As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr is a trusted expert in the UK private medical insurance market. This guide explores the common causes of hip pain, the journey to treatment, and how having the right private health cover can provide peace of mind and faster access to care.
WeCovr explains hip conditions and how PMI supports treatment access
Hip pain is one of the most common complaints we see among adults in the UK. It can range from a minor annoyance to a debilitating condition that severely impacts your quality of life, affecting your ability to walk, work, and enjoy your favourite activities.
When hip pain becomes severe, surgery, such as a hip replacement, might be the best solution. However, navigating the path to treatment can be daunting, especially with long NHS waiting lists. This is where private medical insurance (PMI) can be a lifeline, offering a faster, more comfortable route to diagnosis and treatment.
In this comprehensive guide, we'll break down everything you need to know:
- The common causes of hip pain.
- The differences between seeking treatment on the NHS versus going private.
- How a hip replacement works.
- The crucial role PMI plays in covering the costs and speeding up the process.
Understanding Hip Pain: Common Causes and Symptoms
Your hip is a large and complex ball-and-socket joint. Because it’s involved in almost every move you make, it’s susceptible to a variety of problems, particularly from wear and tear over time.
Here are some of the most frequent culprits behind hip pain:
- Osteoarthritis: This is the most common cause of hip pain in older adults. It's a "wear and tear" condition where the protective cartilage on the ends of your bones wears down over time, causing pain, stiffness, and inflammation.
- Rheumatoid Arthritis: An autoimmune disease where your body's immune system mistakenly attacks your joints, including the hips. It causes inflammation, pain, and can lead to joint damage.
- Hip Fractures: These are serious injuries, especially common in older people with osteoporosis (a condition that weakens bones). A fracture requires immediate medical attention.
- Bursitis: The bursae are small, fluid-filled sacs that cushion the bones, tendons, and muscles near your joints. When they become inflamed, it's called bursitis, leading to a sharp, localised pain.
- Tendonitis: This is the inflammation or irritation of tendons (the thick cords that attach muscle to bone) around the hip, often caused by repetitive stress from overuse.
- Avascular Necrosis: A less common condition where the blood supply to the head of the femur (the "ball" part of the joint) is disrupted, causing the bone tissue to die and the bone to collapse.
Here’s a simple breakdown of these common conditions:
| Condition | Primary Symptoms | Typically Affects |
|---|
| Osteoarthritis | Deep, aching pain in the groin or thigh; stiffness, especially in the morning; reduced range of motion. | Adults over 50; those who are overweight; people with a history of hip injury. |
| Rheumatoid Arthritis | Pain and stiffness in multiple joints (often symmetrical); fatigue; warmth and swelling in the joint. | Can affect people of any age, but most common between 30 and 60. |
| Bursitis | Sharp pain on the outside of the hip, worse when lying on the affected side or getting up from a chair. | Runners, cyclists, and older adults. |
| Tendonitis | Dull, deep ache in the groin or buttock area, often related to a specific activity. | Athletes and individuals who perform repetitive movements. |
It's vital to understand that private medical insurance is designed to cover acute conditions—those which are curable and arise unexpectedly after your policy has started. It does not cover chronic conditions (like rheumatoid arthritis) or pre-existing conditions (any health issue you had symptoms of or received treatment for before taking out cover).
The Journey to a Diagnosis: Navigating the NHS and Private Routes
Whether your hip pain is a dull ache or a sharp twinge, the first step is always to see your GP. They will assess your symptoms, examine your hip, and may recommend some initial treatments like painkillers or rest.
If your pain persists, the next step is a referral for further investigation. This is where the paths of the NHS and private healthcare begin to diverge significantly.
The NHS Pathway
- GP Referral: Your GP refers you to an NHS orthopaedic specialist.
- Waiting List (Consultation): You will be placed on a waiting list to see the specialist. According to NHS England data, the target is for 92% of patients to be seen within 18 weeks of referral, but in reality, many wait much longer.
- Consultation & Diagnostics: The specialist will assess you and may order diagnostic tests like an X-ray, MRI, or CT scan. There can be another wait for these scans.
- Waiting List (Treatment): If surgery is recommended, you are placed on another, often much longer, waiting list for the operation.
Recent NHS statistics from 2024 highlight the scale of the challenge. The median waiting time for trauma and orthopaedic treatment, which includes hip replacements, was over 14 weeks. Worryingly, tens of thousands of patients were waiting over a year for their procedure.
The Private Pathway (with PMI)
- GP Referral: You still visit your GP, but you ask for a private referral.
