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What is Inpatient vs Outpatient care?

It’s a good idea to understand the difference between inpatient and outpatient medical care, to give you an idea of which treatments will be covered by your health insurance policy. Inpatient medical treatments should be included as standard, and most of the UK’s top health insurance companies will allow you to add outpatient cover to your policy for an extra cost.

Certain insurers (e.g. Aviva) will include a set level of outpatient cover for free, which can be useful if you have a more limited budget.

Examples of typical outpatient medical treatments include things like:

In this guide, our health insurance experts explain the main differences between inpatient vs outpatient medical care in the UK. We have also compiled a detailed list of all the benefits offered by a range of UK insurers, to help you decide which policy might work best for you.

It can be hard to understand how your health insurance policy works, especially if you are applying for the first time. This is why it is important to read your policy documents carefully and get proper advice if you are unsure of which private medical treatments you can claim for.

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60-Second Summary – What is Inpatient vs Outpatient care?

Inpatient care refers to any treatments that requires an overnight stay in a hospital or treatment centre for 24 hours or longer. Outpatient care refers to any treatments where you only visit the hospital for a few hours or less, and you don’t stay in a hospital bed.

  • Inpatient medical treatment includes things like treating burns or traumatic injuries, and major surgeries.
  • Outpatient medical treatment includes things like chemotherapy or radiotherapy, treating skin conditions, and minor surgeries.
  • Most private health insurance policies automatically cover inpatient treatments, while outpatient cover typically requires an additional cost.
  • It’s vital to review your health insurance policy documents to have a proper understanding of what is covered for inpatient and outpatient care.
  • See the ‘What is included in outpatient vs inpatient cover?’ section for a full breakdown of the benefits offered by the UK’s top health insurance companies.

There are key differences between inpatient and outpatient cover, and the benefits in your policy will affect whether your health insurance policy covers your treatment. The type of care that you receive will depend on how serious your symptoms are and whether you need a major or minor procedure or treatment.

Inpatient medical care refers to any treatment where you need to stay in a hospital overnight (24 hours) or for several days or weeks. A hospital inpatient tends to be admitted due to serious illnesses or medical emergencies. You could also be admitted to hospital due to an ongoing medical condition (e.g. cancer) to receive pre-planned surgeries or treatments.

Outpatient medical care would be any consultations or treatments which don’t require you to stay in the hospital for an extended period of time. This would include treatment like dialysis, counselling, and minor surgeries where you can go home immediately after your appointment.

The exact definition of an outpatient according to Bupa is a patient who attends a hospital, consultation, outpatient clinic or treatment facility but doesn’t stay overnight or occupy a bed at any point.

Examples of inpatient careExamples of outpatient care
Major surgeries
Childbirth and recovery
Rehabilitation treatment
Treatment for serious burns or traumatic injuries
Observation after surgery or treatment
Specialist therapies and treatments
Inpatient mental health treatment
Staying in an intensive care ward.
Minor surgeries (e.g. mole removal, laser eye treatment)
Dialysis
Chemotherapy
Radiotherapy
Physiotherapy
Counselling
Treatment from a chiropractor or osteopath
Pre-operative consultations and tests

Certain health insurance companies (e.g. Aviva) will include a level of outpatient cover automatically, but many insurers will require you to add this on for an extra cost. You should consider if you need outpatient cover, and if the additional cost is worth it for you.

What is a day patient?

A day patient falls somewhere in between an inpatient and an outpatient, as they aren’t really one or the other. For example, if you receive surgery where you need to stay for observation for a few hours but can then go home, you would be classed as a ‘day patient’.

You might need follow-up care after your initial treatment or surgery, which would then make you an outpatient unless you need to be admitted to the hospital.

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The answer to this question depends on the insurer and the specific health insurance policy that you have chosen. Health insurance will generally cover inpatient treatment, but not all policies will cover outpatient treatment or will limit what is covered.

With most policies, you would have a set limit for how much outpatient treatment will be covered each year (e.g. £1,500 maximum).

If you wanted further private treatment after this, you would need to cover the cost of this yourself. The alternative would be to use NHS services after your initial diagnosis or treatment to keep the costs down.

This short video from Bupa explains their outpatient limits and how this would affect your health insurance policy.

Bupa By You health insurance | What are outpatient benefit limits?

Note: You should check your policy terms and conditions, as this will explain any claim limits for both inpatient and outpatient treatments. It will also tell you if you need to pay excess when you claim, and how much this excess will be for each treatment.

