Can you beat the NHS waiting list and book in for the royal treatment?

News of King Charles and the Princess of Wales receiving treatment in hospital for medical conditions came as a shock to the nation.

But the royal couple didn’t have to wait in line for an NHS appointment.

For those who can pay, gold-plated health insurance beats you in line for the best care the state can offer.

But is private health insurance just a luxury afforded by the wealthy – or a benefit that anyone can enjoy?

What exactly is private health insurance?

It is a policy that pays monthly or annually to cover private healthcare outside the NHS, which includes services such as GP visits, tests, consultations and operations, physiotherapy, mental health care, dental services and opticians.

The more benefits a policyholder includes in his or her insurance, the higher the cost. As with auto insurance, the no claims discount is affected. The more claims you file, the more expensive your renewal premiums will be. It’s also inevitable that your insurance premiums will rise as you get older.

How many people have the cover?

About 6.9 million adults in the UK have private medical insurance, according to an analysis of figures conducted by employee benefits consultancy Broadstone. This number has increased by about one million people in the past five years.

Brett Hill, head of health and protection at Broadstone, says: “The pain of a condition, the cost of a paycheck if someone has to leave the workforce, and the long wait to receive treatment in the NHS, is pushing people at all income levels to either rely on themselves or “. Fund urgent issues or take out private health insurance as a safety net.

“Health insurance used to be a benefit for the wealthy, but that has changed a lot since the pandemic,” adds Dale Le Page, a medical and life insurance expert at Howden Brokerage. The average age has dropped from customers in their 50s to those in their late 30s.

Employers have also expanded their benefits packages to include private health insurance to assist with the health and well-being of employees and encourage loyalty and a better company.

What is the best coverage… and do I need a broker?

There are about ten providers in the private health insurance market, although four companies dominate the industry: Bupa, AXA Health, Aviva and Vitality. Broadstone says smaller insurers such as WPA and The Exeter provide options for customers who want an alternative to the big brands.

Given the complexity of private health insurance and the number of clauses included in policies which, if not understood, could mean you are not insured for services, it is advisable to use a broker. You do not need to pay a fee to the broker, he receives a commission from the provider. Or you can use a comparison website to compare premiums and read the terms and conditions on each provider’s website.

You may have to complete a lengthy application form if you are applying for what is called a full medical underwriting. This means that all your pre-existing medical conditions are fully examined and your GP is consulted before seeking cover. Some pre-existing conditions such as high blood pressure and diabetes may be covered under your new policy if your condition is stable.

Alternatively, you can go a faster route called a stop guarantee. This gives you coverage, but excludes all pre-existing conditions that occurred in the past five years within the first two years of the policy. You can obtain this cover by filling out a short form online.

The younger you are, the cheaper the cover

The younger you are when you get a policy, the cheaper it is. A policyholder aged between 25 and 34 will pay on average £423 a year, while those aged 55 to 64 will pay £738, according to Howden figures. For a family of four, with the oldest member aged between 35 and 44, they would pay a premium of £1,485. This rises to £1,979 when the oldest family member is between 45 and 54 years old.

Your premium is also affected by any pre-existing health conditions you have and the increase you choose. For example, if you agree to pay the first £500 of cover to keep your premium low.

The insurance company checks the cost of hospitals in your area and the likelihood of them being used.

Treatment covered by your policy

Under most policies, a GP visit is not classified as a claim. You will be given access to a digital GP who will make an appointment for you via video call. If your GP refers you to a consultant, you should contact your insurance company to obtain appointment authorization before attending. Its approval depends on the level of coverage. You must also obtain prior approval for any other treatment. Once your treatment is complete, the hospital will bill your insurance company directly. You don’t have to pay anything except ongoing insurance premiums.

Can everyone buy coverage?

Most people have access to private health insurance, but some pre-existing health conditions may be excluded from coverage.

You can get coverage until age 99, but it will be expensive and come with a lot of strings attached.

How to make your policy cheaper

“Insurance companies have put features in place to make health insurance more affordable,” says Matt Howells, founder of medical insurance company Vizion.

Each policy will come with basic care that covers hospitalization. To keep your premium as low as possible, you can take out an additional £500, cap the maximum value of consultations accepted under your policy or be agreed to self-fund your consultation meaning you pay out of your own pocket.

An initial consultation can cost between £200 and £300, according to Vizion, while a follow-up appointment costs between £150 and £250.

By cutting back on benefits, a policy of limited outpatient services, maximum consultation fees and restrictions on the hospitals you can use could cost £70 a month, for example, for a 40-year-old woman living in Wales.

This could rise to around £190 if you move to London. It will rise to £230 a month by including additional treatments and removing restrictions on hospitals.

Can I just pay for the procedure?

If you want to skip the NHS waiting list but don’t want to take out health insurance, you can pay privately for one-off operations.

According to figures from consumer website My Tribe Insurance, a knee replacement, if paid for privately, would cost £14,499. The cost of removing the tumor is £5,308 and the cost of a hysterectomy is £8,014.

…And what would I get with £50,000 a year?

If you want the “royal” treatment, it could cost up to £50,000 a year for a family of four, says Matt Howells, who specializes in high net worth coverage.

At this price you will get international health insurance, designed to work in countries where there are no state-run medical services.

Policyholders can use any hospital of their choice, inside or outside the UK, as many times as they like. They do not have to wait for treatment, and they can undergo unlimited tests, consultations and operations without having to obtain prior approval from their insurance company. They also have additional services such as on-demand maternity care, dental and eye care, and access to a private GP.

Cancel this policy and reduce the benefits as you look for a more affordable rate. The average premium, according to Howden, has fallen from £1,500 a year in 2019 to £1,100 so far.