TL;DR
Choosing the right private medical insurance (PMI) in the UK can feel like a complex puzzle. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we believe everyone deserves clarity and confidence when protecting their health. This guide provides our expert five-step checklist for comparing quotes effectively in 2026.
Key takeaways
- Who needs cover? Is it just for you, you and a partner, or your entire family?
- What is your budget? Be realistic about what you can comfortably afford each month. Premiums can range from £30 to well over £150 per person, per month.
- What are your health priorities? Are you worried about long diagnostic waits, getting a specific cancer treatment, or accessing mental health support quickly?
- What is your lifestyle? Do you travel frequently? Are you an avid sports player? Your lifestyle can influence the type of cover that offers the most value.
- In-patient and Day-patient Treatment: This covers costs when you are admitted to hospital for a bed overnight (in-patient) or just for the day for a procedure (day-patient). This includes surgery, hospital accommodation, nursing care, and specialist fees.
Choosing the right private medical insurance (PMI) in the UK can feel like a complex puzzle. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we believe everyone deserves clarity and confidence when protecting their health. This guide provides our expert five-step checklist for comparing quotes effectively in 2026.
WeCovr's five-step checklist for comparing private health cover this year
Navigating the private medical insurance market requires a structured approach. With NHS waiting times remaining a significant concern for many—the latest NHS England data from late 2025 shows millions of treatment pathways are still waiting to begin—PMI is a more relevant choice than ever.
Follow these five steps to cut through the jargon and find a policy that truly fits your needs and budget.
Step 1: Define Your "Why" – What Do You Need Cover For?
Before you even look at a quote, take a moment to assess your personal circumstances. A policy that's perfect for a 25-year-old marathon runner will be very different from one for a 55-year-old office worker with a family.
Ask yourself these key questions:
- Who needs cover? Is it just for you, you and a partner, or your entire family?
- What is your budget? Be realistic about what you can comfortably afford each month. Premiums can range from £30 to well over £150 per person, per month.
- What are your health priorities? Are you worried about long diagnostic waits, getting a specific cancer treatment, or accessing mental health support quickly?
- What is your lifestyle? Do you travel frequently? Are you an avid sports player? Your lifestyle can influence the type of cover that offers the most value.
Real-Life Example: Meet David, a 42-year-old self-employed consultant in Bristol. His main concern is speed. If he gets sick, he needs a fast diagnosis and treatment to avoid losing income. For him, a policy with comprehensive outpatient cover for consultations and scans is a top priority, even if it costs a bit more.
In contrast, Chloe, a 28-year-old teacher in London, is more budget-conscious. She is happy to rely on the NHS for diagnostics but wants the peace of mind of private in-patient treatment if she needs surgery. A more basic, inpatient-only policy would be a better fit for her.
Step 2: Understand the Core Cover and What's Excluded
Every health insurance quote is built on a foundation of "core cover." This is the standard level of protection included in every policy. Anything else is usually an optional extra.
What's Almost Always Included (Core Cover):
- In-patient and Day-patient Treatment: This covers costs when you are admitted to hospital for a bed overnight (in-patient) or just for the day for a procedure (day-patient). This includes surgery, hospital accommodation, nursing care, and specialist fees.
- Cancer Cover: This is a cornerstone of UK PMI. Most policies offer extensive cancer cover, including chemotherapy, radiotherapy, and surgical procedures. Some even cover advanced treatments not yet available on the NHS.
What's Almost Always Excluded:
This is one of the most important aspects to understand. Private medical insurance in the UK is designed to cover acute conditions that arise after you take out your policy.
- Chronic Conditions: Long-term illnesses that cannot be cured, only managed (e.g., diabetes, asthma, high blood pressure, arthritis). PMI will not cover the routine management of these conditions.
- Pre-existing Conditions: Any illness, injury, or symptom you had before your policy start date. The way these are handled depends on your choice of underwriting (more on this in Step 3).
- Emergency Services: A&E visits are handled by the NHS. PMI does not replace the 999 service.
