TL;DR
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr understands that choosing the right private medical insurance in the UK can be complex. When standard policies don't fit, specialist insurers like The Exeter and General & Medical offer compelling alternatives for those with specific needs. WeCovr looks at two specialist UK health insurers and their policies In the bustling UK private health cover market, dominated by household names, it’s easy to overlook the specialist providers.
Key takeaways
- Acute Condition: Curable. Examples include appendicitis, a broken bone, or infections that can be resolved with a course of treatment. PMI is designed for these.
- Chronic Condition: Not curable. These are long-term conditions that can be managed but not cured. Examples include diabetes, asthma, arthritis, and high blood pressure. Standard UK PMI policies do not cover the routine management of chronic conditions.
- Tailored Underwriting: They may have more flexible criteria for applicants, such as those who are older or have a complex medical history.
- Niche Expertise: They build deep knowledge in specific areas, like cover for professional athletes or specific industry groups.
- Personalised Service: As smaller organisations, they can sometimes offer a more personal and responsive customer service experience.
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr understands that choosing the right private medical insurance in the UK can be complex. When standard policies don't fit, specialist insurers like The Exeter and General & Medical offer compelling alternatives for those with specific needs.
WeCovr looks at two specialist UK health insurers and their policies
In the bustling UK private health cover market, dominated by household names, it’s easy to overlook the specialist providers. Yet, for many people, these niche insurers offer a more tailored, flexible, and often more suitable solution. Two such providers are The Exeter and General & Medical.
While one is a historic Friendly Society known for its inclusive approach, the other is a dynamic provider with deep roots in the sports and professional sectors. This article will dissect their offerings, compare their strengths, and help you understand which might be the perfect fit for your unique circumstances.
Understanding Private Medical Insurance in the UK
Before we dive into the specifics, let's clarify what private medical insurance (PMI) is and, crucially, what it isn't.
PMI is an insurance policy designed to cover the costs of private healthcare for acute conditions that arise after your policy begins. An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Think of things like joint replacements, cataract surgery, or hernia repairs.
The Critical Distinction: Acute vs. Chronic Conditions
This is the single most important concept to grasp in UK health insurance.
- Acute Condition: Curable. Examples include appendicitis, a broken bone, or infections that can be resolved with a course of treatment. PMI is designed for these.
- Chronic Condition: Not curable. These are long-term conditions that can be managed but not cured. Examples include diabetes, asthma, arthritis, and high blood pressure. Standard UK PMI policies do not cover the routine management of chronic conditions.
Similarly, pre-existing conditions – any illness or injury you had before taking out the policy – are typically excluded from cover, at least for an initial period. This is a fundamental principle of private health cover in the UK. PMI is there to complement the excellent emergency and chronic care services of the NHS, not to replace them.
Why Choose a Specialist Health Insurer?
With major providers like Bupa and AXA offering a wide range of products, why look to a specialist? The answer lies in focus. Specialist insurers often excel in areas where larger companies may be more rigid.
- Tailored Underwriting: They may have more flexible criteria for applicants, such as those who are older or have a complex medical history.
- Niche Expertise: They build deep knowledge in specific areas, like cover for professional athletes or specific industry groups.
- Personalised Service: As smaller organisations, they can sometimes offer a more personal and responsive customer service experience.
- Unique Benefits: Their policies often include benefits and features specifically designed for their target audience.
Choosing a specialist can mean finding a policy that feels like it was made just for you, rather than a one-size-fits-all product.
Meet the Contenders: The Exeter and General & Medical at a Glance
Let's introduce our two specialists. While both operate outside the "big four," they have distinctly different origins and areas of focus.
The Exeter is a Friendly Society, which means it's a mutual organisation owned by its members, not shareholders. Established in 1927, its ethos is built around its community of members. Their reputation is built on providing cover to individuals who might be overlooked elsewhere, including older applicants and the self-employed.
General & Medical was founded in the 1980s and has carved out a strong identity providing flexible health insurance solutions for individuals, families, businesses, and particularly, sports professionals and associations. They are known for their tiered policy structure and specialist schemes.
