Key takeaways: What’s the difference between health insurance and a health cash plan?
In the UK, health insurance and health cash plans work alongside the care available through the NHS. They both give you access to private healthcare, but in slightly different ways.
Private medical insurance: If you need treatment and your plan covers it, your health insurer will pay for your treatment, usually direct to the healthcare provider. You may pay an excess (which you choose when you set up the plan), but often won’t pay anything further, so long as your plan covers the treatment.
Cash plans: These are more likely to cover routine health and dental expenses, such as optician’s fees, dentist’s fees, physiotherapy or podiatry. Some do cover hospital treatment, but usually only pay up to a set amount, rather than paying the full cost. Usually you pay for the treatment upfront, and then the insurer pays back an amount towards the cost.
For both of these, you pay a monthly or annual premium.
What's in this article
Jump to sections:
- What’s the difference between health insurance and a health cash plan?
- Questions to ask yourself
- What is private medical insurance?
- What does private medical insurance cover?
- What else do you get with private medical insurance?
- What are cash plans?
- How do I choose which type of health insurance is best for me?
What’s the difference between health insurance and a health cash plan?
If you’re interested in covering the cost of private health insurance, there are two types of plan you can buy: private medical insurance (sometimes called PMI) and cash plans. It can be tricky working out which of these suits your needs. However, if you think through what you want the insurance to do for you, this will help you choose the plan that’s best for you.
Considering all the options can feel overwhelming and time consuming, so understanding what you need from health insurance is a good starting point.
When you’re thinking about what you need, it’s worth bearing in mind that you’ll still be able to use the NHS if you have health insurance. Health insurance works alongside the NHS and isn’t intended to replace it.
We’ve explained the two main types of health insurance here.
Questions to ask yourself
We’ve put together a few questions you might want to ask yourself when choosing a product.
|
Question |
Answer |
What this means |
|
What kind of private treatment do you want to access using your insurance? |
I want to be able to access hospital appointments and surgery, including hospital stays |
Private medical insurance will cover hospital appointments and surgery (so long as you choose these option when you set it up). With some, you can add options to cover routine dentist’s and optician’s fees too. |
|
I’m more interested in help with the cost of routine healthcare, such as dentist’s fees, optician’s costs or physiotherapy. |
Cash plans will pay you back towards the cost of routine healthcare. Some pay towards hospital treatment too, but only up to a limit. Private medical insurance doesn’t generally cover dentist’s fees and optician’s fees as standard, but you may be able to add an option that allows you to claim back money towards these costs, in a similar way to a cash plan. |
|
|
I’d like to be able to see a GP privately |
Both private medical insurance and cash plans often include an online private GP service. |
|
|
How much do you want to spend each month or year? |
I’m happy to pay more to get access to more types of treatment |
Private medical insurance is usually more expensive than a cash plan. However, you may be able to choose different options when you set up your plan to get the price down. For example, you could choose a larger excess. |
|
I want a lower premium and am happy that this won’t pay for all types of treatment |
Cash plans are usually cheaper than private medical insurance. You may find that if you use them heavily, some years you’ll get more back than you paid in.[1] |
|
|
Do you want to have the full cost covered or are you happy to make up the difference? |
I’d want the full cost covered |
Private medical insurance will usually pay the full cost of treatment so long as it’s one your plan covers. You may need to pay your excess, if you choose to add one to your plan. |
|
I’m fine if I have to pay part of the cost |
Cash plans pay towards the cost but may not cover the full cost of treatment. You’ll need to pay the difference. |
|
|
If you have private treatment, would you be happy to pay for it up front? |
No, I wouldn’t want to pay out myself |
Private medical insurance providers will usually pay medical bills directly. You may need to pay an excess. |
|
Yes, I’m happy to pay up front and be paid back |
Cash plans pay you back an amount towards your costs, rather than paying up front. |
|
|
Do you have any existing conditions or symptoms that I want private treatment for? |
I don’t have any existing symptoms or conditions that I need private healthcare for |
Both private medical insurance and cash plans will pay towards treatment for new conditions that start after you join. |
|
Yes, I have symptoms or an existing diagnosis |
Private medical insurance won’t usually pay for treatment for symptoms or conditions that you’re already aware of, including any that haven’t been diagnosed yet. Cash plans are usually more inclusive, but may still have an initial period of a few months where you can’t claim. |
What is private medical insurance?
With private medical insurance, you pay a monthly or annual premium. Then, if you need medical treatment, and your plan covers it, your health insurer will pay for the cost of private treatment.
The reasons why some people choose private medical insurance include:
- Fast access to care.
- Access to private GP appointments.
- Flexibility on the time and place of specialist appointments.
- Having a choice of specialist or hospital. Some plans may have rules about which hospitals or specialists you can use.
- Having treatment at a private hospital or facility.
Find out more in our guide: How does health insurance work?
What does private medical insurance cover?
What you’re covered for will depend on your insurer, your individual circumstances and the plan you choose. With most health insurance plans, you can tailor what your health insurance covers so that it works best for your needs.
If you’re with AXA Health, you can choose to add cover for:
- Outpatient diagnosis and care
- Inpatient and day patient care
- Cancer care
- Mental health care
With an AXA Health Plan, you can also choose to add Dental and optical cashback to your plan – this gives you the same kind of cover for routine treatment as a cash plan, and pays you back money towards the cost of dentist’s or optician’s fees, up to a limit each year.
It’s worth noting that private medical insurance is not designed to cover conditions or symptoms that you already have, whether you have a diagnosis or not.
What else do you get with private medical insurance?
Most health insurers give you access additional services with your health insurance to support your health and wellbeing. For example, with AXA Health, you’ll get:
- A 24/7 non emergncy health support line for any health information you need
- Access to our 24/7 online GP service, with slots around the clock, including in the evenings and weekends (appointments are usually available within 4 hours, but may not always be available at the exact time you need).
Find out more in our guide: What does health insurance cover?
Find out more in our guides:
What are cash plans?
With a cash plan you pay a monthly or yearly fee, then can claim back money towards routine health and dental expenses. You’ll need to pay up front for your treatment, and then claim the money back from your insurer.
What’s covered will depend on your plan, but it often covers things like dental check-ups, eye tests and physiotherapy. Some plans will cover hospital treatment, but usually only up to a limit.
Unlike private medical insurance, a cash plan can cover you for routine health checks and medical expenses. They also sometimes cover pre-existing conditions, although it’s best to check this before buying a cash plan.
How do I choose which type of health insurance is best for me?
Choosing a health insurance option is a personal decision that will depend on your needs and budget. Think about what you want your private health insurance to do and check if the option you’re considering gives you the cover you need.