- Standard Maternity Care: Routine pregnancy and childbirth are typically not covered, though some policies may cover complications.
- Cosmetic Surgery, Organ Transplants, and certain other specific treatments.
| Feature | Description | Typically Covered? |
|---|---|---|
| Acute Condition | A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. E.g., a hernia, cataracts, joint replacement. | Yes |
| Chronic Condition | A disease, illness, or injury that has one or more of the following characteristics: needs long-term monitoring, has no known cure, is likely to recur. E.g., diabetes, asthma. | No (for routine management) |
| Pre-existing Condition | Any health issue you had symptoms for, received advice on, or were treated for before your policy started. | No |
Step 3: Decode the Jargon – Underwriting, Excess, and Hospital Lists
This is where many people get confused, but understanding these three elements is crucial for a fair comparison.
A. Underwriting: How Insurers Treat Your Medical History
Underwriting is the process an insurer uses to decide whether to offer you cover and on what terms, particularly regarding your pre-existing conditions. There are two main types:
-
Moratorium Underwriting (The "Wait and See" Approach):
- How it works: You don't declare your full medical history upfront. Instead, the insurer automatically excludes any condition you've had symptoms, treatment, or advice for in the last 5 years. However, if you remain symptom-free and need no treatment or advice for that condition for a continuous 2-year period after your policy starts, the exclusion may be lifted.
- Pros: Quicker and less intrusive to set up.
- Cons: Can create uncertainty. You might not know if a condition is covered until you make a claim, leading to potential disputes.
-
Full Medical Underwriting (FMU) (The "Upfront" Approach):
- How it works: You complete a detailed health questionnaire, declaring your full medical history. The insurer assesses it and tells you from day one exactly what is and isn't covered. Any exclusions are clearly stated in your policy documents.
- Pros: Provides complete certainty from the start. You know exactly where you stand.
- Cons: The application process is longer and more detailed.
| Underwriting Type | Application Process | Certainty of Cover | Best For |
|---|---|---|---|
| Moratorium | Fast, no initial health forms. | Lower certainty until a claim is made. | Younger people with a clean medical history. |
| Full Medical (FMU) | Slower, requires a detailed health questionnaire. | High certainty from day one. | People with a past medical history who want clarity. |
B. The Excess: Your Contribution to a Claim
An excess is the amount you agree to pay towards a claim before the insurer pays the rest. It's usually paid once per policy year, regardless of how many claims you make.
- How it works: If you have an excess of £250 and your eligible treatment costs £3,000, you pay the first £250, and your insurer pays the remaining £2,750.
- The trade-off: A higher excess leads to a lower monthly premium. A lower excess means a higher premium.
Choosing an excess of £250, £500, or even £1,000 can significantly reduce your monthly costs. A good strategy is to choose the highest excess you could comfortably afford to pay in the event of a claim.
C. The Hospital List: Where You Can Be Treated
Insurers have partnerships with networks of private hospitals. Your policy will include a "hospital list" which dictates where you can receive treatment. These are often tiered:
- Local/Limited Lists: Include a good selection of hospitals but may exclude premium-priced facilities, especially in Central London. This is a great way to lower costs if you don't live near a major city centre.
- Nationwide Lists: A comprehensive list of private hospitals across the UK.
- Premium Lists: Include all nationwide hospitals plus the most expensive and prestigious facilities, often located in Central London.
When comparing quotes, check that the hospital list includes convenient, high-quality hospitals near your home and workplace. Don't pay for a premium London list if you live in Manchester and have no intention of travelling for treatment.
Step 4: Compare the "Add-ons" and Extra Benefits
Once you have the core cover sorted, you can tailor your policy with optional extras. This is where you can truly match a policy to your priorities.
Common Optional Add-ons:
- Out-patient Cover: This is arguably the most valuable add-on. It covers the costs of consultations and diagnostic tests before you are admitted to hospital. Without it, you would need to rely on the NHS for your diagnosis, which could involve long waits. Policies often offer different levels of outpatient cover (e.g., up to £500, £1,000, or unlimited).
