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How Pre Authorisation Works in Private Health Insurance

Understanding pre-authorisation is key to using your private medical insurance in the UK. At WeCovr, an insurance broker that has helped arrange over 1,000,000 policies, we make this process clear.

Last updated Oct 7, 2026

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TL;DR

Understanding pre-authorisation is key to using your private medical insurance in the UK. At WeCovr, an insurance broker that has helped arrange over 1,000,000 policies, we make this process clear. This guide explains how to get approval for your treatment and what steps to take.

Key takeaways

  • An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include joint replacements, cataract removal, hernia repair, and most cancer treatments.
  • A chronic condition is a disease, illness, or injury that has one or more of the following characteristics: it needs ongoing or long-term monitoring, is managed by medication or tests, has no known cure, or is likely to come back. Standard UK private health insurance does not cover the management of chronic conditions like diabetes, asthma, hypertension, or multiple sclerosis.
  • Moratorium Underwriting: This is the most common type. It automatically excludes any condition you've had symptoms, advice, or treatment for in the five years before your policy began. However, if you go two full years on the policy without any symptoms, advice, or treatment for that condition, it may become eligible for cover.
  • Full Medical Underwriting (FMU): With FMU, you complete a detailed health questionnaire when you apply. The insurer assesses your medical history and lists specific exclusions on your policy from day one. This provides more certainty but can be more complex upfront.
  • It's a Pre-existing Condition: The condition or its symptoms existed before you joined the policy and are therefore excluded under the underwriting terms.

Understanding pre-authorisation is key to using your private medical insurance in the UK. At WeCovr, an insurance broker that has helped arrange over 1,000,000 policies, we make this process clear. This guide explains how to get approval for your treatment and what steps to take.

When and how to get approval for treatment, and what to do if refused

Getting approval, or 'pre-authorisation', is a vital step before you receive most types of private medical treatment. You should contact your insurer right after your GP has referred you to a specialist, but before you book any appointments or procedures. Your insurer will check your cover, confirm the treatment is medically necessary, and give you an authorisation number.

If your request is refused, don't panic. The first step is to ask your insurer for a clear reason in writing. You can then review your policy, speak to your specialist for more evidence, and launch a formal appeal. If that fails, the independent Financial Ombudsman Service is your next port of call. This guide will walk you through each of these steps in detail.

What Exactly is Pre-Authorisation in Private Health Insurance?

Think of pre-authorisation as getting the green light from your insurance provider before you go ahead with private medical care. It's a mandatory checkpoint where your insurer verifies that the consultation, test, or treatment you need may be covered under the terms of your policy.

It is not just a box-ticking exercise; it serves several crucial functions:

  • Confirms Medical Necessity: The insurer checks that the treatment is essential for your health and not for cosmetic or lifestyle reasons.
  • Verifies Policy Cover: It ensures the specific condition and the proposed treatment are included in your plan. This avoids any nasty surprises with unexpected bills later on.
  • Manages Costs: It allows the insurer to confirm the costs with the hospital and specialist, ensuring they are reasonable and customary.
  • Guides You to a Recognised Provider: Insurers have networks of approved hospitals and specialists. Pre-authorisation ensures you are treated by a facility and a professional that meets their quality and cost criteria.

Without a pre-authorisation number, your insurer can refuse to pay for your treatment, leaving you responsible for the entire bill.

The Step-by-Step Pre-Authorisation Process Explained

Navigating the pre-authorisation journey can feel daunting, but it follows a logical path. Here’s a breakdown of the typical steps from initial symptom to final payment.

Step 1: Visit Your GP

For most non-emergency conditions, your journey starts at your local NHS GP surgery. You'll discuss your symptoms, and if they feel you need specialist investigation, they will provide you with an 'open referral' letter. This letter will recommend a type of specialist (e.g., a cardiologist or an orthopaedic surgeon) but won't usually name a specific person.

Step 2: Contact Your Insurer to Get Authorisation

This is the most important step. Before you book any private appointments, call your insurer's claims or pre-authorisation helpline. Have this information ready:

  • Your policy number
  • Personal details (name, date of birth, address)
  • The details from your GP referral letter
  • A description of your symptoms and when they started

The insurer's clinical team will review your case. They will check your policy to ensure the condition isn't excluded and that you have sufficient benefit limits (e.g., for outpatient consultations).

