TL;DR
As an FCA-authorised expert broker that has helped arrange over 900,000 policies, WeCovr understands the nuances of private medical insurance in the UK. When it comes to protecting your children's health, the desire for the best possible care is universal. But is a standalone policy the right financial decision?
Key takeaways
- Pre-existing Conditions: PMI does not cover illnesses or injuries you (or your child) had before taking out the policy. If your child has a known history of ear infections, treatment for that specific issue will likely be excluded.
- Chronic Conditions: PMI does not cover the routine management of long-term conditions that cannot be cured, only managed. This includes conditions like asthma, diabetes, cystic fibrosis, and most types of eczema. The NHS remains the primary provider for managing these lifelong conditions.
- Peace of Mind: The emotional driver is powerful. Knowing you have a way to access swift medical care can alleviate immense worry for a parent.
- Avoiding NHS Waiting Lists: This is the most practical benefit. A child suffering from recurrent tonsillitis or glue ear (requiring grommets) might face a wait of many months for NHS surgery. This can affect their hearing, speech development, schooling, and sleep. With PMI, this procedure could be completed within weeks.
- Faster Diagnosis: Worrying about a symptom is stressful. PMI can provide rapid access to diagnostic tests like MRI scans, CT scans, and specialist consultations, shortening the period of uncertainty.
As an FCA-authorised expert broker that has helped arrange over 900,000 policies, WeCovr understands the nuances of private medical insurance in the UK. When it comes to protecting your children's health, the desire for the best possible care is universal. But is a standalone policy the right financial decision? This guide explores the details.
Finance blogs note few parents actually need standalone PMI for kids, as most family NHS care is good. Childrens PMI is less common—focus on family cover. — MoneyPeopleOnline
This observation gets right to the heart of the matter for many UK parents. Your child's health is your absolute priority, but the path to ensuring their wellbeing isn't always straightforward. The UK is fortunate to have the National Health Service (NHS), which provides excellent, comprehensive care for children, especially for emergencies, chronic conditions, and complex illnesses. It's the bedrock of our nation's health.
Because of this high-quality, free-at-the-point-of-use service, the argument for private medical insurance (PMI) for children becomes more specific. It isn't about replacing the NHS, but supplementing it.
Standalone, or 'kids-only', health insurance policies are relatively rare in the UK market. Insurers and brokers often find that they are not the most cost-effective solution. Instead, the industry focus, and indeed the more common choice for parents, is to add children to a family health insurance policy. This approach typically offers better value and administrative simplicity, providing private cover for the whole family under one plan.
In this guide, we'll break down the pros and cons, explore the more popular family cover options, and give you the clear, authoritative information you need to decide what's right for your family.
Understanding Private Medical Insurance (PMI) in the UK
Before weighing the options, it's vital to understand what private medical insurance is designed for and, just as importantly, what it is not.
What is PMI and What Does It Cover?
Private medical insurance is a type of insurance policy designed to cover the costs of private healthcare for specific conditions. Its primary purpose is to help you bypass NHS waiting lists for diagnosis and treatment of 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. Think of conditions like hernias, cataracts, joint pain requiring replacement, or the removal of tonsils or adenoids.
The Critical Exclusions: Chronic and Pre-existing Conditions
This is the most important aspect to understand about standard UK PMI:
- Pre-existing Conditions: PMI does not cover illnesses or injuries you (or your child) had before taking out the policy. If your child has a known history of ear infections, treatment for that specific issue will likely be excluded.
- Chronic Conditions: PMI does not cover the routine management of long-term conditions that cannot be cured, only managed. This includes conditions like asthma, diabetes, cystic fibrosis, and most types of eczema. The NHS remains the primary provider for managing these lifelong conditions.
The role of PMI is to step in for new, curable health issues that arise after your policy begins.
The NHS vs. Private Healthcare for Children
Both systems have their strengths, and they often work in parallel. A child might have a chronic condition managed by the NHS but use PMI for an unrelated, acute issue.
Here’s a comparison to help you understand the key differences:
| Feature | NHS Paediatric Care | Private Paediatric Care (via PMI) |
|---|---|---|
| Cost | Free at the point of use. | Funded by monthly premiums and potential excess payments. |
| Emergencies | The undisputed best place for A&E, trauma, and life-threatening situations. | Not for emergencies. You go to an NHS A&E. |
| Waiting Times | Can be long for non-urgent specialist appointments and elective surgery. | Significantly shorter waiting times for diagnosis and treatment. |
| Choice | Limited choice of hospital or specialist consultant. | Greater choice of when, where, and by whom your child is treated. |
| Chronic Care | Comprehensive, world-class management of long-term conditions. | Not covered for routine management. |
| Comfort | Usually on a busy, shared children's ward. | A private en-suite room is highly likely, aiding rest and recovery. |
| Mental Health | Child and Adolescent Mental Health Services (CAMHS) are available but often face significant demand and long waits. | Faster access to private therapists and psychiatrists, subject to policy limits. |
As of mid-2024, NHS data showed that hundreds of thousands of children were on waiting lists for community paediatric services, with some waiting over a year for an initial assessment. For mental health, the situation is equally challenging. Reports from The Children's Commissioner for England highlight that demand for CAMHS consistently outstrips capacity, leaving many young people without timely support. It is in this gap—the wait for non-urgent care—that PMI finds its purpose.
