TL;DR
That envelope from your insurer has arrived. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we know that understanding your private medical insurance renewal is vital for your health and your finances. This guide will help you decode your letter and decide what to do next.
Key takeaways
- Price: Has your premium increased significantly?
- Cover: Have the benefits been reduced or restricted?
- Your Health: Have your personal health circumstances changed over the past year?
- Policyholder(s): Are all named individuals on the policy correctly listed?
- Policy Number: Your unique identifier with the insurer.
That envelope from your insurer has arrived. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we know that understanding your private medical insurance renewal is vital for your health and your finances. This guide will help you decode your letter and decide what to do next.
What to look for at renewal and when to switch instead of renewing
The annual renewal of your private medical insurance (PMI) is a critical moment. It's your opportunity to ensure your policy still meets your needs and offers good value for money. Simply letting it auto-renew could mean paying more for less cover, a phenomenon known as the "loyalty penalty."
The key decision is whether to renew with your current provider or switch to a new one. This choice depends on three main factors:
- Price: Has your premium increased significantly?
- Cover: Have the benefits been reduced or restricted?
- Your Health: Have your personal health circumstances changed over the past year?
This article will walk you through the renewal process, highlight the major red flags to watch out for, and explain how to make the best decision for you and your family.
Deconstructing Your PMI Renewal Letter: Section by Section
Your renewal pack might seem bulky, but it contains crucial information. It’s usually made up of a covering letter, a policy schedule or certificate, and a summary of your cover. Let's break down what to look for in each part.
The Renewal Premium
This is the figure that grabs your attention first—the total cost for another year of cover. It will show the annual premium and, if you pay monthly, the new monthly instalment amount. The headline figure is important, but it's the reason for any increase that truly matters. We'll explore this in detail later.
Certificate of Insurance
This document confirms the core details of your policy. Double-check that everything is correct:
- Policyholder(s): Are all named individuals on the policy correctly listed?
- Policy Number: Your unique identifier with the insurer.
- Period of Insurance: The start and end date for the renewed policy term.
Policy Schedule & Summary of Cover
This is the heart of your renewal document. It outlines exactly what you are paying for. Scrutinise it carefully and compare it to last year's schedule.
| Key Area of Cover | What to Check at Renewal |
|---|---|
| Overall Benefit Limit | Is there a cap on the total value of claims per year? Is it still "unlimited"? |
| Out-patient Cover | Check the limit. Has it been reduced from, say, £1,500 to £1,000? Does it include diagnostics, consultations, and therapies? |
| Hospital List | Has your chosen hospital list changed? Your local private hospital might have been moved to a more expensive tier or removed entirely. |
| Excess | Is the excess amount correct? This is the amount you agree to pay towards a claim. A higher excess lowers your premium. |
| Cancer Cover | This is vital. Check for any new limits on chemotherapy, radiotherapy, or access to new, advanced drugs. |
| Mental Health Cover | Has the limit for psychiatric treatment or therapy sessions been altered? |
| Added Benefits | Check the status of extras like digital GP access, wellness apps, or health screenings. |
Endorsements and Policy Changes
Insurers must inform you of any changes to the policy's terms and conditions. This information might be in a separate section labelled "Endorsements," "Important Changes," or woven into the main policy booklet. This is a common place to find hidden reductions in cover. Read this section twice.
Red Flag #1: The Steep Premium Increase
It's the number one reason people feel frustrated at renewal. While some increase is normal, an unexpectedly large jump is a major red flag. Here’s why your premium goes up.
The Three Drivers of Premium Rises
- Age: As we get older, the statistical likelihood of needing medical treatment increases. Most insurers use age bands, and moving into a new band (e.g., turning 40, 50, or 65) can trigger a significant price hike.
- Medical Inflation: The cost of private healthcare consistently outpaces general inflation. Advances in medical technology, new expensive drugs, and rising hospital running costs all contribute. According to industry analysis, medical inflation in the UK typically runs between 7% and 10% per year.
- Your Claims History: If you made a claim in the previous year, you will likely see an impact on your No Claims Discount (NCD). Most insurers reduce your NCD level for each claim, which directly increases your base premium.
Example of an Age-Related Premium Increase (Illustrative Only)
| Age Band | Indicative Monthly Premium | Percentage Increase |
|---|---|---|
| 35-39 | £60 | - |
| 40-44 | £72 | 20% |
| 45-49 | £85 | 18% |
| 50-54 | £105 | 24% |
What is an "unreasonable" increase?
