TL;DR
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr understands the importance of family health. This guide explores adding children to your private medical insurance in the UK, covering rules, costs, and the priceless peace of mind it brings. Rules, costs, and benefits of adding dependents to PMI Adding your children to a private medical insurance (PMI) policy is one of the most common and valued features of family health cover in the UK.
Key takeaways
- The Rules: Insurers have specific guidelines about who can be added as a dependent, age limits, and how pre-existing conditions are handled.
- The Costs: Adding children will increase your premium, but it's often more cost-effective than taking out separate policies for each family member.
- The Benefits: The primary advantage is bypassing long NHS waiting times for eligible treatments, giving you choice over specialists and hospitals, and providing a more comfortable, private healthcare experience.
- Speed of Access: This is the cornerstone of private healthcare. If your child needs to see a specialist, have diagnostic tests like an MRI, or undergo a common procedure like having grommets fitted, PMI can reduce the wait from months to mere days or weeks.
- Choice and Control: Private health cover gives you more control over your child's care. You can often choose the specialist or consultant who treats them and select a hospital that is convenient for your family, or one with a dedicated paediatric wing.
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr understands the importance of family health. This guide explores adding children to your private medical insurance in the UK, covering rules, costs, and the priceless peace of mind it brings.
Rules, costs, and benefits of adding dependents to PMI
Adding your children to a private medical insurance (PMI) policy is one of the most common and valued features of family health cover in the UK. It offers a powerful way to safeguard your family’s well-being, providing swift access to medical care when they need it most.
However, navigating the process involves understanding a few key areas:
- The Rules: Insurers have specific guidelines about who can be added as a dependent, age limits, and how pre-existing conditions are handled.
- The Costs: Adding children will increase your premium, but it's often more cost-effective than taking out separate policies for each family member.
- The Benefits: The primary advantage is bypassing long NHS waiting times for eligible treatments, giving you choice over specialists and hospitals, and providing a more comfortable, private healthcare experience.
This comprehensive guide will walk you through everything you need to know, empowering you to make the best decision for your family's health and financial future.
Why Consider Adding Your Children to Your Health Insurance?
For many parents, the health of their children is their number one priority. While the NHS provides excellent care, especially in emergencies, the strain on its resources can lead to significant waiting times for non-urgent diagnostics and procedures. This is where private health cover for your children becomes invaluable.
According to the latest NHS England data, the median waiting time for consultant-led elective care was around 15 weeks, with hundreds of thousands of patients waiting over a year for treatment. For a child in discomfort or pain, this can feel like a lifetime.
Key Benefits of Adding a Child to Your PMI:
- Speed of Access: This is the cornerstone of private healthcare. If your child needs to see a specialist, have diagnostic tests like an MRI, or undergo a common procedure like having grommets fitted, PMI can reduce the wait from months to mere days or weeks.
- Choice and Control: Private health cover gives you more control over your child's care. You can often choose the specialist or consultant who treats them and select a hospital that is convenient for your family, or one with a dedicated paediatric wing.
- Comfort and Privacy: A stay in the hospital can be a stressful experience for a child (and their parents). Private facilities typically offer a private en-suite room, making the experience more comfortable and less disruptive. This often allows one parent to stay overnight with their child, which is a huge comfort.
- Access to Specialist Paediatric Care: Many policies provide access to a network of hospitals and clinics that specialise in children's health, ensuring your child is seen by experts in their field.
- Peace of Mind: Knowing you have a plan in place to get your child the care they need, when they need it, is perhaps the greatest benefit of all. It removes the stress and uncertainty of waiting lists, allowing you to focus on your child's recovery.
A Real-Life Example
Imagine your eight-year-old son, Leo, is suffering from recurrent ear infections, impacting his hearing and school performance. His GP suggests he may need grommets, a minor but important procedure. On the NHS, you could face a wait of several months. With a family private health insurance policy, you could get a referral to a private ENT specialist within a week, and the procedure could be scheduled just a short time after that.
How to Add a Child to Your PMI Policy: The Practical Steps
Adding a dependent to your private medical insurance is usually a straightforward process. Whether you're taking out a new policy or amending an existing one, here are the typical steps involved.
1. For New Policies:
When you first apply for private health cover, you'll be asked who you want to include on the policy. Simply provide the names and dates of birth for your children. The insurer will then include them in your initial quote.
2. For Existing Policies:
If you already have a policy, you can usually add your children at any time, though it's most common to do so at your annual renewal.
- Contact Your Insurer or Broker: The first step is to call your provider or a broker like WeCovr. They will guide you through the process. It's often beneficial to use a broker, as they can ensure you're still on the best value plan after the changes are made.
- Provide Dependent's Details: You'll need to give your child's full name, date of birth, and answer some questions about their medical history.
- Choose the Underwriting Type: This is a crucial step. The insurer will apply an underwriting method to your child, just as they did for you. The two main types are:
- Moratorium Underwriting (Most Common): Your child will not be covered for any medical conditions they have had symptoms of, or received treatment for, in the five years before joining the policy. However, if they go for two continuous years on the policy without any symptoms, treatment, or advice for that condition, it may become eligible for cover. It's simple and requires no lengthy medical questionnaires.
