Healthcare for most UK residents is available for free on the NHS but the number of people choosing to turn to private insurance for health problems has risen sharply: 44% more people used insurer-provided healthcare services in 2021 than in pre-pandemic 2019, according to the Association of British Insurers (ABI).

Some of that will be to do with NHS waiting lists hitting a record high. Earlier this month it emerged that the number of people waiting longer than 18 months for NHS treatment in England was growing, despite ministers previously promising to eliminate such long waits.

If you are interested in taking out health cover, take care to ensure you get the right policy at the right price.

Know why you want it

What you want it for will dictate the kind of cover you require.

“Some people are looking for fast access to health services, whether that’s a GP appointment or consultant care, others want access to the latest innovations and treatments, and some want support to live a healthier life and reduce their likelihood of becoming ill. Many are looking for all three,” says Dr Keith Klintworth, the managing director of VitalityHealth.

Sarah Coles, the head of personal finance at the investment platform Hargreaves Lansdown, says people will often make use of health insurance to avoid waiting for treatment on the NHS or to get treatment or medication that is not available from the state.

Health insurance policies will often cover drugs or treatments that people cannot access through the NHS because they are too new to have been approved or are too expensive.

“Having speedier access to services and treatment often prevents health conditions from worsening and is a key element of health insurance,” a spokesperson for the Association of British Insurers says.

One area becoming increasingly popular is the use of virtual GPs. The ABI says access to online GP appointments through health insurance rose by 440% between 2019 and 2021.

Check what your employer offers

Health insurance as an employee benefit is likely to be a more affordable option not only for you but for family members, too – if the scheme allows it.

Because the schemes operate at scale, risk is handled differently. “There is typically less medical underwriting, meaning you are unlikely to have to declare pre-existing conditions,” says Gemma Milford, the head of group health at IHC Employee Benefits.

Don’t just look at the cost

If you are buying it yourself, the choice is vast: there are at least 500 private health insurers in the UK. As a rough idea, Vitality’s premiums start at £38 a month, while Aviva says the average annual premium is about £1,000 to £1,100 – or roughly between £83 and £92 a month.

It’s not useful to take cost as the only factor when choosing a policy, though. After all, if it doesn’t do what you want it to, there is no point in paying for it, so comparing policy details as well as premiums is vital.

“As with all insurance, the premium is priced to reflect the risk. While it will be down to individual insurers to determine prices, a number of factors may be used to calculate a premium, such as age, pre-existing health conditions and someone’s current health,” the ABI says.

Insurers often have different “tiers” of cover. “The more you pay, the more comprehensive the cover,” Coles says.

“Always look at modular options,” Milford says. “In the majority of cases, you can add on and remove different elements of cover to get what suits you best and reduce the cost.”

You can, for example, often choose to include or exclude cancer. Or you can choose a policy where you will need to be diagnosed on the NHS but then can be treated privately. Some insurers will also offer a reduced list of treatment centres, which can also mean lower costs.

Up your excess

According to the comparison site HealthWindow, adding a £200 excess to a policy could reduce premiums by 10%.

“Agreeing to pay an excess of £500 means you claim when you really need to,” Milford says. “You probably won’t use it for a series of physio appointments, but you will have it in place if you have a serious health problem.”

Don’t buy when you need it

“If you are considering taking cover out because you have a bad knee and think you need treatment, for example, then it’s almost certainly going to be a waste of money,” Milford says. “Your policy is very unlikely to cover a problem you already have.”

Follow procedure – or you may not be covered

If you need to claim, it is essential you know what to do at each step – which can be challenging if you are also managing health problems and coping with a difficult diagnosis.

“You are likely to need approval at each stage before treatment is arranged. So, for example, if you’re referred by a GP, you should call your insurer. Then, if the private specialist sees you and decides you need treatment, you should call your insurer again. Don’t miss any of the steps or you may not be covered,” Coles says.

Use the day-to-day discounts

Many insurers offer a range of frequently changing discounts with commercial partners. If they match things you ordinarily use, then they might partly offset your premium costs.

For example, Bupa offers 25% off annual membership with English Heritage (usual cost: £69 a year for a family with one adult, or £120 for a family with two adults) and money off gym memberships.

Vitality has a range of discounts for all customers, and other incentives based on their activity levels. The more active you are, the more points you earn – you can use points to get discounts on smaller things such as cinema tickets and coffee, through to Apple Watch and Fitbit products.

Vitality says it paid out more than £60m worth of rewards and discounts last year, with engaged members receiving more than 20% of their monthly premiums back in value. It has a positive impact on members’ health, too: Vitality’s data shows that physically active members are up to 29% less likely to be hospitalised (and also, therefore, less likely to make claims on their policy).

Weigh up the ethics

The simplest way to save money on health insurance is to not buy it.

Muireann Quigley, a professor of law, medicine and technology at the University of Birmingham, says that while “people should be free to choose private care if they wish (via insurance, if that is how they can pay for it), and absolutely ought not to have to wait for care in a system which is falling apart”, there is also an argument that increased use of private care could result in less pressure on the government to provide adequate state-backed services.

“While everyone loses out in this scenario, like all similar things, it affects those who can least afford it most, exacerbating existing health and other inequalities.”

Coles says health insurance is a choice. “Some people will be against it because they believe healthcare should be the same for everyone. Others will believe that if there’s anything worth spending money on, it’s their health.”