The term work benefits may conjure up images of all sorts of things, from office ping-pong tables to company cars. And most employees will have likely experienced some form of benefit from their employer — maybe even without even realising it.
However, when it comes to workplace benefits, one of the most desirable ones is private healthcare for employees. In a UK survey, 27.6% of employees said they wanted their employer to offer a private healthcare plan. With NHS waiting lists at an all-time high, it's little wonder that so many individuals have either already turned to private healthcare or are looking for a health insurance plan through their employer.
With this in mind, we'll run through health insurance for both employers and employees. We'll also cover all you need to know about private healthcare policies, from what they do to how to choose one. So, let's get started!
Private medical insurance - also known as private health insurance - is specialist cover that is designed to cover the costs of private treatment for acute medical conditions that arise after your policy has started.
Health insurance enables you to gain quick access to top-quality treatment and medicines that are often not available on the NHS due to high costs. You'll also have the freedom to choose what kind of care you receive, who you are treated by, and where you receive medical care.
Private health insurance works in the same way as most standard insurance policies. You pay a monthly premium (this may also be quarterly or annually) which allows you to claim on your insurance policy to gain access to private medical care and specialist treatments. Your medical bills will be covered by the insurance company, but you'll need to pay a pre-agreed excess when you claim.
There are several benefits to taking out a private health insurance policy, including:
- Reduced waiting times: if you opt for private medical care, you'll usually receive tests and treatment faster than you would if you used the NHS.
- Quicker access to physiotherapy: you'll usually get physiotherapy sessions faster with medical insurance, rather than going through the NHS.
- Get access to specialist drugs and treatment: with private medical care, you may get access to medical treatment and medicines that are too expensive for the NHS or haven't been approved by certain medical bodies.
- Specialist referrals: you may be able to ask your GP for a referral to a private expert or specialist.
- A surgeon and hospital of your choice: unlike the NHS, you may be able to choose the surgeon and hospital you go to — you'll usually be able to choose from a list of approved healthcare providers.
- Getting scans: you can use your medical insurance to get scans that have been refused or delayed by the NHS.
There are several types of private health insurance policies, but the main ones are:
- Individual: personal policies which can be tailored to the individual's specific needs.
- Joint: policies designed for couples.
- Family: covers all the individuals in a family with one single policy.
- Child: policies that can be taken out by parents who want to provide their children with quicker and more extensive healthcare.
- Company: corporate medical insurance can be taken out by companies as a benefit to give to employees.
- Over 50s: specialist policies for individuals over the age of 50 who want access to better medical care.
Private medical insurance usually only covers the cost of private medical treatment for acute medical conditions that have developed after the insurance policy was taken out. This means any diseases, illnesses or injuries that are likely to respond well to medical treatment, leading to a full recovery or allowing you to return to the state of health you were in before you became ill or injured.
When you take out health insurance, you can also pay an extra premium for add-ons such as:
- Dental care
- Optical care
- Psychiatric care
- A private room if you stay overnight
- At-home medical care and treatment
Private medical insurance does not usually cover treatment costs for chronic illnesses and conditions. This can refer to issues that require ongoing medical treatment or long-term relief or have no known cure. Health insurance will also not usually cover cosmetic surgery for appearance, normal pregnancy and childbirth, or organ transplants.
Your employer may already offer private health insurance as a benefit in kind. Contact your employer to check whether there is a scheme already available. If there isn't private medical insurance available through the company, you could speak to them to see whether this is something they could implement in the future.
Yes, as a business owner, you can offer health insurance as part of your employee benefits package. You can opt for a single business health insurance policy that covers all your employees, but you will usually need to have at least two employees to take out a health insurance policy. Also, if you have less than 250 employees, you may need a specialist policy for small businesses. You can search online for policies that suit your needs, go directly to health insurers, or choose to go through an insurance broker.
There are two ways you can offer your employees health insurance, which are:
- Voluntary health insurance scheme: depending on the size of your company, you may have access to lower health insurance rates which you can offer to your employees. This means employees can opt into the scheme and pay the insurance premiums.
- Employer-paid health insurance: as an employer, you can take out a corporate or small business health insurance policy to cover your employees. In this case, you would pay the insurance premiums on behalf of employees. Additionally, as medical insurance is classed as a benefit in kind, you would be liable to pay tax on it and would need to declare it on the P11D tax return form for benefits and expenses.
Yes, if you are self-employed, you can still take out a health insurance policy. In fact, it's recommended that you have both health insurance and income protection insurance which will greatly benefit you if you become sick and have to take time off work. The reason is that health insurance can provide quicker access to healthcare which can often reduce the amount of time you need to be off work, and income protection insurance pays for some of your income when you are ill and out of work.
Eligible self-employed individuals can take out these policies directly from an insurance company or by contacting an independent financial adviser.
