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How to Claim for Private Knee Surgery on Your PMI

This expert guide from WeCovr explains how to claim for private knee surgery on your UK private medical insurance, providing a step-by-step process for getting referrals and avoiding costly shortfalls. With insights from our experienced team, who have helped arrange over 900,000 policies, you'll learn to navigate the system with confidence.

WeCovr Editorial Team · experienced insurance advisers
Last updated Mar 17, 2026

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How to Claim for Private Knee Surgery on Your PMI 2026

TL;DR

This expert guide from WeCovr explains how to claim for private knee surgery on your UK private medical insurance, providing a step-by-step process for getting referrals and avoiding costly shortfalls. With insights from our experienced team, who have helped arrange over 900,000 policies, you'll learn to navigate the system with confidence.

Key takeaways

  • Always get an 'open referral' from your GP to maximise your choice of consultants and hospitals.
  • Pre-authorisation from your insurer before any consultation or treatment is non-negotiable.
  • Avoid shortfalls by choosing a 'fee-assured' consultant who bills within your insurer's guidelines.
  • PMI only covers 'acute' conditions; long-term chronic knee pain is not covered, but surgery to resolve it often is.
  • Your policy's outpatient limit is crucial for covering diagnostic scans and post-operative physiotherapy.

Navigating a private medical insurance (PMI) claim for knee surgery can feel daunting. Between GP referrals, consultant appointments, and the dreaded fear of unexpected bills, it's easy to feel overwhelmed. At WeCovr, our experienced team has helped thousands of UK clients understand their private health cover, ensuring they get the treatment they need without the financial anxiety.

This definitive guide will walk you through the entire process, from your first GP visit to your final physiotherapy session. We'll demystify the jargon and provide insider tips to help you secure a smooth claim and, crucially, avoid costly shortfall fees.

Step-by-step guide to consultant referrals and avoiding shortfall fees

Accessing private knee surgery through your PMI policy follows a clear, structured path. The key is to communicate with your insurer at every stage. This process is known as pre-authorisation, and it's your single most important tool for ensuring your treatment is covered.

Here is the typical journey for a PMI knee surgery claim:

Step 1: Visit Your GP and Secure an 'Open Referral'

Your journey always begins with your GP. You cannot self-refer to a specialist for a new condition under a UK PMI policy.

  • Explain your symptoms: Detail your knee pain, any injury, and its impact on your daily life.
  • Request an 'Open Referral': This is a critical insider tip. Instead of a letter addressed to a specific named consultant, ask for an 'open referral' letter. This letter will recommend a type of specialist (e.g., "an orthopaedic knee consultant") rather than a specific person.
  • Why an Open Referral is Better: It gives you maximum flexibility. You can choose any consultant who is recognised by your insurer and on your chosen hospital list, rather than being tied to one specific doctor who may not be covered or may charge above insurer-approved rates.

Expert Insight: An open referral puts you in control. It prevents a common issue where a GP refers you to a top London surgeon whose fees aren't fully covered by your policy, leading to an immediate potential shortfall.

Step 2: Contact Your Insurer for Pre-authorisation

With your GP's open referral letter in hand, your next call is to your insurance provider's claims department. Do not book any appointments before speaking to them.

Have this information ready:

  • Your policy number
  • The full name of the patient (if it's a family policy)
  • Details of your symptoms and the GP's diagnosis
  • Your open referral letter

The insurer will check your policy and confirm that your symptoms are covered. They will then provide you with a list of approved orthopaedic consultants and hospitals in your area that fall within your policy's hospital list. You will be given an initial authorisation code for the consultation.

Step 3: Choose Your Consultant and Hospital

Your insurer will provide a list of recognised specialists. Here’s how to choose:

  • Check your Hospital List: Your PMI policy will have a specific "hospital list". This could be a local list, a national list, or an extended list including central London hospitals. You must choose a hospital from your designated list to be fully covered.
  • Select a 'Fee-Assured' Consultant: This is the golden rule for avoiding shortfalls. A fee-assured consultant has an agreement with your insurer to charge within their approved fee schedule. Most major insurers like AXA, Bupa, and Aviva have online directories of their fee-assured specialists.

Step 4: The Initial Consultation and Diagnostics

Book your appointment with your chosen consultant, providing them with your pre-authorisation code.

During this consultation, the specialist will examine your knee. They will almost certainly require diagnostic imaging, such as an MRI scan or an X-ray, to get a clear diagnosis.

