Health Coverage Calculator UK Family vs Individual
As an FCA-authorised expert broker that has helped arrange over 800,000 policies, WeCovr understands the nuances of private medical insurance in the UK. This guide is designed to help you calculate the likely cost difference between individual, couple, and family health insurance, empowering you to make the best choice for your circumstances.
Work out the likely cost difference between single, couple and family health insurance policies
Navigating the world of private health cover can feel complex, especially when trying to budget for yourself, your partner, or your entire family. The fundamental question for many is: is it cheaper to buy one policy for everyone, or separate ones for each individual?
The short answer is that combining people onto a single policy—whether for a couple or a family—is almost always more cost-effective than taking out multiple individual plans. Insurers reward these 'multi-buy' arrangements with discounts, making comprehensive cover more accessible.
In this guide, we'll break down exactly how these costs are calculated, show you illustrative price differences, and explore the factors that will influence your final premium. We'll demystify the jargon and provide practical steps to help you find the right level of cover at the best possible price.
Before we dive in, it's crucial to understand a core principle of UK private medical insurance (PMI): it is designed to cover acute conditions that arise after you take out your policy. It does not cover pre-existing conditions or chronic illnesses like diabetes or asthma.
Understanding the Core Factors That Influence Your PMI Premium
Your final health insurance premium is a personalised figure based on a combination of risk factors and policy choices. Insurers use these details to calculate the likelihood of you making a claim. Let's explore the main components.
1. Age
Age is the single most significant factor. As we get older, the statistical likelihood of needing medical treatment increases. Consequently, premiums rise with age. A policy for a 30-year-old will be substantially cheaper than for a 60-year-old with the exact same level of cover.
2. Location
Where you live in the UK plays a big role in your premium. This is often called the "postcode lottery." Private medical treatment in major cities, particularly Central London where hospitals like The London Clinic and Cromwell Hospital operate, is significantly more expensive. Living in or near these areas will result in a higher premium compared to someone living in a more rural part of the country.
3. Level of Cover
You can tailor your policy to suit your needs and budget. The more comprehensive the cover, the higher the cost.
- Basic Cover: Typically covers in-patient and day-patient treatment only. This means costs are covered only if you are admitted to a hospital bed.
- Comprehensive Cover: Includes in-patient treatment plus out-patient cover. This pays for diagnostic tests, specialist consultations, and scans that don't require a hospital stay.
- Optional Extras: You can add further benefits for an additional premium, such as:
- Mental health cover
- Dental and optical care
- Therapies (physiotherapy, osteopathy, etc.)
4. Policy Excess
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, you pay the first £250 and the insurer pays the remaining £1,750.
Choosing a higher excess is a powerful way to reduce your monthly premium. Excesses typically range from £0 to £1,000.
5. Hospital List
Insurers group hospitals into tiers based on cost. A policy with a limited list of local hospitals will be cheaper than one that gives you access to a nationwide network, including the premium-priced London hospitals.
6. Underwriting Method
This is how the insurer assesses your medical history.
- Moratorium Underwriting: This is the most common and straightforward option. You don't declare your full medical history upfront. Instead, any condition you've had symptoms, treatment, or advice for in the 5 years before your policy starts is automatically excluded. This exclusion can be lifted if you go 2 continuous years on the policy without any issues relating to that condition.
- Full Medical Underwriting (FMU): You complete a detailed health questionnaire. The insurer then reviews your history and may place specific, permanent exclusions on your policy. It takes longer but provides absolute clarity on what is and isn't covered from day one.
7. Lifestyle
Your personal habits, primarily smoking, have a direct impact. Smokers are considered a higher risk and will always pay more for their health insurance than non-smokers.
Single vs. Couple Health Insurance: A Cost Comparison
Taking out a joint policy with your partner is a simple way to secure a discount. While it's not a "buy one, get one free" offer, insurers typically reduce the total premium by around 5% compared to the cost of two separate individual policies. This is because they make an administrative saving by managing one policy instead of two, and they pass a portion of that saving on to you.
Let's look at an illustrative example to see how this works in practice.
Scenario:
- Insured: A couple, both aged 40.
- Location: Bristol (a mid-cost UK region).
- Cover: Mid-range comprehensive cover with a £250 excess.
