Disadvantages of Private Health Insurance

The Policies Don’t Cover Everything

One big disadvantage of having private health insurance for some people is the complexity of the policies themselves. Not all conditions, illnesses or diseases are covered so you could be left without cover if for example you have a particular type of cancer or particular unexpected symptoms from a disease that you thought was covered. There are also restrictions if you have had previous medical conditions as most policies only cover short-term illness or injury. If you have failed to disclose a previous illness, whether deliberately or not, you could invalidate your cover. There are many conditions and treatments which insurers, which will not provide cover for.

Always check with your insurer carefully which conditions, illnesses or diseases they will cover before arranging treatment so you are sure where you stand. Policies are not easy to understand and it is often difficult to work your way around all the jargon and phrasing. Advisers for medical health insurers may give slightly bias advice as they are often trying to promote their own policies. It is your responsibility at the end of the day to make sure that you are covered. Many insurers record phone calls or will have a record of what information you input for an online quote and you will be held to this. The responsibility of reading through your documents and understanding your policy ultimately lies with you and not your insurer.


Price of Private Health Insurance

Private medical health insurance comes at a cost. Generally the rule is true that you get what you pay for. The more you can afford the more comprehensive your policy cover will be, or the better treatment you will receive for the procedures that are covered. The more cover you need the more you will need to pay, and you will also pay more if you are elderly or have suffered health problems in the past. Premium costs for insurance of all types are rising all the time and currently they are rising above the level of inflation, which is making private health insurance out of reach for many people.

Health is Unpredictable

While you can read your cover thoroughly and think you are covered for any procedure you could possibly need to have, your body is unpredictable and there is always the possibility that you will develop in illness or condition, or that you will be involved in an accident, and need treatment that is not covered by your insurer. The NHS does not exclude anyone and you will still be able to receive treatment from them if you can not get it privately, but you may find it frustrating after having paid your insurance premiums. Sometimes the issue is that private specialists do not have the expertise needed to treat your condition and you have to turn to the NHS. You may wish to ask your insurer what happens if they do not have the doctor to treat you (ie is it possible to contract an NHS doctor into a private hospital?).

Less Choice Than With The NHS (for some policies)

In 2009 the British Medical Association (who are the main representative body of British Medical physicians in the UK) expressed unhappiness with certain developments in the private healthcare market. A group of senior phycisians (called the Consultants Policy Group) stated that the British Medical Association was “extremely concerned that the policies of some private healthcare insurance companies are preventing or restricting patients exercising choice about i) the consultants who treat them; ii) the hospital at which they are treated; iii) making top up payments to cover any gap between the funding provided by their insurance company and the cost of their chose private treatment.” What this means is that with some policies if the treatments you want cost more than the amount you have agreed for your company to cover you to, rather than you being able to pay the difference, you just wouldn’t be able to have those treatments or would have to find them cheaper at another clinic or with another doctor. This is different to the NHS, who do offer flexibility where possible with your choice of doctor (you can change if you are unhappy), your location and with the type of procedure you can receive. You are not restricted by the cost of the treatments (although it is worth bearing in mind that the NHS budget is tight and expensive procedures will not be offered unless absolutely necessary).

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