TL;DR
As an FCA-authorised broker that has arranged over 900,000 policies of various kinds, WeCovr understands that your family's health is paramount. This guide demystifies private medical insurance in the UK, helping you find the best protection for your loved ones and navigate the options for children's cover with confidence. Family-friendly options for health insurance, what child cover includes, pregnancy exclusions, and tips for maximizing value when insuring dependents Navigating the world of private medical insurance (PMI) can feel complex, especially when you're making decisions for your entire family.
Key takeaways
- Speed of Access: Quickly see a specialist, such as a paediatrician, dermatologist, or ENT (Ear, Nose, and Throat) consultant, following a GP referral. This can lead to a faster diagnosis and treatment plan.
- Choice and Comfort: You can often choose the hospital and the specialist who treats you or your child. For in-patient stays, a private en-suite room is standard, which usually has space for a parent to stay overnight with their child, reducing stress for everyone.
- Access to Specialist Drugs and Treatments: Some policies provide cover for new or experimental drugs and therapies that may not yet be available on the NHS due to cost or other restrictions.
- Enhanced Mental Health Support: Many modern policies offer excellent mental health pathways, providing access to therapists and psychiatrists without the long waits often seen in Child and Adolescent Mental Health Services (CAMHS).
- 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 joint pain requiring a hip replacement, cataracts needing surgery, or hernias.
As an FCA-authorised broker that has arranged over 900,000 policies of various kinds, WeCovr understands that your family's health is paramount. This guide demystifies private medical insurance in the UK, helping you find the best protection for your loved ones and navigate the options for children's cover with confidence.
Family-friendly options for health insurance, what child cover includes, pregnancy exclusions, and tips for maximizing value when insuring dependents
Navigating the world of private medical insurance (PMI) can feel complex, especially when you're making decisions for your entire family. From understanding how to add a newborn to your policy to knowing what is and isn't covered for children, getting clear, expert advice is essential.
This comprehensive guide breaks down everything you need to know about family and children's health insurance in the UK. We'll explore the benefits, explain the cover in detail, clarify common exclusions like pregnancy, and provide practical tips to ensure you get the best possible value for your money.
Why Consider Private Medical Insurance for Your Family?
While the NHS provides an incredible service to the nation, parents are increasingly looking to private health cover for added peace of mind and faster access to care. The primary driver is often the desire to bypass long waiting lists for specialist consultations and treatments.
According to recent NHS England data, the overall waiting list for consultant-led elective care stands at well over 7 million. For a parent with a child suffering from a painful or worrying condition, waiting months for a diagnosis or treatment can be an incredibly stressful experience.
Key benefits of family PMI include:
- Speed of Access: Quickly see a specialist, such as a paediatrician, dermatologist, or ENT (Ear, Nose, and Throat) consultant, following a GP referral. This can lead to a faster diagnosis and treatment plan.
- Choice and Comfort: You can often choose the hospital and the specialist who treats you or your child. For in-patient stays, a private en-suite room is standard, which usually has space for a parent to stay overnight with their child, reducing stress for everyone.
- Access to Specialist Drugs and Treatments: Some policies provide cover for new or experimental drugs and therapies that may not yet be available on the NHS due to cost or other restrictions.
- Enhanced Mental Health Support: Many modern policies offer excellent mental health pathways, providing access to therapists and psychiatrists without the long waits often seen in Child and Adolescent Mental Health Services (CAMHS).
Ultimately, private medical insurance is about giving your family more options and control over your healthcare journey when you need it most.
How Does Family Health Insurance Work in the UK?
A family health insurance policy operates in a straightforward way. One person, the main policyholder, takes out the plan and then adds their partner and/or children as dependents. This consolidates everyone under a single policy, simplifying administration and often reducing the overall cost compared to taking out individual plans.
Children can typically remain on a family policy until they are 18 or, if they are in full-time education, up to their early 20s (e.g., 21 or 24, depending on the insurer).
The Golden Rule: Acute vs. Chronic and Pre-existing Conditions
Before we go any further, it's vital to understand the fundamental principle of private medical insurance in the UK.
PMI is designed to cover acute conditions that arise after you take out your policy.
- 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 joint pain requiring a hip replacement, cataracts needing surgery, or hernias.
- A chronic condition is an illness that is long-lasting and cannot be cured, only managed. Examples include asthma, diabetes, high blood pressure, and most types of eczema. Standard PMI does not cover the ongoing management of chronic conditions.
- A pre-existing condition is any illness, disease, or injury for which you have had symptoms, medication, advice, or treatment before your policy start date. These are typically excluded from cover.
Understanding this distinction is key to having the right expectations for what your family health insurance can and cannot do.
What Does Private Health Insurance for Children Typically Cover?
When you add a child to your policy, they generally receive the same level of cover as the adult policyholders. This cover is focused on providing diagnosis and treatment for new, acute conditions.