Crucially, you must call your insurer again to get pre-authorisation for the MRI scan. Your outpatient cover limit will determine if this is paid for. Most standard policies have sufficient cover (£1,000 - £1,500) for a consultation and an MRI scan.

Step 5: Getting Authorisation for the Surgery

Once the consultant has diagnosed the issue (e.g., a torn meniscus, ACL rupture, or severe arthritis requiring a replacement), they will recommend a specific surgical procedure.

Their medical secretary will send a detailed treatment plan to your insurer. This includes:

  • The proposed surgery and its procedure code (e.g., W8500 for an arthroscopy).
  • The estimated costs for the surgeon, anaesthetist, and hospital.

Your insurer will review this against your policy terms. If everything is in order, they will issue a final authorisation code for the surgery. Do not proceed to surgery without this code. This is your guarantee that the costs have been approved.

Step 6: The Surgery and In-patient Care

With full authorisation, you can book your surgery. The hospital and consultants will bill your insurer directly. Your PMI policy will typically cover:

  • Surgeon and anaesthetist fees (up to your policy limits).
  • Hospital charges (theatre fees, accommodation, nursing care).
  • The knee prosthesis itself (for a replacement), though some policies have limits.
  • Initial post-operative physiotherapy while you are still in the hospital.

You will only be responsible for paying the excess on your policy, if you have one. You usually pay this directly to the hospital.

Step 7: Post-Operative Care and Physiotherapy

Recovery is as important as the surgery itself. Your consultant will recommend a course of physiotherapy.

Once again, you must call your insurer to pre-authorise these physiotherapy sessions. The number of sessions covered will depend on your policy's outpatient limit. This is a common area where people forget to get authorisation, so stay vigilant. Any follow-up consultations with your surgeon will also require pre-authorisation.

Understanding Key PMI Concepts for Knee Surgery

To navigate your claim effectively, you need to understand the language of private medical insurance. These core concepts dictate what is and isn't covered.

Pre-existing and Chronic Conditions: The Fundamental Rule

This is the most important concept in UK private medical insurance.

  • PMI covers acute conditions. An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. A torn ACL from a skiing accident is a classic example.
  • PMI does not cover chronic conditions. A chronic condition is one that has no known cure and requires long-term management, such as osteoarthritis.
  • PMI does not cover pre-existing conditions. This is any condition for which you have had symptoms, medication, or advice in a set period (usually 5 years) before your policy began.

The Knee Surgery Nuance: While osteoarthritis is chronic, a knee replacement to treat it is often covered. Why? Because the surgery is seen as a one-off treatment to resolve the acute pain and immobility, even though the underlying condition is chronic. However, if you had knee pain and saw a doctor about it before taking out your policy, it would be excluded as pre-existing.

Underwriting: How Insurers Assess Pre-existing Conditions

  • Moratorium (Most Common): Your policy will automatically exclude any condition you've had in the 5 years before joining. However, if you go 2 full years on the policy without any symptoms, treatment, or advice for that condition, the exclusion may be lifted.
  • Full Medical Underwriting (FMU): You declare your entire medical history upfront. The insurer gives you a definitive list of what is excluded from day one. This provides certainty but exclusions are often permanent.

Excesses and Co-payments

An excess is a fixed amount you agree to pay towards a claim. For example, if you have a £250 excess and your knee surgery claim is £10,000, you pay the first £250 and the insurer pays the remaining £9,750. You typically pay this once per policy year, regardless of how many claims you make. A higher excess leads to a lower monthly premium.

Hospital Lists

Insurers group UK private hospitals into bands or lists to manage costs. Your choice of list directly impacts your premium.

Hospital List TierDescriptionImpact on PremiumBest for...
Standard/LocalIncludes a wide range of quality private hospitals across the UK, but excludes the most expensive ones in central London.LowerMost people outside London.
Extended/NationalIncludes most hospitals on the standard list plus more options, including some in central London.HigherThose wanting more choice or access to specific city hospitals.
Premium/LondonProvides unrestricted access to all participating hospitals, including the top private clinics in Central London (e.g., HCA facilities).HighestThose who want complete freedom of choice and live/work in London.

Outpatient Limits

Outpatient cover pays for services where you don't need to be admitted to a hospital bed. For knee surgery, this is vital for:

  1. The initial specialist consultation.
  2. Diagnostic scans (MRI, CT, X-ray).
  3. Post-operative physiotherapy.

A standard policy might offer £1,000 in outpatient cover. A comprehensive policy might offer unlimited cover. When buying a policy, ensure your outpatient limit is sufficient to cover at least a consultation, one major scan, and a course of physio.