- Health: Both are non-smokers.
| Policy Structure | Estimated Monthly Premium | Total Annual Cost | Annual Saving on a Couple Policy |
|---|---|---|---|
| Individual Policy 1 (Person A, 40) | £75 | £900 | N/A |
| Individual Policy 2 (Person B, 40) | £75 | £900 | N/A |
| Total for Two Separate Policies | £150 | £1,800 | - |
| Joint Couple Policy | £142 | £1,704 | £96 |
Disclaimer: These prices are for illustrative purposes only. Your actual quote will depend on your specific circumstances and the insurer chosen.
As the table shows, the saving is modest but meaningful over the course of a year. The primary benefit, alongside the cost saving, is convenience: one set of documents, one renewal date, and one point of contact for any queries.
Family Health Insurance: The Most Cost-Effective Option for Households
The financial benefits become much more significant when adding children to a policy. Family health insurance is where the "multi-buy" discount really comes into its own. Insurers know that while children may need to see a GP, they are statistically far less likely to require major, expensive hospital procedures compared to adults.
Because of this, children can be added to a parent's policy at a heavily discounted rate. Some insurers even run promotions where the first child is added for free, making it an incredibly attractive proposition for new families.
Scenario:
- Insured: The same couple from our previous example (both 40), plus two children aged 10 and 7.
- Location: Bristol.
- Cover: Mid-range comprehensive cover with a £250 excess.
Let's compare the cost of a single family policy versus buying separate policies for the adults and children.
| Policy Structure | Estimated Monthly Premium | Average Cost Per Person | Annual Saving on a Family Policy |
|---|---|---|---|
| Couple Policy (Adults) | £142 | £71 | N/A |
| Two Separate Child Policies | £60 (approx. £30 each) | £30 | N/A |
| Total for Separate Policies | £202 | £50.50 | - |
| Single Family Policy | £170 | £42.50 | £384 |
Disclaimer: These prices are for illustrative purposes only. Actual costs and discounts vary by insurer.
In this example, opting for a single family policy saves the household over £380 a year. The per-person cost drops significantly, making it the clear economic choice. Beyond the financial savings, it provides unified peace of mind, ensuring every family member has access to the same high standard of care under one simple plan.
How to Calculate Your Potential Health Insurance Costs
While online calculators can give you a rough estimate, the only way to get a precise figure is to get a personalised quote. An expert broker can be invaluable here.
Here’s a simple four-step process to work out your likely costs:
Step 1: Gather Your Information
Before you start, have the following details for each person to be insured:
- Full name and date of birth
- Home postcode
- Smoker status
- A general idea of their medical history (you won't need full details for a moratorium quote, but it's good to have in mind)
Step 2: Define Your Ideal Cover
Think about what's important to you:
- Budget: What's a comfortable monthly premium for you?
- Excess: How much could you afford to pay towards a claim? (A higher excess of £500 or £1,000 can dramatically lower your premium).
- Cover Level: Do you just want peace of mind for major surgery (in-patient only), or do you want cover for specialist consultations too (comprehensive)?
- Hospitals: Is access to local private hospitals sufficient, or do you need a nationwide list?
Step 3: Use an Expert Broker like WeCovr
Instead of going to individual insurers one by one, a broker does the hard work for you. At WeCovr, our specialist advisors will:
- Discuss your needs and budget in plain English.
- Compare policies from a wide panel of leading UK insurers like Bupa, Aviva, AXA Health, and Vitality.
- Find the most suitable policy and highlight any special offers, such as free cover for your first child.
- Provide this service at no cost to you. Our commission is paid by the insurer you choose, so you get expert, impartial advice for free.
Step 4: Review Your Personalised Quotes
Your advisor will present you with a few of the best options. They will explain the key differences in cover, benefits, and price, allowing you to compare like-for-like and make a confident, informed decision.
Is Family Health Insurance Worth It? Weighing the Pros and Cons
Deciding whether to invest in private medical insurance for your family is a significant decision. Here are the key arguments to help you weigh it up.
The Pros of Family PMI
- Faster Access to Treatment: This is the number one reason people buy PMI. With NHS waiting lists in the UK reaching historic highs (the referral to treatment list in England stood at over 7.5 million pathways in late 2024), PMI allows you to bypass these queues for eligible conditions. This is especially comforting for parents worried about their children's health.
- Significant Cost Savings: As demonstrated, a family policy is far cheaper than individual plans.
- Convenience and Simplicity: One policy, one payment, one renewal date, and one number to call. It simplifies administration for the whole family.
- Choice and Control: You get to choose your specialist and the hospital where you're treated from the insurer's approved list. You can also schedule treatment at a time that suits your family's life.
- Enhanced Comfort: Private hospitals offer private en-suite rooms, more flexible visiting hours, and better food, making a stressful time a little more comfortable.