Our health insurance experts have looked at the core health insurance policies across a range of the UK’s top health insurance companies. From this research, we have created the table below which highlights the private healthcare inpatient and outpatient benefits that are available with each insurer.

Health insurance benefits

Aviva logo

Aviva Health Insurance

These are the benefits that are available with Aviva Healthier Solutions policies

Inpatient treatment options

  • Full cover for inpatient diagnostic tests, X-rays, scans, and ECGs.
  • Full cover for radiotherapy or chemotherapy.
  • £100 per night for every night spent in an NHS hospital (up to 30 nights maximum).
  • Cover for hospital charges and specialist fees (whether this is covered in full or to a set limit depends on your chosen hospital list).
  • Cover for hospital accommodation, meals, nursing care, drugs, theatre fees and dressings.

Outpatient treatment options

  • Specialist consultations.
  • Specialist medical treatment.
  • CT, MRI and PET Scans (at a diagnostic centre only).
  • Full cover for pre-admission tests to check that you are fit for surgery.
  • Full cover for radiotherapy/chemotherapy.
  • Treatment from a physiotherapist, chiropractor, or osteopath.
  • Up to £2,000 mental health treatment.  

Note: Whether certain benefits are covered in full or to a set limit depends on your chosen hospital list.

AXA Health logo

AXA Health Insurance

These are the benefits that are available with AXA Health insurance policies

Inpatient treatment options

  • Full cover for private hospital fees.
  • Unlimited inpatient specialist treatment.
  • Cancer treatment including radiotherapy and physiotherapy.
  • Hospital accommodation benefit for parents to stay in a nearby hotel if their child under 16 is a hospital inpatient (up to 5 days per year, £100 per night).

Outpatient treatment options

  • Unlimited cover for outpatient surgery (included as standard).
  • CT, PET, and MRI scans are covered in full if you are referred (included as standard).
  • You can add on cover for outpatient specialist consultations and diagnostic tests for an extra cost.

Bupa logo

Bupa Health Insurance

These are the benefits that are available with Bupa By You policies

Inpatient treatment options

  • Full cover for inpatient hospital treatment.
  • Up to 28 days of inpatient mental health treatment.
  • Full cover for any inpatient diagnostic tests.
  • Full cover for MRI, CT and PET scans.
  • £50 benefit per night for every night in an NHS hospital.
  • Option for full cancer cover, NHS Cancer Cover Plus or no cancer cover.

Outpatient treatment options

  • Cover for inpatient diagnostic tests, therapies, and mental health treatment.
  • Full cover for MRI, CT and PET scans.Unlimited cover for eligible cancer treatments.
  • Eligible treatment of mental health symptoms related to specific conditions.  

Note: Options for yearly outpatient limits include unlimited cover, £500, £750, and £1,000

The Exeter logo

The Exeter Health Insurance

These are the benefits that are available with The Exeter Health+ policies

Inpatient treatment options

  • Covers consultant and specialist fees.
  • Covers inpatient diagnostic tests.
  • Covers hospital fees and charges (including the cost of medical aids or drugs that you need to take home).
  • Full and unlimited cancer cover (including palliative care).

Outpatient treatment options

  • Covers CT, MRI, and PET scans (including fees).
  • Covers outpatient surgeries.
  • Covers up to 3 session of physiotherapy following a surgery (post-operative).
  • Can add on unlimited outpatient diagnostics cover for an additional cost.

Vitality logo

Vitality Health Insurance

These are the benefits that are available with Vitality Health policies

Inpatient treatment options

  • Full cover for hospital fees.
  • Full cover for consultant’s fees.
  • Full cover for diagnostic tests and scans.
  • £250 per night benefit if you need inpatient treatment at an NHS hospital (£2,000 maximum).

Outpatient treatment options

  • Full cover for outpatient surgical procedures (included as standard).
  • Up to 8 sessions of cognitive behavioural therapy (CBT) or counselling per year.
  • Can add outpatient cover for an additional cost (includes consultations and fees, physiotherapy, and diagnostic tests).

Sources:

Aviva Healthier Solutions Terms and Conditions – CLICK HERE
AXA PPP Healthcare Private Medical Insurance Product Information Document – CLICK HERE
Bupa By You Comprehensive Policy Product Information Document – CLICK HERE
The Exeter Private Medical Insurance Product Information Document – CLICK HERE
Vitality Health Insurance Product Information Document – CLICK HERE

Health Insurance provider reviews

Many health insurance customers are happy to only cover inpatient treatments or to stick with the limited outpatient cover that is included as standard. If you need to pay more to add a higher level of outpatient cover, you should consider if this is worth it for you and whether this is something that you can afford.