- Therapies Cover: Covers treatments like physiotherapy, osteopathy, and chiropractic care. Essential for anyone with an active lifestyle or a history of musculoskeletal issues.
- Mental Health Cover: While basic mental health support is often included, a comprehensive add-on provides more extensive cover for psychiatric treatment, therapy sessions (like CBT), and in-patient care.
- Dental and Optical Cover: Covers routine check-ups, dental treatments, and the cost of glasses or contact lenses. This is often a lower-value add-on, so check if it's cheaper to pay for these services out-of-pocket.
| Add-on | What It Covers | Who Should Consider It? |
|---|---|---|
| Out-patient Cover | Specialist consultations, diagnostic tests (MRI, CT scans). | Almost everyone. It speeds up the entire treatment journey. |
| Therapies Cover | Physiotherapy, osteopathy, chiropractic sessions. | Active individuals, sports players, those with desk jobs. |
| Mental Health Cover | In-patient and out-patient psychiatric care, therapy. | Anyone wanting fast access to mental health support. |
| Dental & Optical | Routine check-ups, fillings, new glasses. | Those who want to budget for all their health costs in one plan. |
Don't Forget the "Free" Perks: Many insurers now compete on the value-added benefits included as standard. Look out for:
- Digital GP Services: 24/7 access to a GP via phone or video call.
- Wellness Programmes: Discounts on gym memberships, fitness trackers, and healthy food.
- Health & Wellbeing Support: Access to helplines for stress, anxiety, and other concerns.
At WeCovr, we go a step further. When you arrange a PMI or Life Insurance policy through us, we provide complimentary access to our AI-powered nutrition app, CalorieHero, to support your health goals. We also offer discounts on other insurance products, helping you protect more for less.
Step 5: Use an Independent Broker to Compare the Market
You could go to each insurer directly—Aviva, Bupa, AXA Health, Vitality, and others—and get a quote. However, this is time-consuming, and each provider will present their quote in a different format, making a true like-for-like comparison incredibly difficult.
This is where an independent PMI broker like WeCovr provides immense value.
Benefits of Using a Broker:
- Whole-of-Market Comparison: We are not tied to any single insurer. We compare policies and prices from across the UK's leading providers to find the best fit for you.
- Expert Guidance: We understand the complex details of every policy. We can explain the real-world difference between two seemingly similar quotes and help you avoid common pitfalls.
- No Extra Cost: Our service is free to you. We are paid a commission by the insurer you choose, which is already built into the premium. You pay the same price (or often less) as going direct.
- Personalised Advice: We do the work from Step 1 with you, helping you define your needs and then matching those needs to the right policy.
- Claim Support: Should you need to make a claim, a good broker can offer guidance and assistance, acting as your advocate.
Our high customer satisfaction ratings reflect our commitment to providing clear, impartial advice that puts our clients first.
Proactive Health: More Than Just Insurance
While PMI is there for when things go wrong, the best approach to health is a proactive one. Many insurers recognise this and build tools into their policies to help you stay well.
- Nutrition: A balanced diet is fundamental. Focus on whole foods, plenty of fruit and vegetables, lean protein, and healthy fats. Use tools like WeCovr's complimentary CalorieHero app to track your intake and make informed choices.
- Activity: The NHS recommends at least 150 minutes of moderate-intensity activity a week. This could be a brisk walk, cycling, swimming, or a dance class. Find something you enjoy to make it a sustainable habit.
- Sleep: Aim for 7-9 hours of quality sleep per night. It's crucial for mental health, immune function, and physical recovery. Establish a relaxing bedtime routine and minimise screen time before bed.
- Stress Management: Chronic stress can have a significant physical impact. Techniques like mindfulness, yoga, or simply spending time in nature can be powerful tools. Many PMI policies offer access to mental wellbeing apps and helplines to support you.
By focusing on these areas, you not only improve your quality of life but may also benefit from lower insurance premiums over the long term through wellness-linked discounts offered by some providers.