How to Avoid Shortfall Fees: The Insider's Guide

A shortfall occurs when your consultant or hospital charges more than your insurer is willing to pay, leaving you to cover the difference. This can run into hundreds or even thousands of pounds. With careful planning, they are almost always avoidable.

Primary Causes of Shortfalls:

  1. Consultant Fees: The most common cause. Some top consultants charge significantly more than the standard rates set by insurers.
  2. Anaesthetist Fees: Just like surgeons, anaesthetists can also charge above insurer guidelines.
  3. Using an Unlisted Hospital: Choosing a hospital that isn't on your policy's approved list will result in either a partial payment (a co-payment) or no cover at all.
  4. Prosthesis Limits: Some policies have a financial limit on the cost of the artificial joint used in a knee replacement. More advanced or custom prosthetics can exceed this limit.

Your Shortfall Prevention Checklist:

✅ Prioritise 'Fee-Assured' Consultants This is the single most effective way to prevent shortfalls. When your insurer gives you a list of specialists, ask them to highlight the ones who are "fee-assured". You can also check this on the insurer's online specialist directory.

✅ Confirm Fees with the Consultant's Secretary When you book your first appointment, be direct. Ask the medical secretary: "Does the consultant charge within the guidelines for [Your Insurer's Name]? Will there be any shortfall on my consultation or surgical fees?" Get their answer in writing if possible.

✅ Triple-Check Your Hospital List Before agreeing to anything, confirm with your insurer that your chosen hospital is on your policy's list. Do not rely on the hospital's own website or the consultant's suggestion alone.

✅ Get Full Authorisation in Writing Never proceed with surgery or treatment based on a verbal conversation. Wait until you have a formal authorisation letter or email from your insurer that clearly states what is covered and provides an authorisation code.

✅ Review Prosthetic Limits (for replacements) If you are having a knee replacement, check your policy documents or ask your insurer if there are any limits on the cost of prostheses. Inform your consultant of this limit so they can use a joint that is fully covered.

✅ Use an Expert Broker Navigating this can be complex. A specialist broker like WeCovr can provide invaluable support. We help our clients understand their policy limits and can offer guidance during the claims process, all at no extra cost.

Get Tailored Quote

Comparing UK PMI Providers for Orthopaedic Cover

While most major insurers provide excellent orthopaedic cover, they have different strengths and networks. When choosing a policy, it pays to compare how they handle musculoskeletal claims.

ProviderKey Orthopaedic FeatureHospital AccessTypical Outpatient Options
AXA HealthExcellent guided care pathways. Their "Fast Track Appointments" service can help you see a specialist quickly. Strong specialist network.Comprehensive hospital lists with clear tiers.Flexible options from £0 up to full cover. Good value for mid-range cover.
BupaThe UK's largest insurer with a vast network. Their "Open Referral" network helps find fee-assured specialists and book appointments for you.Extensive network, including their own Bupa Cromwell Hospital. Clear list options.Good range of limits. Their "Bupa from Home" service can support remote consultations.
AvivaKnown for their "Expert Select" guided option, which directs you to a curated list of high-performing specialists, helping to avoid shortfalls.Strong national hospital list. Good value for money.Comprehensive outpatient options are available, often competitively priced.
VitalityUnique wellness-focused approach. Rewards active members with discounts, which can help motivate pre-hab and rehab exercises.Good network, with a focus on quality and cost-effectiveness. The "Consultant Select" option is key to managing costs.Outpatient cover is often linked to their wellness programme. The more active you are, the better your potential benefits.

Working with a broker like WeCovr allows you to compare these providers side-by-side, ensuring you find a policy that is a strong fit for your orthopaedic needs and budget. We can also help you understand the subtle differences in their claims processes.

Real-Life Scenario: David's Knee Surgery Journey

Let's illustrate the process with a typical scenario.

  • The Patient: David, 45, is a keen cyclist who suffers a knee injury on a weekend ride. The pain is sharp and he has significant swelling.

