TL;DR
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr understands that your child's health is your top priority. This guide explains how child-only private medical insurance in the UK can provide peace of mind and swift access to high-quality care, even if you don't have a policy yourself. WeCovr's guide for parents seeking cover for children without adult policies Navigating the world of private health insurance can feel complex, especially when it’s for the most precious person in your life.
Key takeaways
- Pre-existing Conditions: Any medical condition, symptom, or ailment your child had before the policy start date will be excluded from cover.
- Chronic Conditions: Long-term, incurable conditions are not covered. This includes illnesses like asthma, diabetes, cystic fibrosis, and most types of eczema. While PMI might cover an acute flare-up of a chronic condition in some specific circumstances, the ongoing management of the condition itself will remain with the NHS.
- Accident & Emergency (A&E): Emergency care is always provided by the NHS. If your child has an accident or a sudden, life-threatening issue, you should go to A&E as usual.
- Speedy Access to Specialists: Avoid lengthy NHS waiting lists for paediatric consultations. If your GP refers your child to a specialist, a PMI policy can mean they are seen within days or weeks, rather than many months.
- Prompt Diagnosis: Faster access to diagnostic tests like MRI scans, CT scans, and X-rays can lead to a quicker diagnosis and the start of a treatment plan.
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr understands that your child's health is your top priority. This guide explains how child-only private medical insurance in the UK can provide peace of mind and swift access to high-quality care, even if you don't have a policy yourself.
WeCovr's guide for parents seeking cover for children without adult policies
Navigating the world of private health insurance can feel complex, especially when it’s for the most precious person in your life. Many parents are surprised to learn they can purchase a standalone private medical insurance (PMI) policy for their child, without needing to be insured themselves.
This comprehensive guide is designed to answer all your questions. We’ll break down what child-only cover is, why it’s worth considering, what it includes (and what it doesn’t), and how to choose the right plan for your family's needs and budget.
What Exactly is Child-Only Health Insurance?
Child-only health insurance is a type of private medical insurance policy designed specifically for an individual under the age of 18. It is a 'standalone' policy, meaning the parent or guardian who purchases it does not need to be a policyholder.
Think of it as a dedicated healthcare safety net for your child. Its primary purpose is to cover the costs of diagnosis and treatment for acute medical conditions that arise after the policy has started.
What is an Acute Condition? An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include infections, joint pains, hernias, or conditions requiring tonsil removal. This is the focus of private health cover.
This is fundamentally different from the care provided by the NHS, which is free at the point of use and covers all types of conditions, including emergencies and chronic care. A PMI policy works alongside the NHS, offering a choice-driven, faster alternative for non-urgent, treatable conditions.
The Critical Point: What UK PMI Does Not Cover
Before we go any further, it is vital to understand the limitations of all standard UK private medical insurance policies, whether for adults or children.
PMI is not designed to cover:
- Pre-existing Conditions: Any medical condition, symptom, or ailment your child had before the policy start date will be excluded from cover.
- Chronic Conditions: Long-term, incurable conditions are not covered. This includes illnesses like asthma, diabetes, cystic fibrosis, and most types of eczema. While PMI might cover an acute flare-up of a chronic condition in some specific circumstances, the ongoing management of the condition itself will remain with the NHS.
- Accident & Emergency (A&E): Emergency care is always provided by the NHS. If your child has an accident or a sudden, life-threatening issue, you should go to A&E as usual.
Understanding these exclusions from the outset is the key to having the right expectations and using your policy effectively.
Why Should Parents Consider Private Health Cover for a Child?
While the NHS provides excellent care, especially in emergencies, it is facing unprecedented pressure. For parents, this can translate into worry and long waits for specialist consultations and treatments.
According to the latest NHS England data from 2024, the total waiting list for consultant-led elective care remains stubbornly high, with millions of treatment pathways yet to be started. A significant portion of these waits exceeds the 18-week target from GP referral to treatment.
Here’s how a child-only PMI policy can offer significant benefits and peace of mind:
- Speedy Access to Specialists: Avoid lengthy NHS waiting lists for paediatric consultations. If your GP refers your child to a specialist, a PMI policy can mean they are seen within days or weeks, rather than many months.
- Prompt Diagnosis: Faster access to diagnostic tests like MRI scans, CT scans, and X-rays can lead to a quicker diagnosis and the start of a treatment plan.
- Choice and Control: You can often choose the specialist consultant and the hospital where your child receives treatment, giving you more control over their care.
- Comfort and Privacy: Treatment is delivered in a private hospital, which typically means a private, en-suite room. This can make a stressful experience far more comfortable for both the child and the parent staying with them.
- Access to Advanced Treatments: Some policies provide cover for newer drugs, therapies, or surgical techniques that may not be available on the NHS or have restricted access due to funding.
- Reduced Disruption: Quicker treatment can mean less time off school for your child and less time off work for you.
