TL;DR
As an FCA-authorised expert that has helped arrange over 900,000 policies, WeCovr knows the questions on your mind when it comes to private medical insurance in the UK. We’ve turned to Google’s autocomplete to see what you’re really asking, and we’re here to provide the definitive answers. WeCovr answers the internets top PMI-related questions Ever typed a question into Google and watched it predict the rest of your sentence?
Key takeaways
- A hernia requiring surgery
- Joint pain needing a replacement (like a hip or knee)
- Cataracts
- Most infections
- Diagnosing the cause of a new symptom, like stomach pain or headaches
As an FCA-authorised expert that has helped arrange over 900,000 policies, WeCovr knows the questions on your mind when it comes to private medical insurance in the UK. We’ve turned to Google’s autocomplete to see what you’re really asking, and we’re here to provide the definitive answers.
WeCovr answers the internets top PMI-related questions
Ever typed a question into Google and watched it predict the rest of your sentence? That’s Google Autocomplete, and it’s a fascinating window into the collective curiosity of the nation. When it comes to private medical insurance (PMI), the questions reveal a mix of confusion, cost-consciousness, and a genuine desire to understand how to get the best possible healthcare.
Let's dive into the most common searches and provide clear, expert answers to help you navigate the world of private health cover.
"Private medical insurance what is...?"
This is the foundational question. At its heart, private medical insurance is a policy you buy to cover the cost of private healthcare for acute conditions that arise after your policy begins.
Think of it as a way to bypass NHS waiting lists for eligible treatments. Instead of waiting for a specialist appointment or surgery on the NHS, you can be seen and treated more quickly in a private hospital or clinic.
What is an 'acute' condition?
This is the most critical distinction to understand. 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:
- A hernia requiring surgery
- Joint pain needing a replacement (like a hip or knee)
- Cataracts
- Most infections
- Diagnosing the cause of a new symptom, like stomach pain or headaches
Crucially, PMI does not cover 'chronic' conditions. A chronic condition is one that is long-lasting and cannot be fully cured, such as diabetes, asthma, high blood pressure, or Crohn's disease. While PMI might cover an acute flare-up, it won't cover the day-to-day management of the chronic illness itself. The NHS remains your port of call for that.
| Feature | Private Medical Insurance (PMI) | National Health Service (NHS) |
|---|---|---|
| Primary Focus | Acute conditions (curable) | All health conditions, including chronic & emergency |
| Main Benefit | Speed of access to specialists and treatment | Free at the point of use |
| What it's for | Bypassing waiting lists for elective care | GP services, A&E, long-term condition management |
| What it's not for | Chronic conditions, pre-existing issues, emergencies | Bypassing waiting lists for non-urgent care |
"Private medical insurance how much...?"
This is the million-dollar question—or rather, the "how many pounds per month" question. The honest answer is: it depends. The price of a private medical insurance UK policy is highly personal and is influenced by several key factors.
Key Factors That Determine Your PMI Premium
- Age: The older you are, the higher the statistical likelihood of needing medical treatment, so premiums increase with age.
- Location: Healthcare costs vary across the UK. Treatment in central London, for example, is more expensive than in other parts of the country, so policies with access to London hospitals cost more.
- Level of Cover: A basic policy covering essential in-patient treatment will be cheaper than a comprehensive one that includes out-patient consultations, therapies, and mental health support.
- Excess (illustrative): This is the amount you agree to pay towards a claim. A higher excess (e.g., £500) will lower your monthly premium, while a lower excess (e.g., £100 or £0) will increase it.
- Hospital List: Insurers have different tiers of hospital lists. A policy that gives you access to every private hospital in the country will cost more than one with a more limited local network.
- Lifestyle: Most insurers will ask if you smoke or use nicotine products. Smokers pay significantly more due to the associated health risks.
Illustrative Monthly Premiums (2025)
To give you a clearer idea, here are some example costs. These are for illustrative purposes only and are based on a non-smoker with a £250 excess.
| Applicant Profile | Basic Cover (In-patient only) | Comprehensive Cover (In/Out-patient & Therapies) |
|---|---|---|
| 30-year-old | £35 - £50 per month | £60 - £85 per month |
| 45-year-old | £50 - £70 per month | £85 - £120 per month |
| 60-year-old | £90 - £130 per month | £150 - £220 per month |
The best way to find out your exact cost is to get a personalised quote. A PMI broker like WeCovr can compare policies from across the market to find a plan that fits your budget and needs, at no extra cost to you.
"Private medical insurance is it worth it...?"
This question boils down to a personal calculation of value versus cost. For many, the answer is a resounding "yes," particularly in light of current healthcare pressures.
As of early 2025, the challenge of NHS waiting lists remains a significant concern for UK families. Based on the latest data from NHS England, the total waiting list for consultant-led elective care stands at several million. While progress is being made, a substantial number of patients are still waiting over 18 weeks for treatment, with tens of thousands waiting for more than a year.
PMI offers a direct solution to this uncertainty.
