As the state-funded system descends ever deeper into crisis, demand for a private alternative is “exploding”, brokers say.

More than 7.2million people are languishing on an NHS waiting list in England, and many have had enough.

People who have previously ruled out private medical insurance (PMI) as too expensive are now having a rethink.

They are now willing to pay for private treatment at a time and place of their choosing, despite the cost-of-living crisis.

Health insurance brokers who specialise in selling PMI report a surge in sales, with big name providers Bupa, Aviva and Vitality selling half a million more policies last year.

Brian Walters, managing director at brokers Regency Health, reports “an explosion of interest in PMI” from ordinary people requesting advice on buying the right policy. “Once seen as a luxury, many now consider PMI a necessity.”

Traditionally, PMI customers seeking treatment from a private consultant would first have to get a referral from an NHS GP, which slows down the process.

That is no longer necessary as the major insurers introduce virtual GP services, allowing customers to have a video consultation in the comfort of their own home, Walters said. “These services are a game-changer as they allow insurers to offer a more joined-up service.”

Walters said many policies cut costs by offering “guided” care options where the insurer directs members to pre-agreed consultants at certain hospitals.

By striking deals with a select number of specialists and treatment centres, insurers are better able to cap costs.

However, Walters said new customers cannot simply sign up to a PMI policy and expect instant private treatment for an ongoing health problem. 

“In most cases, pre-existing medical conditions are excluded from cover. This means you are only covered for illnesses that emerge after you sign up.”

Health insurance doesn’t cover chronic illnesses, either, with ongoing care best delivered by the NHS.

Walters said a mid-priced PMI policy with a £100 excess on claims would cost a typical 40-year-old non-smoker from £61.48 a month on a guided policy with insurer Aviva.

That rises to £76.86 a month for a standard policy offering access to a wider choice of consultants and hospitals.

Smokers can expect to pay double that. Those with extensive prior health problems will also pay more.

Market leader Bupa would charge the same 40-year-old £60.20 a month for a guided policy or £72.95 a month for a standard plan, with Axa, The Exeter and VitalityHealth also offering competitive options.

However, new customers in their 50s or 60s can face starting premiums of £100 a month and these could rise steadily as they move into the 70s and 80s and their health problems pile up.

That puts it well beyond the pockets of most pensioners. They could cut costs by taking out a higher excess but would need cash to pay that before claiming.

The lucky ones get private medical cover through their job but this usually stops when they retire. After that, they have to pay from their own pockets.

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Ian Sawyer, director at protection brokers Assured Futures, reports a 200 percent increase in enquiries for PMI policies in recent months.

PMI has traditionally been bought by wealthy older people but he said that profile is now changing. “We are seeing growing numbers of people taking insurance at younger ages or insuring their children.”

When deciding which policy suits you best, do not get distracted by flashy signing-up offers or discounts, Sawyer said. 

“You will normally have PMI for many years so focus on buying a high quality core product. Plans are complex and have many different features, so advice is essential.”

How much you pay depends on your age, where you live, the level of cover you choose and the insurer, so shop around.

PMI will still be too expensive for most people and the cost rises over time, with medical inflation typically rising at a faster rate than standard inflation. 

Premiums can also jump when you renew your policy at the end of a year when you have made a claim, adding to the pressure for those with serious health problems.

Existing PMI policyholders should check whether their plan still offers the best value at renewal, Sawyer added.

“We have all become adept at doing this for our car and home policies, but the savings available on medical insurance can be huge. In January we saved clients an average of 24 percent on their new policy.”