Family health insurance

What is family health insurance?

A family policy allows you to cover your immediate family on one policy, for a single premium, paid monthly or annually. It pays out to cover all or part of the cost of private medical care for covered individuals within certain limits.

Policies will vary in their level of cover and terms and conditions - so read the fine print when you shop around - but some general rules of thumb apply to nearly all private medical insurance policies in Britain.

In the UK, health insurance is designed to supplement rather than replace NHS care. It mostly covers the cost of the treatment of acute conditions which develop unexpectedly after the policy is taken out and that can be quickly cured.

Private medical insurance generally won’t provide cover for routine appointments, including those with a GP, optician, or dentist, or for the maintenance of chronic, ongoing conditions, especially those which existed before your joining date (pre-existing conditions). However, with more bespoke, expensive plans you can pick and choose exactly what treatments are covered or excluded.

Even with health insurance, you’ll still need to use NHS Accident and Emergency in emergencies. But if you’re admitted to hospital, health insurance can pay for the cost of a private room, which not only gives you privacy but can also protect you from hospital-acquired infections.

Routine care during pregnancy and childbirth typically aren’t covered. Depending on your policy, you may be able to claim for pregnancy-related complications and emergencies.

What are the levels of cover available?

Most health insurance policies will have some cover for both inpatient and outpatient treatment. 

The most basic policies will have stricter caps, especially for outpatient treatment, but in return, you’ll pay cheaper premiums. Entry-level policies will only cover treatment for which you have to wait longer than a certain amount of time to receive on the NHS. The time frame is usually between six weeks and six months.

Comprehensive health insurance policies will be more expensive but will have higher caps and cover a greater range of treatment. The most expensive policies will allow you to pick and choose which treatments you’d like covered, above the standard offerings. Extra coverage can include:

• Dental treatment
• Optical appointments
• Psychiatric treatment
• Treatment for specific diseases, for example, cancer
• Physiotherapy
• In-home treatment and nursing
• Even some alternative treatments not available on the NHS - for instance, homeopathy, acupuncture, and herbal medicine

All policies will have coverage limits, often both annual and lifetime. These can include:

• The total amount you can claim per policy
• The total amount you can claim per person
• How much each claim can be
• How much you can claim for inpatient or outpatient treatment
• How much you can claim per type of treatment
• How much you can claim for some conditions—for example, a £100,000 limit on cancer treatment

How much does family health insurance cost?

The cost your health insurance policy will depend on the following factors:

• The number of people you’re covering, although children are sometimes covered for no or minimal additional cost
• Their ages
• Their medical history, including pre-existing conditions
• Your family history of conditions, including cancer, heart disease, and strokes
• Lifestyle factors, including whether members of your family smoke or drink
• The BMIs of members—overweight people will pay more for coverage
• The amount of coverage you choose—policies which cover more treatments will be more expensive
• The amount you can claim, annually, over the lifetime of the policy, and for specific treatments, etc.

How can you find cheap health insurance for your family?

Private health insurance can be expensive. Here’s how to minimise your premiums, while ensuring you get all the coverage you want.

• Minimise the number of extras you add, for example, for optical care and physiotherapy
• Go with a policy with a lower claims limit
• Reduce your hospital list, or the number of hospitals in which you can receive treatment, giving up some flexibility and choice in return for lower premiums
• Add a waiting period, of between six weeks or six months. Your coverage will only kick in if you can’t get NHS treatment within this time period
• Live healthily, giving up smoking, cutting down on the amount you drink, and losing weight
• See if your employer offers a policy as part of their benefits package
• Consider a healthcare cash plan, which reimburses you for the cost of routine appointments, including for optical and dental care
• Pay premiums annually rather than monthly
• Add an excess, the amount you have to contribute to any care cost

Advantages of family health insurance

• Allows you to bypass NHS waiting times for referrals and surgery, giving you faster treatment
• More choice about where you receive treatment, including the hospitals and specialists you use
• Access to private rooms, even within NHS hospitals
• Access to a greater range of treatments, including cutting edge treatments and medicine not available on the NHS

Disadvantages of family health insurance

• Can be expensive
• Usually excludes treatment of pre-existing conditions, maintenance of chronic conditions, primary care appointments, routine pregnancy care, and childbirth, among other exclusions
• You’ll still need to rely on the NHS for emergency care
• Most treatments you can get privately are available for free on the NHS
• Will typically have an excess