As an FCA-authorised expert broker that has helped arrange over 900,000 policies of various kinds, WeCovr understands the importance of protecting your family's health. This guide explores private medical insurance (PMI) in the UK, helping you make an informed decision for your loved ones. We'll delve into expert advice, costs, and how cover works.
Discuss what Martin Lewis advises families on private health insurance, how cover works for kids, and average premium costs for UK families in 2025. Health insurance can be extremely useful for families to get specialist medical treatment if anything happens, from mild health problems to serious issues. The average cost for a typical family of four in 2025 is around £130 per month. — Family Money Experts on Martin Lewiss advice
Navigating the world of private health insurance can feel daunting, especially when your children's wellbeing is the priority. For many UK families, the question isn't just about cost, but about value and peace of mind. With NHS waiting lists remaining a significant concern, private medical insurance offers a pathway to faster diagnosis and treatment for a wide range of conditions.
This comprehensive guide breaks down everything you need to know. We will examine the typically pragmatic advice from consumer champion Martin Lewis, explore the specifics of how insurance policies cover children, and provide a realistic look at the average costs you can expect in 2025. Understanding these key elements will empower you to decide if private health cover is the right safety net for your family.
Martin Lewis's View on Private Health Insurance: A Pragmatic Approach
When it comes to financial decisions, millions in the UK turn to Martin Lewis and his MoneySavingExpert team for clear, unbiased advice. His perspective on private health insurance is, characteristically, a blend of caution and practicality.
Martin Lewis generally categorises insurance into two types:
- Essential Insurance: This covers catastrophic events you couldn't afford to recover from, such as your house burning down (buildings insurance) or causing a serious car accident (car insurance). These are "must-haves".
- "Nice-to-Have" Insurance: This covers things that are problematic but not financially ruinous. Private medical insurance falls squarely into this category.
Here’s a summary of his key viewpoints on PMI for families:
- PMI is a Luxury, Not an Essential: The UK is incredibly fortunate to have the National Health Service (NHS). It provides excellent care, particularly for emergencies and serious chronic illnesses. PMI isn't designed to replace the NHS; it's designed to supplement it, primarily by speeding up access to non-urgent specialist consultations and treatments.
- The Main Benefit is Speed and Choice: The core value of PMI is bypassing lengthy waiting lists for elective procedures, diagnostic tests (like MRI scans), and specialist appointments. It also gives you more choice over the consultant who treats you and the hospital you're treated in.
- Consider "Self-Insuring": If you have significant savings, Martin Lewis suggests you could consider "self-insuring." This means putting money aside in an accessible savings account. If a medical issue arises that has a long NHS wait, you could use these funds to pay for private treatment directly. However, this carries the risk that a serious condition could cost far more than you have saved.
- Always Compare and Check Exclusions: If you do decide to buy PMI, the golden rule is to never just accept the first quote. You must compare policies from different providers and, most importantly, read the small print. Understanding the exclusions—what the policy won't cover—is just as important as knowing what it will.
In essence, Martin Lewis's advice is to weigh the cost of the monthly premium against the peace of mind and convenience of fast-tracking medical care. For families, this calculation often tips in favour of getting cover, especially when thinking about a child's health.
The Critical Point: What UK Private Health Insurance Does NOT Cover
Before we go any further, it's vital to understand a fundamental principle of standard UK private medical insurance.
PMI is designed to cover acute conditions that arise after you take out the policy. An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery.
PMI does NOT typically cover:
- Pre-existing Conditions: Any medical issue you or your family members have had symptoms of, received advice for, or been treated for before the policy start date.
- Chronic Conditions: Long-term illnesses that cannot be cured, only managed. This includes conditions like diabetes, asthma, arthritis, and high blood pressure. While PMI may cover the initial diagnosis of a chronic condition, the ongoing, long-term management will almost always be handled by the NHS.
- Emergencies: A&E visits, ambulance services, and immediate life-threatening situations are handled by the NHS.
- Routine Pregnancy & Childbirth: Standard policies do not cover planned maternity care.
- Other specific exclusions like cosmetic surgery, organ transplants, and experimental treatments.
