PHIN publishes information to help patients better understand their healthcare options and make better decisions. One of the ways we do this is by collecting information about the fees that consultants who work in private practice charge.
We have been collecting data on the fees for ‘self-pay’ private care patients for some time, but since April 2024, we have also been collecting information about fee arrangements with Private Medical Insurers (PMIs).
This short guide explains the ways the different types of fees work.
When you search for a consultant on our website, if they have submitted fee information (Self-Pay Fees and/or Insured Fees) it will appear in their profile. This will help you compare different consultants.
Self-funding your private medical treatment
The amount you are paying for private treatment out of your own pocket should be clear from the outset so that you can properly assess your finance options. Unfortunately that isn’t always the case.
This article explains:
- the fees that you pay when you are self-funding your private medical treatment – often known as ‘self-pay’
- the questions you should ask your consultant or GP, and
- how you can use our website to get help.
Who pays for their own private medical treatment?
In the UK around 800,000 healthcare treatments each year are privately funded, and most of these are for patients who use the NHS for the majority of their health services. A high proportion of people use private medical insurance to pay for their treatment, but paying directly for the cost of your treatment is also possible and has become more common since the Covid-19 pandemic.
In 2019 (before the impacts of Covid-19) around one in four of all private treatments in the UK were self-funded. Since the end of Covid lockdowns in the UK, the number of people choosing to self-pay has been increasing, at least partly in response to long waiting lists in the NHS, as people look for fast access to treatments.
The most common procedures which people choose to go privately for are cataract surgery, hip replacements, and knee replacements.
What happens at your initial private consultation?
When you are planning to use a private healthcare service, your consultant will always ask you to come in for an initial consultation before any treatment. There will be a fee for this consultation. The fee will vary, but tends to be around £170 to £250. A top expert might charge more, and costs can vary depending on where you are in the UK, with consultants in London often charging a bit more.
Your consultant is required by law to write to you to set out the fees for the initial private consultation. You should get this letter before the appointment. If you are seeing your consultant for an urgent appointment, this information can be provided to you by telephone. You should ask for the fee to be confirmed in writing just so you have a record.
Your consultant may ask you to have diagnostic tests. It is unlikely that any test will be undertaken without a diagnostic charge. The consultant must tell you if there is a fee for any diagnostic tests they do. But if the hospital does a diagnostic test the consultant may not know the fee, so make sure to ask both the consultant and hospital about fees for tests.
How to pay for private medical treatment
After you’ve met your consultant, they must send you a letter that sets out their fees for any additional diagnostic tests as well as for your treatment.
There are two main payment plans for your own treatment if you choose to self-fund it. You can opt for a 'price package' or to 'pay per service'.
You will not always need to pay the complete amount in one go. Speak to your provider about payment plan options. Many providers will also be able to put you in touch with finance companies who can make paying for your treatment more manageable, some will offer 0% options. As always with financial products you should ensure they are affordable and take financial advice if appropriate.
a. How packaged pricing works
Many private hospitals now offer a packaged price for private medical treatment. This bundles up things like the consultant’s charges for treatment, hospital care and aftercare charges into one fee for the private patient.
Self-paying patients offered a package price might be given a ‘guide’ or ‘indicative’ price to begin with. The fee might change after the consultant has seen you, based on your needs.
For peace of mind you should always check what your healthcare provider includes in the package price. For example, one hospital may include all fees for tests, treatment, follow-up appointments and physiotherapy. Another hospital may not include all of those things, even if you need them, so will charge you fees on top of the package price.
If there are complications during your treatment, and you need to stay in hospital longer than expected this may not be included in the price you have been quoted.
The hospital can talk you through this before you commit to an initial consultation.
b. How paying per service works
Not all consultants are signed-up to package prices. If your consultant is not, you will be sent invoices for each part of your treatment and the services you use. For example, if you’re having surgery you may be charged separate invoices from:
- your consultant
- the consultant anaesthetist
- the hospital
The hospital’s fee may come as pre-defined charge for all of their services, or this fee may be an itemised bill where things like medication, dressings, meals, walking aids and tests are all additional costs.
You should get a letter setting out the consultant’s total fee before you agree to treatment. However, it is sometimes difficult to predict all of the additional costs, and the consultant may not include the costs charged by the hospital.
It is important to ask your consultant and/or hospital to talk through the full terms and conditions until you are satisfied. These terms and conditions, should tell you what happens if your stay in hospital is extended for some reason, or something goes wrong.
How are private medical consultant fees worked out?
The typical fees consultants will charge for an initial private consultation, the treatment, and any follow-up consultations can be found on the consultant’s PHIN profile, which you can find using our consultant search.
You can also use our interactive tool to help you understand the typical fees consultants charge in your region, which you can then compare with your consultant’s fees.
Private medical insurance (PMI)
PMI: Understand the costs
Private health insurance companies provide a range of schemes for their customers. These can either for be individuals purchasing their own insurance or companies who purchase insurance on behalf of their employees.
Our data shows that the number of people using insurance to pay for their private healthcare procedure is increasing (partly due to long NHS waiting lists), so it is increasingly important that patients understand how it works.
PMI: How do insurance companies work with consultants?
Consultants who provide private sector healthcare (non-NHS) services to patients are obliged to provide PHIN with information about the fees that they charge for consultations and procedures. This allows patients to have a better understanding of what they will be paying for their medical services.
All private consultants are required by insurers to fulfil certain requirements before they can conduct insurance-funded private work for their customers/patients.
Several insurers have formal contractual arrangements with consultants covering these requirements. These usually include an agreement on the fees that they will charge for services.
Other insurers indicate a fee that they will pay for the private professional services of a consultant, either for consultations, performing procedures or both.
PMI: What if the consultant charges more than the insurer will pay?
The consultant may charge the fee agreed with the insurers or choose to charge a higher or lower fee. If the consultant charges a higher fee, you (the patient) may be asked to pay the difference between the fee charged by the consultant and the amount that the insurer will pay. If you do not wish to pay more, then you should try to find a consultant who charges within the fee limits set by the insurer (the PHIN website and your insurer can help with this).
Most private healthcare insurers now provide an option to include an excess arrangement in the schemes purchased by individuals or employers. Many also offer a choice of excess amounts. This can help you be clearer about the amount you would have to pay (if any) if you undergo a procedure.
Some consultants charge for their initial consultation outside of their insurance fee arrangements. You should always check what is covered.
PMI: Paying an excess for private medical treatment
When a claim is made, the excess arrangement will apply, usually as bills are submitted to the insurer from consultants and private hospitals. You will be asked to pay the cost of any treatment or care provided up to the value of the excess.
PMI top tip: Contact you insurer
We strongly encourage you to contact your insurer before making any arrangements to see a consultant or commence a course of treatment.
This will allow you to ensure that you are aware of the full range of services covered by your health insurance policy and avoid any unexpected financial surprises.
Next steps (self-pay or insured)
If you are ready to compare consultants and/or hospitals, then go to our search tool at the top of each page (or on our homepage www.phin.org.uk) and enter the relevant details.
For help with our consultant profiles see our guides.
If you are interested in knowing more about ‘Paying for treatment using private medical insurance’ see our longer guide.
