UK Private Health Insurance: Custom Policy

Custom-Build Your Perfect UK Private Health Insurance Policy: Your Bespoke Guide to Tailored Cover

UK Private Health Insurance: How to Custom-Build Your Perfect Policy

In the UK, the National Health Service (NHS) is a cornerstone of our society, providing free at the point of use healthcare to all. However, faced with increasing waiting lists for specialist appointments, diagnostics, and elective surgeries, many individuals and families are exploring the benefits of private health insurance. But choosing a policy isn't a one-size-fits-all endeavour. To truly maximise the value and peace of mind that private medical insurance (PMI) offers, you need to custom-build a policy that precisely fits your unique health needs, lifestyle, and budget.

This comprehensive guide will demystify the process, breaking down every component of a UK private health insurance policy. We'll show you how to navigate the options, understand the jargon, and make informed choices to craft a policy that delivers exactly what you need, without paying for what you don't.

Why Custom-Build Your Private Health Insurance Policy?

Imagine buying a bespoke suit or a tailored dress. It fits perfectly, accentuating your best features and making you feel confident and comfortable. The same principle applies to private health insurance. A standard, off-the-shelf policy might seem convenient, but it rarely aligns perfectly with your individual circumstances.

Here's why customisation is key:

• Tailored to Your Health Needs: Are you concerned about musculoskeletal issues, or perhaps mental health support is a priority? Do you need comprehensive cancer cover, or are you primarily looking for quicker access to diagnostics? Customisation allows you to focus on the areas that matter most to you, within the constraints of what insurance covers.
• Optimised for Your Budget: Private health insurance can be a significant investment. By understanding and selecting specific cover levels and options, you can control your premium, ensuring you get the most value for your money. You avoid paying for features you'll never use.
• Reflects Your Lifestyle: Do you travel frequently? Are you a keen amateur sports person? Your daily life can influence the kind of medical attention you might need. A bespoke policy can account for these lifestyle factors.
• Addresses Specific Concerns (Non-Pre-existing/Chronic): While private health insurance doesn't cover pre-existing or chronic conditions, it can be tailored to give you peace of mind for new conditions that may arise. For instance, if you have a family history of a certain illness (but have never had it yourself), you might want robust diagnostic and treatment cover for that area.
• Flexibility and Adaptability: Your health needs change over time. A custom-built policy can be reviewed and adjusted at renewal, ensuring it continues to meet your evolving requirements.

Without a tailored approach, you might end up with a policy that's either too expensive for the level of cover you need, or worse, one that falls short when you genuinely need it.

The Foundation: Understanding Core Cover

Every private health insurance policy starts with a 'core cover' or 'inpatient cover' foundation. This is the bedrock, providing essential protection for serious medical conditions that require a hospital stay. It's often the most expensive component, and understanding its scope is crucial.

Core cover generally focuses on:

• Inpatient Treatment: Medical conditions that require you to be admitted to a hospital bed overnight. This includes accommodation in a private room, nursing care, consultant fees, and specialist procedures.
• Day-Patient Treatment: Procedures or treatments where you're admitted to a hospital bed for a few hours but don't stay overnight (e.g., minor surgery, chemotherapy sessions).
• Surgical Procedures: Both inpatient and day-patient surgeries are typically covered, including consultant fees, anaesthetist fees, and operating theatre costs.
• Diagnostic Tests (Inpatient/Day-patient): If you're an inpatient or day-patient, tests like MRI scans, CT scans, X-rays, blood tests, and other pathology tests are usually covered.
• Cancer Treatment (Basic): Most core policies will offer some level of cancer care for new diagnoses, often covering surgery, chemotherapy, and radiotherapy as an inpatient or day-patient. The extent of this cover can vary significantly between insurers.
• Post-Operative Care: Follow-up consultations and some physiotherapy directly related to an inpatient or day-patient procedure.

It's important to note that core cover typically does not include routine GP visits, A&E treatment, or extensive outpatient consultations and diagnostic tests unless you add optional extras.

Table: Common Core Cover Components

Your core cover sets the scene for what the policy is fundamentally designed to do: provide access to private hospitals for significant medical events. The next step is to consider how you want to enhance this foundation.

Layering Up: Optional Extras and How to Choose Them

This is where the 'custom-build' aspect truly comes into play. Optional extras allow you to tailor your policy to address specific health concerns, expand your access to private healthcare services, and fine-tune your budget. Each addition will increase your premium, so it's vital to select options that genuinely align with your needs.

