TL;DR
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr understands the nuances of private medical insurance in the UK. This guide clarifies the rules on holding multiple policies, helping you make an informed decision and avoid common pitfalls for your private health cover. The rules around multiple PMI plans and overlapping benefits In the UK, it is perfectly legal to hold more than one private medical insurance (PMI) policy.
Key takeaways
- A low limit on outpatient consultations and diagnostics (e.g., £500 per year).
- No cover for mental health treatment.
- A high compulsory excess (the amount you pay towards a claim).
- A restricted hospital list, excluding premium hospitals in major cities.
- David has a company PMI policy through his job in marketing. It provides good inpatient cover but has a £1,000 excess and no mental health support.
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr understands the nuances of private medical insurance in the UK. This guide clarifies the rules on holding multiple policies, helping you make an informed decision and avoid common pitfalls for your private health cover.
The rules around multiple PMI plans and overlapping benefits
In the UK, it is perfectly legal to hold more than one private medical insurance (PMI) policy. There is no law preventing you from having a policy from your employer and another personal policy simultaneously. However, the critical point to understand is that you cannot claim twice for the same medical treatment.
This is governed by a fundamental principle of insurance known as the ‘Contribution Clause’.
Imagine you need a knee operation costing £8,000. You have two separate PMI policies. You might think you can claim £8,000 from each, but this is not the case. The Contribution Clause means that your two insurance providers will communicate with each other and share the cost of the £8,000 bill. You will not receive a payout greater than the actual cost of your treatment.
In essence, while you can pay two sets of premiums, you will only get one set of benefits for any single claim. This prevents individuals from 'profiting' from an insurance claim, which is a core tenet of insurance regulation in the UK.
Why Might Someone Have Multiple Health Insurance Policies?
While often inefficient, there are several common scenarios where an individual might find themselves with more than one private health cover policy. Understanding these situations can help you assess your own cover.
1. Workplace Scheme plus a Personal 'Top-Up' Policy
This is the most frequent reason for holding multiple policies. Many UK employers offer PMI as a valuable employee benefit. However, this cover can sometimes be quite basic.
A standard workplace scheme might have:
- A low limit on outpatient consultations and diagnostics (e.g., £500 per year).
- No cover for mental health treatment.
- A high compulsory excess (the amount you pay towards a claim).
- A restricted hospital list, excluding premium hospitals in major cities.
In this case, an individual might purchase a separate personal policy to fill these gaps.
Real-Life Example:
- David has a company PMI policy through his job in marketing. It provides good inpatient cover but has a £1,000 excess and no mental health support.
- David is concerned about mental health and wants a lower excess.
- He purchases a personal policy that specifically includes comprehensive mental health cover and has a £250 excess.
- If David needs physiotherapy (covered by both plans), the insurers will 'contribute' to share the cost. If he needs therapy for anxiety (only covered by his personal plan), that policy alone will respond.
2. Couples or Families with Separate Workplace Policies
It's common for both partners in a relationship to be offered private health cover through their respective jobs. They might both be enrolled in their own company’s scheme, effectively having two policies covering the family.
When a family member needs treatment, they can choose which policy to claim on—typically the one with the better benefits (e.g., lower excess or a more extensive hospital list). However, they cannot claim on both for the same treatment.
3. Specialised Policies Alongside a General PMI Plan
This is a more strategic way of holding multiple policies. Instead of overlapping, the policies are complementary.
- General PMI Policy: Covers acute conditions, surgery, hospital stays, and specialist consultations.
- Specialised Policy: This could be a standalone dental plan, a cash plan for routine optical and dental check-ups, or a dedicated cancer-only policy.
These policies are designed to work together. Your PMI won't cover a routine dental filling, but your dental plan will. Your PMI will cover a knee replacement, but your cash plan might give you money back for the initial physiotherapy sessions.
4. Overlap During a Policy Switch
A temporary overlap can occur when you are switching from one provider to another. You might have a few days or weeks where both your old and new policies are active to ensure there are no gaps in your cover. This is usually a short-term situation.
The Pitfalls of Holding Multiple PMI Policies: Is It Worth It?