  • The Claim:

    1. GP Visit: David sees his NHS GP, who suspects a meniscal tear. The GP provides an open referral for an orthopaedic consultation.
    2. Insurer Call: David calls his PMI provider, gives his policy number, and explains the situation. The insurer confirms his cover is active and authorises an initial consultation and an MRI scan, providing a single authorisation code for both. They give him a list of three local, fee-assured knee specialists.
    3. Consultation: David chooses a specialist from the list. The MRI confirms a complex tear of the medial meniscus. The consultant recommends an arthroscopy (keyhole surgery).
    4. Surgical Authorisation: The consultant's secretary sends the diagnosis and procedure code (W8500) to the insurer. Within 48 hours, the insurer sends David an email confirming full authorisation for the surgery, anaesthetist, and a two-night hospital stay.
    5. The Treatment: David has his surgery two weeks later. The hospital and surgeon bill the insurer directly. David pays his £200 policy excess to the hospital upon admission.
    6. Post-Op: After the surgery, David calls his insurer again. They authorise ten sessions of physiotherapy from his £1,500 outpatient limit.

  • The Outcome: Within three months, David is back on his bike. His total claim cost was over £8,000, but he only paid his £200 excess. The process was smooth because he followed the key steps: open referral, pre-authorisation at every stage, and choosing a fee-assured specialist.

The Role of a PMI Broker in Your Knee Surgery Claim

While you deal directly with the insurer during a claim, a good broker offers a layer of expert support.

At WeCovr, we don't just sell policies; we build long-term relationships. Here’s how we add value during a claim:

  • Policy Expertise: If you're unsure about a term in your policy, like your prosthesis limit or outpatient cover, we can clarify it for you in plain English.
  • Troubleshooting: If there's a misunderstanding or delay with your insurer, we can liaise on your behalf to help resolve it.
  • Market Knowledge: We can provide guidance on which insurers have the strongest networks and best claims processes for orthopaedics when you're buying or renewing your policy.
  • Added Value: As a WeCovr client, you also get complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, to support your health and recovery. Plus, our clients often receive discounts on other insurance products like life or income protection cover.

Will my PMI cover a knee replacement for osteoarthritis?

Generally, yes, provided the osteoarthritis was not a pre-existing condition before you took out the policy. While osteoarthritis is a chronic condition (which PMI doesn't usually cover for long-term management), a joint replacement is considered an acute intervention to resolve pain and restore mobility. Insurers will cover the surgery as long as you did not have symptoms or seek advice for your knee pain in the 5 years prior to your policy start date.

How long is the waiting time for private knee surgery in the UK?

The waiting time for private knee surgery is significantly shorter than the NHS. Once you have a GP referral, you can often see a specialist within a week and have surgery within 2-4 weeks. In contrast, according to NHS England data, the median waiting time for Trauma & Orthopaedic treatment was over 14 weeks as of early 2026, with many waiting much longer.

What if my chosen surgeon isn't on my insurer's list?

If a surgeon is not recognised by your insurer or is not "fee-assured," you have two options. You can either choose another surgeon from the insurer's approved list to ensure you are fully covered, or you can proceed with your chosen surgeon and pay the shortfall (the difference between their fee and what the insurer will pay) yourself. We always recommend choosing a fee-assured specialist to avoid unexpected costs.

Does private health insurance cover physiotherapy for my knee?

Yes, most private medical insurance policies cover physiotherapy under their outpatient benefits. This is essential for recovery from knee surgery. However, the number of sessions covered depends on the financial limit of your outpatient cover (e.g., £500, £1,000, or unlimited). It is crucial to get physiotherapy sessions pre-authorised by your insurer before you begin your treatment.

Navigating a PMI claim for knee surgery is straightforward when you follow the right steps. By understanding your policy, getting pre-authorisation for everything, and choosing fee-assured specialists, you can access fast, high-quality treatment without the stress of unexpected bills.

If you're considering private medical insurance or want to review your current cover to ensure it's suitable for your needs, our expert team at WeCovr is here to help. We compare policies from across the market to find a well-matched option for your circumstances, completely free of charge.

Contact WeCovr today for a no-obligation quote and let us help you find the peace of mind that comes with robust health cover.

Sources

NHS England Office for National Statistics (ONS) Financial Conduct Authority (FCA) gov.uk National Institute for Health and Care Excellence (NICE)

Disclaimer: This is general guidance only and does not constitute formal tax or financial advice. Tax treatment depends on individual circumstances, policy terms, and HMRC interpretation, which cannot be guaranteed in advance. Whenever applicable, businesses and individuals should always consult a qualified accountant or tax adviser before arranging such policies.

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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
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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?
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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.

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Why is it important to get private medical insurance early?

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👉 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.

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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.

