Health Insurance for Retirees in the UK
As an FCA-authorised broker that has helped arrange over 800,000 policies, WeCovr understands that planning for retirement involves more than just pensions. This guide to private medical insurance (PMI) in the UK will help you secure your health and wellbeing as you step into a new, exciting chapter of life.
WeCovr explains how to maintain PMI after leaving an employer scheme
Retirement marks a significant life change. You're leaving the daily grind behind, with more time for family, hobbies, and travel. However, it also means leaving behind your workplace benefits, including, for many, a company private medical insurance (PMI) policy.
Losing this valuable cover at a time when you may be more conscious of your health can be a genuine concern. With NHS waiting lists remaining a key issue for the foreseeable future, having a plan for private healthcare provides invaluable peace of mind.
This comprehensive guide will walk you through your options, explain the jargon, and help you make an informed decision about securing private health cover for your retirement years. We'll explore how to continue your cover seamlessly and what to look for when choosing a policy that fits your new lifestyle.
Understanding the Shift: From Company PMI to Personal Cover
For years, you may have enjoyed the security of a Group Private Medical Insurance scheme provided by your employer. These policies are a fantastic workplace perk, offering fast access to private diagnosis and treatment.
However, when you retire, your membership in this group scheme typically ends. This is because the contract is between your employer and the insurance provider, not between you and the insurer directly.
The good news is that most leading UK insurers offer a way to move from your company plan to an individual one without losing the cover you’ve built up. This is known as a 'continuation option' or a 'switch' policy.
What is a PMI Continuation Option and How Does It Work?
A continuation option is a special facility offered by insurers that allows you to switch from a company scheme to a personal policy without any new medical underwriting.
This is the single most important benefit of continuing with your current provider.
Here’s how it typically works:
- Notification: Shortly before you retire, your employer’s insurer will usually write to you, offering you the chance to continue your cover on a personal basis.
- Decision Window: You will be given a limited time frame, often 30 to 90 days, to accept this offer. It's crucial not to miss this deadline.
- Seamless Transfer: If you accept, your cover transfers to a new personal policy. The key advantage is that the insurer will continue to cover any conditions that arose and were covered while you were on the company scheme.
For example, imagine you developed a knee problem two years before retiring and used your company PMI for physiotherapy. With a continuation policy, that knee problem would remain covered. If you took out a new policy with a different insurer, it would almost certainly be excluded as a pre-existing condition.
The Golden Rule of UK Private Medical Insurance: Pre-Existing and Chronic Conditions
Before we go any further, it's vital to understand a fundamental principle of standard private medical insurance in the UK. This knowledge is crucial for making the right choice in retirement.
PMI is designed to cover acute conditions that arise after you take out your policy.
- An Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include joint replacements, cataract surgery, or treatment for hernias.
- A Chronic Condition: A disease, illness, or injury that has one or more of the following characteristics: it needs ongoing or long-term monitoring, requires palliative care, has no known cure, or is likely to come back. Examples include diabetes, asthma, arthritis, and high blood pressure.
Standard UK PMI does not cover the routine management of chronic conditions. It may cover an acute 'flare-up' of a chronic condition, but the day-to-day monitoring and medication will be handled by the NHS.
Equally, PMI policies generally exclude pre-existing conditions – any health issue you knew about before your policy began. This is why the 'continuation option' is so valuable for retirees.
Your Two Main Pathways After Leaving a Company Scheme
When your company cover ends, you face a crossroads. You have two main choices, each with significant pros and cons.
| Feature | Path 1: Accept the Continuation Policy | Path 2: Shop for a New Personal Policy |
|---|---|---|
| Underwriting | Continued Medical Exclusions (CME). No new medical checks. | New Underwriting. You'll need Full Medical Underwriting or Moratorium. |
| Pre-existing Conditions | Conditions that began while on the company scheme are covered. | All past conditions are likely to be excluded. |
| Choice of Insurer | You must stay with your employer's current insurer. | You can choose from any provider on the market. |
| Choice of Benefits | Limited to the personal plans offered by that one insurer. | Full freedom to tailor your cover, hospital list, and excess. |
| Cost | Can sometimes be more expensive as there is no market competition. | You can often find a cheaper premium by comparing providers. |
| Simplicity | Very simple and straightforward process. | Requires completing applications and comparing quotes. |
| Best For... | Someone with medical conditions they want to keep covered. | Someone in very good health who wants the best price and flexibility. |
Let's look at these two paths in more detail.
