What is the difference between inpatient treatment and outpatient treatment cover?

I am considering a private medical insurance policy and do not fully understand the different between inpatient and outpatient cover and what each covers?

Question asked by Avi Patel
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Answered by Andrew Jenkinson

This is a very important factor to understand when looking for private health insurance as basic plans have a very different level of coverage relative to comprehensive policies.

What is Inpatient treatment?

Inpatient treatment is any treatment required where it is necessary for you to occupy a hospital bed, either for the day (which is called ‘day-patient treatment’) or overnight.

As a hospital bed is required, this type of treatment often relates to more serious procedures. For example, if you were to require any kind of invasive operation this would almost certainly come under inpatient treatment (even if you only required the hospital bed for an afternoon).

What is Outpatient treatment?

Outpatient healthcare most commonly relates to specialist consultations and diagnostic testing. In other words, it often relates to the diagnosis stage of treatment.

For example, if you were experiencing chest pain your GP may refer you to see a Cardiologist, who would examine you and run a series of tests in order to identify the issue. Once a diagnosis has been made the Cardiologist may suggest surgery, which would then come under inpatient treatment.

Essentially, outpatient treatment relates to healthcare where you do not need to occupy a hospital bed (i.e. you are going to a hospital for a few hours for a consultation, test or very minor procedure).

How does this relates to health insurance?

Most basic plans have no cover for outpatient treatment but do typically cover inpatient treatment in full. However, there are a small number of basic plans that will cover certain diagnostic tests but not consultations.

In addition to covering inpatient treatment in full, mid-range plans tend to have a limited amount of outpatient cover (ranging from £500 to £1,500 per policy year) and comprehensive plans tend to cover outpatient treatment in full.

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This information does not constitute financial or other professional advice. You should consult your professional adviser or contact us directly on 02084327333 should you require financial advice. It is important to ensure any insurance policy you take out is suitable for your needs.
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