Step 3: Receive Your Authorisation Number

If your claim is approved, you will be given a pre-authorisation or claims number. This number is your golden ticket. It confirms the insurer has agreed to cover the initial consultation. You will need to give this number to the specialist's secretary and the hospital.

Step 4: Book Your Specialist Consultation

Your insurer will provide you with a list of approved specialists and hospitals in your area. It is crucial to choose from this list. Using a non-approved provider could invalidate your claim. You can then contact the specialist's secretary to book your first appointment, providing them with your authorisation number.

Step 5: The Specialist Recommends Further Tests or Treatment

During your consultation, the specialist may decide you need further diagnostic tests, like an MRI scan, or a specific treatment, such as surgery. For each of these subsequent steps, new pre-authorisation is required. Often, the specialist’s administrative team will handle this on your behalf, contacting the insurer directly with the proposed treatment plan and associated costs (known as procedure codes).

Step 6: Receive Authorisation for the Main Treatment

Your insurer will review the specialist's request. If approved, they will issue a new authorisation for the specific tests or surgery. They will confirm exactly what they are covering and up to what cost.

Step 7: Undergo Your Treatment

With full authorisation in place, you can proceed with your tests or treatment with the peace of mind that the costs may be covered.

Step 8: Invoices are Settled Directly

After your treatment, the hospital and specialist will send their invoices directly to your insurance company, quoting your authorisation number. The insurer settles the bill. You will only be responsible for paying any excess that applies to your policy.

The Golden Rule: What UK PMI Does and Doesn't Cover

Understanding the core purpose of private medical insurance is essential. It is designed to cover acute conditions that arise after you have taken out your policy.

  • An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include joint replacements, cataract removal, hernia repair, and most cancer treatments.
  • A chronic condition is a disease, illness, or injury that has one or more of the following characteristics: it needs ongoing or long-term monitoring, is managed by medication or tests, has no known cure, or is likely to come back. Standard UK private health insurance does not cover the management of chronic conditions like diabetes, asthma, hypertension, or multiple sclerosis.

Furthermore, PMI policies do not cover pre-existing conditions. How this is managed depends on your underwriting type:

  1. Moratorium Underwriting: This is the most common type. It automatically excludes any condition you've had symptoms, advice, or treatment for in the five years before your policy began. However, if you go two full years on the policy without any symptoms, advice, or treatment for that condition, it may become eligible for cover.
  2. Full Medical Underwriting (FMU): With FMU, you complete a detailed health questionnaire when you apply. The insurer assesses your medical history and lists specific exclusions on your policy from day one. This provides more certainty but can be more complex upfront.

Acute vs. Chronic Conditions: A Clear Comparison

FeatureAcute ConditionChronic Condition
DurationShort-termLong-term, often lifelong
OutcomeCurable, leads to recoveryManageable, but not curable
PMI CoverCoveredNot Covered
ExamplesAppendicitis, bone fracture, gallstones, cataracts, most cancersDiabetes, asthma, high blood pressure, arthritis, Crohn's disease

Why Might a Pre-Authorisation Request Be Refused?

Receiving a 'no' from your insurer can be disheartening. It almost always comes down to the specific terms written in your policy document. Here are the most common reasons for a refusal:

  • It's a Pre-existing Condition: The condition or its symptoms existed before you joined the policy and are therefore excluded under the underwriting terms.
  • It's a Chronic Condition: The policy is designed for acute conditions only, and the NHS remains responsible for long-term chronic care.
  • The Treatment is a General Exclusion: Nearly all policies have a list of standard exclusions, which often include:
    • Cosmetic surgery
    • Experimental or unproven treatments
    • Fertility treatment (IVF)
    • Normal pregnancy and childbirth
    • Addiction treatment
    • Self-inflicted injuries
  • You've Reached Your Benefit Limit: Many policies have annual limits on certain benefits, such as outpatient consultations or therapies. If you've already used your yearly allowance, further claims will be denied.
  • The Provider Isn't Recognised: You have chosen a hospital or specialist who is not part of the insurer's approved network.
  • Incomplete Information: You or your specialist may not have provided enough information for the insurer to make a decision.
  • Treatment Not Deemed Medically Necessary: In rare cases, the insurer's clinical team may disagree with the specialist's recommendation, believing there are less invasive or alternative options.

