Family Private Medical Insurance Explained
As an FCA-authorised broker that has helped arrange over 800,000 policies, WeCovr understands that your family's health is your top priority. This expert guide explains family private medical insurance in the UK, cutting through the jargon to help you make an informed choice for your loved ones.
Policy features tailored for parents, children, and full households in the UK
Navigating the world of private health cover can feel daunting, especially when you're trying to find the best fit for your entire family. The good news is that UK insurers have designed family policies with specific features that cater to the unique needs of parents and children, often providing more value and convenience than separate individual plans.
This guide will walk you through everything you need to know, from core benefits and cost-saving options to the crucial details about what is—and isn't—covered.
What is Family Private Medical Insurance?
Family Private Medical Insurance (PMI) is a single health insurance policy that covers two or more members of the same family. Instead of buying separate policies for yourself, your partner, and your children, a family plan bundles them together, which can be simpler to manage and often more cost-effective.
Think of it as a healthcare safety net for your household. If a covered family member develops a new, eligible medical condition, the policy helps cover the costs of private diagnosis and treatment. This allows you to bypass potential NHS waiting lists and gain more control over your family's healthcare journey.
A typical family policy can cover:
- Two partners.
- A single parent and their children.
- A couple and their children.
Children can usually remain on a family policy until they reach a certain age, typically 21, or 25 if they are still in full-time education. This varies by insurer, so it's a key detail to check.
Why Are UK Families Considering Private Health Cover?
The decision to invest in private medical insurance is a personal one, but several factors are driving more UK families to explore their options.
Growing NHS Waiting Lists
The NHS is a national treasure, but it is currently facing unprecedented pressure. According to the latest data from NHS England, the waiting list for routine hospital treatment stood at over 7.5 million in early 2024. For parents, the thought of a child or partner waiting months for a diagnosis or procedure can be a significant source of anxiety.
Real-life example: Imagine your teenage son injures his knee playing football. An MRI scan is needed to check for ligament damage. While the injury isn't life-threatening, the NHS waiting time for the scan could be several weeks or even months. With a comprehensive PMI policy, he could likely be seen by a specialist and have the scan within days, leading to a faster diagnosis and treatment plan.
A Desire for Choice, Speed, and Comfort
PMI offers a level of convenience and choice that can make a stressful situation more manageable for a family:
- Choice of Specialist and Hospital: You can research and choose the consultant you want to see and select a hospital from your insurer's approved list.
- Faster Access: Policies are designed to get you from GP referral to specialist consultation and treatment quickly.
- Private Facilities: A major appeal is the comfort of a private, en-suite room, which can make a hospital stay feel less disruptive, especially for a child.
- Flexible Appointments: Scheduling appointments around work and school commitments is often easier in the private sector.
Core vs. Comprehensive: Understanding Your Family's PMI Options
When you build a family health insurance policy, you'll start with a foundation of 'core' cover and then decide which, if any, optional extras you want to add.
Core Cover: The Essentials
This is the standard level of cover included in every policy. It is designed to cover the most significant medical costs.
Core cover typically includes:
- In-patient treatment: Costs for surgery, medical treatment, and nursing care when you are admitted to a hospital bed overnight.
- Day-patient treatment: Similar to in-patient care, but you are admitted to a hospital or clinic for a day without staying overnight (e.g., for a minor operation).
- Cancer Cover: This is a vital component of most core policies, covering the diagnosis and treatment of cancer, including surgery, chemotherapy, and radiotherapy. The level of cancer cover can vary, so it's important to check the details.
Comprehensive Cover: The Add-ons
For more extensive protection, you can add out-patient cover and other benefits. This is what turns a basic policy into a 'comprehensive' one.
Common add-ons include:
- Out-patient Cover: This is the most popular add-on. It pays for diagnostic tests (like MRI, CT, and PET scans) and consultations with a specialist before you are admitted to hospital. Without this, you would rely on the NHS for your initial diagnosis. You can usually choose a limit, such as £500, £1,000, or fully unlimited cover.
- Therapies Cover: This provides a set number of sessions for treatments like physiotherapy, osteopathy, and chiropractic care. Essential for active families.
- Mental Health Cover: Provides access to psychiatric support, counselling, and therapy sessions. This has become an increasingly important benefit for many families.
- Dental and Optical Cover: A less common add-on that provides cash back for routine check-ups, glasses, and dental treatment.
