Private Healthcare: A Guide for UK Residents

Health insurance in simple terms:

Your health insurance protects you from paying the full costs of medical services when you're injured or sick and it works the same way your car or home insurance works: you or your employer choose a plan and agree to pay a certain rate, or premium, each month.

Before you apply for health insurance, you’ll usually want to see how much it will cost. You can get quotes from different insurance companies to compare their health plans, or you can ask a health insurance broker to help you find the best deal.

Many health insurance providers let you get a quote online by filling out a simple form with some personal details, like the birth dates of the people you need to cover, your contact info, and your postcode.

With Aaron Cover, you can quickly get a free online quote for yourself or your family. Once you have your quote, you can customise it to fit your needs by adding extra health benefits, selecting your level of cover, and choosing your excess.

When Choosing Health Insurance

What are the different options of health insurance?

Types of Private Health Insurance

Private Medical Insurance (PMI)

Health Cash Plans

Critical Illness Cover

Provides access to faster treatments and private hospitals.

Pays a lump sum if diagnosed with a serious condition.

You pay for services (like dental checks, eye tests, or physiotherapy) upfront and then claim back a portion of the costs.

Long-Term Care Insurance

Useful for individuals with long-term illnesses or disabilities that require continuous care.

Dental Insurance

Covers dental costs, such as check-ups, fillings, and crowns.

Understanding Inpatient and Outpatient Cover: A Simple Guide

When it comes to health insurance, it’s important to know what types of cover you can get. Two common terms you’ll hear are inpatient cover and outpatient cover. Let’s break these down in simple terms.

Inpatient Cover

Outpatient Cover

Inpatient cover is for situations where you need to stay in hospital overnight or for a longer time. This could be for surgeries, serious illnesses, or other medical treatments that need you to be looked after by healthcare professionals.

Outpatient cover is for treatments where you don’t need to stay in hospital overnight. This includes trips to see your doctor, consultations with specialists, physiotherapy, or having tests like X-rays or blood tests.

With inpatient cover, your health insurance usually helps pay for:

• Your hospital room and meals
  
  

• The cost of any surgery
  
  

• Supplies and medications you need while you’re in hospital
  
  

• Consultations with specialists during your stay

Think of it as your insurance supporting you when you have to stay in hospital for a more serious health issue.

With outpatient cover, your insurance generally helps pay for:

• Appointments with doctors or specialists
  
  

• Tests to diagnose any issues (like scans or blood tests)
  
  

• Minor procedures that you can have done and go home the same day
  
  

It’s what you’d use for check-ups or treatments that let you leave right after your appointment.

Day-patient care is a type of medical service that falls between inpatient (staying overnight in the hospital) and outpatient (coming in for a quick visit). It means you can have certain procedures, such as surgery, and go home on the same day. These procedures are usually not too risky, so after a few hours in the hospital, you can return home.

In addition, some cancer treatments, especially chemotherapy, are given in a day unit. This means you might spend several hours in the hospital for treatment, but you won’t need to stay overnight.

Day Patient

Why It Matters

Understanding the difference between inpatient and outpatient cover is important because it helps you know how your health insurance works and what’s covered when you need medical help.

Many health insurance plans provide both types of cover, so it’s a good idea to check your policy to see what’s included.

If you have any questions or need assistance in picking the right cover for you, don’t hesitate to ask!

What is not covered under health insurance?

While each health insurance policy may vary, there are some common things that most health insurance plans in the UK do not cover.

Here’s a straightforward list of what to keep in mind:

Not covered by most health insurance:

❌ Chronic conditions – These are ongoing health issues with no known cure. For example, asthma or diabetes.

❌ Pre-existing conditions – These are conditions or injuries you had before your policy started.

❌ Cosmetic treatments

❌ Allergies and food intolerances

❌ Life events like pregnancy, menopause, or aging

What are chronic conditions?

Chronic conditions are health problems that last a long time.

They can affect your daily life and may require ongoing treatment or management.

Common examples include diabetes, asthma, heart disease, and arthritis. Unlike short-term illnesses that you might recover from quickly, chronic conditions can be lifelong and often need regular check-ups, medication, or lifestyle changes to keep them under control.

Understanding chronic conditions is important when looking at health insurance, as some plans may have specific coverage or exclusions related to these long-term health issues.

There are sometimes other exceptions to these rules. For example, Aaron Cover has a few underwriters that may cover ongoing care for mental health or cancer

What are pre-existing conditions?

Pre-existing conditions are health issues or illnesses that you had before you started a new health insurance policy.

This could include anything from asthma and diabetes to a past injury or surgery.

When applying for health insurance, insurers often want to know about any pre-existing conditions because they can affect the coverage and costs of your policy. Some insurers may not cover treatment for these conditions for a certain period, or they may charge higher premiums if you have significant pre-existing health issues.

It’s important to understand how your insurer defines and handles pre-existing conditions so you can make informed decisions about your coverage.

Most health insurance policies don’t cover treatments or surgeries that are done just to change how a person looks.

This is because health insurance is mainly meant to cover treatments for injuries and illnesses, while cosmetic surgery is often seen as a personal choice.

However, if there is a medical reason for the surgery, such as fixing injuries from an accident or reconstructive surgery after cancer treatment, many insurers will pay for it.

It’s always a good idea to check with your insurance provider about what is covered and what isn’t when it comes to surgeries for appearance changes.

Cosmetic surgery

Other Common Exclusions

Most health insurance policies have these exclusions.

Accident and Emergency Treatment: Urgent medical care you receive for serious injuries or sudden illnesses, typically at a hospital.

Pregnancy or Childbirth: Medical care during pregnancy and the process of giving birth, including regular check-ups and delivery.

Fertility Treatment: Help for people who are having difficulty getting pregnant, which can include treatments like IVF.

Gender Dysphoria or Gender Affirmation: Support and medical help for individuals whose gender identity does not match their biological sex, including hormone therapy or surgeries.

Sleep Problems and Disorders: Issues that make it hard to sleep well, such as insomnia or sleep apnea, which may need medical help.

Allergies or Food Intolerances: Reactions your body has to certain substances, like pollen or certain foods, which can cause symptoms like rashes, swelling, or stomach aches.

Deafness: Conditions related to partial or total inability to hear, which may include treatments and support like hearing aids.

Puberty, Menopause, or Ageing: Changes in the body that come with growing up, getting older, or transitions like menopause, which may need medical advice or treatment.

Choosing your hospital options

Most medical insurance plans come with a list of hospitals that you can use for treatment. This is included in the basic coverage. If you choose a hospital that isn't on this list, your insurance won’t usually pay for all the costs, and you'll have to cover the extra yourself. Some insurance companies let you add more hospitals to your list for an additional fee, giving you more choices for your care.

Medical Underwriting Explained

The Basics of Medical Underwriting: A Beginner's Guide

Health Insurance Glossary

The Health Insurance Dictionary

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