Here is a brief overview of how they compare at a high level:
| Feature | The Exeter | General & Medical |
|---|---|---|
| Organisational Structure | Friendly Society (owned by members) | Private Company |
| Primary Niche | Older applicants, self-employed, flexible underwriting | Sports professionals, corporate & group schemes |
| Policy Structure | Core cover with optional add-ons | Multiple tiers of pre-packaged cover |
| Upper Age Limit to Join | None | Typically 74 or 75 for new policies |
| Key Strength | Inclusivity and community-rated renewals for over 70s | Bespoke schemes and specialist sports cover |
A Deep Dive into The Exeter’s Health+ Policy
The Exeter’s flagship private medical insurance UK policy is called Health+. It’s built on a clear, modular principle: a comprehensive core cover to which you can add optional extras.
Core Cover: The Foundation of Your Policy
Every Health+ policy includes the following as standard:
- In-patient and Day-patient Treatment: Covers hospital fees, specialist charges, and diagnostic tests when you are admitted to a hospital bed (even for a day).
- Cancer Cover: Comprehensive cover for the diagnosis and treatment of cancer, including surgery, radiotherapy, chemotherapy, and monitoring.
- Post-operative Consultations: Covers specialist consultations for up to six months after eligible surgery.
- NHS Hospital Cash Benefit: If you choose to receive eligible treatment on the NHS instead of privately, you receive a cash payment for each night you spend in an NHS hospital.
- Private Ambulance & Home Nursing: Covers costs for private road ambulances and necessary home nursing after in-patient treatment.
- Parent Accommodation: Pays for a parent to stay in hospital with a child under 18 undergoing treatment.
Optional Add-ons for Tailored Cover
This is where you can customise the policy to your needs and budget.
| Optional Extra | What It Covers | Who It's For |
|---|---|---|
| Out-patient Cover | Specialist consultations, diagnostic tests, and scans that don't require a hospital bed. Available in different limits (£500, £1,000, or unlimited). | Anyone who wants faster diagnosis and access to specialists without waiting for a GP referral to the NHS hospital system. |
| Therapies Cover | Physiotherapy, osteopathy, chiropractic treatment, and acupuncture. Can be added if you have selected out-patient cover. | Individuals with active lifestyles, those prone to musculoskeletal issues, or anyone who wants fast access to physical therapies. |
| Mental Health Cover | Covers specialist consultations and in-patient/day-patient psychiatric treatment. | Anyone wanting to ensure they have robust support for their mental wellbeing. |
The Exeter’s Key Differentiators
What makes The Exeter stand out in a crowded market?
- No Upper Age Limit: You can apply for a new policy at any age. This is a significant benefit for those seeking cover in later life, as many insurers impose an age cap of 65 or 75 for new members.
- Community-Rated Renewals: For members aged 70 and over, The Exeter pools the claims risk across that age group. This helps to protect individuals from sharp premium increases based solely on their own claims history as they get older.
- Healthwise Member App: This is a fantastic value-add, providing all members with access to remote GP appointments, mental health support, and physiotherapy triage at no extra cost.
- Flexible Underwriting: They are known for taking a more individual approach to applicants with some pre-existing conditions, sometimes offering cover where others might decline.
The Exeter is often the best PMI provider for:
- Individuals over 60 looking for new cover.
- The self-employed who value income protection and health insurance from the same provider.
- People with a minor or well-managed medical history who have struggled to get cover elsewhere.
Unpacking General & Medical’s Policies
General & Medical takes a different approach. Instead of a single core product with add-ons, they offer a range of tiered policies. This allows you to choose a package that most closely matches your desired level of cover and budget from the outset.
Their main policy options include:
- Essentials: A budget-friendly plan focused on in-patient and day-patient treatment, with some cancer cover.
- Everyday: Builds on the Essentials plan with the addition of out-patient consultations and diagnostics.
- Lifestyle: A mid-range comprehensive option with more generous out-patient and therapy limits.
- Premier: A high-tier plan with enhanced benefits and higher financial limits.
- Elite: Their top-level cover, offering extensive benefits including private GP, dental, and optical cover.
A Comparison of General & Medical's Policy Tiers
| Benefit | Essentials | Everyday | Lifestyle | Premier | Elite |
|---|---|---|---|---|---|
| In-patient & Day-patient | Full Cover | Full Cover | Full Cover | Full Cover | Full Cover |
| Out-patient Consultations | Not Covered | Up to £750 | Up to £1,000 | Up to £1,500 | Full Cover |
| Therapies Cover | Not Covered | Not Covered | Up to £500 | Up to £1,000 | Up to £1,500 |
| Mental Health Cover | Limited | Limited | Included | Enhanced | Comprehensive |
| Dental & Optical | Not Covered | Not Covered | Not Covered | Not Covered | Included |
Note: This table is illustrative. Benefit limits are subject to change and the full policy documents should be consulted. A broker like WeCovr can provide the most up-to-date details.
