to pay a £1,000 excess on any claims themselves, to keep a lid on premiums. They also assume the couple opted for a “guided hospital list”, where the insurer directs policyholders to consultants at a select group of hospitals.

Le Page said insurers like Bupa, AXA, Aviva & Vitality offer a range of plans, each with their own benefits and premiums.

Choosing the right plan is complicated, said Karen Woodley, head of healthcare distribution at insurer The Exeter. “A specialist broker can help you balance affordability against overall benefit.”

Typically, you will not pay extra for advice, as your broker will receive commission from the insurer. Always check, first. 

Make sure you choose a broker who can offer advice across the market, rather than sell policies from just one or two insurers.

Inevitably, there’s a catch.

Unfortunately, you cannot buy PMI knowing that you have a health problem and expect to claim immediately.

Insurers typically exclude pre-existing conditions, in one of two ways. They either carry out full underwriting, asking you to disclose your medical history, and exclude past problems. Alternatively, they will impose a moratorium on any pre-existing conditions you have had during the past five years. They won’t treat these for the first two years of the policy.

Those who are stuck on an NHS waiting list can still get private care, through self-pay. Basically, this means paying the full cost of private treatment from your own pocket. It’s not cheap, though.

A hip replacement typically costs between £9,000 and £15,000, and cataract removal between £2,000 and £4,000, LaingBuisson figures show.

If you want fast-track hospital care, you have to pay for it.

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