While there are scenarios where multiple policies exist, actively maintaining two overlapping plans is rarely the most efficient or cost-effective strategy. Here are the significant disadvantages.
1. Paying Twice for the Same Cover
This is the most obvious drawback. You are paying two monthly or annual premiums but, due to the Contribution Clause, you will only receive the value of one payout for any given claim. It is almost always more economical to have one single, comprehensive policy that is tailored to your needs.
How Contribution Works in Practice
Let's say you have two policies and need a procedure costing £6,000.
| Policy Details | Policy A (Workplace) | Policy B (Personal) | Total Claim |
|---|---|---|---|
| Annual Premium | £800 (paid by employer) | £1,200 (paid by you) | N/A |
| Excess | £500 | £250 | N/A |
| Claim Cost | £6,000 | £6,000 | £6,000 |
| Your Contribution (Excess) | N/A | £250 (you'd use the policy with lower excess) | £250 |
| Insurer A's Payout | £2,875 | ||
| Insurer B's Payout | £2,875 | ||
| Total Insurer Payout | £5,750 |
In this scenario, you're paying £1,200 a year for Policy B, but for this specific claim, its main benefit was a lower excess. The insurers simply split the remaining bill. You have not gained £12,000 of cover; you have simply had one £6,000 bill paid.
2. Administrative Complexity and Delays
Making a claim can be more complicated when two insurers are involved.
- Declaration: You are required to inform each insurer about the other policy when you make a claim. Failure to do so can be considered non-disclosure.
- Coordination: The insurers must then coordinate to decide how to split the cost. This can add time to the claims authorisation process, potentially delaying your treatment.
- Paperwork: You will have to manage two sets of policy documents, two renewal dates, and two different sets of terms and conditions.
3. Underwriting Complications
When you apply for a new policy, you undergo underwriting. This is the process an insurer uses to assess your health risk. Having multiple policies can create confusion, especially concerning pre-existing conditions. If you try to claim for a condition on one policy that was excluded by the other, it can raise red flags and complicate the claims process.
A Critical Reminder: What UK Private Medical Insurance Does and Does Not Cover
It is vital to understand the fundamental limitations of standard private medical insurance UK policies. Misunderstanding these points is the source of most customer complaints and disappointment.
PMI is designed to cover
acute conditionsthat arise after you take out the policy.
1. Chronic Conditions are Not Covered
A chronic condition is a long-term illness that can be managed but not cured. Examples include:
- Diabetes
- Asthma
- High blood pressure (Hypertension)
- Arthritis
- Eczema
- Crohn's disease
Standard PMI will not cover the ongoing management of these conditions. The NHS remains the primary provider for chronic care in the UK. A PMI policy might cover an acute flare-up of a chronic condition, but not the day-to-day monitoring, medication, or check-ups.
2. Pre-Existing Conditions are Excluded
A pre-existing condition is any disease, illness, or injury for which you have experienced symptoms, received medication, or sought advice from a medical professional before the start of your policy.
There are two main ways insurers handle this:
| Underwriting Type | How It Works | Pros | Cons |
|---|---|---|---|
| Moratorium (Mori) | Automatically excludes any condition you've had in the last 5 years. This exclusion can be lifted if you go for a continuous 2-year period after your policy starts without any symptoms, treatment, or advice for that condition. | No lengthy medical forms to fill out. Quicker to set up. | Less certainty. You only find out if something is covered when you make a claim. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire, declaring your full medical history. The insurer then states upfront exactly what will be excluded from your policy. | Provides full clarity from day one. You know precisely what is and isn't covered. | The application process is longer. Exclusions are often permanent. |
An expert PMI broker can help you decide which underwriting method is best for your personal circumstances.
The Smarter Alternative: Consolidating into a Single, Comprehensive Policy
Instead of juggling two policies and paying for overlapping benefits, the most sensible approach is to create a single policy that perfectly matches your needs and budget.
Benefits of a Single Policy:
- Cost-Effective: You only pay one premium. The money you might have spent on a second policy can be used to buy a more comprehensive single plan with higher limits, better cancer cover, or a lower excess.
