As an FCA-authorised expert insurance broker that has helped arrange over 900,000 policies, WeCovr provides this guide to navigating the costs of private medical insurance in the UK. Understanding the real price of a policy is the first step towards deciding if it's the right choice for you and your family.
WeCovr explains the real costs of PMI and how to keep premiums affordable
Private Medical Insurance (PMI) is designed to work alongside the NHS, giving you more choice and control over your healthcare. With NHS waiting lists reaching record levels – the latest figures from NHS England show over 7.5 million treatment pathways waiting to begin – it’s no surprise that more people are exploring private options.
But what does it actually cost? The answer isn't a single number. Your premium is personal, calculated using a range of factors from your age to your postcode. In this definitive 2026 guide, we'll break down the costs, explain what drives them, and show you practical ways to secure comprehensive cover without breaking the bank.
What Exactly is Private Medical Insurance (PMI)?
Before we dive into the costs, let's be clear about what PMI is—and what it isn't.
Private health insurance is a policy you pay for that covers the cost of private medical treatment for acute conditions. An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and return you to your previous state of health. Think of things like joint replacements, cataract surgery, or hernia repairs.
Crucially, standard UK private medical insurance does not cover:
- Pre-existing conditions: Any illness or injury you had before taking out the policy.
- Chronic conditions: Long-term illnesses that cannot be cured, only managed. This includes conditions like diabetes, asthma, high blood pressure, and arthritis.
PMI is not a replacement for the NHS. It doesn't cover GP visits (though some policies offer a digital GP service), Accident & Emergency care, or the management of long-term health issues. Its primary purpose is to help you bypass NHS waiting lists for eligible, acute treatments.
How Much Does Private Health Insurance Really Cost in the UK?
The cost of a PMI policy can range from as little as £30 per month to well over £200. This variation depends entirely on you and the level of cover you choose.
To give you a clearer picture, we've compiled some estimated monthly costs based on different ages and cover levels.
Please Note: These figures are illustrative estimates for a healthy non-smoker in 2026, assuming a mid-range policy with a £250 excess. Medical inflation often runs higher than standard inflation, so costs are subject to change.
| Age Group | Estimated Monthly Premium (Basic Cover) | Estimated Monthly Premium (Comprehensive Cover) |
|---|
| 20-29 | £35 - £50 | £60 - £85 |
| 30-39 | £45 - £65 | £75 - £110 |
| 40-49 | £60 - £90 | £100 - £150 |
| 50-59 | £85 - £130 | £140 - £220 |
| 60-69 | £120 - £180 | £190 - £300+ |
| 70+ | £170 - £250+ | £280 - £450+ |
As you can see, age is the most significant factor. Now, let's explore what separates a 'basic' policy from a 'comprehensive' one.
| Feature | Basic Cover | Mid-Range Cover | Comprehensive Cover |
|---|
| Inpatient & Day-patient | ✅ Included | ✅ Included (often with higher limits) | ✅ Included (fully covered) |
| Outpatient Cover | ❌ Not included or very limited (e.g., post-surgery only) | ✅ Included (up to a set limit, e.g., £1,000) | ✅ Included (often fully covered) |
| Cancer Cover | ✅ Included (often with limits on treatments/drugs) | ✅ Enhanced cancer cover | ✅ Full cancer cover (incl. experimental drugs) |
| Mental Health Cover | ❌ Often excluded | ✅ Limited cover (e.g., outpatient therapy) | ✅ Comprehensive cover (incl. inpatient treatment) |
| Therapies (Physio etc.) | ❌ Often excluded | ✅ Included (limited number of sessions) | ✅ Included (more sessions) |
| Hospital List | Limited (local hospitals) | National list (most private hospitals) | Full list (including premium London hospitals) |
| Estimated Monthly Cost (40-year-old) | ~£60 | ~£75 | ~£110 |
The 8 Key Factors That Determine Your PMI Premium
Your final quote is a blend of personal details and policy choices. Understanding these levers is the key to finding affordable private health cover.