Real-Life Example: Imagine 8-year-old Leo develops persistent knee pain after playing football. His GP suspects a cartilage issue and refers him to an orthopaedic specialist. On the NHS, the wait to see a consultant could be several months, followed by another wait for an MRI scan. With a child-only PMI policy, Leo’s parents could get an appointment with a chosen specialist the following week, have the MRI shortly after, and schedule any required keyhole surgery promptly, getting him back to his active life much faster.
How Does a Child-Only Health Insurance Policy Work in Practice?
Using a child's PMI policy is a straightforward process. Here are the typical steps:
- Visit Your GP: Your first port of call for any health concern is your NHS GP. A private policy does not replace your GP.
- Get an Open Referral: If the GP believes your child needs to see a specialist, they will write a referral letter. It's best to ask for an 'open referral', which doesn't name a specific consultant. This gives your insurer the most flexibility to find a suitable, fee-approved specialist.
- Contact Your Insurer: Call your insurance provider's claims line. You'll need your policy number and the details from the GP referral letter.
- Claim Authorisation: The insurer will check that the condition is covered by your policy. They will then provide you with a list of approved specialists and hospitals from their network.
- Book Your Appointment: You can now book the private consultation and any subsequent tests or treatment.
- Direct Settlement: The insurance company will usually settle the bills directly with the hospital and specialists, so you don't have to handle invoices yourself (apart from paying your chosen excess).
At WeCovr, we not only help you find the perfect policy but can also offer guidance during the claims process, ensuring it's as smooth and stress-free as possible.
What's Typically Covered? A Breakdown of Core and Optional Benefits
Child-only PMI policies are built around a core foundation of cover, with optional extras you can add to create a more comprehensive plan.
Core Cover (Included as Standard)
This is the foundation of every policy and focuses on the most expensive treatments.
| Benefit | Description |
|---|---|
| In-Patient & Day-Patient Treatment | Covers all costs when your child is admitted to hospital for a bed overnight (in-patient) or for the day (day-patient). This includes surgery, accommodation, and nursing care. |
| Specialist & Surgeon Fees | Pays for the consultants who oversee your child's treatment and perform any necessary procedures. |
| Hospital Fees | Covers the cost of the operating theatre, drugs, and dressings used during their hospital stay. |
| Diagnostic Tests | Includes costs for tests like MRI, CT, and PET scans and pathology when they are part of an in-patient or day-patient admission. |
| Cancer Cover | Comprehensive cover for the diagnosis and treatment of cancer is a standard and crucial feature of all UK PMI policies. This often includes access to specialist drugs and therapies. |
Optional Add-Ons (To Enhance Your Cover)
These extras allow you to tailor the policy to your needs and budget. The most common add-on is out-patient cover.
| Benefit | Description |
|---|---|
| Out-Patient Cover | This is a highly recommended add-on. It pays for specialist consultations and diagnostic tests that do not require a hospital admission. Without this, you would have to pay for the initial consultations and scans yourself. It often comes in different levels (e.g., up to £500, £1,000, or unlimited). |
| Therapies Cover | Pays for a set number of sessions with physiotherapists, osteopaths, chiropractors, and sometimes speech therapists. Essential for recovery from injuries or surgery. |
| Mental Health Cover | A growing priority for parents. This can provide cover for consultations with psychiatrists and sessions with psychologists or therapists to support your child's mental wellbeing. |
| Dental & Optical Cover | Less common, but some policies allow you to add cover for routine dental check-ups, accidental dental injury, and contributions towards glasses or contact lenses. |
Understanding Underwriting: The Most Important Choice You'll Make
When you apply for health insurance, the insurer needs to assess the risk. This process is called underwriting. For child-only policies, there are two main types, and your choice has a big impact on what is and isn't covered.
1. Moratorium (Mori) Underwriting
This is the most common and simplest option.
- How it works: You don't complete a medical questionnaire. Instead, the policy automatically excludes cover for any medical conditions your child has had symptoms, treatment, medication, or advice for in the 5 years before the policy start date.
- The '2-Year Rule': An exclusion might be lifted if your child then goes for 2 continuous years on the policy without experiencing any symptoms or needing any treatment, medication, or advice for that condition.
- Pros: Quick and easy to set up. No need to dig out old medical records.
- Cons: There can be uncertainty at the point of claim, as the insurer will need to investigate your child's medical history to see if the condition is pre-existing.
2. Full Medical Underwriting (FMU)
This method provides more certainty from the beginning.
- How it works: You complete a detailed health questionnaire about your child's medical history. The insurer reviews this and then issues policy documents that explicitly state any conditions that are permanently excluded from cover.
- Pros: You know exactly what is and isn't covered from day one. There are no surprises when you need to make a claim.
- Cons: The application process takes longer. Any declared conditions are usually excluded permanently, with no chance of being covered later.
Which is right for your child? An expert PMI broker like WeCovr can help you decide. If your child has a clean bill of health, a Moratorium policy is often a great, simple choice. If they have a more complex medical history, FMU can provide valuable clarity.
How Much Does Child-Only Private Medical Insurance Cost?