- Full Medical Underwriting (FMU): You will complete a detailed health questionnaire about your child's medical history. The insurer will review this and explicitly list any conditions that will be excluded from cover from the outset. This provides certainty but can be more time-consuming.
- Receive Your New Policy Documents: Once approved, the insurer will send you updated documents confirming the new premium and that your child is now covered.
Adding a Newborn Baby
Most UK insurers have special rules for newborns, often called a "newborn clause." This allows you to add your new baby to your policy, usually within the first 3 to 6 months of their birth, without any medical underwriting. This means they can be covered immediately for eligible conditions, regardless of any health issues identified at birth. This is a significant benefit and a key reason to inform your insurer as soon as possible after your family grows.
Understanding the Costs: How Much Extra Will It Be?
Adding a child to your policy will increase your monthly or annual premium. However, the cost of adding a child is typically much lower than the premium for an adult, and family policies often have pricing structures that make it more affordable.
Several factors influence the final cost:
- Age of the Child: Premiums for children are low and don't change much until they reach their late teens or early 20s.
- Level of Cover: A comprehensive plan with full outpatient cover will cost more than a basic plan that only covers in-patient treatment.
- Policy Excess (illustrative): Choosing a higher voluntary excess (the amount you pay towards a claim) will lower your premium. A typical excess might be £100, £250, or £500.
- Hospital List: Policies with a limited list of local hospitals are cheaper than those offering access to premium central London hospitals.
Illustrative Cost Comparison
To give you an idea, here is a table with example monthly premiums for a mid-range policy. Please note these are for illustration only; your actual quote will depend on your specific circumstances.
| Policy Holder(s) | Example Monthly Premium (with £250 excess) |
|---|---|
| Single Adult (35) | £60 |
| Couple (Both 35) | £110 |
| Family (Couple 35, one child 8) | £145 |
| Family (Couple 35, two children 8 & 5) | £170 |
As you can see, the cost to add the first child is £35, and the second is only an additional £25. Many insurers use a "per-family" pricing model where you pay for the first child, and any subsequent children are often included at no extra cost. This can make family cover extremely good value. (illustrative estimate)
What's Covered? Typical Inclusions for Children's PMI
A good private medical insurance policy will cover your child for a wide range of acute conditions—that is, diseases, illnesses, or injuries that are likely to respond quickly to treatment.
Here’s a breakdown of what is typically included:
| Category | Common Covered Treatments and Services for Children |
|---|---|
| Diagnostics | Consultations with specialists, MRI/CT/PET scans, X-rays, blood tests. |
| In-patient & Day-patient Treatment | Hospital accommodation, surgeon and anaesthetist fees, nursing care, operating theatre costs. |
| Common Paediatric Surgeries | Grommet insertion, tonsillectomy, adenoidectomy, hernia repair, appendectomy. |
| Cancer Care | Comprehensive cover for chemotherapy, radiotherapy, and surgery. Many policies also include access to the latest approved cancer drugs, even those not yet available on the NHS. |
| Mental Health Support | Many modern policies include cover for a limited number of sessions with a child psychologist or psychiatrist for conditions like anxiety or depression. |
| Out-patient Cover (if selected) | Specialist consultations and diagnostic tests that don't require a hospital stay. |
| Therapies | Post-operative physiotherapy to aid recovery. |
What's Not Covered? Key Exclusions to Be Aware Of
This is the most important section to understand to avoid disappointment at the point of claim. Private medical insurance is designed to treat new, acute conditions that arise after you take out the policy. It is not a replacement for the NHS and does not cover everything.
Critical Exclusion 1: Pre-existing Conditions
No standard UK PMI policy will cover you or your child for medical conditions you had before taking out the cover.
- With Moratorium underwriting, any condition you’ve had symptoms, medication, or advice for in the 5 years before joining is excluded. This exclusion can be lifted if you go 2 full years on the policy without needing any treatment, advice, or medication for it.
- With Full Medical Underwriting, you declare all previous conditions, and the insurer will permanently exclude them from your cover.
Critical Exclusion 2: Chronic Conditions
PMI does not cover the routine, long-term management of chronic conditions. These are conditions that cannot be cured and require ongoing monitoring, such as:
- Asthma
- Diabetes
- Eczema
- Epilepsy
- Allergies
While the day-to-day management of your child's asthma (e.g., regular inhalers, GP check-ups) is not covered, PMI may cover an acute flare-up. For example, if a severe, unexpected asthma attack requires a hospital stay, this could be covered as an acute event. Always check the fine print of your policy.
Other Common Exclusions
- Emergency Care: A&E visits are handled by the NHS. PMI is for planned, non-emergency treatment.
- Normal Pregnancy & Childbirth: Routine maternity care is not covered, though complications of pregnancy may be.