Here are the most common and impactful optional extras:

1. Outpatient Cover

This is arguably the most frequently chosen add-on and for good reason. Core cover typically only provides inpatient diagnostic tests and consultations. Outpatient cover allows you to access private specialists for diagnosis and initial consultations without needing to be admitted to a hospital.

• Consultations: See a consultant privately for an initial assessment, follow-up, or second opinion.
• Diagnostic Tests: Get MRI, CT, X-rays, ultrasound, blood tests, and other pathology tests as an outpatient, often much faster than on the NHS.
• Minor Procedures: Some minor outpatient procedures that don't require an overnight stay.

Considerations:

• Full Cover: No limits on consultations or tests. This is the most comprehensive and expensive.
• Limited Cover: A set financial limit (e.g., £500, £1,000, £1,500 per year) for outpatient consultations and tests. Once the limit is reached, you'd pay out-of-pocket or use the NHS. This can be a good compromise for budget-conscious individuals.
• No Cover: You'd pay for all outpatient consultations and diagnostics yourself, or rely on the NHS. You'd only use your private insurance once admitted as an inpatient.

2. Therapies (Physiotherapy, Osteopathy, Chiropractic, Podiatry)

Often grouped with outpatient cover or available as a standalone module, this covers the costs of various therapies.

• Physiotherapy: For musculoskeletal issues, rehabilitation after injury or surgery.
• Osteopathy & Chiropractic: Manual therapies for joint, muscle, and nerve problems.
• Acupuncture/Podiatry: Some policies may include limited cover for these.

Considerations:

• Referral Needed: Most insurers require a GP or consultant referral before you can access therapy sessions.
• Session Limits/Financial Limits: Policies typically impose limits, e.g., 10 sessions per year, or a financial cap of £500-£1,000.
• Initial Diagnosis: Ensure you have outpatient cover or are willing to pay for the initial consultant diagnosis that leads to the therapy referral.

3. Mental Health Cover

With growing awareness and demand, mental health cover is becoming a popular and vital addition.

• Psychiatric Consultations: Access to private psychiatrists.
• Counselling & Psychotherapy: Sessions with accredited therapists (e.g., CBT, talking therapies).
• Inpatient Psychiatric Treatment: For more severe conditions requiring hospital admission.

Considerations:

• Exclusions: As with all conditions, pre-existing mental health conditions and chronic mental health conditions (e.g., schizophrenia, bipolar disorder) will not be covered. The policy covers new, acute episodes of mental ill-health.
• Limits: Often has separate, specific financial limits or session limits, which can be lower than physical therapy limits.
• Referral: Typically requires a GP or consultant referral.

4. Comprehensive Cancer Cover

While basic cancer cover is usually part of the core policy, this optional extra significantly enhances it.

• Extended Treatment Options: Access to a wider range of treatments, including some not yet available on the NHS, or newer, more expensive drugs.
• Post-Treatment Support: Cover for rehabilitation, psychological support, and specialist nursing care long after initial treatment.
• Palliative Care: In some cases, may include cover for end-of-life care within a private setting.

Considerations:

• Crucial for Peace of Mind: For many, this is a non-negotiable add-on due to the comprehensive nature of private cancer care.
• Genetic Testing: Typically not covered unless directly part of a diagnosis pathway for a new, acute condition.
• Proactive Screening: Routine screening (e.g., mammograms, colonoscopies for prevention) is generally not covered unless for diagnostic purposes after symptoms appear.

5. Dental and Optical Cover

These are often separate 'modules' and are more akin to cash plans than traditional health insurance, covering routine check-ups and minor treatments.

• Dental: Covers routine check-ups, hygienist appointments, fillings, and sometimes a percentage of major work like crowns or root canals, up to an annual limit.
• Optical: Covers eye tests, and a contribution towards glasses or contact lenses, up to an annual limit.

Considerations:

• Limits: Very strict annual financial limits apply, often quite low.
• Exclusions: Pre-existing dental issues (e.g., needing root canal for a long-standing problem) or cosmetic dental work are usually excluded.
• Alternatives: Sometimes more cost-effective to pay for these services directly or through a separate, dedicated dental/optical plan if your needs are high.

6. Hospital Choice / Network

This option directly impacts your premium and the hospitals you can access.