1. Your Age
This is the number one factor. As we get older, the statistical likelihood of needing medical treatment increases. Insurers price this risk accordingly, which is why premiums rise significantly in your 50s, 60s, and beyond.
2. Your Location
Where you live in the UK affects your premium. Medical treatment costs more in certain areas, particularly London and the South East. Insurers reflect this by creating tiered hospital lists. A policy that includes access to expensive central London hospitals will cost more than one limited to a network of local private facilities.
3. Your Level of Cover
This is the area where you have the most control.
- Inpatient vs. Outpatient: All policies cover inpatient treatment (where you need a hospital bed overnight). The big variable is outpatient cover, which pays for consultations, diagnostic scans (MRI, CT), and tests that don't require a hospital stay. A policy with limited or no outpatient cover is much cheaper.
- Cancer Care: All PMI policies offer some level of cancer cover as standard, but the depth varies. Comprehensive policies provide access to the latest drugs and therapies, some of which may not be available on the NHS.
- Add-ons: You can often add dental, optical, and mental health cover for an additional premium.
4. The Policy Excess
Just like with car or home insurance, a policy excess is the amount you agree to pay towards a claim. For example, if you have a £250 excess and need a procedure costing £3,000, you pay the first £250 and your insurer pays the remaining £2,750.
Choosing a higher excess is one of the easiest ways to lower your monthly premium.
| Excess Amount | Impact on Premium |
|---|
| £0 | Highest Premium |
| £100 | High Premium |
| £250 | Standard Premium |
| £500 | Lower Premium |
| £1,000 | Lowest Premium |
5. Your Medical History & Underwriting
When you apply, the insurer needs to know about your medical history to exclude pre-existing conditions. There are two main ways they do this:
- Moratorium Underwriting: This is the most common method. You don't declare your full medical history upfront. Instead, the insurer automatically excludes any condition you've had symptoms, treatment, or advice for in the last 5 years. If you then remain symptom-free for a continuous 2-year period after your policy starts, that condition may become eligible for cover.
- Full Medical Underwriting (FMU): You complete a detailed medical questionnaire. The insurer reviews it and gives you a definitive list of what is and isn't covered from day one. This can take longer but provides absolute clarity.
6. The Hospital List
Insurers negotiate rates with different hospital groups. Your choice of hospital list directly impacts the price.
- Local List: Restricts you to specific hospitals in your area. The cheapest option.
- National List: Gives you access to a wide range of private hospitals across the UK, but may exclude the most expensive ones in central London.
- Premium/London List: The most comprehensive and expensive option, including top facilities like The London Clinic or HCA hospitals at The Shard.
7. No Claims Discount (NCD)
Many PMI providers operate a No Claims Discount system. For every year you don't make a claim, you get a discount on your renewal premium, up to a maximum level (e.g., 65-75%). Making a claim will typically reduce your NCD level, increasing your premium the following year.
8. Your Lifestyle
Insurers will ask about your smoking habits. Smokers and recent ex-smokers will always pay more for private medical insurance UK policies than non-smokers, sometimes by as much as 30-50%, due to the associated health risks.
7 Smart Ways to Keep Your Private Health Insurance Costs Down
Worried about the cost? There are plenty of clever ways to make PMI more affordable without sacrificing the core benefits.
- Increase Your Excess: As shown above, opting for a £500 or £1,000 excess can dramatically reduce your monthly payments. It's a trade-off: you're betting on not needing to claim often.
- Opt for the '6-Week Wait' Option: This is a fantastic cost-saving feature. With this option, if the NHS can provide the inpatient treatment you need within six weeks of your specialist's recommendation, you'll use the NHS. If the wait is longer than six weeks, your private cover kicks in. This can reduce your premium by 20-30%.
- Tailor Your Hospital List: Do you really need access to every hospital in the country, including those in central London? If not, choosing a more restricted national or local list is an easy way to save money.
- Review Your Outpatient Cover: A policy with full outpatient cover is convenient but expensive. Consider a policy with a limit (e.g., £1,000 per year) or one that only covers diagnostics after a specialist referral. You could self-fund initial consultations and save the insurance for major expenses.
