Can You Pause Private Health Insurance Without Losing Benefits
As an FCA-authorised expert with over 900,000 policies arranged, WeCovr understands that life's circumstances can change unexpectedly. This guide explores whether you can pause your private medical insurance in the UK, a process known as a policy holiday, without jeopardising your long-term health cover and benefits.
Rules and fees on policy holidays or suspensions in the UK market
The ability to pause or suspend your private health insurance is a valuable but often misunderstood feature. While it sounds like a simple "pause button," the reality is more complex. Most major UK insurers offer some form of policy suspension, but the rules, eligibility, and consequences vary significantly.
A policy "holiday" or "suspension" means you temporarily stop paying premiums, and in return, your health cover is put on hold. You cannot make any claims during this period. The primary appeal is to save money during times of financial pressure or extended travel without outright cancelling your policy.
However, this decision carries significant risks, particularly concerning your continuity of cover and how new medical conditions are treated upon your return.
What is a Private Health Insurance Policy Holiday?
Think of a policy holiday as a formal agreement with your insurer to take a temporary break from your contract. It's a structured pause, not a cancellation.
- During the Pause: You pay no premiums. Your cover ceases completely, meaning you cannot access any private medical treatment for new conditions that arise during this time.
- After the Pause: You resume paying premiums, and your cover is reinstated. However, the terms of reinstatement are crucial and can affect your future cover.
The key difference between a pause and a cancellation lies in the underwriting. When you cancel a policy, you sever the relationship. To get cover again, you must apply for a brand new policy, which will involve a full re-assessment of your health and age, almost certainly leading to new exclusions and higher costs. A suspension is designed to make resuming cover smoother, but as we'll see, it's not without its pitfalls.
Why Might You Need to Pause Your Health Insurance?
People consider pausing their PMI for several legitimate reasons. Understanding these can help you have a more productive conversation with your insurer or a broker like WeCovr.
- Financial Hardship: This is the most common reason. Sudden job loss, a reduction in income, or an unexpected large expense can make monthly premiums unaffordable. According to the Office for National Statistics (ONS), economic shifts can impact household discretionary spending, making insurance premiums a target for cuts.
- Extended Travel: If you're planning a sabbatical, a gap year, or a long-term work assignment abroad, your UK PMI policy is unlikely to cover you. Pausing it can seem logical, but you must have comprehensive travel insurance in its place.
- Temporary Employer Cover: You might start a new job that provides private health cover as a benefit. Pausing your personal policy could save you from paying for double cover.
- Joining the Armed Forces: Military personnel receive medical care through the Ministry of Defence, making personal PMI redundant during service.
Real-life Example: Meet Chloe, a 45-year-old marketing consultant with a PMI policy. She decides to take a six-month sabbatical to travel through Southeast Asia. She contacts her insurer to request a policy suspension for her travel period to save on premiums. The insurer agrees, but stipulates that any new medical conditions she develops while away will be treated as pre-existing and excluded when her policy resumes.
The Critical Difference: Acute vs. Chronic Conditions
Before diving deeper into policy suspensions, it's essential to understand a fundamental principle of the private medical insurance UK market.
Standard UK PMI is designed to cover ACUTE conditions that arise AFTER your policy begins.
- Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include joint replacements, cataract surgery, hernia repair, or treatment for an infection.
- Chronic Condition: A condition that is long-lasting, has no known cure, and needs ongoing management. Examples include diabetes, asthma, arthritis, hypertension, and Crohn's disease. PMI does not cover the routine management of chronic conditions.
- Pre-existing Condition: Any illness, disease, or injury for which you have had symptoms, medication, advice, or treatment before your policy started. These are typically excluded from cover, at least for an initial period.
This distinction is the single most important factor when considering a policy pause. Any new health issue that develops while your policy is suspended—from a bad back to a heart palpitation—will become a pre-existing condition when you reinstate your policy. This means it will likely be excluded from future cover.
Do UK Insurers Allow Policy Suspensions? A Provider-by-Provider Look
While most insurers offer the option, their generosity and terms differ. It is rarely an automatic right and is usually granted on a case-by-case basis. Below is a general overview of the typical stance of major UK providers.