The Case For and Against Kids-Only Health Insurance
While uncommon, some parents do explore standalone cover. Let's examine the motivations and the drawbacks.
Why Might a Parent Consider Standalone PMI for a Child?
- Peace of Mind: The emotional driver is powerful. Knowing you have a way to access swift medical care can alleviate immense worry for a parent.
- Avoiding NHS Waiting Lists: This is the most practical benefit. A child suffering from recurrent tonsillitis or glue ear (requiring grommets) might face a wait of many months for NHS surgery. This can affect their hearing, speech development, schooling, and sleep. With PMI, this procedure could be completed within weeks.
- Faster Diagnosis: Worrying about a symptom is stressful. PMI can provide rapid access to diagnostic tests like MRI scans, CT scans, and specialist consultations, shortening the period of uncertainty.
- Access to Specialist Care: While the NHS has outstanding specialists, PMI can offer quicker access to a consultant of your choice, including seeking a second opinion from a leading expert in a particular field.
- Comfort and Convenience: A private room means a quieter, more comfortable environment for your child to recover. It also provides more space and privacy for a parent to stay with them, reducing stress for everyone.
- Enhanced Mental Health Support: This is a growing reason for considering PMI. With long waits for NHS CAMHS, a policy that provides prompt access to a child psychologist or psychiatrist can be invaluable for a young person in crisis.
Why Standalone Child PMI is Often Not the Best Route
Despite the clear benefits, financial experts and insurance professionals often guide parents away from child-only policies for several compelling reasons.
- Cost-Inefficiency: A standalone policy for a child can be surprisingly expensive, sometimes costing nearly as much as a policy for a young adult. Insurers' pricing models often make it poor value compared to family plans.
- Family Policies Offer Better Value: The most common reason is that it is almost always cheaper to add a child to a parent's existing or new policy. Many insurers offer significant discounts or even "free" cover for children (especially after the first child).
- Limited Availability: Not all major UK insurers offer standalone policies for minors. Their focus is on the family and corporate markets, so your choice of provider will be restricted.
- Administrative Hassle: Managing separate policies for different family members is more complex than having a single family plan with one renewal date and one point of contact.
Family Health Insurance: The More Common and Cost-Effective Alternative
For the vast majority of parents, a family policy is the superior choice. It aligns with how insurers structure their products and delivers the best value.
How Family PMI Policies Work
A family policy is a single private medical insurance UK plan that covers multiple members of the same family, typically:
- One or two adults.
- One or more dependent children (usually up to age 21, or 25 if in full-time education).
Premiums are calculated based on the age and medical history of the adults, with a smaller, fixed cost added for each child.
A common pricing structure you might see:
- You pay the full premium for the oldest adult.
- The second adult gets a small discount.
- The first child is added for a set fee.
- Often, the second, third, and any subsequent children are added for free.
This "free cover" for additional children makes family PMI an incredibly attractive proposition compared to insuring each child separately. An expert broker like WeCovr can quickly run the numbers to show you the precise savings.
Comparing Standalone vs. Family Cover
| Feature | Standalone Child Policy | Family Policy |
|---|---|---|
| Cost-Effectiveness | Generally poor value for money. | High. Often cheaper to cover a family of four than two adults and one child separately. |
| Availability | Limited. Not offered by all major providers. | Widely available from all leading UK health insurers. |
| Simplicity | Requires a separate policy and administration. | One policy, one premium, one renewal date. Simple to manage. |
| Child Discounts | Not applicable. You pay the full child premium. | Excellent discounts, often with free cover for second and subsequent children. |
| Parental Cover | Does not cover the parents. | Covers the entire family, ensuring parents also have fast access to care. |
What to Look For in a Health Insurance Policy for Your Child
Whether you are considering a standalone policy or adding your children to a family plan, the key features to scrutinise are the same. A good policy is not just about the price; it's about the level of cover.
Core Cover
This is the foundation of any policy and typically includes costs for treatment when your child is admitted to hospital as an in-patient (staying overnight) or day-patient (admitted for a procedure but not staying overnight). This covers surgeon fees, anaesthetist fees, hospital charges, and nursing care.
Out-patient Cover
This is one of the most important variables. It covers diagnostic tests and consultations that do not require a hospital admission.
