The UK health insurance industry is mature, stable and experiencing limited growth. Such are the pressures on customer affordability that maintaining – let alone growing – levels of take-up is a constant challenge. For more than a decade, falling numbers of individual customers has been a recurring theme in both in the PMI (private medical insurance) and HCP (health cash plan) markets. This is mainly linked to rising medical expenses inflation and, more recently, increases in IPT (insurance premium tax), which has driven up premiums and squeezed providers’ margins.

In the PMI market, in particular, rising cost pressures has fuelled M&A (merger and acquisition) activity, creating a highly consolidated marketplace. Yet although little more than a handful of companies now operate in the private health insurance arena, there is still strong competitor activity. Market conditions remain tough, with providers having to adapt to a gradually shrinking pool of individual customers and a more cautious corporate environment, linked to Brexit uncertainty.

Taking these issues into consideration, Mintel’s consumer research explores ownership of, and consumer attitudes toward, health insurance and related products such as limited-cover policies and cash plans. It investigates policyholders’ claims experience and renewal intentions, assesses the level of product interest among the non-insured and reveals the most appealing cover benefits. Additionally, it assesses the level of public concern over NHS waiting lists and quality of care, waiting times to see a GP (general practitioner), everyday healthcare costs and getting insured for a pre-existing condition.

This Report examines the UK market for health insurance, which the ABI (Association of British Insurers) and the PRA (Prudential Regulation Authority) term as ‘medical expenses insurance’. The market encompasses PMI and HCPs, along with various product variants.

Product definitions are as follows:

Health cash plan – provides cash benefits to cover the costs of primary care treatment, expenses associated with hospital treatment (though not the treatment itself) and post-operative care. The majority of plans do not cover the full cost, but pay a set amount or a fixed rate, usually between 50% and 75%. Plans may also include occupational health, wellness services and telephone helplines. Unlike PMI, health cash plans work on the basis of ‘guaranteed acceptance’, meaning that subscribers are not required to undergo a medical examination. However, most plans do not cover pre-existing conditions. Premiums are not age-related, but most plans have an upper age limit of 65 or 70.

Private medical insurance – designed to cover the costs of private treatment for what are commonly known as acute medical/surgical conditions (ie curable, short-term illnesses or injuries). The main advantage of having this cover is that it ensures prompt access to treatment should the policyholder become ill or injured. Policies are either fully underwritten (requiring the policyholder to disclose their full medical history) or written on a moratorium basis (the policyholder needs to give more limited information and the policy excludes pre-existing conditions, whether or not diagnosed).

Alongside traditional PMI policies, there are a number of product variants that limit cover to some degree. These include:

Condition-specific policy – covers the cost of private treatment for a specified condition or small number of conditions, typically cancer and heart disease.

Treatment-only policy – covers the cost of private treatment and aftercare following an initial diagnosis on the NHS.

Treatment specific policy – this differs from the above in that it is designed to cover the cost of certain specified treatments, such as physiotherapy, psychiatry and alternative therapy.

Diagnostic-only policy – a lower-cost policy, which is designed to cover the cost of the initial consultation/diagnosis, including diagnostic tests (eg MRI, CT, PET scan).

Other related products include:

International health insurance – designed to cover the insured for essential hospital treatment while living or working abroad. This is also referred to as IPMI (international private medical insurance).

Dental plan – an insurance policy that covers the policyholder for a maximum number of examinations and treatments at any dentist, and for emergency treatment up to a set amount per year. These differ from capitation plans, where the individual has a contract with a specific dentist to provide routine care or maintenance. Capitation plans, therefore, do not fall under the category of “medical expenses insurance”.