How much would you pay for health care fit for a king? Since Charles and Kate are undergoing medical treatment, this is everything you need to know about private health insurance

The news that King Charles and the Princess of Wales were being treated in hospital for medical conditions came as a shock. But the royal couple didn’t have to wait in line for an NHS appointment. For those who can afford to pay, gold-plated health insurance will get you past the line for the best care the country can offer.

Is private health insurance just a luxury afforded by the wealthy or a benefit that everyone can enjoy?

Here we explain exactly what private health insurance can offer you, how much it costs and provide advice on how to get it at the cheapest rate.

What is private health insurance?

Private health insurance is a policy paid monthly or annually to cover you for private healthcare outside the NHS. It includes GP visits, tests and consultations, surgeries, physiotherapy, mental health care and dental and optician services. The more reimbursements a policyholder includes in his insurance, the higher the costs.

Just like with car insurance, this affects your no-claim discount. The more claims you make, the more expensive your renewal premiums will be. As you get older, your premiums increase over the life of your policy.

How many people have private health insurance?

In Britain, there are 6.9 million adults who have private health insurance, according to analysis of Financial Conduct Authority figures by consultancy Broadstone. This number has risen by a million people in the five years since the FCA first began its investigation.

Experts say there are a number of reasons for the increase. Brett Hill, head of health and protection at Broadstone, said: ‘The pain of the condition, the wage costs of someone having to leave the job market, and the long wait for treatment on the NHS are pushing people of all incomes into using their own resources. urgent matters or take out private health insurance as a safety net.’

Dale Le Page, medical and life insurance expert at estate agent Howden, added: ‘Health insurance used to be a benefit for the incredibly wealthy, but this has changed significantly since the pandemic. Now the average age has dropped from fifty to over fifty.’

Employers have also expanded their benefits packages to include private health insurance to ensure employees stay healthy.

Which insurer suits you best… and always use a broker

There are ten providers in the private health insurance market, although four companies dominate the sector: Bupa, AXA Health, Aviva and Vitality.

Broadstone said smaller insurers such as WPA and The Exeter are offering options for customers who want an alternative to the big brands.

Given the complexity of private health insurance and the number of clauses in policies that, if not understood, could mean that you are not covered for services, it is advisable to use an intermediary.

You do not have to pay the broker a fee, they receive 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 need to fill out a long application form if you are applying for what is known as full medical acceptance. This means that all your existing medical conditions will be examined and your GP will be consulted before seeking cover.

Some pre-existing conditions, such as high blood pressure and diabetes, may be covered by your policy if your condition has been stable.

Moratorium guarantee

Alternatively, you can take a faster route called moratorium acceptance. This process gives you cover but excludes any pre-existing conditions that have arisen within the last five years for the first two years of the policy. You can obtain this coverage by completing a short form online. Your healthcare provider will only contact your GP if you come to submit a claim.

With most policies, a visit to the doctor is not considered a claim.

The younger you are, the cheaper the policy

The younger you are when you take out a policy, the cheaper it is. A policyholder aged 25 to 34 would pay £423 a year, compared to those aged 55 to 64 who would pay £738, according to Howden figures.

For a family of four where the oldest member is aged between 35 and 44, they will pay a premium of £1,485. This rises to £1,979 when the eldest family member is between 45 and 54 years old.

The policy premium is also affected by any pre-existing health conditions you have and the deductible you choose. For example, if you agree to pay the first $500 of coverage to keep the premium low. The insurer checks the costs of hospitals in your area and the likelihood that you will use them.

What your policy allows

With most policies, a visit to the doctor is not considered a claim. You will have access to a digital GP who will give you an appointment via video call. If your GP refers you to a consultant, you must call your insurer before your arrival to have the appointment authorized. Whether it is approved depends on the coverage you have. Prior permission must also be given for any other treatment.

Once your treatment is complete, the hospital will bill your insurer directly. You do not have to pay anything other than your current premiums.

Is everyone eligible?

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

A spokesperson for Vitality said: ‘If someone has a pre-existing condition it is worth speaking to the provider or your financial advisor who can tell you what is and is not included. You should not assume that everything is excluded.’

Some providers also set age limits. For example, Vitality concerns policyholders between 18 and 79 years old. You can get coverage for up to 99 years, but it is expensive and comes with many conditions.

How to make your policy cheaper

Mr Howells said: ‘Insurers have introduced affordable provisions to make health insurance more affordable.’

Each policy comes with basic care that covers hospital treatment.

To keep your premium as low as possible, you can have a £500 excess, set a limit on the value of consultations accepted under your policy, or agree to self-fund your consultation, which means you get out of pays out of pocket.

According to broker Vizion, an initial consultation can cost between €200 and €300, while a follow-up appointment costs between €150 and €250.

By cutting benefits, a policy with limited outpatient services, a cap on consultation costs and a restriction on the hospitals you can use could cost £70 a month.

Can I pay for the operations myself?

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, the cost of a knee replacement if you pay privately would be £14,499. Removing a bunion costs £5,308 and a hysterectomy costs £8,014.

What if a treatment goes wrong?

Your first point of contact is to file a complaint with your insurer. All private health insurers fall under the supervision of the FCA and therefore have a formal complaints policy. If the customer cannot resolve his complaint with the insurer, he can submit his complaint to the Financial Ombudsman for independent assessment.

…and what do I get for the super-rich £50,000 cover?

Matt Howells, founder of high-network health insurer Vizion, says if you want the ‘royal’ treatment it could cost you up to £50,000 a year for a family of four.

For this price you get international health insurance, designed to work in countries without state-run medical services.

Policyholders can use any hospital of their choice inside or outside Britain as often as they wish. They do not have to wait for treatment and can undergo unlimited tests, consultations and operations without having to request prior permission from their insurer.

They also have additional services such as maternity care on request, dental and eye care and private GP access. Eliminate this policy and reduce the benefits and you’re looking at a more affordable price. The average premium has fallen from £1,500 per year in 2019 to £1,100, according to Howden.