- Simplicity: One renewal date, one set of documents, and one number to call when you need to make a claim. The entire process is streamlined and stress-free.
- Clarity: With one policy, there is no ambiguity about what is covered. There's no risk of administrative delays caused by insurers needing to negotiate contributions.
- Tailored to You: Working with an independent broker like WeCovr allows you to build your ideal policy from the ground up. You choose the hospital list, the excess level, and the outpatient limits that suit you, rather than accepting a generic off-the-shelf plan.
How WeCovr Helps You Find the Perfect Single Policy
Navigating the private health insurance market can be daunting. With dozens of providers and complex policy options, it's hard to know if you're getting the best deal. That's where we come in.
As an FCA-authorised broker, WeCovr provides free, impartial advice to help you find the best PMI provider for your unique situation. We don't favour one insurer over another; our goal is to find the right cover for you.
Our simple, four-step process:
- Free Consultation & Needs Analysis: We start with a friendly chat to understand what's important to you. We'll discuss your budget, family needs, health priorities (like mental health or physiotherapy), and your preferred hospitals.
- Whole-of-Market Comparison: Our experts use their knowledge and technology to compare policies from all the UK's leading insurers, including Aviva, AXA Health, Bupa, The Exeter, and Vitality.
- Clear, Jargon-Free Recommendation: We present you with the best options in plain English. We'll explain the differences, the pros and cons, and provide a clear cost breakdown so you can make a confident choice.
- Application and Ongoing Support: We handle the application paperwork for you and ensure the underwriting is completed smoothly. Our support doesn't stop there; we're here to help at renewal or if you have questions down the line.
Exclusive WeCovr Benefits:
- CalorieHero App: All our PMI clients get complimentary access to our AI-powered calorie and nutrition tracking app, helping you stay on top of your health goals.
- Multi-Policy Discounts: When you purchase PMI or Life Insurance through us, you may be eligible for discounts on other types of cover you need.
- Trusted Service: Our high customer satisfaction ratings on major review websites reflect our commitment to providing exceptional, client-focused service.
Wellness & Lifestyle: Proactive Health is the Best Insurance
While having robust private medical insurance provides peace of mind, the best strategy is always to invest in your long-term health. Many modern PMI providers, like Vitality, actively reward members for healthy living.
Here are some evidence-based tips for improving your overall wellbeing, supported by data from UK health organisations.
- Nourish Your Body: A balanced diet rich in fruits, vegetables, lean proteins, and whole grains is crucial. The NHS recommends aiming for at least five portions of a variety of fruit and veg each day. A Mediterranean-style diet has been shown to reduce the risk of heart disease and other chronic illnesses.
- Prioritise Sleep: According to the Office for National Statistics (ONS), sleep problems are a significant issue in the UK. Aim for 7-9 hours of quality sleep per night. Establish a routine, reduce screen time before bed, and create a dark, quiet sleeping environment to improve your sleep hygiene.
- Stay Active: The NHS advises adults to do at least 150 minutes of moderate-intensity activity a week or 75 minutes of vigorous-intensity activity. This could be brisk walking, cycling, swimming, or playing a sport. Regular exercise is proven to reduce your risk of major illnesses, such as coronary heart disease, stroke, and type 2 diabetes, by up to 50%.
- Mind Your Mental Health: Mental wellbeing is just as important as physical health. Practices like mindfulness, spending time in nature, and maintaining strong social connections are vital. Don't hesitate to seek support if you're struggling. Many PMI policies now offer excellent mental health pathways, providing fast access to therapy and psychiatric support.
Can I claim the full cost of a treatment from two different health insurance policies?
Do I need to declare my other private medical insurance policy when making a claim?
Is it better to have a workplace policy and a personal one, or just one comprehensive plan?
Can I use one PMI policy to pay the excess on another policy?
Ready to simplify your health cover and ensure you have the best protection without overpaying?
The expert team at WeCovr is here to help. We'll compare the UK's leading insurers to find you the perfect single policy, tailored to your needs and budget—all at no cost to you.
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