Does my health insurance cover seeing a private GP?
Updated: Nov 29, 2019
If you are reading this, you are probably looking into seeing a private GP. So how does it all work? Don’t worry, it is actually very simple.
You can choose to you “pay-as-you-go”, or some clinics will offer membership packages at a reduced cost. If you run a business, it may also be worth looking into corporate packages for your employees. There is also the option to have the appointment cost reimbursed by your health insurance provider.
So, does your health insurance provider cover this cost? We have looked at the main policy providers in the UK and found that there is quite a variety. In some cases, it will depend on your individual policy, or it may also depend which GP you are planning to see.
A lot of health insurance companies have a private GP working directly with them, but this could be limited by the distance you would need to travel to see them. Some examples include Nuffield Health which has one private GP based in Edinburgh and Vitality insurance which is based in London. This may not suit you if you can’t easily get to these locations.
Many private GPs are registered with insurance companies, therefore the policy will cover you if you go to a registered GP. Bupa UK and Bupa Global use this method.
You may also find that, if you work for a big corporation, the company itself will be allied to a certain private healthcare provider. The main corporate providers in the UK are Babylon, Vitality and Aviva. It is worth consulting with your employer about whether health insurance is included in you employment package.
All providers have online information to direct their customers, as well as helplines to ensure you completely understand what the policy include. Make sure you have all the facts before you book a private GP appointment, if you are planning to get this reimbursed with insurance.
It is also really important to note that some insurance providers will only cover the cost of specialist Consultant clinics if you have been referred there by a GP. I have known a few patients run into difficulties with this. So, don’t assume you can refer yourself directly to a private hospital as some insurance companies won’t then pick up the tab; they need proof that a GP would have agreed with your referral.
The three leading providers for health insurance within the UK are BUPA, Vitality and AVIVA. Private medical insurance is designed to cover the cost of private medical treatment for acute conditions that are likely to respond quickly to treatment. Health insurance does not always cover treatment of chronic conditions, and if it does so then it is likely to be at an extra cost. Here I will go into a bit of detail about each providers policy on GP care.
BUPA do not generally cover the cost of access to primary care services, that is seeing a private GP or at a private urgent walk-in clinic. They do have some policies which specifically over this though, and for those you would be expected to see a BUPA registered GP.
The website quotes £70 for 15 minute private GP appointment and £128 for a 30 minute appointment. Longer appointments are available for a higher fee.
Next is Vitality
The core cover of Vitality gives access to Vitality’s own GP either over a video consultation (up to 4 in a year) or face-to-face appointments (up to 2 a year). They will not cover the charge of a GP consultation is you don’t see a Vitality GP, or a GP registered in their network.
Aviva will give you access to around-the-clock GP care, provided over a video link through Now Healthcare Group. In looking at their T&Cs it is not entirely clear whether they will cover the cost of seeing another private GP- so it is worth checking when you take out your policy.
Every country has slightly different regulations with regards to health insurance and seeing a private GP. It is more widely accepted in the USA that health insurance policies cover private GP appointments. In many ways this is due to the culture of how we use NHS primary care in the UK. Until recently, there was very little in the way of private General Practice. As this grows in popularity we may find that health insurance policies start to include it as standard.
In essence, all health insurance companies differ and if you plan to make a claim for your private GP appointment, you should check with your provider first. If you are taking out a new policy, be aware that it might not necessarily include GP cover, or there may be strict guidelines about which GPs you can see.