
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr specialises in private medical insurance in the UK. Leaving work is a major life milestone, but it often means losing company health benefits. This guide explains how you can secure your health cover and maintain peace of mind in retirement.
Retirement is often called the "golden years," a time for well-earned rest, travel, and hobbies. However, for many, the transition from employment brings an unwelcome surprise: the loss of company-sponsored private medical insurance (PMI). Suddenly, the safety net that provided fast access to specialists and private hospitals is gone, precisely when health concerns may become more prominent.
The good news is that you don't have to face a future of relying solely on an often-stretched NHS. With careful planning, you can transition seamlessly from a group scheme to a personal policy, often maintaining the level of cover you've become accustomed to.
This comprehensive guide will walk you through your options, explain the industry jargon in plain English, and empower you to make the best decision for your health and finances in retirement.
Understanding why your cover ceases is the first step to finding a solution. Company health insurance is typically offered as a "group scheme," which is a single policy that covers a group of employees.
Here’s why it ends when you leave your job:
According to the Office for National Statistics (ONS), the population of those aged 65 and over is projected to grow significantly in the coming decades. This demographic shift underscores the importance of planning for healthcare needs post-employment, as public services face increasing demand.
When your company cover ends, you're faced with a critical choice. You essentially have three main paths to continue your private medical insurance journey. Each has distinct advantages and disadvantages, especially for retirees.
This is often the most straightforward option. Many company schemes have a "continuation" or "group leaver" clause that allows you to take your cover with you when you leave. You essentially convert your membership from the group policy to a personal one with the same insurer.
How it Works: You typically need to inform the insurer within a short window (e.g., 30-60 days) of leaving your job. You'll receive a quote for a personal policy, and if you accept, your cover continues without any new medical underwriting.
| Pros of a Continuation Scheme | Cons of a Continuation Scheme |
|---|---|
| ✅ No New Medical Underwriting: This is the biggest benefit. Any conditions that were covered under your company scheme will continue to be covered. | ❌ Potentially Higher Cost: You lose the group discount, so the personal premium can be significantly higher than what you (or your employer) paid before. |
| ✅ Seamless Cover: There are no gaps in your protection. You don't need to worry about the 2-year moratorium period that comes with some new policies. | ❌ Tied to One Insurer: You cannot shop around for a better deal. You are stuck with the benefits, hospital lists, and pricing of your previous insurer. |
| ✅ Simple and Fast: The process is usually very quick and requires minimal paperwork. | ❌ Limited Flexibility: You may not be able to change your level of cover easily. The policy might be a "one-size-fits-all" conversion. |
Real-Life Example: David, 66, has been treated for knee pain under his company PMI with Bupa. He retires and opts for Bupa's continuation scheme. Because there is no new underwriting, his future knee treatments (such as a potential hip replacement) remain covered. If he had started a new policy, his knee would have been classed as a pre-existing condition and excluded.
CPME is a savvy way to shop the market while protecting the cover you've built up. It's a "middle-ground" option that allows you to move to a new insurer while keeping the same underwriting terms you had on your old policy.
How it Works: With CPME, the new insurer agrees to take you on with the same medical exclusions you had before. Any condition that was covered by your old policy will be covered by the new one. Any condition that was excluded by the old policy will remain excluded.
| Pros of a CPME Switch | Cons of a CPME Switch |
|---|---|
| ✅ Access to the Whole Market: You can compare prices and benefits from multiple insurers to find a better deal or a policy that better suits your retirement needs. | ❌ More Complex: This requires more paperwork. You'll need your policy documents from your previous insurer to prove your underwriting terms. |
| ✅ Keep Your Continuous Cover: Like a continuation scheme, you avoid new medical underwriting for conditions that were already covered. | ❌ Not All Insurers Offer It: While common, not every insurer offers CPME terms, which might limit your choices slightly. |
| ✅ Potential for Big Savings: By switching, you could find a policy with similar benefits for a much lower premium. | ❌ Exclusions are Carried Over: If your old policy had a specific exclusion (e.g., for back problems), that exclusion will follow you to the new policy. |
Working with a specialist PMI broker like WeCovr is highly recommended for a CPME switch. We can handle the comparison and paperwork, ensuring the transition is smooth and that no cover is accidentally lost.
This means starting from scratch with a brand-new policy. This can be a good option if you are in excellent health and had no significant claims on your company policy. You will be subject to new medical underwriting.