- Fast-Track Consultation: With PMI, you can typically see a specialist of your choice from your insurer's approved list within days or weeks, not months.
- Rapid Diagnostics: Any necessary MRI or CT scans are usually arranged within a few days at a private hospital or clinic.
- Swift Treatment: If surgery is needed, it can be scheduled at your convenience, often within a few weeks, at a private hospital.
The difference is clear: PMI bypasses the lengthy queues, getting you from diagnosis to treatment in a fraction of the time.
When is Hip Replacement Surgery Necessary?
A hip replacement, or total hip arthroplasty, is a major operation and is only recommended when other, less invasive treatments have failed to provide relief.
Your specialist will likely recommend surgery if:
- Your hip pain is severe and limits your everyday activities (walking, bending, sleeping).
- Non-surgical treatments are no longer effective.
- Stiffness in your hip significantly restricts your ability to move or lift your leg.
- X-rays show advanced arthritis or significant joint damage.
Non-Surgical Treatments Tried First:
- Painkillers and Anti-inflammatories: Over-the-counter or prescription medications.
- Physiotherapy: A targeted exercise programme to strengthen muscles around the hip and improve flexibility.
- Steroid Injections: An injection directly into the hip joint to reduce inflammation and pain temporarily.
- Lifestyle Changes: Weight loss to reduce stress on the joint and using a walking aid.
If these measures don't work, a hip replacement offers an excellent chance of relieving pain and restoring mobility. The procedure involves removing the damaged sections of your hip joint and replacing them with artificial parts (a prosthesis) typically made of metal, ceramic, or durable plastic.
The Role of Private Medical Insurance (PMI) for Hip Conditions
This is where private health cover truly proves its worth. A PMI policy is designed to cover the costs of private treatment for acute conditions that develop after you join.
The Golden Rule: Pre-existing and Chronic Conditions
It is absolutely essential to understand this point: standard UK private medical insurance does not cover pre-existing conditions. A condition is usually considered "pre-existing" if you have experienced symptoms, sought advice, or received treatment for it in the five years before your policy start date.
Furthermore, PMI is for acute conditions (e.g., a hip injury requiring surgery, or osteoarthritis that newly develops and requires a replacement) and not for managing long-term chronic conditions.
This is why it's wise to consider taking out cover when you are healthy, before problems arise.
How PMI Underwriting Affects Cover for Hip Pain
When you apply for PMI, the insurer will underwrite your application to determine what they will and won't cover.
| Underwriting Type | How It Works for Hip Pain | Best For... |
|---|
| Moratorium (Most Common) | Your policy automatically excludes any condition you've had in the last 5 years. However, if you go 2 full years without symptoms, treatment, or advice for that condition after your policy starts, it may become eligible for cover. | People who want a quick and simple application process without a full medical questionnaire. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire. The insurer assesses your medical history and may permanently exclude specific conditions (e.g., "any issues with the right hip"). | People who want complete clarity from day one about what is and isn't covered. |
At WeCovr, our expert advisors can explain these options in detail, helping you choose the underwriting method that best suits your personal circumstances.
What Does a PMI Policy Typically Cover for a Hip Replacement?
A comprehensive PMI policy can cover the entire private treatment journey:
- Specialist Consultations: The initial and follow-up appointments with your orthopaedic surgeon.
- Diagnostic Tests: The full cost of MRI scans, CT scans, and X-rays.
- Hospital Fees: The cost of the hospital room (usually a private, en-suite room), operating theatre, and nursing care.
- Surgeon and Anaesthetist Fees: The fees charged by the medical team performing your surgery.
- Post-Operative Physiotherapy: A course of physiotherapy to aid your recovery and rehabilitation, which is crucial for a successful outcome.
Comparing NHS vs. Private Hip Replacement Surgery
To see the benefits of PMI clearly, let's compare the two pathways side-by-side.