The Pros and Cons of Private Health Cover
| Pros (Why it could be worth it) | Cons (Why it might not be for you) |
|---|---|
| Speed of Access: Get diagnosed and treated faster. | The Cost: It's an ongoing monthly expense. |
| Choice and Control: Choose your specialist and hospital. | Exclusions: Doesn't cover pre-existing or chronic conditions. |
| Comfort and Privacy: A private room is often standard. | No Emergency Cover: You still need the NHS for A&E. |
| Access to Specialist Drugs: Get drugs or treatments not yet available on the NHS. | Excess Payments: You may have to contribute to a claim. |
| Peace of Mind: Knowing you have a backup plan for your health. | Underwriting: You must declare your medical history or accept a moratorium. |
A Real-Life Example:
Imagine Sarah, a 45-year-old graphic designer, starts experiencing debilitating knee pain. Her GP suspects a torn meniscus and refers her to an NHS orthopedic specialist. The waiting time for the initial consultation is four months, with a further eight-month wait for potential surgery. This means a year of pain, reduced mobility, and difficulty working.
With a PMI policy, Sarah could get a GP referral, see a private specialist within a week, have an MRI scan a few days later, and be scheduled for surgery within a month. For Sarah, the value of getting back to her life quickly far outweighs the monthly premium.
"Private medical insurance for pre-existing conditions...?"
This is one of the most misunderstood areas of PMI. Let's be unequivocally clear:
Standard private medical insurance in the UK is designed for new, acute medical conditions that arise after you take out the policy. It does not cover pre-existing conditions.
A pre-existing condition is any disease, illness, or injury for which you have experienced symptoms, received medication, advice, or treatment in the years before your policy starts (typically the last 5 years).
However, how this is managed depends on the type of underwriting you choose.
1. Moratorium Underwriting (The "Wait and See" Approach)
This is the most common type of underwriting.
- You don't declare your full medical history upfront.
- The insurer automatically excludes any condition you've had in the 5 years before the policy began.
- However, if you go for a set period (usually 2 years) without any symptoms, treatment, or advice for that specific condition, the insurer may then agree to cover it in the future.
Example: You had physio for back pain 3 years ago. With a moratorium policy, that back pain won't be covered initially. If you go 2 full years on the policy with no back-related issues, it may become eligible for cover in year 3.
2. Full Medical Underwriting (FMU) (The "Declare Everything" Approach)
- You complete a detailed health questionnaire, disclosing your entire medical history.
- The insurer assesses your history and tells you from day one exactly what is and isn't covered.
- Any pre-existing conditions are typically excluded permanently.
FMU provides certainty from the start, but moratorium offers the possibility of covering past conditions after a trouble-free period. An expert at WeCovr can help you decide which is right for you.
"Private medical insurance vs NHS...?"
This isn't a battle; it's a partnership. A robust health strategy for many people in the UK involves using both systems for what they do best. PMI is not a replacement for the NHS.
Here’s how they work together:
- Emergencies: If you have a heart attack or are in a car accident, you go to A&E. The NHS handles all emergency care.
- GP Services: Your NHS GP remains your first point of contact for any health concerns. You need a GP referral to start a private medical insurance claim.
- Chronic Conditions: The NHS manages long-term illnesses like diabetes or asthma.
- Elective Treatment: This is where PMI steps in. For non-urgent but necessary procedures like a hip replacement, hernia repair, or cataract surgery, PMI provides the fast-track option.
| Service | Typically handled by NHS | Typically handled by PMI (with NHS GP referral) |
|---|---|---|
| Emergencies (A&E) | ✅ | ❌ |
| GP Appointments | ✅ | ❌ (Some policies offer virtual GP services) |
| Chronic Condition Management | ✅ | ❌ (Except for acute flare-ups in some cases) |
| Elective Surgery (e.g., hip replacement) | ✅ (with long wait) | ✅ (with short wait) |
| Diagnostic Scans (MRI, CT) | ✅ (with wait) | ✅ (quickly) |
| Specialist Consultations | ✅ (with wait) | ✅ (quickly) |
| Cancer Treatment | ✅ | ✅ (Often more comprehensively) |
"Private medical insurance which is best...?"
There is no single "best" private medical insurance provider. The best provider for a 25-year-old marathon runner in Manchester will be different from the best provider for a 55-year-old office worker in London.
"Best" depends entirely on your:
- Budget: How much are you comfortable spending each month?
- Needs: Do you need comprehensive mental health cover? Is a specific hospital near you essential?
- Priorities: Do you value wellness rewards and gym discounts, or just core hospital cover?
A Look at Major UK Providers
The UK market is served by several excellent, highly-regarded insurers.
| Provider | Often Known For |
|---|---|
| AXA Health | Strong core cover, excellent customer service, and a clear, modular approach. |
| Aviva | A major, trusted brand with a wide range of options and good value. |
| Bupa | One of the oldest and largest providers with an extensive hospital network and direct cancer cover pathways. |
| Vitality | A unique focus on wellness, rewarding healthy living with discounts and perks like cinema tickets and coffee. |
| The Exeter | A friendly society known for excellent service and consideration of some pre-existing conditions with their underwriting. |
Navigating these choices can be overwhelming. This is where an independent PMI broker is invaluable. WeCovr's experts have deep knowledge of each provider's strengths and weaknesses. We can quickly narrow down the options to find the policy that offers you the best value for your specific circumstances, saving you time and money.