Here’s a breakdown of what is usually included and what is typically excluded.
| Feature Covered | Typically Included? | Notes |
|---|
| Specialist Consultations | Yes | For acute conditions after a GP referral to see specialists like paediatricians. |
| Diagnostic Scans (MRI, CT) | Yes | To investigate eligible symptoms and conditions. |
| Surgery & Hospital Stays | Yes | Cover for in-patient and day-patient procedures, including hospital fees and surgeon costs. |
| Cancer Treatment | Yes (Often comprehensive) | Most policies offer extensive cancer cover, including chemotherapy, radiotherapy, and surgery. |
| Mental Health Support | Often, as an add-on | May have limits on sessions or total financial benefit. Provides an alternative to long CAMHS waits. |
| Parent Accommodation | Yes | Most insurers cover the cost of one parent staying in the hospital with a child under a certain age. |
| Home Nursing | Yes | Post-operative care from a registered nurse at home can be included. |
| Pre-existing Conditions | No | Any condition your child had before the policy started will be excluded. |
| Chronic Conditions | No | Long-term management of conditions like asthma, diabetes, or eczema is not covered. |
| Routine Vaccinations | No | These are provided by the NHS as part of the national immunisation programme. |
| A&E Visits | No | Emergency care is always handled by the NHS. PMI does not cover emergencies. |
| Developmental Issues | No | The investigation and treatment of learning difficulties like dyslexia or developmental disorders like ADHD and autism are standard exclusions. |
| Routine Dental & Optical | No | These require separate dental insurance or a health cash plan. |
Example in Practice:
Imagine your 10-year-old son develops persistent knee pain after a football season. Your GP suspects a cartilage tear. With PMI, you could get a referral to a private orthopaedic specialist within days, have an MRI scan the following week, and if surgery is needed, it could be scheduled promptly at a private hospital of your choice.
The Crucial Point: Understanding Pregnancy and Childbirth Cover
This is one of the most frequently asked questions, and the answer is simple: standard UK private medical insurance does not cover routine pregnancy, childbirth, or post-natal care.
The entire UK private health insurance market is built on covering unforeseen risks, not planned life events. Because pregnancy is a planned event rather than an unexpected illness, insurers do not cover the costs of routine obstetric care, midwife appointments, or the delivery itself. The NHS provides comprehensive maternity services for all UK residents, and this remains the primary pathway for pregnancy and childbirth.
However, some policies may offer cover for unexpected medical complications that arise during pregnancy. These must be acute conditions that are not directly related to the normal course of pregnancy. For example, if a mother-to-be developed appendicitis during her second trimester, the treatment for that (an appendectomy) could be covered as it's an unrelated acute condition.
A few high-end, premium policies might offer a small "cash benefit" on the birth of a child, which is a fixed lump sum payment (e.g., £100-£250) to celebrate the new arrival, but this does not constitute cover for the birth itself.
Adding a Newborn to Your Policy: What You Need to Know
One of the most valuable features of a family policy is the ability to add your newborn baby. Most insurers offer a "newborn provision" with a key benefit:
If you add your baby to your policy within a specific timeframe (usually 90 to 120 days from birth), they can often be added on a "Medical History Disregarded" basis for that initial period.
This means that if the baby develops an unexpected condition in their first few months of life, before you have had a chance to add them to the policy, the insurer will still consider covering it once they are added. This provides invaluable protection against unforeseen health issues that can occur in a baby's early weeks.
It's crucial to contact your insurer or a broker like WeCovr as soon as possible after the birth to get your new child added to the policy and ensure continuous cover.
How Much Does Family Health Insurance Cost?
The cost of private medical insurance for a family can vary significantly based on several factors:
- Age and Number of Dependents: The age of the adults on the policy is a major factor. Children can often be added at a much lower cost, and some insurers have offers like "pay for the first child, get others covered for free."
- Location: Premiums are higher in areas with more expensive private hospitals, such as Central London.
- Level of Cover: A comprehensive plan with full out-patient cover, mental health support, and therapy options will cost more than a basic plan covering only in-patient treatment.
- Excess: This is the amount you agree to pay towards a claim. A higher excess (e.g., £500) will lower your monthly premium.
- Hospital List: Choosing a policy with a "guided" or regional hospital list, which excludes the most expensive facilities, can reduce your premium.
To give you an idea, here are some illustrative monthly premium ranges. Please note these are for guidance only and your quote will be specific to your circumstances.
| Family Profile | Location | Illustrative Monthly Premium Range |
|---|
| Couple (35) + 1 child (5) | Manchester | £90 - £160 |
| Couple (40) + 2 children (8, 11) | London | £190 - £320 |
| Single Parent (38) + 1 child (10) | Bristol | £80 - £130 |
The only way to know the true cost for your family is to get a personalised quote.
Top Tips for Maximizing Value on Your Family's Health Insurance
Getting the right cover isn't just about finding the cheapest policy; it's about finding the best value. Here are our expert tips for families:
- Compare the Market with an Expert Broker: The UK PMI market has numerous providers, each with different strengths. Using an independent, FCA-authorised broker like WeCovr costs you nothing. We do the hard work of comparing policies from leading insurers to find the one that best suits your family's needs and budget.