• Restricted List: You can only use hospitals from a specific, smaller list, often excluding premium Central London facilities. This results in a lower premium.
• Full National List: Access to virtually all private hospitals in the UK. This is the most expensive option.

Considerations:

• Location: If you live outside a major city, a restricted list might still include perfectly suitable local hospitals.
• Desired Hospitals: Check if your preferred hospitals or consultants are on the list before committing.

7. Other Less Common Add-ons

• Travel Cover: For emergency medical treatment when travelling abroad. Often limited compared to dedicated travel insurance.
• Health Cash Plans: For everyday health expenses not covered by PMI, like routine dental, optical, chiropractor, or sports massage. Often better sourced separately.
• Excess Waiver: Some policies offer an option to pay a higher premium to waive the excess in certain circumstances.

Table: Optional Extras and Key Considerations

Demystifying Underwriting: How Your Policy is Assessed

This is one of the most critical, yet often misunderstood, aspects of private health insurance. Underwriting is the process by which an insurer assesses your medical history to determine what they will and won't cover. It directly impacts your eligibility, the conditions covered, and ultimately, your peace of mind.

Crucial Point: Private health insurance in the UK does not cover pre-existing medical conditions or chronic conditions. This is a fundamental principle across all insurers. Understanding how your medical history is assessed is vital to avoid disappointment later.

What are Pre-Existing and Chronic Conditions?

Let's be crystal clear:

• Pre-existing Condition: Any disease, illness, or injury for which you have received medication, advice, or treatment, or experienced symptoms, before the start date of your private health insurance policy. This is true whether you were formally diagnosed or not.
• Chronic Condition: A disease, illness, or injury that has one or more of the following characteristics:
  • It needs ongoing or long-term management.
  • It requires long-term monitoring, consultations, check-ups, or examinations.
  • It requires rehabilitation or for you to be specially trained to cope with it.
  • It continues indefinitely.
  • It has no known cure.
  • It comes back or is likely to come back.

Examples of chronic conditions include diabetes, asthma, epilepsy, arthritis, high blood pressure, and many mental health conditions. Private health insurance is designed for acute conditions – those that respond quickly to treatment and can be cured or lead to a full recovery.

Types of Underwriting

There are two main types of underwriting for individual policies in the UK:

1. Full Medical Underwriting (FMU)

• How it Works: You complete a detailed medical questionnaire at the time of application, disclosing your full medical history. The insurer may also contact your GP for further information (with your consent).
• Pros:
  • Clarity from Day One: You know exactly what's covered and what's excluded before your policy starts. There are no surprises later if you need to make a claim.
  • Potentially Lower Premiums: Because the insurer has a full picture of your health, they can price the risk accurately, which can sometimes lead to lower premiums if you have a very clean medical history.
• Cons:
  • Time-Consuming: The application process takes longer as the insurer needs to review your history and potentially contact your GP.
  • Intrusive: Requires full disclosure of your medical past.

2. Moratorium Underwriting (Moratorium)

• How it Works: This is the most common type of underwriting. You generally don't have to provide a detailed medical history upfront. Instead, the insurer applies a 'moratorium' period (typically 2 years) during which any medical condition you've had symptoms, advice, or treatment for in the 5 years before your policy started will be excluded.
  • The "Clean Slate" Rule: If, after the initial 2-year moratorium period, you have been completely symptom-free, treatment-free, and advice-free for a pre-existing condition, it may then become eligible for cover.
• Pros:
  • Simpler & Faster Application: No detailed medical forms or GP reports needed upfront.
  • Immediate Cover: Your policy can start sooner.
• Cons:
  • Uncertainty at Claim Stage: You don't know for sure what's covered until you make a claim. If you claim for a condition, the insurer will then investigate your past medical history to see if it's pre-existing and if it falls within the moratorium rules. This can lead to unexpected exclusions.
  • Ongoing Exclusions: If a pre-existing condition is chronic or you experience symptoms within the 2-year moratorium, it will remain excluded.

3. Continued Personal Medical Exclusions (CPME)

• How it Works: This option is available when you're switching from an existing private health insurance policy with another insurer. Your new insurer will carry over the underwriting terms (and therefore the exclusions) from your previous policy.
• Pros:
  • Seamless Transition: You maintain continuity of cover for conditions that were already covered, and pre-existing conditions that were excluded on your old policy remain excluded on the new one.
  • No New Underwriting: Avoids having to go through a new underwriting process.
• Cons:
  • Not for First-Timers: Only applicable if you're already insured.

