What is the difference between private healthcare and health insurance?

Private healthcare is the treatment itself, delivered in a private hospital or private wing. Health insurance is one way of paying for it; the alternative is self-pay, where you fund each episode of treatment yourself.

Can I use private healthcare for a condition I already have?

You can pay for private treatment for any condition, but an insurance policy will usually exclude conditions that pre-date the policy. If your concern is an existing condition, self-pay or an NHS route may be more realistic and a broker will tell you that honestly.

Do I need a GP referral for private treatment?

Most insurers require a GP or, on some plans, a digital GP referral before they will authorise a specialist consultation. Always get authorisation from the insurer before booking, or the claim may not be paid.

Is private healthcare faster than the NHS?

Waiting times vary by specialty, hospital and region, so we cannot promise a timescale. What private cover generally gives you is a choice of consultant and appointment date rather than a fixed waiting list position.

Private healthcare

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Private healthcare and private health care both describe the same thing: treatment delivered outside the NHS, either funded by an insurance policy or paid for episode by episode. Here is how the two routes differ.

Understand the difference between insured cover and self-pay treatment
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Two ways to fund private treatment

Insured. You pay a monthly or annual premium and the insurer funds eligible treatment for new conditions, subject to your plan's limits, excess and exclusions. Costs are predictable, but the policy decides what is eligible.

Self-pay. You pay the hospital directly for a consultation, scan or procedure, often on a fixed-price package. There is no underwriting, so existing conditions are not excluded, but a complex course of treatment can become expensive.

The private healthcare journey with insurance

See your GP, or a digital GP if your plan includes one, and get a referral.
Call the insurer to open a claim and get pre-authorisation.
Book the consultation with a consultant recognised by your insurer.
Have diagnostics or treatment at a hospital on your list; the insurer settles eligible invoices, and you pay any excess or shortfall.

Skipping pre-authorisation is the most common reason a claim is refused, so check first even when the treatment is obviously covered.

Where the NHS still comes in

Private healthcare works alongside the NHS, not instead of it. Emergency and urgent care, most maternity care, long-term chronic condition management and many complex specialties stay with the NHS. A private policy is best thought of as an additional route for new, treatable conditions.

Frequently asked questions

Private health insurance

How plans are structured and what changes the premium.

Private health

A plain-English introduction if you are new to private cover.

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The features worth checking before price.

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