TL;DR
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr understands that one of the biggest questions about private medical insurance in the UK is cost. A key factor driving your premium is, quite simply, where you live. Your postcode can have a surprisingly large impact on what you pay.
Key takeaways
- Pre-existing Conditions: Any medical condition you had before taking out the policy will not be covered.
- Chronic Conditions: Long-term conditions that require ongoing management, such as diabetes, asthma, or high blood pressure, are not covered by standard PMI.
- Emergencies: For accidents and emergencies, you should always go to your local A&E. PMI does not cover emergency treatment.
- Routine Care: Standard GP visits, prescriptions, and preventative screenings are typically excluded, although many policies now offer a Digital GP service.
- The Cost of Private Hospitals: This is the single biggest driver of regional price differences. Private hospitals in Central London, such as The London Clinic, The Cromwell Hospital, or any HCA UK facility, have much higher operating costs. These are driven by prime real estate prices, higher staff salaries, and the cost of housing the latest cutting-edge medical technology. A procedure in a Central London hospital can cost 20-40% more than the exact same procedure in a hospital in Manchester or Bristol.
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr understands that one of the biggest questions about private medical insurance in the UK is cost. A key factor driving your premium is, quite simply, where you live. Your postcode can have a surprisingly large impact on what you pay.
WeCovr compares PMI premiums by region, from London to rural areas
Private health insurance is designed to work alongside the NHS, offering you faster access to eligible treatment for acute medical conditions. While the NHS provides excellent care, long waiting lists for certain procedures have led many to consider private options. But the price for this peace of mind isn't the same for everyone.
This in-depth guide breaks down the regional cost differences for private health insurance, explaining why a policy in Kensington can cost significantly more than one in Cornwall, and what you can do to find the best value cover for your needs.
What is Private Medical Insurance (PMI) and What Does It Cover?
Before we dive into costs, let's clarify what private medical insurance is. PMI, also known as private health cover, is an insurance policy that pays for the cost of private medical treatment for specific conditions.
Think of it as a way to bypass NHS waiting lists for consultations, diagnostics, and procedures. You pay a monthly or annual premium, and in return, the insurer covers the cost of eligible private healthcare.
Crucially, it is vital to understand what PMI does not cover:
- Pre-existing Conditions: Any medical condition you had before taking out the policy will not be covered.
- Chronic Conditions: Long-term conditions that require ongoing management, such as diabetes, asthma, or high blood pressure, are not covered by standard PMI.
- Emergencies: For accidents and emergencies, you should always go to your local A&E. PMI does not cover emergency treatment.
- Routine Care: Standard GP visits, prescriptions, and preventative screenings are typically excluded, although many policies now offer a Digital GP service.
PMI is specifically for acute conditions – illnesses or injuries that are likely to respond quickly to treatment and return you to your previous state of health. Examples include joint replacements, cataract surgery, or hernia repairs.
Why Your Postcode Dictates Your Premium: The Key Factors
Insurers don't just pick numbers out of a hat. Your location directly influences their risk and the potential cost of any claims you might make. Here are the main reasons why:
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The Cost of Private Hospitals: This is the single biggest driver of regional price differences. Private hospitals in Central London, such as The London Clinic, The Cromwell Hospital, or any HCA UK facility, have much higher operating costs. These are driven by prime real estate prices, higher staff salaries, and the cost of housing the latest cutting-edge medical technology. A procedure in a Central London hospital can cost 20-40% more than the exact same procedure in a hospital in Manchester or Bristol.
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Availability of Specialists: London has the highest concentration of leading medical specialists in the country. While this offers incredible choice, their consultation and treatment fees are often higher, contributing to the overall cost base for insurers.
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Insurer's Claims Data: Insurers meticulously track claims data by postcode. If their data shows that people in a particular area are more likely to claim, or that the average cost of those claims is higher, they will adjust their premiums accordingly. Urban areas often have higher claim frequencies.
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The "Hospital List" System: Your premium isn't just based on your home address, but on the network of hospitals you want access to. Insurers offer different "hospital lists" at varying price points. A policy that includes elite Central London hospitals will always be the most expensive, regardless of where you live.
London vs. The Rest of the UK: A PMI Cost Comparison
To illustrate the difference, let's look at some estimated monthly premiums. These examples are for a non-smoker on a mid-range policy with £250 excess and full outpatient cover.
Important: These are illustrative figures for 2025. Your actual quote will depend on your specific circumstances, chosen cover level, and the insurer.
| Age Profile | Central London | Greater London (Suburbs) | Major City (e.g., Manchester) | Rural Area (e.g., Devon) |
|---|---|---|---|---|
| 30-Year-Old Individual | £85 - £120 | £65 - £90 | £55 - £75 | £45 - £60 |
| 45-Year-Old Individual | £130 - £180 | £100 - £140 | £85 - £110 | £70 - £95 |
| Family (2 Adults, 2 Children) | £280 - £400 | £220 - £310 | £180 - £250 | £150 - £210 |
As you can see, a policyholder in Central London can expect to pay nearly double what someone in a rural area pays for comparable cover. Even moving from Central London to a suburb in Zone 4 or 5 can result in a significant saving.
Deeper Dive: How Insurers' Hospital Lists Work
Understanding hospital lists is the key to controlling your location-based costs. Most major UK PMI providers, including Aviva, Bupa, and AXA Health, use a tiered system.
- Tier 1: Premium / Central London: This is the top-tier and most expensive list. It grants you access to every private hospital in the UK, including the prestigious HCA hospitals in Central London. This is often referred to as a "London uplift."
- Tier 2: National: This list typically includes most private hospitals across the country but excludes the most expensive Central London facilities. It's a popular choice for those who live outside the capital but may travel or work across the UK.