General & Medical's Specialist Focus
Where General & Medical truly shines is in its specialisms.
- Sports Health Insurance: This is their standout niche. They have deep expertise in providing cover for professional and semi-professional athletes, sports clubs, and governing bodies. Their policies can be tailored to cover injuries sustained during training and competition – something explicitly excluded by most standard PMI policies.
- Corporate and Group Schemes: They are highly adept at creating bespoke private health cover schemes for businesses and professional associations. This allows organisations to offer a highly valued employee benefit that is tailored to the specific needs of their workforce.
- Health and Wellbeing Services: All members get access to a 24-hour GP advice line, stress counselling helplines, and online health resources, providing support beyond just insurance claims.
General & Medical is an excellent choice for:
- Amateur or professional sportspeople.
- Sports clubs and associations.
- Companies seeking a flexible and tailored group PMI scheme.
- Individuals who prefer a tiered "package" approach to buying insurance.
Head-to-Head Comparison: The Exeter vs General & Medical
Let's put them side-by-side on the features that matter most to UK consumers.
| Feature | The Exeter (Health+) | General & Medical (Tiered Policies) | WeCovr's Expert Take |
|---|---|---|---|
| Target Audience | Older applicants, self-employed, those needing underwriting flexibility. | Sports professionals, corporate groups, individuals wanting packaged cover. | This is the key difference. Your personal profile will heavily influence which is a better fit. |
| Policy Structure | Core policy + optional modules (Out-patient, Therapies, Mental Health). | Tiered packages (Essentials, Everyday, Lifestyle, etc.) with increasing benefit levels. | The Exeter's model offers more granular control, while G&M's is simpler to understand at a glance. |
| Cancer Cover | Comprehensive cover as standard on all policies. | Included on all tiers, but the extent of cover (e.g., for monitoring, experimental drugs) can vary by tier. | Both offer strong cancer cover, but The Exeter's is more uniformly comprehensive across the board. |
| Mental Health | An optional add-on for comprehensive cover. Healthwise app provides initial support. | Level of cover depends on the policy tier chosen. Higher tiers offer more extensive psychiatric cover. | If mental health is a priority, you need to compare the cost of The Exeter's add-on versus a higher G&M tier. |
| Member App | Healthwise: A powerful app with remote GPs, physio, and mental health support. | Focus is more on telephone helplines and online resources rather than a single integrated app. | The Exeter has a clear advantage here with its feature-rich and highly-regarded Healthwise app. |
| Hospital List | A national list of quality private hospitals. Options to reduce the list for a lower premium. | A range of hospital lists tied to different policy tiers and price points. | Both offer good access, but checking that your local private hospital is on the list is crucial. WeCovr can do this for you. |
| Excess Options | Wide range from £0 to £5,000, allowing for significant premium control. | Good range of excess options, typically from £100 upwards. | Both providers offer great flexibility here, which is a key way to manage the cost of your premium. |
| No Claims Discount | A straightforward scale, rewarding members for not claiming. Protected NCD is available. | A standard NCD structure is in place to reward claim-free years. | The mechanics are similar. An independent PMI broker can model how a claim would affect future premiums with each. |
The Cost Factor: What Influences Your PMI Premium?
It's impossible to give a single price for PMI, as it's highly personalised. Your premium is calculated based on several factors:
- Age: Younger applicants pay less.
- Location: Premiums are often higher in London and the South East due to higher hospital costs.
- Level of Cover: An all-singing, all-dancing policy will cost more than a basic one.
- Excess: A higher excess (the amount you pay towards a claim) means a lower premium.
- Underwriting Type: Moratorium underwriting is often cheaper initially than Full Medical Underwriting.
To illustrate, a 35-year-old non-smoker in Leeds seeking mid-level cover might pay between £40-£60 per month. A 65-year-old in London seeking comprehensive cover could expect to pay upwards of £200-£300 per month. These are purely illustrative figures.