What to Do If Your Pre-Authorisation is Denied

A denial is not necessarily the end of the road. There is a clear process to follow if you believe the decision is unfair.

  1. Step 1: Get the Reason in Writing. Ask your insurer for a detailed written explanation for the denial. They must reference the specific clause in your policy terms and conditions that justifies their decision.
  2. Step 2: Review Your Policy Documents. Carefully read the section your insurer has cited. Compare it with your understanding of your cover. Sometimes, there can be misinterpretations on either side.
  3. Step 3: Talk to Your Specialist. Discuss the insurer's decision with your consultant. They may be able to provide a supporting letter that clarifies why the treatment is medically necessary and falls within the definition of an acute condition, or why it isn't related to a pre-existing issue.
  4. Step 4: Launch a Formal Appeal. Every insurer has a formal internal complaints and appeals procedure. Write a clear, concise letter outlining why you are appealing the decision, and include any new evidence from your specialist.
  5. Step 5: Escalate to the Financial Ombudsman Service (FOS). If your appeal is rejected and you have reached a 'deadlock' with your insurer, you can take your case to the FOS. This is a free and impartial service that resolves disputes between consumers and financial companies. They will review all the evidence from both sides and make a final, binding decision. You must typically approach the FOS within six months of the insurer's final response.

Throughout this process, a knowledgeable PMI broker like WeCovr can provide invaluable support, helping you understand the terminology and advocating on your behalf.

Real-Life Pre-Authorisation Scenarios

Let's look at how pre-authorisation plays out in different situations.

Scenario 1: Smooth Sailing (Knee Surgery)

  • Patient: John, 55, a keen runner.
  • Problem: Develops persistent knee pain. His GP suspects a torn meniscus and gives him an open referral to an orthopaedic surgeon.
  • Action: John calls his insurer, provides his policy details and referral information. He gets an authorisation number for an initial consultation and an MRI scan. He chooses a surgeon from the insurer's approved list.
  • Outcome (illustrative): The MRI confirms a torn meniscus. The surgeon's secretary contacts the insurer with the procedure code for an arthroscopy (keyhole surgery). The insurer authorises the surgery at a specific hospital. John has the operation, pays his £250 policy excess, and the insurer settles the remaining £7,500 bill directly.

Scenario 2: The Grey Area (Back Pain)

  • Patient: Emily, 42, with moratorium underwriting.
  • Problem: Suffers from severe lower back pain and sciatica. She saw a physio for a minor back strain four years ago, before her policy started. Her GP refers her to a spinal specialist.
  • Action: Emily calls her insurer. The claims handler notes the previous back trouble and flags it as potentially pre-existing. They request more information from Emily's GP.
  • Outcome: Emily's GP writes a letter confirming the previous issue was a simple muscular strain in the upper back and is entirely unrelated to the current nerve-related problem in her lower back. After reviewing this new evidence, the insurer's clinical team agrees this is a new, acute condition and provides pre-authorisation for the consultation.

Scenario 3: The Refusal (Chronic Condition)

  • Patient: Mark, 60, recently diagnosed with Type 2 Diabetes.
  • Problem: His GP refers him to a private endocrinologist for ongoing management and monitoring of his condition.
  • Action: Mark calls his insurer to get pre-authorisation for the specialist appointment.
  • Outcome: The insurer politely explains that as Type 2 Diabetes is a chronic condition requiring long-term management, it is not covered under the terms of his private medical insurance policy. The pre-authorisation request is denied. Mark will continue to receive his diabetes care through the NHS.

How a WeCovr Specialist or Trusted Broker Partner Can Help

Navigating the world of private health insurance can be complex, but you don't have to do it alone. A regulated PMI broker acts as your expert guide.

At WeCovr, our service is about more than just finding a cheap price.

  • Personalised Advice: We take the time to understand your needs, budget, and health concerns to recommend the policy that offers the right level of cover, from the right provider.
  • Market Comparison: We compare plans from a wide range of leading UK insurers, explaining the key differences in their cover, hospital lists, and claims processes.
  • Claim Support: Should you need to make a claim, we are on hand to offer guidance. If you run into issues like a denied pre-authorisation, we can help you understand the insurer's reasoning and formulate your appeal.
  • No Separate Broker Fee: Our expert service has no separate broker fee for you. We are paid a commission by the insurer you choose, so you get our expertise without paying a penny more.