- Developmental or Learning Difficulties: Conditions like ADHD, autism spectrum disorders, and dyslexia are typically excluded.
- Routine Dental & Optical Care: Check-ups and glasses are not covered unless you add a specific dental and optical cashback plan.
- Cosmetic Surgery: Procedures that are not medically necessary.
Comparing Family vs. Individual Policies: Which is Better?
When covering more than one person, you have two main options: a single family policy or separate individual policies. For most families, a joint policy is the superior choice.
| Feature | Family Policy | Separate Individual Policies |
|---|---|---|
| Cost | Usually more cost-effective due to family discounts and "free" cover for second/third children. | Almost always more expensive in total. |
| Administration | One policy, one set of documents, one renewal date, one direct debit. Much simpler to manage. | Multiple policies to manage, each with its own renewal date and paperwork. |
| Underwriting | The whole family is typically on the same underwriting basis (e.g., moratorium). | Can choose different underwriting for each person, but this adds complexity. |
| Flexibility | Less flexible. If one person needs a very high level of cover and others don't, you all pay for it. | More flexible. You can tailor each policy to the individual's needs (e.g., lower cover for children). |
Verdict: For the vast majority of families, a single family policy offers the best balance of cost, simplicity, and comprehensive cover. An expert PMI broker can help you run the numbers to see which approach works best for your unique situation.
Age Limits and Rules for Dependents on PMI
Children can remain on a family policy as dependents up to a certain age. This limit varies between insurers but typically falls into one of these categories:
- Up to age 18: This is the most basic limit.
- Up to age 21: A common upper limit.
- Up to age 24 or 25: This is often conditional on the child being in full-time education (e.g., at university) and still living at the family home or being financially dependent.
What Happens When Your Child Reaches the Age Limit?
When your child "ages out" of your family policy, they are no longer eligible for cover as a dependent. However, insurers offer solutions to ensure they don't lose their health cover.
The most common option is a Continuation Policy. This allows your child to take out their own individual policy with the same insurer without any new medical underwriting. This is a huge advantage, as it means any conditions that were covered under the family plan will continue to be covered under their new individual plan. They are effectively "carrying over" their underwriting terms.
It's crucial to arrange this continuation before your child is removed at renewal to ensure there is no gap in their cover.
Additional Perks and Wellness Benefits for Families
Modern private health insurance is about more than just paying for hospital stays. Insurers now offer a suite of wellness benefits and added-value services designed to keep your family healthy.
- Digital GP Services: Get a virtual GP appointment via phone or video call 24/7, often within a couple of hours. This is incredibly useful for parents worried about a child's symptoms late at night.
- Mental Health Support Lines: Access to confidential phone lines staffed by trained counsellors for you or your older children to discuss issues like stress, anxiety, or exam pressure.
- Wellness Apps and Discounts: Many providers offer discounts on gym memberships, fitness trackers, and healthy food. At WeCovr, we go a step further. All our PMI clients receive complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, helping your family build healthy eating habits.
- Multi-Policy Discounts: When you arrange your private medical insurance through us, we can also offer you preferential rates on other essential cover, such as life insurance or income protection.
Choosing the Right Provider for Your Family's Needs
The UK private medical insurance market is competitive, with major providers like Bupa, Aviva, AXA Health, and Vitality all offering excellent family policies. However, they differ in their cover levels, hospital lists, and approach to wellness.
Choosing the "best" provider depends entirely on your family's priorities and budget.
- Do you want the most comprehensive cancer cover?
- Is a wide choice of hospitals important?
- Are you interested in rewards for staying active?
- What is your ideal monthly budget?
This is where an independent PMI broker is indispensable. A specialist broker like WeCovr works for you, not the insurer. We take the time to understand your family's needs and then compare policies from across the market to find the perfect fit. Our service comes at no cost to you, but our expertise can save you hundreds of pounds and ensure you get the cover that truly protects your loved ones.
Do I need to declare my child's pre-existing conditions when adding them to my policy?
Can I add a newborn baby to my private health insurance policy immediately?
Is it cheaper to get a family policy or separate policies for each person?
What happens when my child is too old to be a dependent on my family policy?
Get Your Family Covered Today
Protecting your family's health provides a foundation of security and peace of mind. Adding your children to your private medical insurance is a simple, cost-effective way to ensure they can access the best possible care quickly, without the stress of long waiting lists.
At WeCovr, our expert advisors are ready to help you navigate your options. We'll compare the UK's leading insurers to find a policy that fits your family's needs and budget perfectly.
Contact WeCovr today for a free, no-obligation quote and give your family the gift of first-class health protection.
Sources
- NHS England: Waiting times and referral-to-treatment statistics.
- Office for National Statistics (ONS): Health, mortality, and workforce data.
- NICE: Clinical guidance and technology appraisals.
- Care Quality Commission (CQC): Provider quality and inspection reports.
- UK Health Security Agency (UKHSA): Public health surveillance reports.
- Association of British Insurers (ABI): Health and protection market publications.