| Feature | NHS Pathway | Private Pathway (with PMI) |
|---|
| Waiting Time | Can be 18 weeks to over a year from GP referral to surgery. | A few weeks from GP referral to surgery. |
| Choice of Surgeon | You will be treated by the available surgeon and team on the day. | You can choose your consultant surgeon from your insurer's approved list. |
| Choice of Hospital | You will be treated at an NHS hospital assigned to you. | You can choose from a list of high-quality private hospitals. |
| Hospital Room | Typically a shared ward with several other patients. | A private, en-suite room with a TV, WiFi, and flexible visiting hours. |
| Surgery Scheduling | Your surgery date is fixed by the hospital and can be cancelled at short notice. | Your surgery is scheduled at a time that is convenient for you. |
| Post-Op Care | Physiotherapy may be provided in group sessions with limited availability. | One-to-one physiotherapy sessions are usually included in your cover. |
| Cost | Free at the point of use, funded by taxation. | Can cost £12,000 - £15,000+ if self-funding. Covered by your PMI policy (subject to your excess). |
Choosing the Right Private Health Cover for Orthopaedic Needs
Not all PMI policies are the same. When considering cover, especially with potential orthopaedic needs in mind, you need to look at a few key features:
- Outpatient Cover: This pays for your initial consultations and diagnostic scans. Some policies have a limit (e.g., £1,000 per year), while others offer full cover. A higher limit is better for ensuring all pre-op investigations are paid for.
- Hospital List: Insurers have different tiers of hospitals they work with. Ensure the hospitals near you, and those with leading orthopaedic departments, are on your chosen list.
- Excess: This is the amount you agree to pay towards a claim. A higher excess (£500 or £1,000) will lower your monthly premium, but you'll have to pay that amount if you need treatment.
- Therapies Cover: Check that the policy includes a good level of cover for post-operative physiotherapy, as this is vital for your recovery.
Navigating these options can be complex. As an independent PMI broker, WeCovr compares policies from across the market to find the one that offers the best value and the most appropriate level of cover for you, all at no cost for our advice.
Beyond Surgery: Wellness and Recovery Tips for Healthy Hips
Maintaining good hip health isn't just about surgery. A proactive approach to wellness can help prevent problems, aid recovery, and improve your overall quality of life.
- Maintain a Healthy Weight: Every extra pound you carry puts several extra pounds of pressure on your hip joints. Keeping your weight in a healthy range is the single best thing you can do for your joints. As a WeCovr client, you get complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, to help you achieve your weight management goals.
- Eat for Your Joints: A balanced diet rich in calcium and vitamin D is essential for strong bones. Anti-inflammatory foods, such as oily fish, nuts, and leafy greens, can also help manage symptoms of arthritis.
- Stay Active with Low-Impact Exercise: High-impact activities like running can stress the hips. Opt for joint-friendly exercises like swimming, cycling, or walking. Strengthening the muscles in your glutes, quads, and core provides better support for your hip joints.
- Listen to Your Body: Don't push through pain. If an activity hurts, stop. Rest is a crucial part of recovery and prevention.
Remember, if you purchase private medical or life insurance through WeCovr, you may also be eligible for discounts on other types of cover, helping you protect your health and finances in one place.
Does private medical insurance cover pre-existing hip pain?
Generally, no. Standard private medical insurance in the UK is designed for new, acute conditions that arise after your policy begins. Any hip pain or related condition for which you have had symptoms, medication, or advice in the 5 years before taking out cover will be excluded as a pre-existing condition. Some policies with moratorium underwriting may cover it later if you remain symptom-free for a continuous two-year period after your policy starts.
How much does a private hip replacement cost in the UK without insurance?
If you are paying for yourself (self-funding), the cost of a private hip replacement in the UK typically ranges from £12,000 to £15,000, and can sometimes be more. This price usually includes the surgeon's fees, hospital stay, the prosthesis, and some initial post-operative physiotherapy. A private medical insurance policy can cover these costs, making private treatment much more accessible.
What's the waiting time for a hip replacement on the NHS vs. privately?
On the NHS, the target is to treat patients within 18 weeks of a GP referral, but recent data from 2024 shows median waits for orthopaedics are often around 14 weeks, with many people waiting much longer, sometimes over a year. Privately, with PMI, you can often see a specialist within a week or two and have the surgery scheduled within a few weeks after that, dramatically reducing the time spent in pain.
Can I choose my surgeon and hospital with private health cover?
Yes, one of the main benefits of private health cover is choice. Your insurer will provide you with a list of approved specialists and private hospitals. This allows you to research and select a leading surgeon and a hospital that is convenient for you and has excellent facilities, giving you greater control over your care.
Does WeCovr charge a fee for helping me find a policy?
No, our expert advice and comparison service is completely free for you. WeCovr is an independent broker, and we receive a commission from the insurance provider if you decide to purchase a policy through us. Our priority is to provide you with impartial, expert guidance to help you find the best possible cover for your needs and budget.
Ready to explore your options for private health cover? The expert advisors at WeCovr are here to help. We compare policies from leading UK insurers to find the right fit for you.
Get your free, no-obligation quote today and take the first step towards faster access to the care you deserve.