What's more, WeCovr clients get complimentary access to our AI-powered nutrition app, CalorieHero, to help support their health goals. You may also be eligible for discounts on other insurance products, such as life or income protection cover, when you take out a PMI policy with us.

Proactive Health & Wellness in the UK

While having private medical insurance provides a crucial safety net, prevention is always better than cure. With NHS waiting lists in England affecting several million people, taking proactive steps to manage your health has never been more important.

  • A Balanced Diet: The NHS Eatwell Guide provides a fantastic blueprint for a healthy diet. Aim for five portions of fruit and veg a day, incorporate lean proteins, and choose wholegrain carbohydrates. Tools like the CalorieHero app can make tracking your intake simple and effective.
  • Regular Physical Activity: According to the Office for National Statistics (ONS), around one in four adults in the UK are classified as physically inactive. The official recommendation is for at least 150 minutes of moderate-intensity activity (like brisk walking or cycling) or 75 minutes of vigorous-intensity activity (like running or tennis) each week.
  • Prioritise Sleep: Consistently getting 7-9 hours of quality sleep per night is vital for both physical and mental recovery. Poor sleep is linked to a higher risk of developing chronic conditions.
  • Mental Wellbeing: Many modern PMI policies offer excellent mental health support, from therapy sessions to digital wellbeing apps. Don't be afraid to use them. Simple daily practices like mindfulness, spending time in nature, and staying connected with loved ones can also make a huge difference.

Comparing Pre-Authorisation Across Major UK Insurers

While the core principle is the same, different insurers have unique approaches and tools for managing pre-authorisation.

InsurerKey Pre-Authorisation FeatureDigital Tools
BupaOften offer 'Open Referral' where Bupa helps find and book you in with a recognised consultant, speeding up the process.Excellent Bupa Touch app for managing policies, starting claims, and finding specialists.
AXA HealthGuided Care pathway for complex claims, where a dedicated case manager supports you from start to finish.Doctor@Hand digital GP service is often the first step. Strong online customer portal.
AvivaStrong emphasis on their 'Expert Select' hospital network, which can help manage costs and may reduce your premium.Aviva Digital GP app provides quick access for referrals. Well-regarded online claims centre.
VitalityProcess is linked to their 'ABC' referral system (A=Adviser, B=Body, C=Consultant). The Vitality GP app is a key part of the journey.Well-regarded app that integrates claims with their wellness and rewards programme.

Disclaimer: Insurer processes and features are subject to change. A specialist at WeCovr or one of our broker partners can provide the most current and detailed comparison based on your specific needs.

Do I need pre-authorisation for a GP appointment?

Generally, no. Most UK private medical insurance policies are designed to work alongside the NHS, so you would use your NHS GP for your initial diagnosis and referral. However, many modern policies now include a digital or virtual GP service as a benefit. You do not usually need pre-authorisation to use this service, but you should always check your policy documents.

What happens if I need emergency treatment?

Private medical insurance is not for life-threatening emergencies. In an emergency situation (like a heart attack, stroke, or serious accident), you should always call 999 and be taken to an NHS A&E department. Once your condition is stabilised, it may be possible to be transferred to a private hospital for ongoing eligible treatment, but this would require pre-authorisation from your insurer at that point.

Can my specialist's secretary handle pre-authorisation for me?

Yes, very often they can and do. While you must initiate the first pre-authorisation for the initial consultation, the specialist's administrative team is usually very experienced in dealing with insurers. They will typically handle the subsequent pre-authorisation requests for any tests, scans, or procedures the specialist recommends, which streamlines the process for you.

How long does pre-authorisation take?

For straightforward requests, pre-authorisation can often be granted over the phone in a single call that might take 15-30 minutes. For more complex cases, or if the insurer needs more medical information from your GP, it could take a few days. This is why it is important to contact your insurer as soon as you have your referral letter and not to wait until the day before you hope to be seen.

Ready to find a private medical insurance policy that gives you peace of mind? a WeCovr specialist or trusted broker partner is here to help. We compare plans from leading UK insurers to find the right fit for your needs and budget, all with no separate broker fee. Get your free, no-obligation quote today and take the first step towards fast, quality healthcare.