Understanding these limitations is key to having realistic expectations of what a policy can do for your family.
How Does Private Health Insurance for Children Work?
Adding your children to a private health insurance policy is one of the most common reasons families opt for cover. The thought of a child being in pain or discomfort while on a long waiting list is a powerful motivator.
Here’s how cover for children typically functions:
1. Adding Children to Your Policy:
You can usually add children to a policy in one of two ways:
- Family Policy: You buy a single policy that covers two adults and one or more children. This is often the most straightforward and cost-effective method.
- Adding to an Existing Policy: If you already have individual or couple's cover, you can contact your insurer to add your children. Newborns can typically be added without any new medical underwriting, provided you add them within a few months of birth.
Most insurers will allow children to remain on a family policy until they are around 21, or even 24 if they are still in full-time education.
2. Key Benefits for Children's Health:
A family health insurance policy provides several specific advantages when a child falls ill:
- Fast-Track to Paediatric Specialists: Bypassing long NHS waits for appointments with paediatricians, dermatologists, ENT (ear, nose, and throat) specialists, or orthopaedic surgeons.
- Prompt Diagnostics: Quickly getting access to tests like MRI scans, CT scans, and allergy tests to get a clear diagnosis and start treatment sooner.
- Comfort and Privacy: If your child needs to stay in hospital, a private policy usually provides a private room, making a stressful experience more comfortable. Crucially, most policies include accommodation for one parent to stay in the room with their child.
- Mental Health Support: This is an increasingly vital benefit. With NHS Child and Adolescent Mental Health Services (CAMHS) facing overwhelming demand, many PMI policies offer a set number of therapy or counselling sessions, providing crucial early support for issues like anxiety and depression.
- Virtual GP Services: 24/7 access to a GP via phone or video call is a standard feature on most policies. This is invaluable for parents wanting quick advice on a child's fever or rash in the middle of the night, avoiding a trip to A&E.
Real-Life Example: The Value of PMI for a Child
Imagine 8-year-old Leo develops recurring, painful ear infections. His GP refers him to an NHS ENT specialist, but the waiting list for an initial consultation is six months. During this time, Leo continues to suffer, missing school and sleep.
With a family PMI policy:
- The family uses the virtual GP service. The GP provides an open referral letter.
- They call the insurer, who provides a list of approved private ENT specialists.
- Leo sees a specialist within a week.
- An investigation reveals he needs grommets fitted, a minor surgical procedure.
- The surgery is scheduled for two weeks later in a private hospital. Leo gets a private room, and his mum stays with him overnight.
In this scenario, PMI reduced the time from referral to treatment from over six months to less than a month.
What is the Average Cost of Family Health Insurance in 2025?
The cost of private health insurance for a family is not one-size-fits-all. It varies significantly based on several key factors. However, we can provide some reliable estimates for 2025.
Based on market analysis, the average monthly premium for a typical UK family of four (two adults in their late 30s, two children under 10) is projected to be around £130-£150 in 2025 for a mid-range policy.
Factors That Influence Your Family's Premium
Understanding what drives the cost will help you tailor a policy to your budget.
| Factor | Impact on Premium | How to Manage the Cost |
|---|
| Age of Adults | Higher age = Higher premium. | You can't change your age, but buying sooner rather than later locks in cover before age-related conditions develop. |
| Location | Premiums are highest in Central London due to higher hospital costs. | Opting for a policy that excludes expensive city-centre hospitals can significantly reduce your premium. |
| Level of Cover | Comprehensive plans with full outpatient and therapy cover cost more. | Choose a more basic plan that covers diagnostics and in-patient treatment but limits outpatient consultations. |
| Policy Excess | A higher excess (the amount you pay per claim) lowers your premium. | Selecting a voluntary excess of £250 or £500 can create substantial monthly savings. |
| Hospital List | A restricted list of local hospitals is cheaper than a nationwide list. | Assess which hospitals are near you and choose a list that meets your needs without being overly extensive. |
| Underwriting | How the insurer assesses your medical history affects the price and cover. | 'Moratorium' underwriting is simpler and often cheaper initially, but 'Full Medical Underwriting' provides more certainty on what's covered from day one. |
Illustrative Family PMI Costs in the UK (2025 Estimates)
The table below provides estimated monthly premiums for different family profiles and cover levels. These are for illustrative purposes; your actual quote will depend on your specific circumstances.
