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How does private health insurance work?

Private health insurance is similar to other types of insurance. You pay a monthly or yearly fee called a premium.

1.

Getting Referred

If you have a health issue, see your GP and let them know that you have private insurance. They may refer you to a specialist, and you might choose to go to private hospitals or specialists not offered by the NHS.

2.

Informing Your Insurer

Tell your insurer that you want to make a claim. They'll check if your policy covers the treatment you need. If it does, your claim will be approved.

3.

Cost Coverage

Your GP will book your appointment, and your insurer will cover the cost as long as your policy is active. Depending on your policy, you may be required to pay an excess.

What is mental health cover?

Mental health cover is an add-on to private health insurance that specifically addresses private mental health care. It provides coverage for services, such as therapy, counselling, psychiatric consultations, and medications within private healthcare facilities. This contrasts with the often lengthy waiting lists for psychiatric care within the NHS. With private cover, members can access these services more quickly and efficiently without such extended waiting periods

Does health insurance cover mental health?

In most cases, health insurance plans don’t include mental health services by default. Yet, you can choose to add mental health coverage for an extra cost. This add-on extends coverage to include disorders like depression or anxiety, along with services like therapy and psychiatric consultations.

You should always check what specific disorders and services are covered, as well as any additional costs involved.

Is mental health covered as standard with health insurance?

No, mental health coverage isn’t normally included as standard in basic health insurance policies. Some plans offer it as a standard feature at the basic level, though.

Mental health insurance is more of an additional option that you can choose to include, which then increases your premiums. In other words, if you want comprehensive mental health coverage, you’ll need to pay extra for it on top of your regular health insurance costs.

What can mental health insurance cover?

Mental health covers various mental health issues, such as:

  • Anxiety disorders
  • Depression, including postnatal depression
  • Bipolar disorder
  • Eating disorders
  • PTSD
  • OCD
  • Phobias

Covered treatments for these conditions include:

  • In-patient care (hospital psychiatric treatment, accommodation, diagnostic tests, prescribed drugs)
  • Outpatient care (talking therapies like counselling and cognitive behavioural therapy, consultations with mental health specialists, access to online resources and helplines)

The full range of treatments covered will be outlined in your policy booklet.

What additional support do insurers provide for people with mental health conditions?

Health insurers sometimes provide extra support for individuals with mental health conditions. This can be stress counselling helplines, interactive online platforms, and mental health wellness apps:

  • Stress counselling helplines offer immediate access to professionals who offer support and guidance during times of stress or crisis.
  • Interactive online services include self-help articles, interactive tools for managing symptoms, and online communities where individuals can connect with individuals experiencing similar difficulties.
  • Mental health wellness apps offer features like tracking mood, guided meditation exercises, and tools for setting and tracking personal goals.

Are any types of mental health issues not covered?

These issues are usually excluded from mental health insurance:

  • Chronic conditions like dementia
  • Developmental disorders
  • Intentional self-harm, such as attempted suicide
  • Mental health problems caused by substance abuse or addiction
  • Intellectual disability or psychiatric disorders resulting from drug or alcohol abuse
  • Experimental treatments not commonly accepted by doctors
  • Alternative treatments like hypnosis and yoga

Does health insurance cover pre-existing mental health conditions?

The way insurers cover pre-existing mental health conditions varies depending on the policy. Typically, private health insurance is meant to cover medical conditions that arise after taking out the policy. This would exclude a pre-existing condition.

If you’ve had treatment or symptoms of a mental health condition in the last five years, it probably won’t be covered. However, some insurers cover pre-existing conditions if you’ve been symptom-free and untreated for two years after getting the policy.

Benefits of private mental health cover

Private mental health support offers:

Quicker care accessInstead of waiting, you’ll see specialists and start treatment faster than with public healthcare.
Tailored treatmentYour care plan is customised to suit your specific needs.
Freedom to choose providersSelect your healthcare team. Plus, private facilities offer a broader range of specialised experts and resources.
Flexible treatment optionsYou have more flexibility in choosing the therapy or treatment approach that suits you best.
Extended therapy sessionsSessions are longer than with the NHS, and this allows for more thorough discussions and therapeutic work.
Comprehensive holistic carePrivate doctors address all aspects of your well-being, including your body, emotions, and how you live.
Family supportMany programs include family therapy for a supportive network.

Will my mental health issues affect my insurance premiums?

Having mental health problems, especially if classified as disabilities, can impact insurance premiums for various products. If insurers believe these issues increase the risk of claims, you will be classified as a “high-risk customer”. This will probably result in a higher premium.

If you’re unemployed due to mental illness, it can also increase your premiums. Insurers usually classify applicants as “in work" or “unemployed,” and choosing the latter could mean paying more. Finally, if you’re taking medication or getting medical treatment for mental health issues, many providers will increase prices.

Remember to read your policy carefully to know what exactly affects your premiums and coverage.

Insurers with mental health insurance cover plans

Aviva

With Aviva’s health insurance, you get up to £2,000 for GP-referred outpatient mental health treatment offered as an add-on. If you choose this option, you’ll also be covered for in-patient and day-patient care if you’re diagnosed with an acute mental health condition. This includes full coverage for accommodation, nursing costs for up to 28 days, and specialist fees.

