How private healthcare works in the UK
Private healthcare operates alongside the NHS and is delivered through independent hospitals or private units within NHS facilities.
You can access it in two main ways:
Self-funding (self-pay): Paying directly for treatment when you need it.
Private medical insurance (PMI): Paying a monthly or annual health insurance premium so an insurer covers eligible costs.
Private healthcare use in the UK has increased in recent years, largely due to longer NHS waiting times and growing demand for faster access to diagnosis and treatment.
According to the Private Healthcare Information Network, almost 950,000 treatments and operations were carried out privately in the UK in 2025.
Private healthcare is not designed to replace the NHS. Emergency care, A&E services and maternity care are still typically handled within the NHS.
Self-funding healthcare: a ‘pay as you go’ approach
Self-funding means paying for private healthcare directly from your own money. Some people spread the cost using savings, credit cards or finance plans, but this can introduce borrowing costs if not managed carefully.
Research from Howden Life & Health found that the equivalent of almost 15 million people have paid for private treatment themselves over the past five years, spending an average of £6,000.
Benefits of self-funding:
Full flexibility: Choose any hospital, consultant or treatment without restrictions.
No exclusions: Access treatments not typically covered by insurance, including pre-existing or chronic conditions.
Greater control: Decide when and where you’re treated.
Drawbacks of self-funding:
High upfront costs: Treatment can run into thousands or even tens of thousands of pounds.
Financial uncertainty: Unexpected health issues can be difficult to budget for.
Affordability challenges: Not everyone has the savings to cover large one-off bills.
What do people typically self-fund?
People often choose to self-fund treatments that are relatively quick to arrange and relatively low in cost. This commonly includes initial consultations, private GP appointments, diagnostic tests such as scans, and minor procedures. Some also self-fund treatments like physiotherapy or mental health support.
Research from Howden Health & Life highlights this trend, with diagnostic tests and scans (22%), injuries (19%) and mental health services (15%) among the most common reasons people choose to pay for treatment themselves.
Depending on the level of health insurance cover you have in place, you may also choose to self-fund some treatments not covered by your insurance policy.
How much does self-funded private health care cost?
The cost of private treatment can vary widely depending on the procedure, the provider and your location, but even relatively common treatments can be expensive. This table gives you an idea of the approximate cost of private treatment:
Cost of UK private healthcare | |
Treatment/service | Typical cost |
Private GP appointment | £95 |
Initial consultant consultation | £145 |
Cataract surgery (per eye) | £2,900 |
Hip or knee replacement | £14,000 |
Femoral hernia repair | £3,000 – £6,000 |
Slipped disc surgery | £8,399 |
Carpal tunnel surgery | £2,349 |
Gallbladder removal | £6,649 |
Tennis elbow surgery | £3,099 |
These figures highlight why many people consider arranging health insurance instead of self-funding, as a single unexpected treatment could result in a significant financial outlay.
Health insurance: reducing the risk of large medical bills
When you’re deciding how to pay for private healthcare, one of the biggest considerations is risk. Self-funding means taking on the full cost of treatment yourself, which can be manageable for smaller expenses but more challenging if you face a serious or unexpected condition.
This is where private health insurance can shift the balance. By paying a regular premium, you’re effectively protecting yourself against the financial impact of larger medical bills, while also gaining access to private care when you need it.
Private medical insurance helps cover the cost of eligible treatments in exchange for that ongoing premium.
Benefits of health insurance:
Protection from large bills: Reduces the risk of unexpected high costs.
Predictable budgeting: Spread the cost through monthly payments.
Faster access to care: Benefit from shorter waiting times and more flexible appointments.
Additional perks: Some policies include wellbeing benefits such as gym discounts or mental health support.
Customisable cover: Options to include or exclude options such as inpatient or outpatient care, mental health cover and therapies.
Affordable family cover: Joint and family plans available, which often come with discounts. Additionally, some plans cover your younger children for free, only charging for the eldest child on your plan.
Drawbacks of health insurance:
Ongoing cost: Premiums increase with age and level of cover.
Exclusions apply: Pre-existing and chronic conditions are usually not covered. However, opting for moratorium underwriting can allow some pre-existing conditions to be covered after a certain time, depending on your insurer’s terms.
Out-of-pocket costs: You may still need to pay an excess or contribute towards treatment.
Limits and restrictions: Some policies cap payouts or limit hospital choice.
What does your health insurance premium actually cover?
While the monthly cost of health insurance is often the first thing people look at, it’s just as important to understand what you’re getting in return. The level of cover can vary significantly between policies, so knowing what’s included can help you decide whether a plan offers good value for your needs.
Most policies typically include access to specialist consultations, diagnostic tests such as scans, private hospital treatment including surgery, and cancer care. Many also include some level of mental health support, although the extent of this can vary.
For example, one leading insurer includes the following as part of its cover:
Outpatient appointments before treatment.
Hospital treatment.
Cancer cover.
Dental allowance.
Remote GP access.
Mental health cover.
Private ambulance.
NHS cash benefit.
Tests before and after treatment.
Scans before and after treatment (MRI, CT, PET).
Treatment at home, such as chemotherapy.
Outpatient therapies.
Home nursing.
What does health insurance not cover?
It’s also important to understand what isn’t covered. Most policies won’t cover pre-existing conditions, particularly where ongoing treatment is required, although some insurers may offer limited cover over time. Other common exclusions can include certain age-related conditions, as well as areas like menopause, puberty, allergies and food intolerances.
If a treatment isn’t covered by your policy, self-funding can still be an option, giving you access to private care for specific conditions or services that fall outside your insurance.
As cover can vary significantly between providers and policy types, it’s always worth checking the details carefully to make sure you understand exactly what is and isn’t included before making a decision.