| Family Profile | Location | Level of Cover | Estimated Monthly Premium (2025) |
|---|
| 2 adults (early 30s), 1 child (<5) | Leeds | Basic (High Excess) | £75 - £95 |
| 2 adults (late 30s), 2 children (<10) | Bristol | Mid-Range | £120 - £150 |
| 2 adults (early 40s), 2 teens | Outer London | Comprehensive | £180 - £240 |
| Single Parent (35), 1 child (8) | Birmingham | Mid-Range | £80 - £110 |
Working with an expert broker like WeCovr is the best way to get an accurate picture of the costs. We can compare the market for you and find a plan that balances comprehensive cover with a premium that fits your family's budget.
Is Family Health Insurance Worth It? A Balanced View
Deciding whether to invest in private medical insurance is a personal choice. Here are the main arguments for and against to help you decide.
The Case For Family PMI (Pros)
- Peace of Mind: Knowing you can access fast treatment for your children and partner if they become unwell is the single biggest benefit for most people.
- Bypassing NHS Waiting Lists: As of mid-2024, the NHS England waiting list stood at over 7.5 million treatment pathways. While the NHS is working to reduce this, significant waits for elective care are likely to persist. PMI allows you to bypass these queues.
- Choice and Control: You get to choose your specialist from a list of approved consultants and select the hospital where you or your child will be treated.
- Enhanced Comfort: A private room, more flexible visiting hours, and better food can make a hospital stay far less stressful for both children and parents.
- Access to Advanced Treatments: Some policies provide access to new drugs or treatments that may not yet be available on the NHS due to cost or NICE (National Institute for Health and Care Excellence) approval delays.
- Valuable Added Benefits: Most modern policies come bundled with extras like 24/7 virtual GPs, mental health support lines, and even discounts on gym memberships and fitness trackers.
The Case Against Family PMI (Cons)
- The Monthly Cost: PMI is an ongoing financial commitment. For a family, this can be a significant addition to the monthly budget, especially during a cost-of-living crisis.
- The Exclusions: The fact that PMI does not cover pre-existing or chronic conditions is its biggest limitation. You must be clear on this from the outset.
- The NHS Handles Emergencies: You are still reliant on the NHS for any urgent or emergency care. A PMI policy is not a replacement for calling 999.
- You Might Not Use It: You could pay premiums for years and never need to make a claim. This is the nature of insurance, but some people would rather save the money instead.
How to Choose the Best UK Private Medical Insurance for Your Family
If you've decided that the benefits of PMI outweigh the costs, the next step is to find the right policy. A methodical approach will ensure you get the best value.
Step 1: Assess Your Family's Needs and Priorities
Discuss with your partner what is most important to you.
- Is comprehensive cancer cover a must-have?
- Is mental health support for your children a priority?
- Do you want access to alternative therapies like physiotherapy or osteopathy?
- Are you happy with a local hospital list, or do you want nationwide choice?
Step 2: Determine Your Budget
Decide on a monthly premium that you can comfortably afford without straining your finances. Remember to factor in the policy excess – a higher excess will lower your monthly cost, but you need to be able to afford it if you make a claim.
Step 3: Understand the Key Policy Levers
Familiarise yourself with the main options that you can adjust to control your cover and cost:
- Outpatient Cover: You can choose a plan with full outpatient cover, a limited number of consultations, or no outpatient cover at all (relying on the NHS for diagnostics).
- Hospital List: Insurers offer tiered hospital lists. A list that excludes the most expensive hospitals in Central London can save you up to 20%.
- "6-Week Wait" Option: Some policies include a clause where if the NHS can treat you within six weeks, you use the NHS. If the wait is longer, your private cover kicks in. This can be a very cost-effective option.
Step 4: Use an Independent PMI Broker
This is the most crucial step. Instead of going directly to individual insurers, using an independent, FCA-authorised broker like WeCovr gives you several advantages:
- Whole-of-Market Comparison: We compare policies from leading UK providers like Aviva, AXA Health, Bupa, and Vitality to find the best fit for you.