A total increase of over 20%—especially if you haven't claimed—should be a trigger to investigate. This suggests your insurer may be applying a "loyalty tax" on top of the standard age and inflation increases. This is the perfect time to ask an expert PMI broker like WeCovr to run a market comparison.
Red Flag #2: Your Cover Has Been Reduced or Restricted
A cheaper renewal premium isn't always a victory. Some insurers reduce costs by quietly chipping away at your benefits. This is a critical red flag because it means you're paying for a policy that may not deliver when you need it most.
Look for these subtle but significant downgrades:
- A Smaller Hospital List: Your insurer may have re-categorised hospitals. The convenient private hospital near you might now be excluded from your list, meaning you'd have to travel further for treatment or pay extra to use it.
- Reduced Out-patient Limits (illustrative): A common tactic is to lower the financial limit for consultations and diagnostic tests (like MRI or CT scans) that don't require a hospital stay. A policy that once offered "unlimited" or a £2,000 limit might now only offer £1,000.
- New Limits on Therapies: The number of sessions for physiotherapy, osteopathy, or chiropractic treatment might be capped at a lower number than before.
- Changes to Cancer Care: This is the most important area to check. Insurers may change their cancer drug formularies or introduce new restrictions on experimental treatments.
- "Fair and Reasonable" Clauses: Look for new wording that states the insurer will only pay "fair and reasonable" charges. This can create ambiguity and potential shortfalls if your chosen consultant's fees are higher than the insurer's set rate.
If you spot any of these changes, you need to ask yourself if the policy still provides the security you originally bought it for.
Red Flag #3: The "Loyalty Penalty" – Are New Customers Getting a Better Deal?
Insurers often compete for new business by offering attractive introductory discounts. Unfortunately, these discounts disappear after the first year, and the price is then ramped up at renewal. This means a new customer could be paying significantly less than you for the exact same policy.
The Financial Conduct Authority (FCA) has cracked down on this "price walking" in the home and motor insurance markets, but it can still be a factor in private health cover.
How to Check for a Loyalty Penalty:
The simplest way is to get a quote from your current provider as if you were a new customer. However, a far more effective method is to use a PMI broker. They can instantly compare the price of your renewal against what a new customer would pay, not just with your insurer but across the entire market. This gives you powerful leverage for negotiation or a clear reason to switch.
When to Switch vs. When to Renew: A Decision Framework
Making the right choice requires a clear-headed assessment of your situation.
Strong Reasons to RENEW
It's not always best to switch, especially in these circumstances:
- You are currently undergoing treatment: If you are in the middle of a course of treatment for an acute condition (e.g., chemotherapy, post-surgery physiotherapy), you must renew your policy. Switching insurers would make this condition "pre-existing," and your new policy would not cover the ongoing costs.
- You have developed a new chronic condition: Standard UK PMI does not cover the routine management of chronic conditions like diabetes or asthma. However, if you developed a chronic condition while insured, your policy will often cover acute flare-ups. Switching could risk losing this benefit.
- Your renewal offer is genuinely competitive: If the price increase is modest (e.g., under 10-15%) and your cover remains unchanged, staying put can be the simplest option.
- You value your provider's service: If you've had a positive claims experience and are happy with the customer service, this has real value.
Strong Reasons to SWITCH
You should seriously consider switching if:
- Your premium has increased by over 20% without a claim: This is a clear sign you should shop around.
- Your cover has been significantly reduced: You are no longer getting the level of protection you paid for.
- You are in good health and haven't claimed for several years: You are a "clean slate" and highly attractive to a new insurer. You will likely be able to find a better deal.
- Your needs have changed: Perhaps you want to add your partner, need better mental health support, or want access to a different hospital network.
- You've had a poor service experience: A difficult claims process or poor communication is a valid reason to move your business elsewhere.
The Switching Process: Understanding Underwriting Options
If you decide to switch, it's vital to understand how your medical history will be treated by the new insurer. This is where underwriting comes in.
Remember the Golden Rule: Private medical insurance in the UK is designed to cover acute conditions (illnesses that are short-term and curable) that arise after you take out the policy. It does not cover pre-existing conditions or the day-to-day management of chronic conditions.
There are three main ways to be underwritten when you switch:
-
Moratorium (Mori) Underwriting: This is the most common method. You don't fill out a medical questionnaire. Instead, the insurer automatically excludes any condition for which you have had symptoms, treatment, or advice in the 5 years before your policy starts. If you then go 2 continuous years on the new policy without any treatment, symptoms, or advice for that condition, it may become eligible for cover.
