TL;DR
Navigating the UK's private medical insurance market can feel overwhelming. At WeCovr, our experienced advisers have helped arrange over 900,000 policies, giving us unparalleled insight into finding the right cover. This guide cuts through the jargon to show you exactly how to get private medical insurance, compare your options, and choose a policy that truly protects you and your family.
Key takeaways
- In-patient and day-patient treatment: Costs for surgery and procedures where you need a hospital bed, even for just a day.
- Out-patient consultations and diagnostics: Seeing a specialist and having tests like MRI, CT, and PET scans to find out what's wrong.
- Cancer care: Comprehensive cover for chemotherapy, radiotherapy, and surgery is a cornerstone of most PMI policies.
- Mental health support: Increasing numbers of policies offer support for acute mental health conditions.
- Therapies: Physiotherapy, osteopathy, and other therapeutic treatments following a diagnosis.
Navigating the UK's private medical insurance market can feel overwhelming. At WeCovr, our experienced advisers have helped arrange over 900,000 policies, giving us unparalleled insight into finding the right cover. This guide cuts through the jargon to show you exactly how to get private medical insurance, compare your options, and choose a policy that truly protects you and your family.
How to get private medical insurance, compare options, and choose the right private health policy for your needs
Private Medical Insurance (PMI) offers a powerful way to supplement the excellent care provided by our NHS. It gives you more control over your healthcare, allowing you to bypass long waiting lists for eligible treatments and receive care in a comfortable, private setting.
But with so many providers, policy options, and technical terms, where do you start? This comprehensive guide is your roadmap. We’ll walk you through the entire process, from understanding the basics to customising your policy and making the final purchase online.
What is Private Medical Insurance (PMI) and What Does It Cover?
In simple terms, PMI is an insurance policy that covers the cost of private healthcare for 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.
Think of it as your passport to faster diagnosis and treatment for new, curable health issues.
What PMI Typically Covers:
- In-patient and day-patient treatment: Costs for surgery and procedures where you need a hospital bed, even for just a day.
- Out-patient consultations and diagnostics: Seeing a specialist and having tests like MRI, CT, and PET scans to find out what's wrong.
- Cancer care: Comprehensive cover for chemotherapy, radiotherapy, and surgery is a cornerstone of most PMI policies.
- Mental health support: Increasing numbers of policies offer support for acute mental health conditions.
- Therapies: Physiotherapy, osteopathy, and other therapeutic treatments following a diagnosis.
The Golden Rule: What PMI Does NOT Cover
This is the most critical point to understand. UK private medical insurance is designed for new, short-term conditions.
PMI does not cover:
- Pre-existing conditions: Any illness or injury you had before your policy started.
- Chronic conditions: Long-term illnesses that cannot be cured, only managed (e.g., diabetes, asthma, arthritis, high blood pressure). The NHS remains your primary provider for chronic care.
- Accident & Emergency (A&E) visits.
- Normal pregnancy and childbirth.
- Cosmetic surgery (unless medically necessary).
- Drug and alcohol rehabilitation.
| Feature | NHS | Private Medical Insurance (PMI) |
|---|---|---|
| Cost | Free at the point of use | Monthly/annual premium |
| Waiting Times | Can be long for non-urgent care | Significantly shorter for eligible treatment |
| Choice of Hospital | Limited to local NHS trust | Choice from a national list of private hospitals |
| Choice of Consultant | Usually assigned by the hospital | Often able to choose your specialist |
| Accommodation | Typically on a shared ward | Private, en-suite room |
| Scope of Care | Comprehensive (A&E, chronic, acute) | Acute conditions arising after policy start |
Your Step-by-Step Guide to Buying the Right PMI Policy
Follow these five steps to secure a policy that fits your needs and budget perfectly.
Step 1: Assess Your Needs and Budget
Before you look at a single quote, take a moment to define what you need.
- Who are you covering? Is it just for you (individual), for you and your partner (couple), or your entire family? Family policies often offer good value.
- What's your priority? Are you primarily concerned about fast access to diagnostics? Comprehensive cancer cover? Or do you just want a basic policy for major surgical procedures?
- What's your budget? Be realistic about what you can afford each month. A basic policy can start from as little as £30-£40 per month for a young, healthy individual, but comprehensive cover for a family in London could be several hundred pounds.
Your age, location, and medical history are the biggest factors influencing your premium.
Step 2: Understand the Core Policy Options
This is where the jargon can get confusing. Let's break down the key terms you must understand to make an informed choice.
1. Underwriting: The Most Important Choice You'll Make
Underwriting is how insurers assess your medical history to decide what they will and won't cover. There are two main types:
| Underwriting Type | How It Works | Pros | Cons |
|---|---|---|---|
| Moratorium (Mori) | You don't declare your full medical history upfront. The insurer automatically excludes any condition you've had symptoms, treatment, or advice for in the 5 years before your policy starts. | Quicker to set up. Less initial paperwork. | Can lead to uncertainty at the point of claim. The "2-year rule" can be complex. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire, declaring your full medical history. The insurer then tells you exactly what is excluded from day one. | Provides complete certainty. You know precisely what is and isn't covered from the start. | Takes longer to set up. Requires more initial effort. |
Adviser Tip: While Moratorium seems easier, we often recommend Full Medical Underwriting for clarity. With FMU, there are no grey areas when you need to make a claim. An expert broker, like WeCovr, can help you complete the health declaration accurately.
2. Policy Excess
An excess is the amount you agree to pay towards a claim each year. For example, if you have a £250 excess and your treatment costs £3,000, you pay the first £250 and the insurer pays the remaining £2,750.
- A higher excess will lower your monthly premium.
- Excesses typically range from £0 to £1,000.