How to Save Money on Your Private Health Cover in 2026
Looking for the best value? Here are some proven strategies for reducing your monthly premium without sacrificing essential cover.
- Increase Your Excess: As discussed, moving from a £0 to a £500 excess can cut your premium by 20-30%.
- Choose a Limited Hospital List: If you don't need access to prime Central London hospitals, opting for a regional or nationwide list can offer significant savings.
- The 6-Week Wait Option: Some policies offer a feature where if the NHS can treat you within 6 weeks for an eligible procedure, you will be treated by the NHS. If the wait is longer, you can go private. This can substantially lower your premium, acting as a great backstop to the NHS.
- Review Your Add-ons: Do you really need full dental cover, or is your outpatient limit higher than you'll ever need? Trimming non-essential extras is a quick win.
- Pay Annually: Most insurers offer a small discount (around 5%) if you pay for your policy in one annual lump sum.
- Compare Annually: Don't just auto-renew. Prices and policies change. Use a broker each year to ensure you're still on the best deal.
Example Cost Comparison (Illustrative)
Here's how different choices can impact the monthly premium for a 40-year-old non-smoker in Manchester.
| Core Cover | Excess | Out-patient Cover | Hospital List | Illustrative Monthly Premium |
|---|---|---|---|---|
| In-patient Only | £500 | None | Local | £45 |
| Comprehensive | £250 | £1,000 Limit | Nationwide | £80 |
| Comprehensive | £100 | Unlimited | Premium (incl. London) | £125 |
As you can see, the choices you make during the comparison process have a dramatic impact on the final cost.
Final Thoughts: Making Your Decision
Choosing private medical insurance is a significant financial decision, but it's also an investment in your health and peace of mind. By following this five-step checklist, you can move from a position of confusion to one of control.
- Define your needs.
- Understand core cover vs. exclusions.
- Grasp the key terms: underwriting, excess, and hospital lists.
- Compare add-ons and benefits.
- Use an expert broker to get a clear, whole-of-market view.
This structured approach ensures you are not just comparing prices, but comparing value. The cheapest policy is rarely the best. The right policy is one that provides the protection you need, from a provider you trust, at a price you can afford.
Do I need to declare a minor illness I had years ago when applying for health insurance?
It depends on the type of underwriting you choose. If you opt for Full Medical Underwriting (FMU), you must declare your entire medical history as accurately as possible. The insurer will then make a specific decision on what to cover. If you choose Moratorium underwriting, you do not need to declare conditions from your past. However, any condition for which you have had symptoms, treatment, or advice in the 5 years prior to the policy start date will be automatically excluded until you complete a 2-year continuous period without any symptoms, treatment, or advice for it.
Can I switch my private medical insurance provider if I find a better deal?
Yes, you can switch providers, and it's wise to review your options annually. However, it's crucial to handle the switch carefully, especially if you have developed new medical conditions. When switching, you can often do so on a 'Continued Medical Exclusions' (CME) basis, which means your new insurer will carry over the same exclusions as your old policy, but will cover any new conditions that arose while you were insured. A PMI broker can provide expert advice on the best way to switch without losing valuable cover.
What is the difference between private medical insurance (PMI) and a healthcare cash plan?
They are very different products. Private Medical Insurance (PMI) is comprehensive cover designed to pay for major medical treatments, such as surgery, cancer care, and specialist consultations for acute conditions. It provides access to private hospitals and specialists. A healthcare cash plan, on the other hand, is a budgeting tool. You pay a monthly premium and can then claim back cash (up to an annual limit) for routine healthcare costs, such as dental check-ups, eye tests, physiotherapy, and prescriptions. Cash plans do not cover major private surgery or in-patient treatment.
Ready to take the next step? Get a clear, no-obligation quote and expert advice from our friendly team at WeCovr today. We'll do the hard work of comparing the market for you, ensuring you find the best private medical insurance UK has to offer.