The cost of a policy depends on several factors. It's often more affordable than parents think.
Key Factors Influencing Your Premium:
| Factor | How It Affects the Price |
|---|---|
| Child's Age | Premiums are generally very low for young children and increase slightly as they get older. |
| Location | Where you live matters. Premiums are highest in Central London due to the higher cost of private medical care there. |
| Level of Cover | A basic, core-only policy will be cheaper than a comprehensive plan with full out-patient and therapies cover. |
| Policy Excess | This is the amount you agree to pay towards the cost of a claim. A higher excess (e.g., £500) will significantly lower your monthly premium compared to a lower excess (e.g., £100). |
| Hospital List | Insurers have different tiers of hospital lists. Choosing a list that excludes the most expensive central London hospitals can reduce the cost. |
Illustrative Monthly Premiums for Child-Only PMI
The table below gives an indication of costs. These are estimates for a healthy child on a mid-range policy with a £250 excess.
| Child's Age | Location | Underwriting | Estimated Monthly Premium |
|---|---|---|---|
| 4 | Birmingham | Moratorium | £25 - £38 |
| 9 | Manchester | Moratorium | £30 - £45 |
| 13 | Outer London | Moratorium | £40 - £60 |
| 7 | Bristol | Full Medical | £28 - £42 |
Disclaimer: These are illustrative prices for 2025 and are for guidance only. The final premium depends on the insurer, chosen options, and individual circumstances.
The best way to get an accurate price is to get a comparison quote. WeCovr can compare the UK's leading insurers in minutes to find a policy that fits your budget.
Leading UK Providers of Child-Only Health Insurance
Several major UK insurers offer excellent standalone policies for children. Each has slightly different strengths and features.
| Provider | Key Strengths & Features | Why It Might Be a Good Fit |
|---|---|---|
| Bupa | Highly respected brand with an extensive network of hospitals and consultants. Their cancer cover is renowned. | A trusted, reliable choice offering a range of plans from essential to comprehensive. |
| Aviva | Strong digital offering, including a Digital GP service. Their 'Expert Select' claims process guides you to the best specialist. | Great for parents who value digital tools and a guided process at the point of claim. |
| AXA Health | Focus on a holistic approach to health. Often include generous mental health support and access to a 24/7 health support line. | A good option for parents who want comprehensive cover with a strong focus on overall wellbeing. |
| Vitality | Unique model that rewards healthy living. By tracking activity, children can earn rewards like cinema tickets and discounts. | Perfect for active families who will engage with the rewards programme to reduce premiums and earn perks. |
| The Exeter | A mutual society known for excellent customer service and a clear, straightforward approach. Well-regarded by brokers. | A great choice for parents looking for quality cover from a provider with a strong service reputation. |
Comparing these providers can be time-consuming. A broker does the hard work for you, presenting the options in a clear, easy-to-understand format.
Beyond Insurance: Tips for Your Child's Health and Wellbeing
A health insurance policy is a safety net, but prevention is always better than cure. Fostering healthy habits is one of the best gifts you can give your child.
- Balanced Nutrition: Encourage a varied diet rich in fruits, vegetables, lean proteins, and whole grains. The NHS "Eatwell Guide" is a fantastic resource. Limit processed foods, sugary drinks, and snacks.
- Great Sleep Hygiene: Consistent bedtimes are crucial for development, mood regulation, and immune function. The NHS recommends 9-12 hours for school-age children and 8-10 hours for teenagers.
- Stay Active: Children aged 5-18 should aim for at least 60 minutes of moderate to vigorous physical activity each day. This can be anything from playground fun and team sports to cycling or swimming.
- Open Conversations about Mental Health: Create a safe space for your child to talk about their feelings. Normalise conversations about stress, anxiety, and sadness. Simple activities like family dinners without screens can make a huge difference.
WeCovr Health & Wellbeing Perks As a WeCovr client, you get more than just insurance. We provide complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, to help your family make healthier food choices. Furthermore, clients who purchase private health or life insurance through us are eligible for exclusive discounts on other insurance products, helping you protect your family in every way.
Your Questions Answered: FAQs about Child-Only PMI
Can I get private health insurance for my child if they have a pre-existing condition?
Is it cheaper to get a child-only policy than adding my child to my own policy?
Do we still need the NHS if my child has private health insurance?
Take the Next Step with WeCovr
Choosing the right health insurance for your child is a significant decision. You need clarity, choice, and confidence that you're getting the best possible cover for your budget.
At WeCovr, our friendly, expert advisors are here to help. We are an independent, FCA-authorised broker, meaning our advice is impartial and focused entirely on your needs. We'll take the time to understand your requirements, explain your options in plain English, and compare the UK's leading insurers for you.
Our advice and comparison service is completely free, with no obligation to proceed. Let us handle the complexity so you can focus on what matters most: your child's health and happiness.
Ready to find the perfect health cover for your child? Contact WeCovr today for your free, personalised quote.
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.