- Pay Annually: Most insurers offer a small discount (around 5%) if you pay for your policy in one lump sum each year rather than by monthly direct debit.
- Live a Healthier Lifestyle: Quitting smoking is the single best thing you can do for your health and your wallet. Many insurers also offer rewards and discounts for staying active, tracked via apps and wearables.
- Use an Independent Broker: The PMI market is complex. A specialist broker like WeCovr can compare policies from all the leading UK providers in minutes. We know the market inside out and can find a policy that fits your specific needs and budget—and our service is completely free to you.
Real-Life Cost Examples
Let's put this all together with a few examples.
-
Persona 1: Sarah, a 32-year-old graphic designer in Leeds.
- Needs: Fast access to diagnostics and treatment for peace of mind. Not concerned about a London hospital.
- Policy Choice: Mid-range cover with a £1,000 outpatient limit, a £250 excess, a national hospital list, and a 6-week wait option.
- Estimated Monthly Cost: £48
-
Persona 2: The Jones Family, two adults (45, 43) and two children (12, 9) in Bristol.
- Needs: Comprehensive cover for the whole family, including good mental health support for the teenagers.
- Policy Choice: Comprehensive family policy, full outpatient cover, a £500 excess, and a national hospital list.
- Estimated Monthly Cost: £195
-
Persona 3: David, a 64-year-old retired teacher in Edinburgh.
- Needs: Robust cover for potential joint issues and access to the best cancer care available.
- Policy Choice: Comprehensive cover, full cancer care, a low £100 excess, and a full UK hospital list.
- Estimated Monthly Cost: £210
The WeCovr Difference: More Than Just a Quote
At WeCovr, we believe in adding value beyond simply finding you the cheapest price. When you choose us to help you find the best PMI provider, you get more than just insurance.
- Expert, Unbiased Advice: As an FCA-authorised broker, our primary duty is to you, not the insurance company. We listen to your needs and find the right fit.
- Complimentary CalorieHero App: All WeCovr clients get free access to our AI-powered calorie and nutrition tracking app, CalorieHero, helping you build and maintain a healthy lifestyle.
- Multi-Policy Discounts: When you take out a private health or life insurance policy through us, you can often get discounts on other types of cover you might need, like home or travel insurance.
- Exceptional Service: We pride ourselves on our high customer satisfaction ratings, guiding you through the application process and being there to help if you ever need to claim.
Frequently Asked Questions (FAQ)
Can I get private health insurance if I have a pre-existing medical condition?
Yes, you can absolutely get a policy. However, standard private medical insurance in the UK is designed for new, acute conditions. This means the policy will not cover the pre-existing condition itself or any related treatments. For example, if you have pre-existing arthritis in your knee, a new policy would not pay for a knee replacement. It would, however, cover you for new, unrelated conditions like hernias or cataracts that arise after your policy begins.
Will my private health insurance premium go up every year?
It is very likely, yes. Premiums tend to increase annually for two main reasons. Firstly, you are a year older, which moves you into a higher risk bracket. Secondly, medical inflation—the rising cost of new drugs, technology, and hospital charges—means insurers have to adjust their prices. This typically adds 5-8% per year. Making a claim can also lead to a larger increase at renewal as it may reduce your No Claims Discount.
What is a 'moratorium' on a health insurance policy?
A moratorium is the most common type of underwriting for PMI in the UK. With this method, you don't need to provide your full medical history when you apply. Instead, the policy automatically excludes any medical conditions for which you have had symptoms, medication, or advice in the 5 years before the policy started. However, if you then go for a continuous 2-year period after your policy start date without any treatment, symptoms or advice for that condition, it may become eligible for cover.
Take Control of Your Health Today
The cost of private health insurance is not a mystery—it's a calculation based on clear factors. By understanding them, you can build a policy that gives you valuable peace of mind and fast access to treatment, all at a price you can afford.
The best way to find out your exact cost is to get a personalised comparison.
Let WeCovr do the hard work for you. Get a free, no-obligation quote today and compare the UK's leading private health insurance providers in minutes.