Sources

  • NHS England: Waiting times and referral-to-treatment statistics.
  • Office for National Statistics (ONS): Health, mortality, and workforce data.
  • NICE: Clinical guidance and technology appraisals.
  • Care Quality Commission (CQC): Provider quality and inspection reports.
  • UK Health Security Agency (UKHSA): Public health surveillance reports.
  • Association of British Insurers (ABI): Health and protection market publications.

Important Information and Risks

No advice: This article is for general information only. It is not financial, legal, insurance, or tax advice, and it is not a personal recommendation. WeCovr does not assess your individual circumstances or recommend a specific product through this article.

Policy exclusions and underwriting: Insurance policies, including life insurance, private medical insurance, critical illness cover, and income protection, are subject to insurer underwriting, eligibility, acceptance criteria, terms, conditions, limits, and exclusions. Pre-existing medical conditions may be excluded, restricted, or accepted on special terms unless an insurer confirms otherwise in writing.

Tax treatment: References to tax treatment, HMRC rules, or business reliefs are based on current UK legislation and guidance, which can change. Tax treatment depends on your personal or business circumstances and may differ from examples in this article.

Before you buy: Always read the Insurance Product Information Document (IPID), policy summary, and full policy terms before buying, renewing, changing, or keeping cover. If you are unsure whether a policy is suitable for you, speak to an insurance adviser.

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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!

There is no need to wait until the renewal of your current policy.
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 experienced 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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Life Insurance and Private Medical Insurance cover you for two different purposes, so you will need to assess your needs but may wish to consider holding the two policies. Private Medical Insurance covers you if you get sick or need treatment and want or need to go privately. Life Insurance covers you in the case of death, giving a payout to family/those left behind.

Private medical insurance is designed for conditions that start after your policy begins, so pre-existing conditions are usually excluded, at least at first. With moratorium underwriting, a pre-existing condition may become eligible for cover once you have gone two continuous years on the policy without symptoms, treatment or advice for it. With full medical underwriting, the insurer tells you upfront which conditions are excluded. If you are switching from another policy or leaving a company scheme, you may be able to keep your existing underwriting terms, and some larger company schemes use Medical History Disregarded underwriting, where pre-existing conditions aren't excluded. Chronic conditions that need long-term management aren't covered by standard policies.

If you prefer to get straight into treatment in the private sector without the long waiting times with the NHS, or you just prefer the private sector anyway, without having to pay it all yourself, then you would need to have Private Medical Insurance to cover it. Some policies can also cover treatments and drugs that aren't routinely available on the NHS.

There's no fee to get quotes through WeCovr. WeCovr and its broker partners are typically paid a commission by the insurer when you take out a policy. The cost of the policy itself depends on your age, where you live, the cover you choose and your excess.

It depends on your personal choice and preferences. If you are prepared to limit yourself to NHS-covered treatments only and can or want to endure long waiting times to get into treatment, then yes, NHS might work for you. Your cover there is free. If you don't want to be exposed to long waiting times or if your treatment is not covered by the NHS, then you may benefit from Private Medical Insurance.

Private Medical Insurance is an important financial product, and policies differ in ways that matter. Speaking to a specialist at WeCovr or one of its broker partners helps make sure your requirements are understood so you can choose the right cover.

WeCovr's broker partners are firms authorised and regulated by the Financial Conduct Authority (FCA), which requires them to treat customers fairly. You can check any firm on the FCA Register.

WeCovr and its broker partners are typically paid a commission by the insurer when a policy is taken out. The premium is set by the insurer, and you don't pay a separate fee for using the service. You can ask about the commission at any time.

The cost of private health insurance depends on several factors, including your age, location, smoking status, and the type of policy you choose. Your health insurance policy is tailored to your needs, and the cost can vary based on the level of cover you require, such as the amount of excess and specific treatment allowances.

Private health insurance covers eligible conditions that arise after your policy begins. You pay a monthly or annual premium and can claim for private healthcare covered by your policy. Benefits can include quicker access to treatment than on the NHS and, on some policies, access to drugs or treatments that aren't routinely available on the NHS.