Table: Underwriting Types Comparison

Choosing the right underwriting type is a critical decision. If you have any medical history, discussing this with an expert like us at WeCovr can help you understand the implications of each option and determine which is best for your circumstances.

Cost Control: Managing Your Premium

Once you've decided on your core cover and desired optional extras, you can further fine-tune your policy to manage its cost. Premiums are influenced by several factors, including your age, location, and the level of cover chosen. However, there are also direct actions you can take to reduce your monthly or annual payments.

1. Choosing an Excess

An excess is the amount you agree to pay towards the cost of a claim before your insurer pays the remainder. It works much like an excess on a car insurance policy.

• How it Works: If you choose a £250 excess and your treatment costs £2,000, you pay the first £250, and the insurer pays £1,750. The excess is typically applied per condition per policy year, or sometimes per policy year regardless of the number of claims.
• Impact on Premium: The higher the excess you choose, the lower your premium will be.
• Considerations: Choose an excess you can comfortably afford to pay if you need to make a claim. A small excess (e.g., £0, £100) means a higher premium. A larger excess (e.g., £500, £1,000) can significantly reduce your premium but means you bear more of the initial cost.

2. The Six-Week NHS Wait Option

This is a popular option for those looking to significantly reduce their premium.

• How it Works: If the NHS can provide your required inpatient or day-patient treatment within six weeks, you agree to have it done on the NHS. Your private insurance policy only kicks in if the NHS waiting time for that specific treatment is longer than six weeks. Outpatient treatments are usually exempt from this wait.
• Impact on Premium: Can result in a substantial reduction in your premium (often 10-25%).
• Considerations: This option requires you to be comfortable using the NHS for non-urgent procedures if the wait is short. It's best suited for those primarily concerned about long waiting lists for specific, usually elective, treatments.

3. Hospital List Restriction

As mentioned earlier, restricting the list of private hospitals you can access can significantly lower your premium.

• Restricted List: Limits your choice to a defined network of hospitals, often excluding higher-cost facilities (e.g., in Central London or specific premium hospitals).
• Full National List: Provides access to almost all private hospitals in the UK, resulting in a higher premium.

Considerations: Review the restricted list to ensure it includes convenient and suitable hospitals near your home or work. If you primarily use local hospitals, a restricted list might be a perfect fit.

4. No Claims Discount (NCD)

Similar to car insurance, many health insurance policies offer a No Claims Discount.

• How it Works: For each year you don't make a claim, you accrue a discount on your premium for the following year. This discount typically builds up over several years to a maximum percentage.
• Impact on Premium: Can lead to substantial savings over time.
• Considerations: Making a claim will reduce your NCD. Some insurers offer "protected NCD" as an add-on, allowing you a certain number of claims without losing your discount, but this comes at an extra cost.

5. Annual vs. Monthly Payments

Paying annually often results in a slightly lower overall cost compared to paying monthly, as insurers sometimes add a small administration fee for monthly instalments.

6. Healthy Lifestyle Rewards

Some modern insurers, like Vitality, offer programmes that reward healthy living.

• How it Works: You can earn points for activities like going to the gym, walking, cycling, or having regular health checks. These points can translate into discounts on your premium, cashback, or rewards from partner companies.
• Impact on Premium: Can significantly reduce your premium over time if you actively engage with the programme.
• Considerations: Requires commitment to tracking and maintaining a healthy lifestyle.

Table: Premium Reduction Strategies

By strategically combining these cost control measures, you can create a policy that is not only perfectly tailored to your health needs but also to your financial comfort.

What Private Health Insurance Doesn't Cover (Crucial Exclusions)

Understanding what is not covered by private health insurance is just as important, if not more so, than understanding what is. Misconceptions in this area can lead to significant disappointment and financial strain when you most need support.

We've already touched upon pre-existing and chronic conditions, but let's reiterate and expand on other common exclusions:

1. Pre-existing Conditions

• Recap: Any condition you had symptoms of, received treatment for, or had advice about, before your policy started.
• Why Excluded: Insurers cover unforeseen future risks, not conditions that already exist or are likely to emerge based on past history. It would be akin to buying fire insurance after your house is already on fire.