3. Hospital List
Insurers have agreements with networks of private hospitals. Your choice of hospital list directly impacts your premium.
- Comprehensive List: Includes all hospitals, including premium central London clinics. This is the most expensive option.
- Standard List: A broad national network, excluding the most expensive hospitals.
- Local/Limited List: A smaller selection of hospitals, often focused on your local area, offering significant savings.
4. Out-patient Cover
This covers the costs of specialist consultations and diagnostic tests before you are admitted to hospital. Policies offer different levels, from £0 (no cover) to £500, £1,000, or even fully comprehensive cover. Capping this is a very effective way to manage your premium.
Step 3: Compare Insurers and Policies
You have two main paths to compare the market: going direct to insurers one-by-one, or using an independent broker.
- Going Direct: This can be time-consuming, and you'll only see one provider's view of the market.
- Using a Broker: An independent, unbiased broker works for you, not the insurer. They compare policies from across the market to find the best fit for your specific needs and budget.
At WeCovr, our service is completely free to you. We get paid by the insurer you choose, but our advice is always impartial and focused on your best interests. We can often find better terms than if you go direct.
Leading UK Private Health Insurance Providers:
- Bupa: One of the UK's oldest and most recognised health insurers.
- AXA Health: A global insurance giant with a strong UK presence and extensive hospital network.
- Aviva: The UK's largest general insurer, offering a wide range of PMI products.
- Vitality: Known for its innovative approach, rewarding healthy living with discounts and benefits.
- The Exeter: A specialist friendly society known for excellent service and flexible underwriting.
- WPA: A not-for-profit insurer with a strong reputation for customer satisfaction.
Step 4: Get Your Personalised Quotes
Once you've decided on your preferred level of cover and underwriting type, it's time to get quotes. Whether doing it yourself or with a broker, you'll need to provide:
- Full name and date of birth for everyone to be covered.
- Your postcode.
- Your chosen underwriting type (or your medical history for FMU).
- Your desired level of cover (excess, hospital list, etc.).
Be 100% honest and accurate. Failing to disclose relevant medical information can invalidate your policy when you need it most.
Step 5: Review and Purchase
You'll receive a "Policy Summary" or "Insurance Product Information Document (IPID)" with your quote. Read this carefully. It summarises the key features, benefits, and exclusions.
Once you are happy, you can complete the application and set up your payment. UK policies come with a 14-day cooling-off period, during which you can cancel and receive a full refund, provided you haven't made a claim.
How to Customise Your PMI Policy and Save Money
One of the best things about modern private health cover is its flexibility. You can adjust several levers to bring the price down to a level you're comfortable with.
| Cost-Saving Lever | How It Works | Potential Saving |
|---|---|---|
| Increase Your Excess | Agree to pay a larger portion of any claim (e.g., £500 instead of £100). | High |
| Add a 6-Week Option | Your PMI only kicks in if the NHS waiting list for your in-patient procedure is longer than 6 weeks. | High |
| Choose a Limited Hospital List | Exclude premium-priced city centre hospitals from your cover. | Medium-High |
| Limit Out-patient Cover | Reduce the financial limit for consultations and diagnostics. | Medium |
| Select a "Guided" Option | Allow your insurer to guide you to a pre-approved list of specialists. | Medium |
An expert adviser can model these options for you in real-time, showing you exactly how each change affects your premium.
Common Mistakes to Avoid When Buying PMI
As specialists in the field, we see the same pitfalls time and again. Avoid these common errors:
- Assuming Everything is Covered: Remember the golden rule: PMI is for new, acute conditions. It is not a replacement for the NHS.
- Choosing on Price Alone: The cheapest policy might have a very restrictive hospital list, a huge excess, or no out-patient cover, making it less useful in practice.
- Misunderstanding Moratorium: Many people choose Moratorium thinking it's a "don't ask, don't tell" policy. It's not. The insurer will investigate your medical history at the point of a claim, which can lead to delays or denials if the condition is found to be pre-existing.
- Not Checking the Hospital List: Don't assume your local private hospital is covered. Always check the list before you buy.
- Not Using a Broker: Trying to navigate the market alone means you might miss out on better cover or a more competitive price available from an insurer you hadn't considered.
Switching Your Private Health Insurance Provider
If you already have a PMI policy, it's wise to review it every year. Your current insurer's renewal price is often not the most competitive.
You can switch providers without losing cover for conditions that have developed since you took out your original policy. This is done using a special type of underwriting called "Continued Personal Medical Exclusions" (CPME).
With CPME, your new insurer agrees to match the terms of your old policy, carrying over any personal exclusions you had. This ensures you have continuous cover. A broker is essential for managing a CPME switch smoothly.
Why Get Private Medical Insurance with WeCovr?
Choosing the right private medical insurance is a significant financial decision. Partnering with an expert, independent broker like WeCovr makes the process simple, clear, and effective.
- Whole-of-Market Advice: We are not tied to any single insurer. We compare leading providers to find the policy that is genuinely best for you.
- Expert Guidance at No Cost: Our specialist advice is completely free. You get the benefit of our deep market knowledge without paying a penny extra.
- We Handle the Hard Work: From filling in forms to explaining complex terms and even helping with claims, we are with you every step of the way.
- Exclusive Benefits: As a WeCovr client, you get complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, to support your health goals. You may also be eligible for discounts on other policies like life or income protection insurance.
- Trust and Regulation: WeCovr is fully authorised and regulated by the Financial Conduct Authority (FCA), and our high customer satisfaction ratings speak for themselves.
Do I need a GP referral to use my private medical insurance?
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Ready to take control of your healthcare? The first step is to see what your options are. Get a free, no-obligation comparison quote from our friendly experts today and discover how affordable peace of mind can be.