If you don’t add outpatient cover, you risk not being able to access care such as diagnostic tests unless you are admitted to hospital. You would either have to pay for this yourself, or wait on an NHS waiting list which could take weeks or months.

Pros and cons of adding outpatient cover

ProCon
Cover for a wider range of medical situations, including aftercare following inpatient treatments.You will have to pay more to add outpatient cover with most insurers and the cover may be limited (e.g. £1,500 per year).
Will often cover treatments such as chemotherapy, radiotherapy, or dialysis.Not all insurers will offer the same outpatient benefits, so it can be hard to compare policies.
Some insurers will include certain outpatient treatments within their core cover with no extra cost.You may not need much or any outpatient care within the next year, so might not get full value for money.
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It can be difficult to compare health insurance policies and quotes, as insurers will vary significantly in what they cover initially and any benefits that can be added on. It can be helpful to check what each provider offers, and the price that you would pay for each level of cover.

Many consumers find it useful to speak to a health insurance specialist for advice about what type of cover they need, and which policies will be affordable for them. You can contact our friendly health insurance experts for free advice by CLICKING HERE or by calling 0800 009 6559.

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What is the average cost of health insurance UK?

One of the top questions that people ask about health insurance is, ‘how much does it cost on average per month?’. According to recent research taken in 2023, the average cost of a health insurance is £86 per month for a standard personal protection policy. Health insurance policies can vary dramatically based on your age and the type of cover that you need, as well as which insurance provider you choose.

Most core health insurance policies will provide a similar level of protection and coverage for private medical treatments. You can tailor your health insurance policy to suit your needs and your budget by changing the benefits and levels of cover that you receive.

Is health insurance worth it?

Health insurance is the same as most other personal protection policies that you can buy, it is down to your own personal preference and attitude to risk. The other major issue is whether you can afford to pay for health insurance every month because it can be expensive.

If you ever need to claim on your health insurance policy then the benefits can be life changing and even lifesaving. The medical treatments and care that is provided by the NHS in the UK is among the best in the world, especially for chronic illness. Unfortunately, it is a well-known fact that the NHS is struggling to meet demand and that the levels of private medical treatment are generally far superior to public health treatments.

Example: If you needed knee surgery then you would have to wait for months or even years on the NHS, whereas private health insurance will give you access to better treatment, leading specialists, and within weeks usually. Rehabilitation and therapies cover that are also provided by most health insurance policies can be invaluable, especially if you are self-employed for example.

Is private health insurance better than the NHS?

Currently, the biggest issue with the NHS is the waiting times for any consultations and access to treatments, because of how stretched its resources are. The NHS provides some of the best care in the world for chronic illnesses and diseases, such as diabetes, MS, epilepsy, and asthma.

Health insurance is designed to complement and support the treatment that you can receive on the National Health Service, as well as giving you access to specialists for other medical issues such as musculoskeletal issues and cancer treatment, which are also the top reasons for claims on health insurance cover.

The main issues with NHS treatment currently and reasons for people taking out health insurance:

  • Long waiting lists for consultations, results and treatment
  • Overcrowded hospitals
  • Lack of beds
  • Shortages of NHS nurses and doctors
  • Some treatments not available (especially cancer treatments)
  • Specialists only available on private health insurance
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What is the best health insurance UK?

There are lots of different policy options when considering health insurance as well as your choice of several main insurance providers. The other consideration is whether you don’t take out health insurance and opt for receiving treatment on the NHS or paying for treatment yourself as and when you need it.

We’re constantly reviewing the top health insurance companies in the UK to find out which provide the best service, value, products and treatments. Based on our most recent reviews we suggest the following as the best health insurance UK 2023:

  1. Aviva Healthcare Solutions (Trustpilot score: 4.1 out of 5.0)
  2. BUPA Health Insurance (Trustpilot score: 4.0 out of 5.0)
  3. Vitality Personal Healthcare (Trustpilot score: 3.9 out of 5.0)
  4. Exeter Health+ (Trustpilot score: 4.4 out of 5.0)
  5. AXA PPP (Trustpilot score: 4.1 out of 5.0)
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https://www.iaminsured.co.uk » guides

Best Private Health Insurance 2023 - iam|INSURED

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