POSTED: December 27 2018
A reminder: what does health insurance cover?

A reminder: what does health insurance cover?

The ABI produces consumer guides to health insurances. As a reminder of where health insurance is and is not effective we have outlines the pros and cons.

Outlined are the questions often asked on health insurances and the ABI’s answers.

What treatment does private health insurance pay for?

Medical insurance helps you to get through the health system quickly, with access to a speedy diagnosis and reduced waiting times. It also helps to pay for the treatment that you may need. Health insurance is designed to work alongside, not to replace, all the services offered by the NHS. Even if you have a private health insurance policy you will still be entitled to use NHS services.

Health insurance usually covers the costs of expensive drugs, stays in a hospital and faster admission to specialist consultants. This can help speed up your access to tests, scans, diagnosis and procedures.

A health insurance policy will also give you access to a 24-hour virtual GP, flexibility around your appointment times, more choice over your hospital and doctor, and you will often get you your own private room if you are admitted.

Though these tend to be standard aspects of health insurance, always check what your own individual policy offers when shopping around.

Find out more about buying a health insurance policy here.

Does health insurance cover physiotherapy?

One of the main benefits of health insurance is that it can also give you access to further treatments such as physiotherapy, which may not be readily available through the health system.

What isn’t covered by health insurance?

Usually organ transplants, pre-existing medical conditions, normal pregnancy and childbirth costs, cosmetic treatments and chronic illnesses such as diabetes, high blood pressure and epilepsy are not covered by health insurance.

If you’re looking for a policy to cover pre-existing or chronic conditions, it may be helpful to advo.

Does health insurance cover treatments for mental health?

Mental health conditions might not be as easy to pin down as physical health conditions, but insurers are increasingly recognising the need to provide cover and support to people suffering with mental ill health.

Some insurance policies offer mental health care cover within their health insurance policies or as a policy add on. These can give support for those suffering with mental health conditions through:

  • Preventative measures – Many insurers provide specialist mental health service support, which enables employees of company schemes or individual policy holders to receive rapid access to assessment, often within 48 hours.
  • Access to support services – Most insurers have dedicated Employee Assistance Programmes which provide access to support services 24 hours a day. These can offer support on a range of topics which may trigger stress or anxiety, such as finances, relationships and legal issues, as well as dedicated mental health counsellors.
  • Rehabilitation services – Many insurers offer access to rehabilitation teams who help manage an employee’s or individual policy holder’s sickness absence. They often offer access to counselling and a wide range of other services, including assistance with HR issues and legal assistance.

Find out more about how insurance can help support your mental health and wellbeing here.

Does health insurance cover cosmetic surgery?

Though cosmetic surgery is not usually offered under health insurance policies, there can be some exceptions in extreme circumstances. Corrective surgery and treatments following burns, illness or trauma are sometimes available, for example treatment to reduce scarring after an accident, or reconstructive surgery following a mastectomy.

Some procedures can also be available if the customers health is otherwise being affected, for example a breast reduction could be offered to help mitigate back problems. Talk to your health insurer to find out what your policy might cover.

Treatments or procedures for purely cosmetic reasons will not be covered by a health insurance policy.

Does health insurance cover mole removal?

If a mole needs to be removed for medical reasons (e.g. there is concern that it could become cancerous) then insurance will usually cover this.

If it is being removed for cosmetic reasons however, this would not be covered by your health insurance.

Does health insurance cover IVF and fertility treatments?

Your health insurance policy would not typically cover IVF or fertility treatments.

Does health insurance cover laser eye surgery?

Insurers do not typically cover laser eye surgery purely for correction of refractive errors but may cover some laser surgery for other conditions, such as post-cataract YAG laser procedures.


If you have any further questions on how health insurance can support your employees and your business you can contact advo’s Jamie Tuffield our Employee Benefits Manager on