- Valuable Added Perks: Modern PMI policies come with a host of benefits you can use even when you're not ill:
- 24/7 Virtual GP: Get a GP appointment via phone or video, often within a few hours.
- Mental Health Support: Access to telephone counselling or digital therapy services.
- Wellness Programmes: Rewards and discounts for staying active and healthy.
- Exclusive Discounts: When you buy PMI or Life Insurance through WeCovr, you may be eligible for discounts on other types of cover.
- Free Health Tools: WeCovr customers also get complimentary access to our AI-powered diet and calorie tracking app, CalorieHero, to support their health goals.
The Cons and Considerations
- The Cost: While cheaper than separate policies, family PMI is still a monthly expense that needs to be factored into the household budget.
- The Exclusions: This is the most critical point to understand. Private medical insurance does not cover everything. Key exclusions are:
- Pre-existing conditions from the last 5 years (under moratorium underwriting).
- Chronic conditions such as diabetes, asthma, and high blood pressure.
- Emergency services (A&E).
- Normal pregnancy and childbirth.
- Cosmetic surgery.
- The NHS is Still Essential: PMI is a supplement to the NHS, not a replacement. You will still rely on the NHS for emergencies, GP services (unless you have a virtual GP add-on), and the management of any chronic conditions.
Top Tips for Reducing Your Family Health Insurance Premiums
If you've decided that family PMI is right for you, there are several effective strategies to manage the cost without sacrificing essential cover.
- Increase Your Excess: Agreeing to a higher excess (e.g., £500) is the fastest way to lower your premium.
- Opt for a 6-Week Wait Option: This clever option can reduce your premium by up to 30%. With this, if the NHS can provide the required treatment within six weeks of you being referred, you use the NHS. If the waiting list is longer than six weeks, your private policy kicks in.
- Tailor Your Hospital List: If you don't live near London, removing the expensive central London hospitals from your list can create significant savings.
- Choose a 'Guided' Consultant List: Some insurers offer a reduced premium if you agree to choose a specialist from a smaller, pre-approved list. These are still top consultants, but the insurer has negotiated preferential rates with them.
- Pay Annually: Most insurers offer a discount of around 5% if you pay for your policy in one annual lump sum instead of monthly.
- Look for Child-Friendly Offers: Ask your broker to specifically look for insurers with offers like "first child covered free" or discounted rates for multiple children.
- Review Your Cover Annually: Don't just auto-renew. Premiums can rise each year. By speaking to a broker like WeCovr at renewal, you can re-scan the market to ensure you're still on the best possible deal. WeCovr's high customer satisfaction ratings are built on helping clients find long-term value.
A Note on Pre-existing and Chronic Conditions
We cannot stress this enough: understanding what PMI does and does not cover is vital to avoid disappointment later.
- An Acute Condition is a disease, illness or injury that is likely to respond quickly to treatment and from which you are expected to make a full recovery. Examples include joint replacements, hernia repair, and removal of gallstones. This is what PMI is for.
- A Chronic Condition is an illness that continues for a long time, has no known cure, and needs ongoing management. Examples include diabetes, asthma, arthritis, and high blood pressure. PMI does not cover the management of chronic conditions.
- A Pre-existing Condition is any ailment for which you have experienced symptoms, sought advice, or received treatment in the 5 years before your policy starts. These are excluded, typically for the first 2 years of your policy.
Private medical insurance is your partner for new, unexpected health issues, providing fast access to diagnosis and treatment. For day-to-day and long-term health management, the NHS remains your primary provider.
Can I add a newborn baby to my family health insurance policy?
What happens to my family policy when my children become adults?
Is mental health treatment covered on a standard UK PMI policy?
Ready to find out how much you could save on health insurance for you and your loved ones? The process is simpler than you think.
Contact the friendly, expert team at WeCovr today for a free, no-obligation quote. We'll compare the UK's leading insurers to find the perfect cover for your family's needs and budget.
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.
By tapping the button below, you can book a free call with them in less than 30 seconds right now:
Our Group Is Proud To Have Issued 800,000+ Policies!
We've established collaboration agreements with leading insurance groups to create tailored coverage
How It Works
1. Complete a brief form
2. Our experts analyse your information and find you best quotes
3. Enjoy your protection!
Any questions?
Learn more
Who Are WeCovr?
WeCovr is an insurance specialist for people valuing their peace of mind and a great service.👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.
Just a quick and simple form and an easy conversation with one of our experts and your valuable insurance policy is in place for that needed peace of mind!