There are two main types of underwriting for new policies:
| Full Medical Underwriting (FMU) | Moratorium (Mori) Underwriting |
|---|---|
| Process: You declare your medical history on a form. | Process: No initial health questions asked. |
| Clarity: You know exactly what is and isn't covered from the start. | Clarity: Can be ambiguous. A claim may be delayed or denied while the insurer investigates your 5-year history. |
| Best For: People who want certainty and have a clear medical history. | Best For: People in good health who want a quick start and don't want to fill out forms. |
| Exclusions: Exclusions are specific and permanent (unless successfully reviewed later). | Exclusions: Exclusions are general and may be temporary. |
Crucial Warning: With either FMU or Moratorium, any health issues you had before the new policy starts will be considered pre-existing conditions and will not be covered. This is the single biggest risk of starting a new policy in retirement.
Underwriting is the process insurers use to assess risk and decide whether to offer you a policy and on what terms. For retirees, this is the most critical concept to grasp.
UK private medical insurance is designed to cover acute conditions, not chronic conditions. Understanding this difference is essential.
Standard UK PMI does not cover the routine, long-term management of chronic conditions. Your policy may cover the initial diagnosis of a chronic condition (the acute phase), but once it's diagnosed and a long-term management plan is in place, the care typically reverts to the NHS.
| What UK Private Medical Insurance Typically Covers | What UK Private Medical Insurance Typically Excludes |
|---|---|
| ✅ New, acute conditions that arise after your policy starts | ❌ Pre-existing conditions (from before your policy began) |
| ✅ Surgical procedures (e.g., hip/knee replacement, cataract surgery) | ❌ Management of long-term, chronic conditions (e.g., diabetes, asthma) |
| ✅ Consultations with specialists for new symptoms | ❌ Routine check-ups, screening, and preventative treatment |
| ✅ Advanced cancer treatment (drugs and therapies not always on the NHS) | ❌ Cosmetic surgery, unless reconstructive |
| ✅ Diagnostic tests and scans (MRI, CT, PET) for eligible conditions | ❌ A&E visits, drug and alcohol abuse treatment, fertility issues |
| ✅ In-patient and day-patient hospital stays | ❌ Unproven or experimental treatments |
With the market full of options, choosing the right provider can feel overwhelming. The "best" provider is the one that offers the right balance of benefits, hospital access, and price for your specific needs.
When evaluating policies, don't just look at the monthly premium. Dig deeper into these key features:
Here is a brief overview of some of the leading providers in the UK market. An expert broker can provide a detailed comparison based on your needs.
| Provider | Key Feature / Focus | Example of a Common Benefit |
|---|---|---|
| Aviva | Strong all-around cover with a reputation for excellent customer service and comprehensive cancer care. | Often includes a "Six Week Option" which can lower premiums. |
| AXA Health | Known for flexible policies and a strong focus on mental health support and digital GP services. | Guided option where AXA helps choose the specialist can reduce costs. |
| Bupa | One of the most recognised names, offering extensive hospital networks and direct settlement with many facilities. | Offers comprehensive cancer cover with no time limits on eligible treatment. |
| Vitality | Unique approach that rewards healthy living with discounts and benefits, including lower premiums. | Active Rewards programme offers cinema tickets, coffee, and more for being active. |
| The Exeter | A Friendly Society known for its flexible underwriting and consideration of some pre-existing conditions on certain policies. | Often favoured by those with some prior medical history. |
The biggest concern for retirees is cost. With a fixed income, a high monthly premium can be a strain. Fortunately, there are many ways to tailor a policy to make it more affordable without sacrificing quality.
While having the right insurance is crucial, the best way to manage your health and keep premiums down is to stay healthy. Retirement offers a fantastic opportunity to focus on your wellbeing.
As a WeCovr customer, you also get complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, to help you on your wellness journey. Furthermore, clients who purchase PMI or Life Insurance through us are often eligible for discounts on other types of cover, such as home or travel insurance.
Navigating the transition from a company scheme to a personal policy can be complex. Using an independent, FCA-authorised broker like WeCovr simplifies the entire process and provides numerous benefits, especially for retirees.
Leaving a company health scheme doesn't have to mean leaving quality healthcare behind. By understanding your options—Continuation, CPME, or a new policy—you can take control of your health cover for the years ahead. The right private medical insurance policy gives you the security of knowing that should you need eligible treatment, you can access it quickly, comfortably, and with a specialist of your choice.
Ready to explore your options and find the perfect private health cover for your retirement?
Contact WeCovr today for a free, no-obligation quote. Our expert advisors are ready to help you compare the market and secure your peace of mind.