2. Chronic Conditions

• Recap: Conditions that are long-term, ongoing, have no known cure, or require continuous management.
• Why Excluded: Private health insurance focuses on acute conditions that can be cured or lead to a full recovery. Chronic conditions require lifelong management, which would be an unsustainable cost for insurers. The NHS remains the primary provider for chronic disease management.

3. Emergency Treatment

• A&E and Emergency Services: Private health insurance does not cover A&E visits or emergency services that are critical for life or limb. These are always the domain of the NHS. If you have a true medical emergency, you should go to an NHS A&E department.
• GP Visits: Standard GP consultations are generally not covered, as GPs act as the gatekeepers to specialist care on the NHS. Some policies may offer a virtual GP service as an add-on, but this is for advice, not direct treatment cover.

4. Maternity and Infertility Treatment

• Maternity Care: Routine pregnancy and childbirth are almost universally excluded. Some policies may offer limited complications cover for specific, unexpected issues during pregnancy, but this is rare and not for elective births.
• Infertility Treatment: IVF, fertility investigations, and other infertility treatments are typically excluded.

5. Cosmetic Surgery

• Elective Procedures: Surgery purely for aesthetic reasons (e.g., nose job, breast augmentation for appearance) is not covered.
• Exceptions: May be covered if it's medically necessary and directly reconstructive after an accident, disease (e.g., breast reconstruction after mastectomy), or to correct a congenital abnormality that is causing significant physical or psychological distress.

6. Organ Transplants

• While related diagnostic tests might be covered, the actual cost of organ transplants and associated donor costs are almost always excluded due to their complexity and expense. These are typically handled by the NHS.

7. Self-Inflicted Injuries and Substance Abuse

• Treatment for injuries resulting from intentional self-harm or conditions arising from drug or alcohol abuse are generally excluded.

8. Experimental or Unproven Treatments

• Treatments that are not widely recognised as standard medical practice, or those still undergoing clinical trials, are usually not covered.

9. Routine Check-ups and Screenings (Unless Diagnostic)

• General health check-ups, routine blood tests without symptoms, or preventative screenings (e.g., routine mammograms or colonoscopies) are typically not covered unless they are diagnostic (i.e., you have symptoms and a consultant requests them to investigate a specific medical issue).

10. Overseas Treatment

• Unless you have a specific international or travel add-on, your UK private health insurance policy will only cover treatment within the UK.

Table: Common Exclusions from Private Health Insurance

Being aware of these exclusions upfront will manage your expectations and prevent potential frustration should you need to make a claim. This knowledge is an integral part of custom-building the right policy.

The Application and Claims Process

Understanding the journey from application to making a claim can alleviate anxieties and ensure a smoother experience.

The Application Process

1. Initial Enquiry: You'll typically start by gathering quotes. This is where a broker like WeCovr excels, comparing options from multiple insurers for you.
2. Information Gathering: You'll need to provide personal details (name, address, date of birth, occupation) and your chosen cover options (core cover, optional extras, excess, hospital list).
3. Underwriting Declaration: This is the critical step.
   • Full Medical Underwriting (FMU): You'll complete a detailed medical questionnaire. The insurer may then request a GP report (with your consent) to verify your history. This can take several weeks. Once reviewed, the insurer will confirm any specific exclusions for your policy.
   • Moratorium Underwriting: You won't need to provide a detailed medical history upfront. The policy can start much faster, but remember the 2-year moratorium on pre-existing conditions.
4. Quote & Acceptance: Based on your chosen options and underwriting, the insurer will provide a final quote. Once accepted and the first premium paid, your policy will commence.
5. Policy Documents: You'll receive your policy schedule, terms and conditions, and membership card. Read these carefully, especially the sections on what's covered and excluded.
6. Cooling-Off Period: All policies come with a statutory 14-day cooling-off period (sometimes longer). If you change your mind within this time, you can cancel and receive a full refund.

The Claims Process

This is where your private health insurance policy demonstrates its value.