How much does private health insurance cost?
The cost of private health insurance can vary significantly depending on your circumstances and the level of cover you choose. As an example from one leading UK insurer, monthly policies cost around £45 per month for a healthy 40-year old in Lancashire selecting a comprehensive plan. This rises to around £102 for a 60-year old.
Several key factors influence the price you pay:
Age: Premiums typically increase as you get older.
Location: Living in areas with higher private healthcare costs, such as London, can push premiums up.
Level of cover: More comprehensive policies with outpatient care will cost more.
Optional extras: Adding benefits such as dental can raise premiums.
Excess: Choosing a higher excess can reduce your monthly premium.
Hospital list: Access to a wider network of hospitals can increase the cost.
How often you pay: Some insurers charge more for monthly payments, while offering a discount if you choose to pay annually.
The financial and practical case for and against each approach
Choosing between self-funding and insurance depends on your financial situation, health history and how much certainty you want over future costs.
Self-funding vs health insurance: key differences at a glance | ||
Factor | Self-funding | Health insurance |
Cost structure | Pay-as-you-go, although payment plans can sometimes be arranged. | Monthly or annual premiums. |
Upfront expense | Potentially high. | Lower, spread over time. |
Choice of hospitals and consultants | Wide choice. | Depends on your policy’s hospital list. |
Conditions covered | All. | Usually excludes chronic conditions (although cancer is typically covered) and pre-existing conditions. |
Suitability | Often better for lower-cost, one-off treatments or those with available savings. | Often better for ongoing protection against higher-cost or unexpected medical treatment. |
When self-funding can work out cheaper
Self-funding can be the more cost-effective option if you only need occasional or lower-cost treatment. For example, paying for a one-off consultation, diagnostic scan or minor procedure could work out cheaper than committing to ongoing monthly insurance premiums over several years.
It may also suit those who are generally in good health and unlikely to need regular or complex treatment, particularly if you already have savings set aside to cover unexpected costs.
When insurance offers better value
Private health insurance often becomes better value when there’s a higher risk of needing more expensive treatment. Surgery, ongoing specialist care or cancer treatment can quickly run into thousands of pounds, making the cost of premiums seem relatively small in comparison.
Insurance can also be worthwhile if you prefer certainty, spreading costs over time rather than facing a large, unexpected bill. For many people, that financial protection and peace of mind is just as important as access to private care itself.
The role of a health savings pot
Even if you have health insurance, having a dedicated savings pot for healthcare can be useful. It can help cover policy excesses, treatments not included in your cover, or smaller costs like consultations and prescriptions.
For those who choose to self-fund, a health savings pot becomes even more important. Setting money aside regularly can help you prepare for unexpected treatment costs and avoid relying on credit or finance options.
In practice, many people combine both approaches, using insurance for larger, high-cost treatments while relying on savings to cover day-to-day or excluded healthcare expenses.
Can you combine self-funding with insurance?
Yes, it’s absolutely possible to combine self-funding with private health insurance, and in many cases, this blended approach can offer the best of both worlds. One of the biggest advantages of private health insurance is how flexible it can be. There isn’t a one-size-fits-all policy, you can tailor cover depending on how you want to use private healthcare.
At one end of the scale, you can choose comprehensive cover, which is designed to protect you against acute illnesses and injuries you develop after arranging cover. These policies often include inpatient and outpatient treatment, diagnostics, consultations and cancer care, helping you access private care from start to finish.
Alternatively, if you’re looking for a more budget-friendly option, there are more modular plans that let you combine private healthcare with self-pay or NHS services in a way that suits you. For example, some prioritise getting you a fast diagnosis, covering scans and tests privately before you either return to the NHS for treatment or choose to self-fund the next stage of care.
You can also choose policies that only cover inpatient care when you require a stay in hospital, leaving outpatient services such as tests and minor treatment to be accessed through the NHS or arranged separately through self-funding.
Some people choose to mix and match in this way, using insurance to cover larger, more expensive treatments, while paying out of pocket for smaller procedures, consultations or services not included in their policy, or relying on the NHS where appropriate.
Frequently asked questions
Is it cheaper to self-fund healthcare than take out insurance?
It depends on your circumstances and how often you need treatment. If you only require occasional, lower-cost care, self-funding could work out cheaper than paying ongoing insurance premiums. However, if you need more complex or unexpected treatment, costs can quickly run into the thousands, with hip or knee surgery easily coming in at around £14,000. This is where having insurance in place can offer good financial protection.
What happens if I self-fund and face a large medical bill?
If you’re self-funding and need an expensive procedure, you’ll need to cover the cost yourself. Some private providers offer payment plans or finance options to spread the cost, but these may include interest so be sure to check first. Without sufficient savings, a large medical bill can be difficult to manage, which is why some people prefer the added security of insurance.
Can I self-fund some treatments and use insurance for others?
Yes, this is very common. Many people take a flexible approach, using insurance for major treatments or hospital stays, while paying out of pocket for smaller procedures, consultations or services not covered by their policy. You can also choose to use the NHS alongside both options where appropriate.
How much should I save if I plan to self-fund healthcare?
There’s no fixed amount, but it’s worth considering the potential cost of common procedures. Routine appointments may not cost very much, but surgery can range from a couple of thousand pounds to over £10,000. Having a dedicated healthcare fund that could cover at least one significant procedure can provide a useful safety net.
Does self-funding affect my eligibility for health insurance later?
Self-funding treatment doesn’t prevent you from taking out health insurance in the future. However, any conditions you’ve already experienced or received treatment for are likely to be classed as pre-existing and may not be covered by a new policy. This is an important factor to consider if you’re thinking about switching to insurance later on.