At WeCovr, an FCA-authorised broker that has helped arrange over 800,000 policies, we understand that private medical insurance in the UK is not a ‘set and forget’ product. Your health, finances, and family needs evolve, and your policy should too. This guide will help you conduct a thorough annual review.
Why annual policy reviews matter, what changes to look for, and tips on updating coverage as personal or regulatory circumstances evolve
Think of your private medical insurance (PMI) policy like a car. It needs an annual MOT to ensure it’s still fit for purpose, running efficiently, and providing the protection you need. Forgoing an annual review is like driving without checking your tyres or oil – you might be fine for a while, but you risk a breakdown when you least expect it.
An annual review is your single best opportunity to ensure you have the right cover at the best possible price. Insurers update their products, your personal circumstances change, and the healthcare landscape itself is in constant flux. A policy that was perfect last year might be inadequate or overpriced today. This guide will walk you through every step of the review process, empowering you to make informed decisions about your health cover.
The Critical Importance of an Annual PMI Health Check
Renewing your private health cover without a proper review is a common but costly mistake. Each year, your renewal notice arrives, and it’s tempting to simply let it roll over. However, several factors make an annual assessment essential.
1. Managing Premium Inflation:
Your premium will almost certainly increase at renewal. This isn't just a random price hike; it's driven by three key factors:
- Age: As we get older, the statistical likelihood of needing medical treatment increases. Most insurers have age-related price bands, and moving into a new one means a higher base premium.
- Medical Inflation: The cost of private medical care—including new drugs, advanced diagnostic technologies, and specialists' fees—consistently rises faster than general inflation. According to industry analysis, medical inflation in the UK often runs between 8% and 12% per year.
- Claims History: If you've made a claim, you may see a reduction in your No Claims Discount (NCD), leading to a higher premium.
An annual review allows you to counteract these increases by adjusting your cover or comparing the market to find a more competitive option.
2. Aligning Cover with Your Life's Journey:
Life rarely stands still. A policy designed for a single person in their 20s is seldom suitable for a family of four or someone approaching retirement. Major life events should always trigger a policy review:
- Starting a Family: You'll want to add your newborn to the policy.
- Marriage or Partnership: It's often cheaper to have a joint policy than two single ones.
- Children Growing Up: When children leave home for university or start working, their cover needs might change.
- Career Changes: A new job might come with a corporate PMI scheme, meaning you can cancel your personal one. Conversely, leaving a job with company cover means you'll need to arrange a personal policy.
- Moving House: Your current insurer's "hospital list" might not have good coverage in your new area.
3. Responding to a Changing Healthcare Environment:
The UK's healthcare landscape is dynamic. Pressures on the NHS can have a direct impact on the value of your PMI. For instance, according to the latest data from NHS England, the waiting list for routine hospital treatment stood at over 7.5 million cases in 2024. Long waits for diagnostics and consultations make the rapid access offered by PMI more valuable than ever. An annual review helps you re-evaluate your "6-week wait" option and other features in light of current NHS performance.
A Critical Reminder: Pre-existing and Chronic Conditions
Before we delve deeper, it's vital to restate a fundamental rule of UK private medical insurance. Standard PMI policies are designed to cover acute conditions—illnesses or injuries that are short-term and likely to respond to treatment. They do not cover chronic conditions (like diabetes or asthma) or pre-existing conditions you had before taking out the policy. This is why understanding your underwriting is crucial when switching.
Decoding Your Renewal Pack: What to Scrutinise
When your renewal documents arrive, typically a month before your policy expires, don't just glance at the price. Here’s a checklist of what to examine closely.
| Document Section | What to Look For | Why It Matters |
|---|
| Renewal Premium | The total new cost and the percentage increase from last year. | This is the headline figure. A steep rise is your primary motivation to review your options. |
| Policy Schedule | Your level of cover, excess, outpatient limits, hospital list, and any add-ons. | Check that these are still appropriate for your needs. Has the insurer changed the name or composition of your hospital list? |
| Table of Benefits | A detailed breakdown of what is and isn't covered. | Insurers can change terms year-on-year. Look for new limits (e.g., on physiotherapy sessions) or new exclusions. |
| No Claims Discount (NCD) | Your current NCD level and how it has been applied. | Ensure it's correct. If you haven't claimed, it should have increased. If you have, it will likely have decreased. |
| Endorsements | Any special terms or personal exclusions applied to your policy. | These are crucial. They might relate to a previous medical issue and will carry over if you stay. |
Personal Circumstances: The Ultimate Driver of Change
Your policy should be a reflection of your life. Use your annual review as a moment to take stock of what has changed in the past year and what might change in the year ahead.