1. GP Referral: If you develop a new medical condition, your first step is typically to consult your NHS GP. They can assess your symptoms and, if appropriate, provide an open referral to a private specialist. (Some policies with extensive outpatient cover might allow direct access to a private consultant, but a GP referral is generally best practice.)
2. Contact Your Insurer (Pre-Authorisation): This is crucial. Before any private consultation, diagnostic test, or treatment, you must contact your insurer to get pre-authorisation.
   • You'll provide details of your symptoms, the GP referral, and the consultant you wish to see.
   • The insurer will check if your condition is covered under your policy terms (e.g., not a pre-existing or chronic condition) and if the proposed treatment is medically necessary and within your chosen benefits.
   • They will provide an authorisation number for the consultation or treatment.
3. Consultation & Diagnosis: You attend your private consultant appointment. If further tests (MRI, CT, etc.) or treatment (physiotherapy, surgery) are recommended, you must get further pre-authorisation from your insurer for each step.
4. Treatment: Once authorised, you can proceed with treatment.
5. Payment:
   • Direct Billing: Most commonly, the hospital or consultant will bill your insurer directly using the authorisation number. This is the smoothest option for you.
   • Pay & Reclaim: In some cases, you might pay the bill upfront and then submit the invoices to your insurer for reimbursement. Ensure you have the authorisation number and itemised bills.
6. Follow-up: For ongoing treatment or follow-ups, continue to get pre-authorisation as required by your insurer.

Key Rule: Always obtain pre-authorisation before incurring any private medical costs. Failure to do so could result in your claim being declined, leaving you liable for the full cost.

Choosing the Right Insurer and Policy

With numerous reputable insurers in the UK market (e.g., Bupa, AXA Health, Vitality, Aviva, WPA, National Friendly), making the right choice can feel overwhelming.

When evaluating insurers, consider:

• Financial Stability: Is the insurer well-established and financially sound?
• Customer Service: How easy is it to contact them? Are their claims processes efficient and straightforward? (Online reviews can be helpful here).
• Hospital Network: Does their network include hospitals convenient for you, and those you trust?
• Policy Flexibility: Do they offer the range of customisation options you need?
• Pricing: Are their premiums competitive for the level of cover offered?

The Role of a Health Insurance Broker (Like WeCovr)

Navigating the complexities of private health insurance, comparing policies from different providers, and understanding the nuances of underwriting and exclusions can be a daunting task. This is where an independent health insurance broker, like us at WeCovr, becomes an invaluable asset.

Here's how we help you custom-build your perfect policy:

• Impartial Advice: We work for you, not for any single insurer. We provide unbiased recommendations based on your needs, not sales targets.
• Market Comparison: We have in-depth knowledge of policies from all major UK insurers. We can quickly compare features, benefits, exclusions, and pricing to find the most suitable options for you.
• Expert Guidance: We explain the jargon, clarify complex terms (like underwriting types or specific exclusions), and help you understand the implications of each choice.
• Needs Assessment: We take the time to understand your individual health concerns, lifestyle, budget, and priorities to help you identify which core elements and optional extras are truly beneficial.
• Saving You Time & Effort: Instead of spending hours researching different providers and filling out multiple forms, you just tell us what you're looking for once. We do the legwork.
• Simplifying the Application: We assist with the application process, ensuring all necessary information is provided accurately, which can speed up underwriting.
• Ongoing Support: Our support doesn't end once your policy is in place. We can assist with questions about claims, policy changes, and help you review your policy at renewal to ensure it remains the best fit.
• It's Free for You: Our services are typically funded by a commission from the insurer if you purchase a policy through us, meaning you get expert, personalised advice and support at no direct cost to you. The premium you pay is the same whether you go direct to an insurer or use a broker.

We believe that getting the right advice is paramount. We take pride in helping our clients custom-build policies that provide genuine peace of mind and excellent value.

Renewing Your Policy: A Chance to Re-Customise

Your private health insurance policy is typically reviewed annually. This renewal period is not just about paying another year's premium; it's a golden opportunity to reassess and re-customise your cover.

• Review Your Health: Has your health changed over the past year? Do you have new concerns (not pre-existing, of course) that might warrant adding more comprehensive cover (e.g., mental health or physiotherapy)?
• Assess Usage: Did you use your policy much? If you had a high excess and didn't claim, perhaps that worked well. If you hit your outpatient limits, maybe it's time to upgrade.
• Budget Check: Has your financial situation changed? Could you afford a higher excess to lower your premium, or do you have more budget to enhance your cover?
• Premium Increases: Insurers typically increase premiums at renewal due to age, general medical inflation, and any claims made. Don't simply accept the renewal offer.
• Market Review: This is where a broker like WeCovr can again provide immense value. We can compare your existing policy's renewal offer against new policies from other insurers, ensuring you continue to get the best value and most suitable cover. Sometimes, switching insurers, even for an identical level of cover, can result in significant savings.

