Eyecare Insurance

Optical Health Insurance

59% of people in the UK wear glasses or contact lenses, and there are 2 million people living with significant visual impairment or sight loss, so it should come as no surprise to learn that ophthalmology is the busiest outpatient department in the NHS. 

Although the NHS employs more than 1,500 ophthalmologists, referrals to ophthalmology still account for more than 10% of the entire NHS waiting list specifically because it is the busiest department. 

That’s why it might be worth considering optical health insurance, which could reduce your waiting time dramatically if you ever need to see an ophthalmologist or get screened for diabetic retinopathy, glaucoma or cataracts. 

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How does private eyecare differ from NHS services? 

The NHS employs thousands of ophthalmologists, opticians, ophthalmic surgeons and ophthalmic nurses, so the vast majority of eyecare treatments and surgeries that you can get privately can be performed by the NHS as well.  

The difference is that private ophthalmology patients will often be seen more quickly, surgeries may be scheduled more quickly, and the patient may be able to choose their preferred hospital and consultants. 

What are the advantages of private eyecare insurance? 

The two main advantages of having an eyecare insurance policy that enables you to ‘go private’ for your eyecare treatment are shorter waiting times, and your choice of consultants. 

When you have private optical insurance, or you add a separate ‘optical, dental and hearing’ add-on to your private health insurance policy, your waiting times will usually be much shorter if and when you need specialist eyecare compared to NHS treatment. 

In many cases, you’ll also be able to choose your ophthalmologist when you have a private insurance policy, either from the insurance provider’s shortlist of consultants or from the full range of specialists if the provider doesn’t have a shortlist. 

Are there any drawbacks to this type of insurance policy? 

The obvious one is the cost – you’ll be paying for a private optical insurance policy either monthly or annually, whereas NHS eyecare treatment would obviously be free at the point of need. 

The other potential drawback is that some private health insurance providers will have a shortlist of doctors and consultants for you to choose from, which means your choice may be more limited with those providers than you might expect, even though you will still have greater flexibility than you would if you were receiving NHS treatment. 

Is private health insurance for eyecare worth the cost? 

Every patient is different, so the decision about whether or not this type of insurance policy or add-on is worth the cost will need to be made on an individual basis as well. 

However, with some optical health insurance policies offering policyholders as much as £400 or £500 towards eyecare and prescription glasses per year, the right policy could well pay for itself if you do require glasses, contact lenses or other types of eye care treatments. 

How much does this type of insurance policy typically cost? 

Our own research has revealed that the cost of this policy can vary quite a bit from one policyholder to the next since many of the risk factors insurance providers will take into account when they’re calculating the premium will be specific to that policyholder. 

That’s why we’d recommend comparing real quotes that take your own risk factors into account, in order to get a genuine understanding of how much you’ll pay for this optical health insurance. 

What factors influence the cost of private eyecare insurance? 

Health insurance providers take a lot of different variables into account when calculating the cost of this policy, including your age, your lifestyle, your smoking habits, your drinking habits, your medical history and your insurance claims history. 

How much of a factor is my age? 

Age is an important risk factor for any type of private health insurance policy, including eyecare insurance, because medical data shows that people are more likely to develop a wide range of different medical conditions as they age, both eye-related and otherwise.  

If there’s a family history of macular degeneration in my family will this increase the cost of this insurance? 

Some health insurance providers may ask about your family’s medical history, but these types of questions are much more common with life insurance than they are with health insurance policies. 

The type of health insurance you’re most likely to be offered in the UK will be underwritten on a moratorium basis, which means rather than requiring a full and in-depth assessment of your own (and your family’s) medical history, the insurance provider will instead exclude from coverage any condition that you have suffered from, sought treatment for, been prescribed medication for or been referred to a specialist for. 

Moratorium underwriting will usually exclude conditions you had within the past two, three or five years, depending on the provider.  

The reason many providers use moratorium underwriting for their private health insurance policies is that it vastly simplifies the risk assessment and underwriting process – the alternative would be to require every potential policyholder to provide a full account of their medical history (and potentially even undergo a medical examination), which would prevent many people from taking out this type of insurance. 

Can I choose my optician or ophthalmologist with this type of private health insurance? 

Yes, private eyecare insurance should give you a choice of opticians or ophthalmologists, although how flexible this is will depend on your particular insurer.  

Some insurance companies will have a shortlist of medical professionals that you’ll be able to choose from, while others will have no limitations at all when it comes to choosing. 

Will glaucoma be covered by this type of health insurance? 

Yes, provided you hadn’t been referred for or treated for glaucoma prior to taking this policy out, then your private health insurance policy will usually cover glaucoma. 

If you were referred to an ophthalmologist for glaucoma before you signed up for this insurance then the glaucoma will almost certainly be classed as a ‘pre-existing condition’, which means it’ll be excluded from coverage. 

Will this type of insurance cover ailments or conditions in other parts of my body besides my eyes? 

Yes, eyecare insurance will usually be bundled with a private health insurance policy, which means you should be covered for other conditions that might arise in other parts of your body.