Most health insurance covers private hospital stays and may include outpatient treatments like scans, tests, or appointments. Policies vary in coverage, and exclusions often include emergency treatment, maternity care, cosmetic surgery, chronic conditions and conditions present before the policy started.

Usually not on a new personal policy: pre-existing conditions are generally excluded, whatever the premium. Depending on your underwriting, a condition may become eligible later, and if you are switching policies or leaving a company scheme you may be able to keep existing terms. If you have questions about what is covered, contact WeCovr and a specialist at WeCovr or one of its broker partners can explain the options.

Your health insurance policy begins once you've selected your policy and set up your payment. After setup, you'll receive your cover documents detailing what is and isn't covered. It's important to review these details carefully as policies differ.

An excess is the amount you contribute towards treatment when you make a claim. Choosing a higher excess can reduce your policy's monthly cost but requires a larger contribution when claiming. Depending on the insurer, it applies once per policy year or once per claim. A specialist at WeCovr or one of its broker partners can explain the excess options available.

To reduce health insurance costs, consider choosing a higher excess, which lowers the monthly premium. However, ensure the plan still meets your needs. Other factors affecting cost include lifestyle choices like smoking and potential savings for couples or family plans.

Some insurers have an upper age limit for new customers, while others don't, and age affects the price. Many insurers will renew an existing policy regardless of age. A specialist at WeCovr or one of its broker partners can help you find insurers that accept your age.

A specialist at WeCovr or one of its broker partners can compare health insurance plans from a range of insurers for you, with no fee to you. Consider individual, couple, or family plans and review coverage details thoroughly before choosing.

Usually, yes. Many insurers let you add a partner or dependent children, either at any time or at renewal, depending on the insurer. The cost depends on factors like their age, where you live and the cover you choose. Contact WeCovr or your insurer for help adding someone to your policy.

UK private medical insurance is designed for treatment in the UK, although some policies include limited cover abroad. If you live or work abroad, international health insurance may be more suitable, and WeCovr or one of its broker partners can help you compare options. For holidays, travel insurance is recommended.

Comprehensive cover usually includes more extensive benefits, such as fuller outpatient cover for consultations, diagnostic tests, physiotherapy and mental health therapies, within the policy limits. A specialist at WeCovr or one of its broker partners can explain the different levels of cover.

Private health insurance typically does not cover routine dental treatment, although some insurers offer a dental option and there are standalone dental policies. A specialist at WeCovr or one of its broker partners can help you compare policies with dental options.

Most private medical insurance policies include cover for cancer diagnosed after the policy starts, but the level of cover varies: some policies limit drugs, treatment time or cost. A specialist at WeCovr or one of its broker partners can help you compare cancer cover between policies.

You can usually change your cover at renewal, and some insurers allow changes during the year. You also have a 14-day cooling-off period after receiving your policy documents, during which you can cancel. A specialist at WeCovr or one of its broker partners can help with changes.

Many policies include a digital GP service provided by the insurer, often with same-day or next-day appointments. Check what your policy includes.

Yes, family members on the same policy can potentially have different levels of cover tailored to their individual needs.

Yes. Insurers offer a range of cover levels to suit different budgets and needs, and a specialist at WeCovr or one of its broker partners can talk you through the options.

Your insurer can tell you which hospitals and specialists are included in your policy. For help comparing policies' hospital lists, tap one of the buttons above or below and fill in a few details, and a specialist at WeCovr or one of its broker partners will be in touch.

A fee-assured (or fee-approved) consultant has agreed to charge within your insurer's fee limits, so for eligible, authorised treatment you shouldn't have to pay a shortfall for their fees.

Many policies include some mental health cover, either as standard or as an option, usually with limits on therapy sessions or costs. Cover varies between insurers, so check the details.

Yes, children up to a certain age can usually be included on your policy, and some insurers offer discounts for children.

Like most health insurance plans, premiums may increase annually due to factors such as age and medical cost inflation.

The cost of health insurance varies based on several factors. Tap a button below to get your own personalised quote through WeCovr.

Private health insurance can offer quicker access to consultations and treatment for eligible conditions, and more choice over when and where you are treated.

Many policies include physiotherapy, sometimes with limits on sessions or cost. A specialist at WeCovr or one of its broker partners can help you find plans that include it.

