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At the start of 2006, more than 7.5million people in the UK were covered by private medical insurance (PMI). But what if you don't want to be tied to monthly premiums or you've only just found out that you are ill?

You don't have to have medical insurance to get private treatment. Many private patients are now opting for so called 'self-pay' treatment - paying directly for one-off surgery.

Why go private?

Traditionally, avoiding the NHS waiting list is the most common reason for going private.

In February 2006 there were 784,300 people waiting for operations on the NHS, and this doesn't include those waiting for diagnosis before they can join this list.

In theory, if your local NHS hospital has a long waiting list, you can seek another with a shorter one. Information about NHS waiting lists in your local area can be obtained from the NetDoctor Hospital Guide.

So should you pay to avoid waiting or wait to avoid paying? Weighing up the cost of pain and discomfort against a big bill can be a huge dilemma.

Previously, doctors have recommended the NHS for urgent illnesses and private treatment for non-urgent surgery, such as hernias or varicose veins. However some patients are now going private for urgent problems like heart disease.

There are also benefits such as choosing where you're treated and by who, having your own room, privacy and unrestricted visiting hours. You may have access to medical techniques that are unavailable or difficult to get on the NHS.

Self-pay or PMI?

What factors should you consider when deciding whether to opt for self-payment instead of PMI?


The older you are, the more you pay for PMI. This is because a 70-year-old man is far more likely to need treatment than a 20-year-old.

Age can account for a five-fold difference in your monthly premium costs.

Self-pay charges are not usually affected by age. However, a hospital will probably charge more if they anticipate a particular patient will need a longer than usual stay.

Your medical history

PMI benefits usually don't cover pre-existing conditions - anything diagnosed before the policy takes effect.
For example, cardiac surgery wouldn't normally be included if you have a history of heart disease. This may be the treatment you most require.
With 'self-pay', you pay for what you need.

Other exemptions

All PMI policies have exclusions - medical conditions and services they won't cover.
Medical insurance is intended to cover the costs of private treatment for short-term illnesses and injuries.

Things that are not covered include long-term (chronic) conditions such as asthma or diabetes, normal pregnancy and cosmetic surgery. If you pay for one-off treatment, these exclusions won't apply. The only limitations are whether or not the service you require is offered by the hospital.

Some people prefer to opt for the peace of mind that PMI offers, and are happy to pay for it. Others believe that it is better to put your cash into savings schemes, using it for self-pay treatment if necessary. Ultimately, you have to weigh up what suits your situation best.

How do I arrange self-pay treatment?

For most operations, you will need a referral letter from your GP.
If you choose the self-pay route, you will need to find and contact local hospitals, get quotes and agree a fixed price for treatment (fixed price surgery).
The contract should clearly set out what treatment/tests/aftercare is included and what isn't, so you don't get a surprise from the end bill.
You can arrange private treatment this way at most hospitals, be they NHS or in the private sector, eg Bupa or BMI Healthcare.


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