Here’s a simple table to illustrate the difference:
| Feature | Core Cover | Comprehensive Cover |
|---|---|---|
| Hospital Stays (In-patient) | Included | Included |
| Day-patient Procedures | Included | Included |
| Comprehensive Cancer Cover | Included (check level) | Included (check level) |
| Specialist Consultations | Not Included | Included |
| Diagnostic Scans (MRI/CT) | Not Included | Included |
| Physiotherapy Sessions | Not Included | Optional Add-on |
| Mental Health Support | Not Included | Optional Add-on |
Key Policy Features for Families: What to Look For
The details of your policy determine how it works in practice and how much it costs. Understanding these levers is key to tailoring the right plan for your household.
1. Hospital Lists
Insurers group UK private hospitals into tiers. The list you choose directly impacts your premium.
- Local/Regional List: A restricted list of hospitals near your home. This is the most affordable option.
- National List: A comprehensive list of private hospitals across the UK (usually excluding the most expensive central London hospitals). This is the most popular choice.
- Premium/London List: Includes all national hospitals plus the exclusive, high-cost hospitals in central London. This is the most expensive option.
For most families outside London, a national list offers an excellent balance of choice and cost.
2. Out-patient Cover Limits
If you add out-patient cover, you'll need to choose a limit. This is the maximum amount the policy will pay for out-patient consultations and tests per person, per year. A higher limit means a higher premium. A common mid-range choice is £1,000, which is usually sufficient to cover the consultations and diagnostics for a typical claim.
3. Excess Levels
An 'excess' is the amount you agree to pay towards a claim. For example, if you have a £250 excess and make a claim for £2,000 worth of treatment, you pay the first £250 and the insurer pays the remaining £1,750.
- Higher Excess = Lower Premium: Choosing a higher excess (£250, £500, or even £1,000) is one of the most effective ways to reduce your monthly cost.
- Per Person, Per Year: The excess is usually applied once per person, per policy year, regardless of how many claims they make.
4. The '6-Week Option'
This is another excellent cost-saving feature. If you add the 6-week option, your private treatment is only covered if the waiting time for that treatment on the NHS is longer than six weeks. If the NHS can see you within six weeks, you use the NHS. This significantly lowers your premium because it reduces the number of potential claims, while still providing a safety net for longer waits.
5. Underwriting Options Explained
Underwriting is how an insurer assesses your family's medical history to decide what they will cover. This is a critical choice.
| Underwriting Type | How It Works | Pros | Cons |
|---|---|---|---|
| Moratorium (Mori) | No medical questionnaire is needed upfront. The policy automatically excludes any condition for which you've had symptoms, medication, or advice in the 5 years before joining. However, if you go 2 full years on the policy without any issues relating to that condition, it may become eligible for cover. | Quick and simple to set up. You don't need to dig out old medical records. | Less certainty at the start. Claims can be slower as the insurer needs to check your medical history at that point. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire for all family members. The insurer reviews it and states exactly what is covered and what is excluded from day one. These exclusions are often permanent. | You have complete clarity from the start. Claims can be processed faster. | The application process is longer. Pre-existing conditions are likely to be permanently excluded. |
For many families with a relatively clean bill of health, a Moratorium policy is a straightforward and popular choice. If you have a more complex medical history, FMU provides valuable certainty. An expert broker at WeCovr can help you decide which path is right for your family.
The Crucial Rule: Pre-existing and Chronic Conditions
This is the single most important concept to understand about private medical insurance in the UK.
PMI is designed to cover 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 (e.g., joint replacement, cataract surgery, hernia repair).
- A chronic condition is a long-term illness that cannot be cured, only managed (e.g., diabetes, asthma, high blood pressure, arthritis).
Standard UK private health insurance does not cover the routine management of chronic conditions. Similarly, it will not cover pre-existing conditions—any illness or injury for which you had symptoms, advice, or treatment in the years immediately before taking out the policy (usually the last 5 years).
The NHS will always remain your primary provider for accident and emergency services, GP visits (unless you add a virtual GP service), and the management of chronic conditions. PMI is there to work alongside it.
Specialist Benefits for Children and Parents
Beyond the core features, many providers offer benefits specifically designed to support families.
For Children:
- Parent Accommodation: If your child needs to stay in hospital, most policies will pay for one parent to stay in the hospital with them.