"Private medical insurance does it cover...?"
The specifics of cover are what really matter. While all policies cover in-patient treatment (care requiring a hospital bed overnight), the differences lie in the out-patient and add-on benefits.
Does PMI cover cancer?
Yes, and this is arguably one of the most valuable aspects of modern PMI. Cancer cover is a core component of virtually all policies and is often exceptionally comprehensive. It typically includes:
- Access to specialist oncologists.
- Full cover for chemotherapy and radiotherapy.
- Surgical procedures.
- Advanced diagnostics like PET and CT scans.
- Access to breakthrough drugs, treatments, and immunotherapies that may not be available on the NHS due to cost or NICE approval delays.
Does PMI cover mental health?
Cover for mental health has improved dramatically in recent years, but it varies significantly between policies.
- Basic Policies: May offer no mental health cover or just a limited number of therapy sessions.
- Comprehensive Policies: Can provide extensive cover for psychiatrist consultations, therapy sessions (e.g., CBT), and in-patient treatment at specialist facilities.
If mental health support is a priority, it is vital to check the policy details carefully.
Does PMI cover dental and optical?
Standard PMI policies do not cover routine dental check-ups or optical care (eye tests, glasses). These are usually offered as optional add-ons for an extra premium. The cover is often a cashback-style benefit, where you pay for your treatment and claim back a portion of the cost, up to an annual limit.
What about therapies?
Physiotherapy, osteopathy, and chiropractic treatment are often included, especially on mid-range and comprehensive plans. However, there will usually be a limit on the number of sessions per year.
| Benefit | Basic Policy (Typical) | Comprehensive Policy (Typical) |
|---|---|---|
| In-patient/Day-patient Care | ✅ Full cover | ✅ Full cover |
| Cancer Cover | ✅ Comprehensive cover | ✅ Enhanced comprehensive cover |
| Out-patient Consultations | ❌ or limited to ~£500 | ✅ Full cover |
| Diagnostics (Scans) | ❌ or limited | ✅ Full cover |
| Therapies (e.g., Physio) | ❌ or as paid add-on | ✅ Included (e.g., 10 sessions) |
| Mental Health Cover | ❌ or limited | ✅ Included (often extensive) |
| Dental & Optical | ❌ | ❌ (Almost always a paid add-on) |
Proactive Health: A WeCovr Philosophy
While PMI is there for when things go wrong, we believe in empowering you to stay healthy. A healthy lifestyle can reduce your risk of many acute conditions.
- Balanced Diet: Focus on whole foods, fruits, vegetables, and lean proteins. Small changes can have a big impact.
- Regular Activity: Aim for at least 150 minutes of moderate-intensity activity a week, like brisk walking, cycling, or swimming.
- Quality Sleep: Prioritise 7-9 hours of quality sleep per night. It's crucial for physical and mental recovery.
- Stress Management: Find healthy outlets for stress, whether it's mindfulness, hobbies, or spending time in nature.
To support our clients on their wellness journey, WeCovr provides complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, when you take out a PMI or Life Insurance policy with us. What's more, our clients enjoy exclusive discounts on other types of insurance, helping you protect all aspects of your life.
How to Get Private Medical Insurance
You have two main paths to getting a policy:
- Go Direct to an Insurer: You can approach a provider like Bupa or Aviva directly. The downside is that you will only see their products and prices, with no way to know if you're getting the best deal on the market.
- Use an Independent Broker: A specialist private medical insurance broker works on your behalf.
Using a broker like WeCovr has significant advantages:
- Whole-of-Market View: We compare policies and prices from all the UK's leading insurers.
- Expert Advice: We explain the jargon and help you understand the nuances of each policy so you can make an informed choice.
- No Cost to You: Our service is free. We are paid a commission by the insurer you choose, which doesn't affect the price you pay.
- Personalised Service: We take the time to understand your unique needs and find the right fit. Our clients consistently give us high satisfaction ratings for our friendly, professional approach.
Do I need a medical before getting private health insurance?
Can I use private medical insurance for emergencies?
What is an 'excess' on a health insurance policy?
Ready to Find Your Perfect Health Cover?
The questions you ask Google show you're taking a smart, proactive approach to your health. The next step is to get clarity on the options available to you.
At WeCovr, our friendly experts are ready to answer all your questions and provide a free, no-obligation comparison of the UK's leading private medical insurance providers. Let us do the hard work and find you a policy that gives you peace of mind and incredible value.
Get Your Free, Personalised PMI Quote from WeCovr Today
Sources
- Office for National Statistics (ONS): Mortality, earnings, and household statistics.
- Financial Conduct Authority (FCA): Insurance and consumer protection guidance.
- Association of British Insurers (ABI): Life insurance and protection market publications.
- HMRC: Tax treatment guidance for relevant protection and benefits products.