Based on ratings and the variety of policies on offer, the top five private health insurers in the UK are:
- Bupa: a not-for-profit healthcare provider, Bupa is a firm favourite in the UK thanks to its focus on customers rather than shareholders. At Bupa, you can tailor your policy to your needs, including adding cover for mental health and cancer treatments. You can also opt to be diagnosed by the NHS and still receive private treatment.
- Aviva: the most popular medical insurance provider in the UK, Aviva is an award-winning insurer. The company offers plenty of policies to suit your needs, whether that's for you as an individual or your whole family.
- AXA Health: another big name in private healthcare, AXA offers flexible coverage with plenty of additional extras so you can really make the most of your policy. AXA also offers CashBack plans to cover some of the costs associated with daily healthcare and well-being.
- WPA: - winner of the Health Insurance Provider of the Year at the Moneyfacts Consumer Awards 2022, WPA has been building up its expertise for more than 120 years. Choose from their range of policies and opt for additional cover to suit your lifestyle and health needs.
- Saga: specialists in insurance policies for the over 50s, Saga offers four base health insurance plans that can be added to and tailored.
Generally, these are the steps you'll need to follow to make a claim on your private medical insurance:
- Check your insurance policy details to ensure you're eligible: your insurance policy will outline the conditions of your policy, what you can claim for and how much you can claim per condition, so you'll need to check that the issue you are claiming for is covered by your policy. For example, if you've opted for NHS care within a six-week waiting period, you will be unable to claim on your private medical insurance if you can be seen by an NHS hospital within this time frame.
- Make a claim with your health insurer: usually, you'll need a written GP referral to a specialist before making a claim to ensure you see the best person for your treatment. Once the referral has been made, you can contact your health insurer and provide them with the information they require to start the claims process. Some insurers will refer you to a specialist without a GP, at which point you'll be able to start the claims process by contacting your insurer's customer service department online or over the phone.
- Receive your treatment: once your insurer has agreed to pay for your treatment, you can choose an approved healthcare provider and book an appointment. You won't need to pay anything as it will be directly covered by your insurance provider.
It is worth remembering that each insurer will have a slightly different set of steps. If you're still unsure what you need to do to make a claim, check with your policyholder.
When choosing a health insurance policy, these are the things to take into consideration:
- The type of policy: choose a policy that suits your needs. This could be a specific policy, such as critical illness cover or small business health insurance. Alternatively, you could opt for a standard policy for you as an individual or a policy for your entire family.
- Decide what you want your insurance to cover: for example, you may need cover for a pre-existing condition. Insurers will usually ask for your medical history, so you must disclose any issues you are looking to get treated through private healthcare. You can also choose the type of treatment you want access to, such as physiotherapy or psychiatric care.
- Decide your excess: this is the amount of money you will have to put towards the cost of medical bills in the event of a claim. Generally, the higher the excess, the lower the monthly premium. However, ensure that you can afford the amount you choose.
- Compare quotes: compare insurance quotes across different healthcare providers to find the best policy and price for you. You can do this by looking at the details, such as what the policies cover, how much the monthly premium will be, the excess, and any limitations of the policy.
- Check the fine print: before taking out an insurance policy, check the fine print to ensure you don't get caught out by anything later down the line. For example, there may be a qualifying period which determines how long you must wait before being able to make a claim.
Employee benefits packages offered by companies often include perks such as:
- Gym memberships
- Dental Insurance
- Seasonal rail tickets
- Mobile phones
- Company cars
- Mileage allowances
- Personal electronic equipment such as laptops and headphones
Other health plans that differ from private medical insurance include:
- Critical illness cover: rather than covering the cost of medical bills and private treatment, this type of insurance provides you with a set lump sum payout in the event that you are diagnosed with certain critical illnesses.
- Accident, sickness and unemployment cover: also known as income protection, this type of cover provides a predetermined monthly payout if you have to take time off work due to an accident, unemployment, or illness. It helps cover the cost of things like bills and mortgage repayments.
- Health cash plans: this is a scheme where you pay a monthly premium which allows you to claim back some of the cost of routine health expenses such as eye tests, dental check-ups, and physio sessions.
Statutory Sick Pay (SSP) is £99.35 per week. It can be paid by your employer for up to 28 weeks if you are too ill to work.
If you do have to stop working due to illness, health insurance can help you by reducing the amount of time you are off sick. The reason is it can cut waiting times for treatments and specialist care, meaning you can get back to work quicker and receive your full salary.
Private healthcare insurance for many is considered a luxury. But, with NHS waiting lists reaching the longest they've been since before the pandemic, many are considering alternatives — even employees are looking to their employers for help.
Your employer may already offer a healthcare scheme, so it's best to talk to them and see whether you can be included. If not, it's something to suggest for them to take into consideration. It's also worth remembering that you don't have to be an employee to take out a health insurance policy. You can go directly to an insurer or ask for advice from a broker. By shopping around for quotes and tailoring your policy, you can get the best cover for your money, and your insurance will benefit you in the long run.