- Basic policies may have no out-patient cover or a very low limit (e.g., £500). This means you might need to rely on the NHS for the initial diagnosis before the PMI will pay for the treatment.
- Comprehensive policies offer higher limits (e.g., £1,000, £1,500, or even unlimited) for specialist consultations, blood tests, and scans (MRI, CT, PET). A good out-patient limit is crucial for speedy diagnosis.
Mental Health Cover
Check this carefully. Some policies offer no mental health cover, while others provide substantial benefits for both out-patient therapy and in-patient psychiatric treatment. For parents of teenagers, this can be a deciding factor.
Therapies Cover
This covers treatments like physiotherapy, osteopathy, and chiropractic care. If you have an active, sporty family, this is a valuable benefit for treating injuries quickly.
Hospital List
Insurers offer different 'tiers' of hospitals. A cheaper policy might restrict you to a limited local network, while a more expensive one will give you access to premium hospitals, including those in Central London. Ensure the list includes hospitals near you with good paediatric facilities.
Policy Excess
This is the amount you agree to pay towards the cost of a claim. For example, if you have a £250 excess and your child's treatment costs £3,000, you pay the first £250 and the insurer pays the remaining £2,750. Choosing a higher excess (£500 or £1,000) is a very effective way to reduce your monthly premium.
The Real Cost of Children's Private Medical Insurance
Premiums vary hugely based on location, age, level of cover, and chosen excess. However, we can provide some illustrative examples to give you a general idea. These are industry estimates for 2025 for non-smokers with no adverse medical history.
| Scenario (Comprehensive Cover, £250 Excess) | Estimated Monthly Premium |
|---|---|
| Adding a 10-year-old to a 40-year-old parent's policy | £30 - £50 |
| Standalone policy for a 10-year-old (where available) | £45 - £75 |
| Full family policy (2 adults aged 40, 2 children aged 8 & 10) | £160 - £280 |
Disclaimer: These are illustrative figures only. The only way to get an accurate price is to get a personalised quote. A PMI broker can compare the market for you in minutes.
Beyond PMI: Promoting Your Child's Health and Wellbeing
While insurance provides a safety net, prevention and a healthy lifestyle are the first line of defence. As experts in health and wellbeing, we believe in a holistic approach.
The Pillars of a Healthy Childhood
- Nutrition: A balanced diet rich in fruits, vegetables, lean proteins, and whole grains is fundamental. Limiting sugar and processed foods can have a huge impact on energy levels, mood, and long-term health. To help families with this, WeCovr provides complimentary access to its AI-powered calorie and nutrition tracking app, CalorieHero, for all its PMI and Life Insurance clients.
- Physical Activity: The NHS recommends that children and young people aged 5 to 18 should do at least 60 minutes of moderate to vigorous intensity physical activity each day. This doesn't have to be organised sport; family walks, bike rides, swimming, or even just playing in the park all count.
- Quality Sleep: Sleep is vital for physical growth, brain development, and emotional regulation. The Sleep Charity UK recommends 9-12 hours for children aged 6-12, and 8-10 hours for teenagers. A consistent bedtime routine away from screens is key.
- Mental Resilience: Fostering an environment of open communication where children feel safe to talk about their worries is crucial. Managing screen time and encouraging hobbies and real-world social interaction helps build robust mental health.
How WeCovr Can Help You Find the Right Cover
Navigating the private medical insurance UK market can be complex. This is where an independent, FCA-authorised broker like WeCovr becomes your most valuable asset.
Instead of going to insurers directly, which can be time-consuming and confusing, we do the hard work for you.
- Expert, Unbiased Advice: We are not tied to any single insurer. Our loyalty is to you, our client. We listen to your family's needs and budget to find the policy that fits perfectly.
- Market-Wide Comparison: We have access to policies from all the UK's leading providers, including specialist plans you might not find on your own. We find the best PMI provider for your specific circumstances.
- No Cost to You: Our service is completely free for you to use. We are paid a commission by the insurer you choose, which does not affect the price you pay.
- Save Money: We are experts at tailoring policies to be as cost-effective as possible. We also offer exclusive discounts on other insurance products, like life or home insurance, when you purchase a PMI policy through us.
- Trusted Service: Our high customer satisfaction ratings reflect our commitment to clear, honest, and helpful service. We've helped over 900,000 individuals and families secure the right protection.
For most families, the question is not if they should get cover for their children, but how. The evidence overwhelmingly points towards family health insurance as the smartest, most affordable, and most comprehensive solution.
Is private health insurance for children worth it in the UK?
Does children's PMI cover pre-existing conditions like asthma or ADHD?
How much does it cost to add a child to my health insurance?
Ready to protect your family's health and explore your options? Get your free, no-obligation quote from WeCovr today and let our friendly experts find the perfect health cover for you and your children.
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.