Key Life Events Triggering a PMI Review
-
Relationship Status:
- Getting Married/Civil Partnership: Insurers often offer a small discount for joint policies. It's also simpler to manage one policy than two.
- Separation/Divorce: You will need to separate a joint policy into two individual ones.
-
Growing Your Family:
- Having a Baby: Most insurers allow you to add a newborn to your policy without medical underwriting, but only if you do so within a specific timeframe (usually 3 months). Don't miss this window!
-
Your Children's Status:
- Turning 21 or 25: Children can typically stay on a family policy until their early-to-mid 20s, but the cut-off age varies. After this, they will need their own policy.
- Leaving Home: If they move to a different part of the country for university, check that your hospital list provides good coverage near them.
-
Career & Financials:
- New Job with PMI: You may no longer need your personal plan.
- Losing Company PMI: You'll need to secure personal cover. An expert PMI broker like WeCovr can help you transition smoothly, often on 'Continued Personal Medical Exclusions' (CPME) terms to maintain cover for conditions that arose under your old scheme.
- Salary Change: A pay rise might allow you to enhance your cover, whilst a drop in income may mean you need to find ways to reduce your premium.
- Retirement: This is a major trigger. You lose any company-provided cover and your risk profile changes. It's a critical time to get expert advice.
The Evolving UK PMI Market: Innovations and Trends for 2025
The private health cover market is not static. Insurers are constantly innovating to attract and retain customers, often in response to NHS pressures and changing consumer expectations.
Rise of Digital Health and Wellbeing Services
The best PMI providers now offer far more than just hospital treatment. Look for these valuable additions, which are often included as standard:
- Virtual GP Appointments: 24/7 access to a GP via phone or video call. This is incredibly convenient and can lead to faster referrals.
- Mental Health Support: Most top-tier policies now include extensive mental health cover, from therapy sessions to access to a 24/7 stress helpline. This is a huge shift from a decade ago when it was a common exclusion.
- Wellness Programmes: Insurers actively encourage healthy living. This can include:
- Discounted gym memberships.
- Wearable tech deals.
- Rewards for hitting activity goals.
- Access to health and wellbeing apps.
At WeCovr, we enhance this by providing our PMI and Life Insurance clients with complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, to support their health goals.
Navigating the Switch: A How-To Guide
If your review suggests your current policy is no longer the best fit, you have two main options: adjust your existing policy or switch to a new provider.
Option 1: Adjusting Your Current Policy
This is your first port of call, especially if you have recently had health issues. Contacting your insurer (or your broker) to discuss adjustments can yield significant savings.
Levers to Adjust Your Premium:
| Adjustment Option | How It Reduces Your Premium | Key Consideration |
|---|
| Increase Your Excess | You agree to pay a larger initial amount towards any claim (£250, £500, £1000). | The most effective way to lower premiums. Ensure the excess is an amount you can comfortably afford. |
| Introduce a 6-Week Wait | You only use your PMI if the NHS waiting list for the required treatment is longer than six weeks. | Can significantly cut costs, but you give up immediate private access for non-urgent conditions if the NHS is quick. |
| Reduce Outpatient Cover | Limit the value of your cover for consultations and diagnostics (e.g., to £1,000 or £500). | Scans and tests can be expensive. A lower limit might not cover the full cost of diagnosis. |
| Change Your Hospital List | Switch to a more restricted list of hospitals, excluding expensive central London facilities. | Check that the new list still provides convenient, high-quality options in your local area. |
Option 2: Switching to a New Provider
If another insurer offers better value or more suitable benefits, switching can be a great move. However, this must be done carefully, with full awareness of the underwriting implications. This is where using a specialist PMI broker is invaluable.
Understanding Underwriting on a Switch:
- Moratorium Underwriting: You won't fill out a medical questionnaire. The new insurer will automatically exclude treatment for any condition you've had symptoms of, or sought advice for, in the last 5 years. This exclusion can be lifted if you go 2 full years on the new policy without any trouble from that condition. This is a risky way to switch if you have a recent medical history.
- Full Medical Underwriting (FMU): You declare your full medical history. The insurer gives a definitive 'yes' or 'no' on what they will cover from the start. It provides clarity but may lead to specific exclusions.