Path 1: Accepting the Continuation Policy
This is the path of continuity. By sticking with your current insurer, you ensure that your medical history is carried over seamlessly.
- Pros: The primary advantage is protecting cover for conditions that have developed. It removes the risk of new exclusions being applied. The process is simple, with minimal paperwork.
- Cons: You have no ability to shop around. The premium offered might be higher than what you could find elsewhere. You are also limited to the personal policy options offered by that one insurer, which may not be the perfect fit for your retirement lifestyle.
Path 2: Shopping for a New Personal Policy
This is the path of choice and potential savings. By exploring the whole market, you can find a policy that is perfectly tailored to your needs and budget.
- Pros: You can compare prices from all the UK's leading providers like AXA, Bupa, Aviva, and Vitality. You can customise every aspect of your cover, from the hospital list to the excess level, to get the best value. This is where an expert PMI broker like WeCovr can be invaluable, doing the comparison work for you at no cost.
- Cons: The major drawback is that you will be subject to new underwriting. Any medical condition you have experienced in the past (typically the last 5 years for moratorium, or ever for full medical underwriting) will be excluded from your new policy. This is a significant risk if you have any ongoing health concerns.
How Different Underwriting Types Affect Your Cover
'Underwriting' is the process an insurer uses to assess your health risk and decide what they will and will not cover. Understanding the types is key to choosing the right path.
| Underwriting Type | How It Works | Best For... |
|---|---|---|
| Continued Medical Exclusions (CME) / Switch | Your underwriting terms are carried over from your old group scheme. No new medical questions are asked. | Retirees leaving a company scheme. This is the gold standard for maintaining cover. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire, declaring your full medical history. The insurer then lists specific exclusions on your policy certificate. | People who want absolute clarity on what is and isn't covered from day one. |
| Moratorium (MORI) | You don't complete a health questionnaire. Instead, any condition you've had symptoms, treatment, or advice for in the 5 years before joining is automatically excluded. This exclusion can be lifted if you go 2 full years on the policy without any issues relating to that condition. | Younger, healthier individuals with a clean bill of health who want a quicker application process. It can be less suitable for retirees who may have a more complex medical history. |
For most retirees leaving a company plan, a Continued Medical Exclusions (CME) basis is the most sensible option if they have any health conditions they wish to keep covered.
Key Factors That Influence the Cost of Retiree Health Insurance
Private medical insurance premiums are calculated based on risk. For retirees, several factors come into play:
- Age: This is the single biggest determinant of cost. Premiums increase as we get older because the statistical likelihood of needing medical treatment rises. Insurers apply age-related price bands, so you will see increases on renewal each year.
- Location: Treatment costs vary across the UK. Living in or requiring access to hospitals in Central London will result in a significantly higher premium than a policy that excludes them.
- Level of Cover: A comprehensive policy with high limits for outpatient care, full cancer cover, and mental health support will cost more than a basic plan covering inpatient treatment only.
- Excess Level: The excess is the amount you agree to pay towards the cost of a claim. A higher excess (e.g., £500) will lower your monthly or annual premium.
- Hospital List: Insurers have tiered hospital lists. Choosing a more restricted list that includes excellent local private hospitals but excludes the most expensive London facilities can lead to substantial savings.
- No-Claims Discount (NCD): Similar to car insurance, most personal PMI policies include an NCD. The longer you go without claiming, the larger your discount, which can help offset age-related price rises.
How to Tailor Your PMI Policy for Retirement and Save Money
Retirement often means moving to a fixed income, so getting the best value from your health insurance is essential. Even if you take a continuation policy, you can usually adjust the plan's benefits to control the cost.
Here are some practical ways to tailor your cover:
- Review Your Hospital List: When you were working, you might have needed a policy with a comprehensive national list. In retirement, a list focused on high-quality hospitals in your local area may be perfectly adequate and much cheaper.
- Increase Your Excess: If you have some savings, consider increasing your excess. Agreeing to pay the first £250, £500, or even £1,000 of a claim can reduce your premium by as much as 35-40%.