- Pro: Quick and simple to set up.
- Con: Creates uncertainty. You only find out if a condition is covered when you try to make a claim.
-
Full Medical Underwriting (FMU): You complete a detailed health questionnaire about your medical history. The insurer assesses it and provides a policy with a clear list of any specific conditions that will be permanently excluded.
- Pro: Total clarity from day one. You know exactly what isn't covered.
- Con: More initial paperwork.
-
Continued Personal Medical Exclusions (CPME) / "Switch" Underwriting: This is the best option for most people switching from an existing PMI policy. CPME allows you to move to a new insurer while keeping the same underwriting terms you had on your old policy.
- How it works: Your new insurer agrees to take you on with the same exclusions you had before. Crucially, any new medical conditions that developed while you were covered by your old policy will be covered by your new policy.
- Benefit: You can switch to a cheaper or better policy without losing cover for conditions that have arisen since you first took out PMI.
- Requirement: You must be switching from another UK PMI policy without any break in cover.
Navigating these underwriting options can be complex. An expert broker is essential to ensure you choose the right path and don't inadvertently lose valuable cover.
How to Lower Your Renewal Premium Without Switching
If you'd prefer to stay with your current provider but want a better price, you have several options. Call your insurer and ask them to requote based on these adjustments:
| Option to Lower Premium | How It Works | The Trade-Off |
|---|---|---|
| Increase Your Excess | You agree to pay a larger amount towards the cost of any claim (e.g., increase from £250 to £500). | You will have to pay more out-of-pocket if you need to claim. |
| Reduce Out-patient Cover | Lower the financial limit for consultations and tests, or remove it entirely and pay for these yourself. | You lose cover for potentially expensive diagnostic procedures. |
| Change Your Hospital List | Move from a "nationwide" list to a more restricted local or regional network. | You have fewer hospitals to choose from and may have to travel for treatment. |
| Add a 6-Week Wait Option | If the NHS waiting list for an eligible in-patient procedure is less than 6 weeks, you use the NHS. If it's longer, your PMI kicks in. | This can significantly cut your premium, but means you may use the NHS instead of going private for some treatments. |
The Role of a PMI Broker at Renewal
Trying to navigate the renewal maze alone can be time-consuming and confusing. An independent PMI broker acts as your expert guide and advocate.
Here’s what an expert broker like WeCovr does for you, at no cost:
- Analyses Your Renewal: We'll break down your renewal offer, explain the changes, and identify any red flags or hidden downgrades.
- Conducts a Full Market Review: We use our technology to compare your renewal against policies from all the leading UK insurers, including Aviva, Bupa, AXA Health, and Vitality.
- Compares Like-for-Like (and Better): We don't just compare on price. We compare the crucial details: hospital lists, cancer cover definitions, mental health support, and more.
- Advises on Underwriting: We'll explain the pros and cons of Moratorium, FMU, and CPME underwriting to ensure you make a seamless switch with no loss of cover.
- Handles the Admin: If you decide to switch, we handle all the application forms and paperwork for you.
Furthermore, clients who purchase PMI or Life Insurance through WeCovr receive complimentary access to our AI-powered nutrition app, CalorieHero, and can benefit from discounts on other types of insurance cover.
Beyond the Policy: Wellness and Prevention
Leading PMI providers are increasingly focused on helping you stay healthy. When reviewing your policy, look for the added-value wellness benefits, which can include:
- Discounted gym memberships
- Free access to digital GP apps for 24/7 consultations
- Mental health support lines and apps
- Rewards for healthy activity, such as walking or cycling
- Discounts on health screenings
Embracing a healthy lifestyle is the best insurance of all. The NHS recommends adults aim for at least 150 minutes of moderate-intensity activity a week. This, combined with a balanced diet, 7-9 hours of quality sleep per night, and stress management techniques, can have a profound impact on your long-term health and reduce your need to claim.
Can I switch my PMI policy if I am currently receiving treatment?
Will my PMI premium always go up every year?
What is the difference between a chronic and an acute condition?
Does using my policy guarantee a big premium increase?
Your Next Step
Your PMI renewal letter is more than just a bill—it's a prompt to review your health protection. Don't let it sit on the side. A steep price, reduced cover, or a change in your needs are all clear signs that it's time to act.
Contact WeCovr today for a free, no-obligation review of your renewal offer. Our experts will compare the entire market to ensure you have the best possible cover at the most competitive price.
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.