- Choose a Sensible Excess: Opting for a small excess of £250 or £500 can significantly reduce your premiums without making a claim unaffordable. Some insurers even offer a per-person excess, so you won't pay it multiple times for the same condition.
- Look for Family-Friendly Deals: Always ask about special offers for families. Many providers offer reduced premiums for the second, third, or fourth child, making it much more affordable to cover the whole family.
- Consider a 6-Week Option: This is a brilliant cost-saving feature. The policy will only pay for in-patient treatment if the NHS waiting list for that procedure is longer than six weeks. As many urgent procedures are done quickly on the NHS, this can be a pragmatic way to lower your premium while still having a safety net for longer waits.
- Use All the Added Benefits: Modern PMI is more than just hospital cover. Make full use of the "value-added" services, which often include:
- 24/7 Virtual GP: Get a GP appointment via phone or video call at any time, perfect for worried parents in the middle of the night.
- Wellness Programmes: Access to gym discounts, fitness trackers, and health advice. Customers who secure their health or life insurance through WeCovr receive complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app.
- Mental Health Hotlines: Confidential support lines for stress, anxiety, and other concerns.
- Bundle and Save: When you purchase PMI or life insurance through us, WeCovr can also offer discounts on other types of cover you may need, like travel or home insurance, delivering even more value.
- Review Your Policy Annually: A family's needs change. What was perfect for a couple with a toddler might not be right for a family with teenagers. An annual review with your broker ensures your cover remains relevant and competitively priced.
Wellness Beyond Insurance: Nurturing a Healthy Family
While insurance provides a crucial safety net, the foundation of a family's health is built on daily habits. Fostering a healthy environment at home not only improves wellbeing but can also reduce the need to claim.
- A Balanced Diet: Aim for regular family meals rich in fruits, vegetables, and whole grains. Involving children in cooking can make healthy eating more fun. The "5 A Day" target is a great goal for everyone.
- Stay Active Together: The UK Chief Medical Officers recommend children and young people get at least 60 minutes of moderate-to-vigorous physical activity each day. This doesn't have to be structured sport; family bike rides, walks in the park, or even a kitchen disco all count.
- Prioritise Sleep: A consistent sleep schedule is vital for children’s physical and mental development, and it's just as important for parents. A calm, screen-free wind-down routine before bed helps everyone switch off.
- Open Communication: Create a home where children feel safe to talk about their worries. Regular, open chats about feelings can build mental resilience and help you spot early signs of anxiety or stress.
The Role of an Expert Broker like WeCovr
Choosing a private medical insurance policy can be daunting. The terminology is confusing, and the differences between policies can be subtle but significant. This is where an expert broker adds immense value.
As an FCA-authorised broker with high customer satisfaction ratings, WeCovr acts as your advocate. Our role is to:
- Listen: We take the time to understand your family's unique needs, priorities, and budget.
- Research: We search the market, comparing policies from the UK's best PMI providers.
- Explain: We cut through the jargon and explain your options in plain English, ensuring you understand exactly what you are buying.
- Support: We assist with the application process and are here to help if you ever need to make a claim.
This expert service is provided at no cost to you. The insurer pays us a commission, so you get impartial advice and access to the best deals without paying a penny extra.
Can I get private health insurance just for my child?
Yes, many UK insurers offer child-only private medical insurance policies. However, it is often more cost-effective to add a child to a parent's or a family policy, as insurers frequently provide discounts or special offers for covering children as dependents. Comparing both options is the best way to find the most valuable solution.
Are routine dental and eye tests covered for children on PMI?
No, standard private medical insurance does not cover routine dental check-ups, treatments like fillings, or routine eye tests and glasses. These services are typically excluded. To get cover for them, you would need to purchase a separate dental insurance policy or a health cash plan, which provides money back for routine healthcare costs.
Do I need to declare my child's past illnesses when applying for health insurance?
Generally, yes. This depends on the type of underwriting you choose. With 'Full Medical Underwriting', you must complete a detailed health questionnaire and declare all pre-existing conditions. With 'Moratorium' underwriting, you don't declare them upfront, but any condition for which your child has had symptoms, treatment, or advice in the 5 years before the policy started is automatically excluded for at least the first 2 years of the policy.
Is the diagnosis of conditions like ADHD or autism covered by private health insurance?
Typically, no. The investigation, diagnosis, and treatment of developmental disorders, learning difficulties (like dyslexia), and behavioural conditions (like ADHD or autism spectrum disorder) are standard exclusions on most UK private medical insurance policies. These fall outside the scope of cover for acute medical conditions.
Secure Your Family's Health Today
Investing in private medical insurance is one of the most proactive steps you can take to protect your family's health and wellbeing. By providing fast access to expert care, it offers peace of mind when you need it most.
Ready to find the right health protection for your family? Speak to one of our friendly experts at WeCovr today. We'll compare the UK's leading insurers to find a policy that fits your needs and budget.
Get your free, no-obligation quote now and give your family the gift of health security.