This is where working with a broker like WeCovr is invaluable. We use our market knowledge to find the provider and policy that offers the best value for your specific needs and budget, saving you time and money.
Beyond the Policy: Wellness, Support, and Added Value
Modern private health insurance isn't just about paying claims. The best PMI providers help you stay healthy.
The Exeter's Healthwise app is a prime example of this. Having on-demand access to a GP can help you deal with health niggles before they become major problems. Getting swift access to a physiotherapist can prevent an ache from becoming a chronic injury.
General & Medical's helplines provide a vital source of support for stress and other wellbeing concerns. Proactive health management is a cornerstone of their service.
At WeCovr, we enhance this further. When you take out a PMI or Life Insurance policy through us, we provide:
- Complimentary access to CalorieHero: Our AI-powered calorie and nutrition tracking app to help you manage your diet and health goals.
- Exclusive discounts: You'll receive discounts on other types of cover you might need, such as travel or home insurance, adding even more value.
Navigating the Small Print: Key Terms You Need to Know
The world of insurance is full of jargon. Here are some key terms explained in Plain English.
- Acute Condition: A health condition that comes on suddenly, has a limited duration, and is expected to be cured with treatment. This is what PMI covers.
- Chronic Condition: A long-term health condition that cannot be cured, only managed (e.g., diabetes, asthma). PMI does not cover this.
- Pre-existing Condition: Any health issue you had, sought advice for, or experienced symptoms of before your policy start date. These are typically excluded.
- Moratorium (Mori) Underwriting: A popular option where the insurer doesn't ask for your full medical history upfront. Instead, they will exclude any condition you've had in the 5 years before the policy started. However, if you go 2 full years on the policy without any treatment, advice, or symptoms for that condition, it may become eligible for cover.
- Full Medical Underwriting (FMU): You provide your full medical history at the start. The insurer reviews it and tells you exactly what is and isn't covered from day one. It provides certainty but can take longer.
- Excess: The fixed amount you agree to pay towards the cost of any claim you make. For example, if your excess is £250 and your treatment costs £3,000, you pay £250 and the insurer pays £2,750.
- Hospital List: The list of private hospitals and facilities where your policy will cover you for treatment.
Real-Life Scenarios: Which Insurer Fits Best?
Let's apply our knowledge to some common situations.
Scenario 1: Barbara, the 69-year-old retiree. Barbara is active and healthy but wants the peace of mind of private health cover for the first time. Many insurers have turned her down due to her age.
- Best Fit: The Exeter. Their policy has no upper age limit for joining, and their community rating for over-70s will protect her from steep individual premium hikes in the future.
Scenario 2: David, the 26-year-old semi-pro rugby player. David's biggest concern is getting injured during a match and facing a long NHS wait for treatment, affecting his career.
- Best Fit: General & Medical. Their specialist sports cover is designed for exactly this scenario, providing cover for sports-related injuries that standard policies would exclude.
Scenario 3: Sarah, the 42-year-old founder of a 15-person tech start-up. Sarah wants to offer private health cover as a key employee benefit to attract and retain talent. She needs a flexible scheme that can adapt as her company grows.
- Best Fit: This is less clear-cut and where a broker is essential. General & Medical have a strong reputation for bespoke corporate schemes. However, The Exeter also offers business policies that could be competitive. An expert at WeCovr would compare both, presenting a detailed analysis of the costs and benefits of each to help Sarah make the best decision for her team.
Making the Right Choice with WeCovr
Choosing between two excellent specialist insurers like The Exeter and General & Medical depends entirely on your personal circumstances, health, lifestyle, and budget.
As an independent, FCA-authorised PMI broker with high customer satisfaction ratings, WeCovr’s role is to provide impartial, expert guidance. We don't work for the insurers; we work for you. Our service is provided at no cost to you, and we can often secure the same or better prices than going direct.
We will help you:
- Understand if The Exeter, General & Medical, or another provider is the right fit.
- Compare policies and prices across the market.
- Decipher the jargon and understand the small print.
- Complete the application and get your cover in place smoothly.
Will my private medical insurance cover my existing asthma?
Is it cheaper to buy a policy directly from The Exeter or General & Medical?
Can I add my children or partner to my private health cover?
Ready to find the specialist health cover that’s right for your niche needs?
Contact WeCovr today for a free, no-obligation quote and let our experts guide you to the perfect private medical insurance solution.