- Continued Personal Medical Exclusions (CPME): This is the gold standard for switching. It allows you to move to a new insurer while keeping the same underwriting terms and exclusions you had on your old policy. It ensures continuous cover for conditions that have developed while you were insured. This option is typically only available through a broker.
Working with an independent broker like WeCovr gives you access to the whole market and expert guidance on the right underwriting method for your situation, ensuring you don't lose valuable cover by mistake. Our high customer satisfaction ratings reflect our commitment to finding the right solution for every client, at no cost to you.
Common Pitfalls to Avoid in Your Annual Review
- The "Loyalty Tax": Don't assume your current insurer is rewarding your loyalty. New customers often get the best deals. The Financial Conduct Authority (FCA) has introduced rules to ensure renewal prices are not higher than the equivalent new business price, but shopping around can still reveal better value.
- Focusing Only on Price: The cheapest private medical insurance UK policy is rarely the best. A low premium could hide a high excess, a very limited hospital list, or poor outpatient cover that leaves you with unexpected bills.
- Forgetting to Declare New Information: When switching and undergoing Full Medical Underwriting, you must be completely honest about your health history. Failing to declare something can invalidate your policy.
- DIY Switching: Going direct and choosing the wrong underwriting can lead to a loss of cover for conditions you thought were protected. A broker's advice here is priceless, yet their service is free to you.
Beyond the Policy: Maximise Your PMI's Value Year-Round
Your PMI is more than an emergency fund for surgery. It's a gateway to a healthier lifestyle.
- Get Active: Use the discounts on gym memberships and fitness trackers. Regular exercise is proven to reduce the risk of many acute and chronic conditions.
- Eat Well: Good nutrition is the foundation of health. Use tools like WeCovr's complimentary CalorieHero app to understand your diet and make healthier choices. A balanced diet can improve energy, aid sleep, and strengthen your immune system.
- Prioritise Sleep: Aim for 7-9 hours of quality sleep per night. It's vital for mental and physical recovery. If you're struggling, your policy's mental health or GP helpline may be able to offer support.
- Use the Digital GP: For minor concerns, a virtual GP is quicker than waiting for an in-person NHS appointment and can get you a referral faster if needed.
By engaging with these wellness benefits, you not only improve your health but also reduce your chances of needing to make a major claim, which can help keep your future premiums down.
What happens to my pre-existing conditions if I switch my PMI provider?
This depends on how you switch. If you switch on a 'Moratorium' basis, any condition you've had in the past 5 years will be excluded for at least the first 2 years of the new policy. However, if you switch using a broker on a 'Continued Personal Medical Exclusions' (CPME) basis, your existing underwriting terms are carried over. This means if a condition was covered by your old policy, it will be covered by your new one, offering seamless protection. This is a key reason to use a specialist broker.
Will making a claim dramatically increase my renewal premium?
Making a claim will likely cause your premium to be higher than it would have been otherwise, primarily because it will reduce your No Claims Discount (NCD). However, it does not mean your cover will become unaffordable. Insurers expect claims. An annual market review with a broker can help you find a new policy at a competitive price, even after a claim, or help you restructure your existing cover to manage the cost.
Can I add my new baby to my private health cover?
Generally, yes. Most UK insurers offer a 'newborn option' where you can add your baby to your policy, often without any medical underwriting. However, there is usually a strict time limit, such as within 3 or 4 months of the birth. It is crucial to contact your provider or broker as soon as possible after your baby is born to take advantage of this benefit and ensure they are covered.
Why should I use a broker like WeCovr instead of going directly to an insurer?
Using an independent broker like WeCovr costs you nothing, but provides immense value. We offer a whole-of-market comparison, not just one company's products. Our expert advisers help you navigate complex choices like underwriting and hospital lists, ensuring you don't make costly mistakes. We can also access special switching terms like CPME that aren't available to the public, and we handle the paperwork for you, saving you time and hassle.
Take Control of Your Health Cover Today
Your annual PMI review is a powerful tool for managing your health and your finances. By taking an hour each year to assess your policy against your needs and the wider market, you ensure you are always properly protected without overpaying.
Don't let your renewal roll over unchecked. Let the experts at WeCovr conduct a free, no-obligation market review for you. We'll compare top UK providers, explain your options in plain English, and help you secure the best possible private health cover. As a bonus, our clients also receive discounts on other insurance products, like life or income protection cover.
[Get Your Free, No-Obligation PMI Quote from WeCovr Today]