- Opt for the 'Six-Week Option': This is a clever way to save money. A six-week option means that if the NHS can treat you for an eligible inpatient procedure within six weeks of when you need it, you use the NHS. If the wait is longer, your private cover kicks in. As the NHS aims to treat urgent cases quickly, this option effectively protects you against long waits for non-urgent elective surgery, like a hip replacement. According to NHS England data from early 2024, the median waiting time for consultant-led elective care was over 14 weeks, making this option highly valuable.
- Adjust Outpatient Cover: Full, unlimited outpatient cover is expensive. You can save money by choosing a plan with a set financial limit (e.g., £1,000 per year) or a limit on the number of consultations.
- Seek Expert Advice: This is where a specialist broker adds huge value. At WeCovr, we can take your specific needs and budget and compare all the available options from the UK's leading insurers, helping you find the perfect balance between cover and cost.
Choosing the Best PMI Provider for UK Retirees
The UK private health cover market is mature and competitive, with several excellent providers. Each has different strengths.
| Provider | Key Strengths for Retirees |
|---|---|
| AXA Health | Renowned for excellent customer service and extensive cancer cover. Often praised for their clear communication and straightforward claims process. |
| Bupa | One of the most recognised names in UK health. Offers extensive mental health support and direct access to services without needing a GP referral for certain conditions. |
| Aviva | Known for their comprehensive 'Healthier Solutions' policy and a strong digital offering (Aviva DigiCare+). Often competitive on price. |
| Vitality | Unique approach that rewards healthy living. Retirees who enjoy staying active can earn significant discounts on their renewal premiums by tracking their activity. |
| The Exeter | A friendly society known for its flexible underwriting and often no upper age limit for joining, which is a key consideration for older applicants. |
This is just a snapshot. The "best" provider is the one that best matches your personal health needs, location, and budget.
Beyond PMI: A Holistic Approach to Health in Retirement
Your health is your most important asset in retirement. Whilst private medical insurance provides a crucial safety net, a proactive approach to your wellbeing can make all the difference.
- Stay Active: Regular, gentle exercise like walking, swimming, or yoga can improve cardiovascular health, maintain muscle mass, and boost mental wellbeing. The NHS recommends at least 150 minutes of moderate-intensity activity a week.
- Eat a Balanced Diet: A diet rich in fruits, vegetables, whole grains, and lean protein supports your immune system and energy levels. As a WeCovr client, you get complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, to help you stay on track.
- Prioritise Sleep: Good quality sleep is essential for physical and mental repair. Aim for 7-9 hours per night and maintain a regular sleep schedule.
- Stay Socially Connected: Retirement is a great time to invest in relationships with family and friends and explore new hobbies. Strong social ties are linked to better mental health and longevity.
- Protect Yourself on Your Travels: If your retirement plans include seeing the world, ensure you have comprehensive travel insurance. Some PMI providers offer travel add-ons, but it's important to check they provide sufficient cover for your trips.
As a WeCovr customer, you may also be eligible for discounts on other types of insurance, such as life or travel cover, helping you protect your finances as well as your health.
How a Specialist PMI Broker like WeCovr Can Help
Navigating the transition from company to personal health insurance can feel daunting. The terminology is complex, and the stakes are high. Using an independent, expert broker like WeCovr simplifies the entire process.
- Impartial Expert Advice: We are not tied to any single insurer. Our goal is to find the best policy for you.
- Market Comparison: We compare plans and prices from across the market, saving you the time and hassle of doing it yourself.
- Navigating Your Options: We can assess the continuation offer from your current insurer and compare it against new policies on the market, giving you a clear, evidence-based recommendation.
- No Cost to You: Our service is free. We are paid a commission by the insurer you choose, but this does not affect the premium you pay.
With high customer satisfaction ratings, WeCovr is a trusted partner for thousands of UK customers seeking clarity and value in the private medical insurance market.
Will my PMI premiums increase every year as I get older?
Can I still get private health cover if I have a pre-existing condition like arthritis or high blood pressure?
What is the main difference between a continuation policy and a new personal policy for a retiree?
Is it cheaper to get private medical insurance as a couple in retirement?
Take the Next Step with Confidence
Retirement should be a time of enjoyment and relaxation, not worry. Securing the right private medical insurance is a key part of ensuring your health and peace of mind for the years ahead.
Whether you need help understanding your continuation offer or want to explore the wider market for a new policy, WeCovr's expert advisors are here to help.
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:
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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!