Treat your annual renewal as a fresh opportunity to ensure your private health insurance remains perfectly tailored to your current needs.

Real-Life Examples of Customisation

Let's illustrate how different individuals might custom-build their policies:

Example 1: The Young, Healthy Professional (Age 30)

• Primary Goal: Quick access to diagnostics and specialist care for unexpected, acute issues, with a focus on affordability.
• Customisation:
  • Core Cover: Yes, essential.
  • Outpatient Cover: Mid-level (e.g., £1,000 annual limit) for consultations and diagnostics, assuming most issues are resolved quickly.
  • Therapies: Yes, with a moderate limit, as they are active and prone to sports injuries.
  • Mental Health: Yes, basic level, recognising the importance of early intervention for acute stress/anxiety.
  • Cancer Cover: Basic (as part of core cover) for now, might upgrade later.
  • Excess: High (£500 or £1,000) to keep premiums down.
  • Six-Week Wait: Yes, comfortable using NHS for non-urgent issues if the wait is short.
  • Hospital List: Restricted, as they primarily need local hospitals outside London.
• Result: A cost-effective policy providing excellent cover for unexpected acute conditions, while using the NHS for very minor or longer-wait issues.

Example 2: The Busy Parent with a Young Family (Age 45, two children)

• Primary Goal: Comprehensive cover for the family, peace of mind for common ailments and potential injuries, focus on quick access for children.
• Customisation:
  • Core Cover: Yes, for all.
  • Outpatient Cover: Full, unlimited cover for quick access to specialists for themselves and the children.
  • Therapies: Yes, generous limits, recognising the need for physio for sports, back issues, etc.
  • Mental Health: Full cover, acknowledging the pressures of modern life and the importance of prompt support.
  • Enhanced Cancer Cover: Yes, critical peace of mind for the whole family.
  • Dental & Optical: Might consider a separate cash plan for routine dental/optical, as limits on PMI are often low.
  • Excess: Moderate (£250 or £500) per person.
  • Six-Week Wait: No, prefers private for quicker access for most conditions.
  • Hospital List: Full National, or a broad regional list, to access specific paediatric specialists or family-friendly hospitals.
• Result: A robust policy designed for family needs, ensuring quick and comprehensive care for a range of new medical conditions.

Example 3: The Pre-Retirement Individual (Age 60)

• Primary Goal: Comprehensive cover for potential age-related acute issues, ensuring comfort and prompt access without long NHS waits.
• Customisation:
  • Core Cover: Yes, absolutely.
  • Outpatient Cover: Full, unlimited, to ensure prompt diagnosis and specialist consultations.
  • Therapies: Yes, generous limits for physiotherapy, osteopathy, and potentially podiatry for mobility and rehabilitation.
  • Mental Health: Moderate cover, understanding the need for support as life stages change.
  • Enhanced Cancer Cover: Definitely, often the highest priority for this age group, ensuring access to cutting-edge treatments.
  • Excess: Low (£0 or £100), as they prefer minimal out-of-pocket expenses at the point of claim.
  • Six-Week Wait: No, prioritises private access for all covered conditions.
  • Hospital List: Full National, for access to the best specialists and hospitals regardless of location.
• Result: A high-level, comprehensive policy that prioritises rapid access and extensive care for new conditions, offering maximum peace of mind in later life.

These examples highlight how versatile private health insurance can be when you take the time to custom-build it.

Conclusion: Your Health, Your Choice, Tailored by Experts

Custom-building your UK private health insurance policy is not just about saving money; it's about ensuring you have the right cover for your specific needs, providing genuine peace of mind when it matters most. From selecting your core foundation to layering on optional extras, choosing your underwriting type, and managing your premium with an excess or the six-week wait option, every decision plays a crucial role in shaping your perfect policy.

Remember, private health insurance is designed for acute, new conditions, and it unequivocally does not cover pre-existing or chronic conditions. Understanding these fundamental exclusions is paramount.

The journey to your ideal policy doesn't have to be complex or confusing. By taking a methodical approach and leveraging expert advice, you can navigate the options with confidence. At WeCovr, we are dedicated to simplifying this process, providing impartial guidance, comparing policies from all major UK insurers, and helping you custom-build the cover that truly fits. Our service comes at no cost to you, making expert advice accessible to all.

Don't settle for an off-the-shelf solution. Take control of your healthcare and invest in a policy that is as unique as you are.