- Tier 3: Regional / Local: These lists restrict your choice to a specific network of local hospitals. They are the most affordable option and are perfect if you're happy to be treated closer to home. Some insurers even offer lists that exclude major cities to reduce costs further.
Top Tip: If you live in a Home County like Surrey or Hertfordshire but don't need access to Central London hospitals, you can save a substantial amount by choosing a hospital list that excludes them. An expert PMI broker like WeCovr can help you navigate these lists to find the perfect balance between choice and cost.
Beyond Location: Other Major Factors That Shape Your PMI Premium
While your postcode is a major factor, it's part of a much larger puzzle. Your final premium is calculated based on a range of personal and policy choices.
| Factor | How It Affects Your Premium |
|---|---|
| Age | This is the most significant factor after location. Premiums increase as you get older because the statistical likelihood of needing medical treatment rises. |
| Level of Cover | Basic cover (inpatient only) is cheapest. Comprehensive cover (including outpatient consultations, scans, and therapies) costs more. |
| Excess | This is the amount you agree to pay towards a claim. Choosing a higher excess (e.g., £500 or £1,000) will lower your monthly premium. |
| Underwriting | Moratorium: Simpler to set up, but pre-existing conditions from the last 5 years are excluded. Full Medical Underwriting: You declare your full medical history. It can sometimes result in a lower premium if you're in good health. |
| No Claims Discount | Similar to car insurance, you build up a discount for every year you don't claim. This can lead to significant savings over time. |
| Lifestyle | Smokers and vapers will always pay more for private medical insurance UK policies due to the associated health risks. |
| Guided Options | Some insurers offer a "guided" or "expert select" option. This means the insurer chooses from a smaller list of approved specialists or hospitals for your treatment in exchange for a lower premium. |
Real-Life Scenarios: Putting It All Together
Let's see how these factors combine in a few real-world examples.
Scenario 1: Amelie, 28, a Graphic Designer in Shoreditch, London
- Needs: Comprehensive cover for peace of mind, fast access to specialists, and a choice of top London hospitals near her work.
- Policy Choice (illustrative): A comprehensive plan with full outpatient cover, a low £100 excess, and a premium Central London hospital list.
- Estimated Cost: £115 per month.
Scenario 2: The Patel Family, 42 & 40, with two children in Solihull
- Needs: A family policy that covers them for major procedures and gives them access to good local private hospitals in the Birmingham area. They are happy to pay a higher excess to keep costs down.
- Policy Choice: A mid-range plan with a local hospital list and a £500 excess.
- Estimated Cost: £225 per month for the whole family.
Scenario 3: David, 67, a Retiree in Rural Scotland
- Needs: A basic, affordable policy to cover him for inpatient surgical procedures, like a hip replacement, to avoid long NHS waits. He is happy to travel to Glasgow or Edinburgh for treatment if needed.
- Policy Choice: An inpatient-only policy with a "guided" option and a £1,000 excess.
- Estimated Cost: £120 per month.
These scenarios show how tailoring your policy to your specific needs and location is essential for finding the right price.
Practical Tips for a Healthier Lifestyle (and Potentially Lower Premiums)
While you can't change your age, proactive health management is always a good investment. Insurers favour healthy clients, and some even offer rewards for staying active.
- Balanced Diet: Focus on whole foods—fruits, vegetables, lean proteins, and whole grains. A healthy diet can reduce the risk of developing many acute and chronic conditions.
- Regular Exercise: Aim for at least 150 minutes of moderate-intensity activity, like brisk walking or cycling, per week. This improves cardiovascular health, strengthens bones, and boosts mental well-being.
- Prioritise Sleep: Good quality sleep (7-9 hours for adults) is fundamental for physical repair and mental resilience. A consistent sleep schedule can have a huge impact on your overall health.
- Manage Stress: Chronic stress can contribute to various health issues. Practices like mindfulness, yoga, or even spending time in nature can help keep stress levels in check.
As a WeCovr client, you get complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, to help you on your wellness journey.
How WeCovr Finds the Best Value for You
Navigating the complexities of hospital lists, underwriting options, and policy benefits can be overwhelming. This is where an independent PMI broker is invaluable.
At WeCovr, we use our expertise and market knowledge to do the hard work for you.
- We Listen: We take the time to understand your unique needs, budget, and location.
- We Compare: We compare policies from a wide range of leading UK insurers to find the most suitable and cost-effective options.
- We Explain: We break down the jargon and explain the pros and cons of each policy, helping you understand exactly what you're buying.
- We Add Value: On top of our free, expert advice, we offer our PMI clients discounts on other insurance products, like life or income protection insurance, helping you protect your finances from all angles. Our service has earned high satisfaction ratings from customers who value our clear, no-pressure approach.
Frequently Asked Questions (FAQs)
Does moving house affect my private health insurance cost?
Can I save money by removing London hospitals from my policy?
Does standard UK PMI cover pre-existing or chronic conditions?
Is private medical insurance worth it if I live outside London?
The cost of private health insurance is not a one-size-fits-all figure. It is a tailored price based on you, your choices, and your address. By understanding the powerful impact of location and hospital lists, you can take control of your premium and find a policy that delivers exceptional value.
Ready to find out how much you could save? Get a free, no-obligation quote from WeCovr today. Our friendly experts will compare the market for you and help you find the perfect private health cover for your needs and budget.
Sources
- Department for Transport (DfT): Road safety and transport statistics.
- DVLA / DVSA: UK vehicle and driving regulatory guidance.
- Association of British Insurers (ABI): Motor insurance market and claims publications.
- Financial Conduct Authority (FCA): Insurance conduct and consumer information guidance.