Health insurance covers conditions that develop after your policy starts. Pre-existing conditions are typically not covered, and insurers may exclude related issues. Some policies may cover symptoms of pre-existing conditions under specific circumstances. Always review your policy's exclusions. Coverage for pre-existing medical conditions may be available if you currently hold a medical insurance policy or are transitioning from a company scheme. However, if you have never had medical insurance before or if your policy is not active at the moment, pre-existing conditions will not be covered. This limitation exists because health insurance is primarily intended to protect against unexpected health issues. To simplify, it's akin to getting into a car accident and then trying to obtain insurance coverage afterward to repair the vehicle — insurance companies typically do not cover such claims. Nevertheless, there is an option to gain coverage for pre-existing conditions after a two-year waiting period, subject to specific rules and conditions.

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. Sometimes treatments and drugs that are not covered by the NHS can be covered by Private Medical Insurance.

It's free to use WeCovr to find health insurance - we never charge you for quotes. Health or private medical insurance is an investment that can pay for itself the first time you might need medical treatment.

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 would benefit from Private Medical Insurance.

Private Medical Insurance is an important financial product that insurance companies take a lot of care and diligence so speaking to real human beings ensures that they understand your requirements fully so that you can get the right cover.

All of our partners are carefully vetted and authorised by the FCA, which means they are held to the highest standards that the FCA expects from them and treat all customers fairly!

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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 you for conditions that arise after your policy begins. You pay a monthly fee and can make claims for private healthcare covered by your policy. One of the main benefits of private healthcare is quicker access to treatment compared to the NHS, along with access to new drugs or specialist treatments.

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, and ongoing conditions present before the policy started.

Unfortunately, you cannot pay extra to have a pre-existing condition covered as part of your health insurance policy. However, you have access to support from a nurse or digital GP. If you have questions about what is covered under your policy, please contact us for clarification.

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. WeCovr's experts will offer you flexible excess options depending on your preferences.

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.

There is no age limit for taking out health insurance, but age influences the policy's cost. The benefits of health insurance are consistent regardless of age. If you're considering health insurance, you can get a quote from WeCovr's experts regardless of your age.

Let WeCovr's experts do the legwork for you and compare health insurance plans at no cost to you to find the best fit for your needs. Consider individual, couple, or family plans and review coverage details thoroughly before choosing. WeCovr provides transparent information on coverage options for easy comparison.

Yes, you can add your partner (if you live at the same address) or dependents to your policy at any time. The cost of couple's or family health insurance depends on factors like location, age, health, and chosen excess. Contact WeCovr or your insurer for assistance in adding someone to your policy.

While WeCovr's private health insurance plans are tailored for the UK, we offer global health insurance options for those living or working abroad. For holiday coverage, travel insurance is recommended.

Comprehensive cover provides extensive benefits, including full outpatient services such as consultations, diagnostic tests, physiotherapy, and mental health therapies. Our team at WeCovr can assist in understanding the various coverage levels available.

Private health insurance typically does not cover dental treatment. However, WeCovr's experts can guide you to dental insurance policies offered by our partner insurers. Reach out to us to explore these options.

Yes, private health insurance covers cancer treatment from diagnosis through treatment. At WeCovr, we can help you navigate the cancer cover options that suit your needs.

At WeCovr, you have flexibility in adjusting your cover. Speak to our experts within 21 days of receiving your paperwork or at policy renewal to make changes.

Accessing a private GP appointment is fast and convenient with WeCovr's services, available through your digital platform provided under your chosen insurance plan.

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

WeCovr works with insurers offering a range of cover levels to accommodate different budgets and needs. Our experts can discuss these options with you.

Discovering healthcare facilities and specialists is easy with WeCovr's resources. Contact us for personalised assistance by tapping one of the buttons above or below and filling in a few details for personalised assistance.

Fee-assured consultants provides transparency and no hidden costs for clients.

WeCovr prioritises mental health support with comprehensive coverage and access to specialist advice and services.

Children up to a certain age can be included in your policy, and we offer discounts for family coverage.

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. Connect with our experts by tapping a button below and get your own personalised quote.

Private health insurance offers quicker access to consultations, treatments, and personalised care compared to the NHS.

Yes, WeCovr's experts can guide you which health insurance plans include coverage for physiotherapy treatments.

Immediate access to certain services like our digital GP app is available upon enrolment.

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 new conditions that arise after the policy starts. Pre-existing conditions and certain exclusions may apply.

WeCovr's experts help you arrange health insurance that simplifies access to private healthcare services, including consultations and treatments.