Services such as the insurer's digital GP app are usually available as soon as your policy starts.

You can obtain a range of suitable quotes easily by tapping one of the buttons above or below and filling in a few details for personalised assistance.

Health insurance covers eligible new conditions that arise after the policy starts. Pre-existing conditions are usually excluded, chronic conditions aren't covered, and other exclusions apply.

Health insurance pays for eligible private healthcare, such as consultations and treatment, up to your policy limits. A specialist at WeCovr or one of its broker partners can help you arrange cover.

Outpatient cover includes consultations, physiotherapy, and mental health therapies outside hospital admissions.

Usually, yes: cover for eligible new conditions starts when your policy starts, and services like a nurse helpline or digital GP app are usually available straight away. If you make a claim soon after starting, the insurer may ask for a report from your GP. Health insurance is designed to cover new conditions that arise after the policy has started.

No, health insurance does not cover A&E (Accident and Emergency) visits. Private hospitals do not typically have the facilities for handling A&E cases. In case of an emergency, please dial 999 or use the NHS emergency services. However, if you require follow-up treatment after an emergency situation, your private medical insurance may be able to assist.

Yes, many insurers offer rewards in leisure, wellbeing, and health. Visit your insurer's website, or ask a specialist at WeCovr or one of its broker partners, for details of member rewards.

You may be able to continue your cover with the same insurer on a personal policy, or take out a new policy. Continuing with the same insurer can mean keeping your existing underwriting, so conditions covered under the company scheme may stay covered. A specialist at WeCovr or one of its broker partners can talk you through your options.

You can tap one of the buttons above or below and fill in a quick form to arrange a call to discuss your options.

Your cover may be similar but not identical, and ongoing medical conditions may be covered, depending on the terms. A specialist at WeCovr or one of its broker partners can help you find the right level of cover.

Usually not, because employers often pay for or contribute to staff cover and group schemes are priced differently. Your cover level and age also affect the price. A specialist at WeCovr or one of its broker partners can give you more detail.

There is usually a limited window after leaving, set by the insurer, so check as early as possible. Your personal policy can often start the day after your work cover ends, and a specialist at WeCovr or one of its broker partners can explain other options.

Have your leaving date and your current policy details ready, then contact WeCovr to discuss your options with a specialist at WeCovr or one of its broker partners.

Ongoing treatment may be covered if you continue with the same insurer on a personal policy, although it could affect the price. A specialist at WeCovr or one of its broker partners can explain your options.

Your insurer will explain how to pay your excess when you contact them for treatment authorisation. Usually you pay it to the hospital or consultant.

Usually not: with most insurers, there's no excess for services such as a digital GP. Check your policy.

Excess changes are usually made at renewal, although some insurers allow changes at other times.

No claims discounts can impact renewal costs based on claims history.

Pre-existing conditions usually aren't covered on a new personal policy. A specialist at WeCovr or one of its broker partners can explain the underwriting options.

This involves health-related questions before policy enrolment to determine coverage.

Moratorium underwriting simplifies enrolment but may require health disclosures during claims.

Claims may require additional information if under moratorium underwriting.

Pre-existing conditions are medical issues that existed before your policy started. Many insurers treat any condition you've had symptoms of, treatment for or advice about in the five years before the policy started as pre-existing. A specialist at WeCovr or one of its broker partners can help you understand how pre-existing conditions affect your options.

While some insurance providers automatically renew your private healthcare cover, it's worth comparing policies when yours is due for renewal to check it still offers good value for the cover you need. A specialist at WeCovr or one of its broker partners can help you compare.

Typically, you must be over 18 to take out your own policy, but children can usually be included on a family policy. Some insurers have an upper age limit for new customers, and premiums typically increase with age. A specialist at WeCovr or one of its broker partners can explain the age rules of different insurers.

Some insurers charge less if you pay annually, but this depends on the insurer. A specialist at WeCovr or one of its broker partners can tell you whether paying annually would save you money.

If your employer offers private health insurance as part of your benefits package, you likely don't need additional cover. However, there may be limits on the cover you receive, and it may not extend to your entire family. Remember, any insurance you get through work only covers you while you're employed there.

Usually not. With full medical underwriting you complete a medical questionnaire, and the insurer may occasionally ask your GP for a report. With moratorium underwriting there's no medical questionnaire upfront. A specialist at WeCovr or one of its broker partners can explain the requirements of different policies.