On top of that, Aviva’s Digital GP app lets you have digital appointments with NHS-registered private GPs 24/7. You can schedule five video consultations each policy year. They also offer a Stress Counselling helpline for private discussions with trained counsellors and mental health support articles.

Bupa

Bupa’s health insurance policy lets you connect with a mental health nurse or reach out to their direct access team, who will refer you to a specialist without a GP referral.

Here’s what else you should know about their mental health cover:

  • Bupa By You insurance includes coverage for all mental health conditions except dementia, learning disabilities, behavioural disorders, and developmental conditions.
  • If you’re worried about something, you can quickly get in front of a specialist without the need to see a GP first.
  • Bupa provides continuous support if a mental health problem returns.
  • If you’re concerned about your child’s mental well-being, you can talk to one of their mental health nurses for support, advice, and guidance.

Also, Bupa By You insurance doesn’t have a time limit on members’ covers. Previously, we’ve mentioned that many insurers typically exclude coverage for drugs and alcohol. Bupa breaks this trend by providing coverage for substance and alcohol misuse.

They also cover those conditions that are often overlooked:

  • Acute stress reaction — A sudden, short-term response to major stressors like crises, bereavement, accidents, or assaults.
  • Adjustment disorder — Difficulty coping after a stressful event, regardless of severity.
  • Psychosis — Perceiving or interpreting reality differently from those around you.

Exeter

Exeter offers a mental health benefit add-on within their Health+ policy. Here’s what it includes:

  • Full coverage for consultations with a psychiatric specialist outside the hospital, up to £2,000.
  • Full coverage for hospital charges during in-patient and day-patient treatment under a psychiatric specialist’s supervision, up to 45 days.

However, please note that Freedom will not cover treatment related to addictions (alcohol or drug misuse) or conditions resulting from them. Also, remember that adding this cover comes at an additional cost.

AXA

AXA’s mental health option provides extra insurance for psychological concerns that occur after you join, both for outpatient visits and hospital stays. It covers:

  • Consultations with specialists like therapists and CBT therapists for out-of-hospital treatment, with no limit on yearly visits.
  • Full payment for hospital care and day visits.

You’ll have coverage for specialist consultations and treatments when referred by a specialist. The referral will be based on the consultation and your medical history.

Added to the specialist mental health coverage is Mind Health. It provides support and assistance through confidential phone sessions with qualified psychologists. Each individual covered by the plan can access up to 6 sessions. It’s available globally and can be accessed using the AXA app for Virtual Care.

Vitality

Vitality’s mental health cover is helpful for a wide range of needs, from preventive measures to comprehensive treatment options. There are two choices, one of which is core cover, included in your standard health insurance. This allows you to access therapies like CBT and counselling early on using the Talking Therapies network of VitalityHealth.

You can also get extra mental health cover to use Talking Therapies as much as you need from their network. It also covers more types of treatment, like hospitalisation and in-hospital therapies.

Within core cover, you get access to:

  • Mindfulness app — Use Vitality’s Healthy Mind feature and link your Headspace app to earn rewards for tracking your mindfulness minutes.
  • Rewards for physical activity — Earn rewards for staying active.
  • Talking therapies — Access up to 8 counselling or CBT sessions per plan year through Vitality’s partnership with Big White Wall and Togetherall’s online support community.

With mental health coverage (for an extra monthly fee):

  • Unlimited talking therapies — Get full coverage for face-to-face or remote talking therapy sessions.
  • Outpatient cover — E.g., sessions with a psychiatrist, up to £1,500.
  • No yearly limit on hospitalisations — You can receive up to 28 days of treatment per year, whether staying overnight or as a day patient. You can request coverage for several rounds of care within the year.

FAQ

Is mental health insurance worth it?

Yes, mental health insurance is worth it in most cases. It helps cover the costs of treatment and supports people in getting the help they need without facing any barriers. This supports individual well-being and reduces the harm caused by untreated mental health issues on society.

Who can I speak to for advice about mental health insurance?

You can speak to insurance specialists, mental health professionals, or representatives from insurance companies. They will give guidance on available policies, coverage options, and how to choose the best plan for your needs.

What happens if I don’t tell my insurer about my mental health condition?

If you don’t fully disclose your mental health condition to your insurer, there will be serious consequences. Your policy might be cancelled or rendered void, so any claim you make, even unrelated ones, could be dismissed. You don’t want that, so be honest and transparent with your insurer.

Can you be denied insurance based on your mental health issues?

It’s more likely that insurance companies will limit coverage or increase premiums due to mental health issues. This will be determined during medical underwriting. However, you can’t be refused cover entirely. In the UK, insurance providers are regulated by laws that prohibit discrimination based solely on mental health conditions. So, they must provide cover to you, just not necessarily full.

Why is it important to look after your mental health?

Taking care of your mental health matters because it helps you deal with life’s ups and downs. It allows you to comfort yourself during tough times, cope with changes and losses, maintain good relationships, and keep learning. Good mental health means having the strength to handle whatever comes your way.

Does the NHS provide mental health treatment?

Yes, the NHS is the primary healthcare provider for most people in the UK, and its therapy services are free to access. However, the waiting times range from four to up to 18 weeks, or sometimes even longer. This may feel discouraging for individuals in distress, which is why some switch to private.