Note: Policy terms are updated frequently. For the most accurate and current information, it's always best to consult an expert PMI broker like WeCovr, who can liaise with insurers on your behalf.
| Provider | Allows Suspension? | Typical Reason | Common Conditions & Rules |
|---|---|---|---|
| Bupa | Yes, on a case-by-case basis. | Financial hardship, travel abroad. | Usually requires the policy to be active for at least a year. Max suspension period is often 9-12 months. Re-underwriting may apply. |
| AXA Health | Yes, often called a 'break in cover'. | Redundancy, travel, maternity leave. | A minimum and maximum suspension period applies (e.g., 3-24 months). A written request is required. Age at reinstatement will affect the premium. |
| Aviva | Yes, considered on request. | Travel, unemployment. | Cover must typically be held for 12+ months. The suspension period is limited, and reinstatement is subject to terms. |
| Vitality | Yes, for specific circumstances. | Financial hardship, travel. | Often requires proof of circumstance. The moratorium clock for pre-existing conditions will be paused and will resume upon reinstatement. |
| WPA | Generally more flexible. | Known for customer-centric approach. | May offer options depending on individual circumstances and policy type. It's crucial to discuss directly or via a broker. |
The Risks of Pausing Your Private Medical Insurance
While saving money is tempting, pausing your health cover is a gamble. You are betting that you and your family will remain perfectly healthy during the break.
-
The New Pre-existing Condition Trap: This is the biggest risk. Let's say you pause your policy for six months. In month three, you develop shoulder pain. You see your NHS GP, who diagnoses it as a rotator cuff issue. When you reinstate your PMI, that shoulder problem is now a documented, pre-existing condition and will be permanently excluded from your private cover. Had your policy been active, you could have accessed prompt private diagnosis and treatment.
-
Resetting the Moratorium Clock: Most PMI policies in the UK are sold on a "moratorium underwriting" basis. This means any condition you've had in the five years before starting the policy is excluded. However, if you go for a continuous two-year period without any symptoms, treatment, or advice for that condition after your policy starts, it may become eligible for cover. Pausing your policy freezes this two-year clock. When you restart, the clock resumes from where it left off, delaying when a pre-existing condition might become eligible for cover.
-
Risk of Re-underwriting: Some insurers may reserve the right to re-underwrite your policy upon your return, especially if the suspension is long. This is like applying for a new policy. They will ask for an updated medical declaration, and any new conditions will be excluded. Your premium will also be recalculated based on your new age and any changes in your health.
-
Losing Continuous Cover Protection: Maintaining a continuous policy is highly valuable, especially as you get older. It protects you from having to declare new conditions. Giving up this continuity, even for a short time, can have long-term consequences for what you can claim for in the future.
Alternatives to Pausing Your Policy
Pausing should be a last resort. Before you take that step, explore these safer alternatives to reduce your premiums. An independent broker like WeCovr can be invaluable here, offering impartial advice tailored to your budget and needs.
1. Reduce Your Cover Level
This is often the best first step. You can lower your monthly premium significantly by adjusting your policy features without creating a gap in your cover.
- Increase Your Excess: The excess is the amount you pay towards a claim. Increasing it from £100 to £500 or £1,000 can reduce your premium by 20-40%. You're taking on more of the initial cost, but your major medical cover remains intact.
- Add a 6-Week Wait Option: This popular option can cut premiums substantially. It means you will use the NHS if the treatment you need is available within six weeks. If the NHS waiting list is longer, your private cover kicks in. Given current NHS waiting times (the NHS referral to treatment (RTT) waiting list stood at around 7.54 million in early 2024), this option often still results in you using your private cover.
- Limit Your Hospital List: Opting for a list of hospitals that excludes expensive central London facilities can lead to significant savings.
- Reduce Outpatient Cover: You could limit the value of your outpatient cover (e.g., to £500) or remove it entirely, relying on the NHS for initial diagnostics. This preserves your core benefit: cover for expensive inpatient surgery and treatment.
- Remove Optional Add-ons: Review your policy for extras like dental, optical, or mental health cover that you might not need right now.
2. Switch to a Different Provider
The private health cover market is competitive. Another insurer might offer a similar level of cover for a lower price. It's crucial to switch on a "Continued Personal Medical Exclusions" (CPME) basis. This underwriting method ensures that any conditions already covered by your current policy will continue to be covered by your new one.
This is where a PMI broker is essential. They can compare the entire market and manage the switching process to ensure no loss of cover for your existing medical history.