- Specialist Paediatricians: Access to consultants who specialise in children's health.
- Virtual GP Access 24/7: The ability to book a video call with a GP at any time of day is a game-changer for parents worried about a child's fever at 2 am.
For Parents and the Whole Family:
- Mental Health Pathways: Fast access to counsellors, therapists, or psychiatrists to help with stress, anxiety, or depression.
- Wellness Programmes and Rewards: Many modern policies include perks designed to keep your family healthy. This can include discounted gym memberships, rewards for hitting activity goals, and health screenings.
- Complimentary Health Tools: When you arrange a policy with WeCovr, you get complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, helping your family build healthy eating habits.
How Much Does Family Private Medical Insurance Cost in the UK?
The cost of a family PMI policy is highly variable. The main factors that influence your premium are:
- Ages of the adults: Premiums increase with age.
- Number and ages of children: Insurers often have special pricing, such as "pay for the first child, get the rest covered for free."
- Your postcode: Healthcare costs vary by region, so premiums are higher in areas like London and the South East.
- The level of cover you choose: Core cover is cheapest; a comprehensive plan with no excess is the most expensive.
To give you an idea, here are some illustrative monthly premium ranges for a non-smoking family of four (two adults aged 40, two children under 10) living outside London.
| Cover Level | Key Features | Estimated Monthly Premium Range |
|---|---|---|
| Basic (Budget-friendly) | Core in-patient cover, £500 excess, 6-week option, local hospital list. | £80 - £120 |
| Mid-Range (Most Popular) | Core cover + £1,000 out-patient limit, £250 excess, national hospital list. | £150 - £220 |
| Comprehensive (Full Cover) | Full in/day/out-patient cover, no excess, therapies, full hospital list. | £250 - £400+ |
Disclaimer: These are example prices for illustrative purposes only. Your actual quote will depend on your specific circumstances.
How to Save Money on Your Family's Health Insurance
- Increase Your Excess: Opting for a £500 excess instead of £100 can reduce your premium by 15-20%.
- Add the 6-Week Option: This can save you up to 30% if you are comfortable using the NHS for shorter waits.
- Review Your Hospital List: If you don't need access to pricey central London hospitals, choose a national or regional list.
- Pay Annually: Most insurers offer a small discount (around 5%) if you pay for the year upfront.
- Look for Child-Friendly Pricing: Some insurers offer free cover for second or third children, making them more competitive for larger families.
- Use an Expert Broker: A specialist PMI broker like WeCovr compares quotes from all the leading UK insurers to find the policy that offers the best value for your family's specific needs. Our service is completely free to you, and we are known for high customer satisfaction.
- Bundle and Save: Customers who purchase Private Medical Insurance or Life Insurance through WeCovr can also benefit from exclusive discounts on other insurance products, such as home or travel cover.
Wellness Tips for a Healthy Family
While insurance provides a safety net, prevention is always the best medicine. Fostering a healthy lifestyle can improve your family's wellbeing and reduce the need for medical treatment.
- Balanced Nutrition: Aim for regular family meals packed with fruits, vegetables, lean proteins, and whole grains. The NHS "Eatwell Guide" is a great visual resource. Using an app like CalorieHero can help you and your older children understand the nutritional content of your food.
- Stay Active Together: According to the Office for National Statistics (ONS), being physically active is associated with better physical and mental health. Instead of focusing on formal exercise, build activity into your family life. Go for weekend bike rides, walk the dog together, visit local parks, or have a kitchen disco.
- Prioritise Sleep: A consistent sleep routine is vital for both children's development and adults' mental resilience. The NHS recommends 9-12 hours for school-age children and 7-9 hours for adults. Limit screen time for at least an hour before bed.
- Talk About Mental Health: Create an environment where it's normal to talk about feelings. Ask your children about their day, listen without judgment, and be open about your own stresses in an age-appropriate way. This builds resilience for the whole family.
Is family private medical insurance worth it in the UK?
Does family health insurance cover pregnancy and childbirth?
Can I add my newborn baby to my policy?
What happens when my children become adults?
Ready to Protect Your Family's Health?
Choosing the right private medical insurance is a big decision, but you don't have to do it alone. The friendly, expert advisors at WeCovr are here to help. We'll take the time to understand your family's needs and budget, then compare policies from the UK's leading insurers to find the perfect fit.
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.
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