No, you really dont. I play on expert and use Iron weapons and armour smithed to fine or superior - NEVER higher. I am very much against being a 1-shot death machine when it comes to Elder scrolls.
So if I can fare on expert with a pretty poor loadout, anyone can. Playing with no HUD makes the game better in so many ways. All of the complaints about immersion I see on here can be remedied by turning off the HUD.
The biggest benefit is the sense of discovery you get yourself, without the GPS compass holding your hand, in both the world and in dungeons.
The connection to your character becomes more intuitive... with feeling dictating your actions rather than an on screen meter. No health meter means you take note of when the screen turns red... no crosshair means you have to shoot your bow with genuine skill rather than playing the line up the crosshair game. No stealth meter means you observe your own movement rather than stealth curser.
No HUD just adds so much to the game. Turning off the music will take it to another level, as the new discovery location sound will not sound. Then you could be standing next to a new ruin and not even notice you've found it. THAT is discovery.