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

Yes, you can use your health insurance cover immediately. You have access to a nurse through your helpline and can consult with a GP using the digital GP app. If you need to make a claim right away, we may require a medical 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. Speak to WeCovr's experts or visit your insurer's website for more details on member rewards.

You may continue your cover or get another own personal policy. If you continue your cover, existing or ongoing medical conditions might be covered depending on the level of cover you choose. Contact our friendly experts to discuss your options and find the right option for you.

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

Your cover may be similar but not identical. We will help you find the right level of cover that suits your needs, and ongoing medical conditions may be covered. Contact our friendly advisers to explore all available options.

No, the price won't be the same as before since employers often contribute to the cost of employee cover. Additionally, different cover levels and medical histories may affect the price. Contact WeCovr's experts for detailed information.

You have a few weeks or months from leaving your job to decide to continue with your insurer or change to another one. Your policy may start the day after you left your work policy, and our experts can guide you through other available options.

After leaving your job, contact WeCovr's experts with your leave date to discuss available options.

Yes, ongoing treatment may be covered on your new personal policy, although it could affect the price. Contact our experts for personalised advice on your options.

Details on paying excess fees will be provided when you contact your insurer for treatment authorisation.

No, there is no excess fee for utilising these services.

Excess adjustments can be made at specific intervals during your policy term.

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

Pre-existing conditions typically aren't covered but can be discussed with our healthcare specialists.

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 refer to medical issues existing before policy inception. A pre-existing condition is anything you've previously had medical treatment for, such as diabetes, heart disease, or asthma. Most insurance providers consider any condition you've had symptoms or treatment for in the past five years as pre-existing. Our experts at WeCovr can help you understand how pre-existing conditions affect your policy options.

While some insurance providers automatically renew your private healthcare cover, it's beneficial to compare policies when yours is about to end. This ensures you're still getting the best deal for the coverage you need. Our experts at WeCovr can assist you in finding a strong fit for your needs for you.

Typically, you must be over 18 to take out your own policy, but minors can usually be included in a family policy. There may also be an upper age limit for private health insurance, and premiums typically increase with age. Our experts at WeCovr can provide guidance on age-related policy aspects.

Paying for health insurance annually often results in savings compared to monthly payments. However, this depends on your insurance provider. For help determining the most cost-effective option, consider consulting our experts at WeCovr.

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.

If you don't have pre-existing conditions, a medical exam is usually not required. You'll just need to complete a medical history form and select your level of cover. However, if you're older, have a pre-existing condition, or lead an unhealthy lifestyle, a medical exam may be necessary. Our experts at WeCovr can clarify 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. Our experts at WeCovr can help you find policies that offer GP services.

With private health insurance, you can often secure a GP appointment much quicker than with traditional methods, sometimes even on the same day. Our experts at WeCovr can help you find policies that offer quick GP appointment services.

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. Our experts at WeCovr can help you understand the different types of care and find a policy that suits your needs.

Private health insurance covers your medical treatment if you fall ill, while critical illness cover provides additional financial help if you develop one of the critical illnesses listed in the policy, such as covering loss of income if you're unable to work. For assistance in understanding the differences and finding the right coverage, consult our experts at WeCovr.

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. Our experts at WeCovr can guide you in finding the appropriate coverage for your travel needs.

If your employer provides health insurance, it's considered a 'benefit in kind' and is not tax deductible. Your employer should calculate the tax you owe for your health insurance premiums and deduct it from your pay. There are some exceptions for small companies. For more information on tax implications, consider reaching out to our experts at WeCovr.

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. Our experts at WeCovr 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. For help understanding the differences and choosing the right option for you, consult our experts at WeCovr.

Some private health insurance providers offer a no-claims discount, similar to car insurance. Every year you don't make a claim gives you an extra year of no-claims discount, potentially reducing your premium when you renew. Our experts at WeCovr can help you find policies that offer no-claims discounts.

To find the best health insurance for you, compare various 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. Our experts at WeCovr can assist you in evaluating your options and selecting the right coverage for you.

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, you'll need to check the terms of your policy to see whether your insurer requires you to consult with a GP first (most insurers do). Some policies offer a direct booking system without a referral for certain conditions, such as counseling 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 conducted extensive 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 practice privately, so you could potentially see the same consultant regardless of whether you choose private or public healthcare. However, private healthcare typically offers shorter waiting times, guaranteed private rooms, and more relaxed visiting hours. Additionally, you may have 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.

Yes, if you have a health concern and pay for private tests and scans but cannot afford to have private surgery, you should be able to have your test results transferred to an NHS provider for treatment.

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