How to Request a Policy Suspension: A Step-by-Step Guide
If you've weighed the risks and still feel a suspension is your only option, follow this process carefully:
- Check Your Policy Documents: Before you call, read your policy terms and conditions. Search for keywords like "suspension," "break in cover," "policy holiday," or "premium holiday." This will tell you if the option is formally available.
- Contact Your Insurer or Broker: We recommend contacting your broker first. A good broker like WeCovr has experience negotiating with insurers and can advocate for you. If you go direct, be prepared to explain your situation clearly and calmly.
- Provide a Valid Reason & Evidence: Insurers are more likely to grant a suspension for a concrete reason like redundancy or extended travel. Be prepared to provide evidence, such as a redundancy letter or travel tickets.
- Get Everything in Writing: This is non-negotiable. Do not agree to anything over the phone without written confirmation. The letter or email should clearly state:
- The exact start and end dates of the suspension.
- Confirmation that you will pay no premiums during this period.
- The precise terms for reinstating the policy, especially regarding underwriting and pre-existing conditions.
- Your new premium upon reinstatement.
- Plan for Reinstatement: Set a reminder in your calendar a few weeks before the suspension period ends. Contact your insurer to confirm the reinstatement and the date your first premium will be taken. Do not assume it will happen automatically.
Beyond Insurance: Maintaining Your Health During a Policy Pause
If you do have a gap in cover, focusing on preventative health becomes even more important. Simple lifestyle choices can significantly reduce your risk of needing medical care.
- Nutrition and Diet: Focus on a balanced diet rich in fruit, vegetables, and whole grains. Planning meals can help you eat healthily and save money. As a WeCovr client, you get complimentary access to our AI-powered nutrition app, CalorieHero, to help you track your diet and make healthier choices.
- Stay Active: You don't need an expensive gym membership. Regular walking, cycling, home workouts, or jogging are excellent ways to maintain cardiovascular health. The NHS recommends at least 150 minutes of moderate-intensity activity a week.
- Prioritise Sleep: Aim for 7-9 hours of quality sleep per night. Good sleep is vital for your immune system, mental health, and physical recovery.
- Manage Stress: Find healthy coping mechanisms for stress, such as mindfulness, yoga, or spending time in nature. Chronic stress can have a real impact on your physical health.
- Travel Insurance: If you are pausing your policy to travel, securing comprehensive travel insurance is absolutely critical. It should cover medical emergencies, repatriation, and any specific activities you plan to do.
WeCovr's Added Value: More Than Just a Broker
Navigating the complexities of private medical insurance can be daunting. At WeCovr, we provide more than just quotes. We offer a complete service at no cost to you.
- Expert, Impartial Advice: As an FCA-authorised broker, our primary duty is to you, the client. We compare policies from across the market to find the best fit for your needs and budget.
- Help with Policy Management: We can help you negotiate a policy suspension or, more importantly, find viable alternatives like reducing your cover or switching providers on a CPME basis.
- Exclusive Benefits: We believe in promoting wellness. That's why our PMI clients receive complimentary access to the CalorieHero nutrition app.
- Customer Loyalty Discounts: When you purchase PMI or life insurance through us, we offer discounts on other types of cover you might need, such as home or travel insurance, providing even greater value.
- High Customer Satisfaction: Our focus on clear, honest advice and ongoing support has earned us consistently high ratings on major customer review platforms.
Pausing your private health insurance is a significant decision with potential long-term consequences. While it can provide short-term financial relief, it exposes you to the risk of new medical conditions being excluded in the future. In most cases, adjusting your cover or switching providers are far safer and more prudent alternatives.
Will pausing my health insurance affect my no-claims discount?
Can I make a claim for something that happened while my policy was paused?
Is it better to pause my policy or just reduce my cover level if I'm struggling financially?
Ready to review your options? Let our expert, friendly team help you find the right private health cover for your needs and budget. Get your free, no-obligation quote from WeCovr today and see how much you could save.
Related guides
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
By tapping the button below, you can book a free call with them in less than 30 seconds right now:
Our Group Is Proud To Have Issued 900,000+ Policies!
We've established collaboration agreements with leading insurance groups to create tailored coverage
How It Works
1. Complete a brief form
2. Our experts analyse your information and find you best quotes
3. Enjoy your protection!
Any questions?
Learn more
Who Are WeCovr?
WeCovr is an insurance specialist for people valuing their peace of mind and a great service.👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.
Just a quick and simple form and an easy conversation with one of our experts and your valuable insurance policy is in place for that needed peace of mind!