- Expert Advice: Our specialists understand the complex jargon and policy details. We can explain the differences in underwriting, cancer cover, and mental health options in plain English.
- No Extra Cost: Our service is free to you. We are paid a commission by the insurer you choose, which does not affect the price you pay.
- Tailored Recommendations: We take the time to understand your family's unique needs and budget to recommend the most suitable options.
A Healthier Lifestyle: Tips for UK Families
While insurance is there for when things go wrong, prevention is always better than cure. Many PMI providers actively encourage healthy living through wellness programmes and benefits. Here are some simple, effective tips for keeping your family healthy and happy.
Embrace a Balanced Diet
A nutritious diet is the foundation of good health.
- The 5-a-Day Rule: Aim for everyone to eat at least five portions of varied fruit and vegetables each day.
- Family Cooking: Involve children in preparing meals. It's a great way to teach them about food and encourage them to try new things.
- Smart Snacking: Swap sugary snacks and crisps for healthier alternatives like fruit, yoghurt, vegetable sticks with hummus, or a handful of nuts.
- Track Your Nutrition: Understanding your family's eating habits can be enlightening. As a WeCovr customer, you get complimentary access to our CalorieHero AI calorie tracking app, making it easy to monitor your nutritional intake and make healthier choices.
Stay Active Together
Regular physical activity is crucial for physical and mental wellbeing.
- Walk to School: If possible, leave the car behind and walk, scoot, or cycle.
- Weekend Adventures: Explore local parks, woodlands, or nature reserves. A family bike ride or a long walk is a fantastic way to spend time together.
- Join Local Groups: Look into local sports clubs, dance classes, or free community events like Parkrun, which has junior events for children aged 4-14.
Prioritise Mental Wellbeing
- Good Sleep Hygiene: Ensure everyone, especially children and teenagers, gets enough sleep. Establish a consistent bedtime routine and limit screen time before bed.
- Talk and Listen: Create an environment where your children feel comfortable talking about their worries. Regular family dinners without screens are a great opportunity for this.
- Digital Detox: Set aside dedicated times each day or week where the whole family puts away their phones and gadgets and engages in a shared activity.
By taking these small steps, you can improve your family's overall health and potentially reduce the need to claim on your insurance. Furthermore, some insurers, like Vitality, actively reward you for healthy living with lower premiums and other perks.
Does family private health insurance cover pregnancy?
Generally, standard private medical insurance policies in the UK do not cover routine pregnancy and childbirth. These are seen as planned life events rather than unforeseen medical conditions. However, some comprehensive policies may offer cover for certain complications of pregnancy or childbirth. If you plan to add a newborn to your policy, most insurers allow you to do so without further medical underwriting within a few months of their birth.
What happens if my child develops a chronic condition while we have the policy?
This is a very important question. Private health insurance is designed for acute conditions. If your child develops a long-term chronic condition (like asthma or diabetes) after your policy has started, the policy will typically cover the initial diagnostic phase to find out what's wrong. Once the condition is diagnosed as chronic, the ongoing management, medication, and routine check-ups will usually be handed back to the NHS, which is set up for long-term care.
Are there any waiting periods before I can claim for my family?
Most policies have an initial waiting period, often called a "moratorium." With moratorium underwriting, any condition you've had symptoms of or treatment for in the five years before joining is excluded. This exclusion can be lifted for a specific condition if you go for a set period (usually two years) without any symptoms, treatment, or advice for it after your policy starts. For new, unrelated conditions that arise after you join, you can typically claim straight away.
Take the Next Step to Protect Your Family
Choosing the right private medical insurance is one of the most important decisions you can make for your family's health and wellbeing. The market is complex, but you don't have to navigate it alone.
At WeCovr, our friendly, expert team is here to help. We provide no-obligation advice, compare the UK's leading insurers, and tailor a policy that gives your family the protection they deserve at a price you can afford. Plus, when you buy a policy through us, you'll receive complimentary access to our CalorieHero nutrition app and may be eligible for discounts on other cover like life insurance.
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