Many private health insurance providers now offer GP services, either digitally or face-to-face. This means you can often get a private GP appointment quickly, sometimes even on the same day. A specialist at WeCovr or one of its broker partners can help you find policies that offer GP services.

With private health insurance, you can often get a GP appointment much more quickly, sometimes even on the same day, through the insurer's GP service. A specialist at WeCovr or one of its broker partners can help you find policies that include it.

Inpatient care refers to any treatment requiring a stay in a hospital or clinic for at least one night. Outpatient care refers to treatments or tests that don't require hospital admission, such as minor diagnostic tests or physiotherapy sessions. A specialist at WeCovr or one of its broker partners can help you understand the different types of care and find a policy that suits your needs.

Private health insurance pays for eligible medical treatment if you fall ill, while critical illness cover pays a lump sum if you are diagnosed with one of the illnesses listed in the policy, which you can use however you choose, for example to replace lost income. A specialist at WeCovr or one of its broker partners can help you understand the differences.

Health insurance policies are designed for cover in the UK. For cover abroad, consider travel insurance for short trips or international health insurance for longer stays or if you have a holiday home overseas. A specialist at WeCovr or one of its broker partners can help you find appropriate cover.

If your employer pays for your health insurance, it's usually a taxable 'benefit in kind': you pay income tax on its value, normally through your tax code or payroll, and your employer pays Class 1A National Insurance. For the employer, the premiums are usually an allowable business expense. If you buy a personal policy, you pay for it from taxed income. For advice on your situation, speak to an accountant.

When you purchase a policy, you choose how much excess you pay, which is your contribution to the cost of treatment if you make a claim. The higher your excess, the lower your premium is likely to be. A specialist at WeCovr or one of its broker partners can help you understand how excess works and choose the right level for you.

These are two methods of underwriting a health insurance policy, relating to how insurance providers consider your pre-existing medical conditions when you take out cover. A specialist at WeCovr or one of its broker partners can help you understand the differences and choose the right option for you.

Some private health insurance providers offer a no-claims discount, similar to car insurance. Each year you don't claim typically adds to your no-claims discount, which can reduce your premium at renewal. A specialist at WeCovr or one of its broker partners can help you find policies that offer no-claims discounts.

To find the right health insurance for you, compare policies to find one that offers the features you need at a price you can afford. Consider your personal circumstances and what you want from your policy. A specialist at WeCovr or one of its broker partners can help you evaluate your options.

If you need treatment, a GP referral is not always necessary. However, this depends on how you plan to pay for your treatment. Most hospitals will allow you to book appointments with a consultant without a GP referral if you are paying out-of-pocket. If you have private medical insurance, check your policy terms to see whether your insurer requires a GP referral first (many do). Some policies offer direct access without a referral for certain conditions, such as muscle and joint problems or counselling for mental health issues.

Yes, you can obtain financing for a loan to cover the cost of surgery. Many private healthcare companies have partnerships with finance companies to allow you to spread the cost of private treatment over time. You could also explore getting an ordinary loan from your bank if this option proves to be more cost-effective for you.

WeCovr has published research into the cost of private health insurance in the UK. Click the link to find out more detailed information.

Yes, you can continue to receive treatment through the NHS even if you have private health insurance and have received private treatment in the past. This could be for rehabilitation after private surgery or for treatment that is not covered by your health insurance policy. For example, some cosmetic surgeries may be available through the NHS but are generally not covered by private medical insurance.

This is a difficult question to answer definitively. There are certain services that cannot be obtained privately, such as emergency treatment at an Accident and Emergency (A&E) department. Many NHS consultants also practise privately, so you could potentially see the same consultant either way. However, private healthcare typically offers shorter waiting times, usually a private room, and more flexible visiting. Some policies also give access to treatments and drugs that are not routinely available through the NHS.

Yes, you can self-refer to a private specialist without the need for a GP referral. However, the British Medical Association believes that in most cases, it is best practice to start with your GP, as they are familiar with your medical history.

Usually, yes. If you have private tests or scans but then want NHS treatment, your GP or private consultant can refer you to the NHS and share your results, although the NHS team may want to repeat some tests.

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