As an FCA-authorised expert broker that has helped arrange over 800,000 policies, WeCovr understands that your child's health is your top priority. This guide explores child-only private medical insurance (PMI) in the UK, helping you give your children fast access to high-quality care when they need it most.
Navigating the application process and finding the best value for child health insurance
Securing private health cover for a child might seem daunting, but it's a straightforward process when you know the steps. The key to finding the best value isn't just about finding the lowest price; it's about striking the right balance between comprehensive cover, an affordable premium, and a policy that genuinely meets your child's potential needs.
The journey involves three main stages:
- Understanding the Cover: Knowing what is and isn't included, especially the distinction between acute and chronic conditions.
- The Application: Choosing an underwriting method and providing accurate medical history.
- Customising the Policy: Adjusting elements like the excess and hospital list to control the cost without sacrificing essential benefits.
Working with an expert PMI broker can simplify this journey, ensuring you compare the whole market and understand the fine print before committing.
Why Consider a Child-Only Private Health Insurance Policy?
While the NHS provides excellent care, parents are increasingly turning to private medical insurance for their children to gain peace of mind and overcome the challenge of long waiting lists. Recent data highlights the pressures on paediatric services. For instance, NHS England statistics consistently show hundreds of thousands of children on waiting lists for consultant-led elective care.
The core benefits of a child-only PMI policy are clear:
- Speed of Access: This is the primary driver for most parents. PMI allows you to bypass lengthy NHS queues for specialist consultations, diagnostic tests (like MRI or CT scans), and non-emergency surgery. For conditions like recurrent tonsillitis or grommet insertion for glue ear, this can mean treatment in weeks rather than many months.
- Choice and Control: Private cover gives you more say over your child's healthcare journey. You can choose the specialist or consultant you want to see and select a hospital that is convenient for you, often from an extensive list of high-quality private facilities.
- Comfort and Privacy: A private hospital stay often means your child gets a private room with an en-suite bathroom. This can make a stressful experience far more comfortable for both the child and the parent, who can usually stay overnight with them.
- Access to Advanced Treatments: Some newer drugs, therapies, and surgical techniques may become available privately before they are approved for widespread use on the NHS due to funding decisions. PMI can provide access to these cutting-edge options.
- Enhanced Mental Health Support: Many PMI policies offer excellent mental health pathways, providing faster access to child and adolescent mental health services (CAMHS) than is often possible through the NHS, where waiting times can be particularly long.
Understanding What Child-Only PMI Covers (and What It Doesn't)
This is the most critical area to understand before you buy a policy. UK private medical insurance is designed to cover acute conditions that arise after your policy begins.
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 things like infections, joint injuries, hernias, or cataracts.
Conversely, PMI does not cover chronic or pre-existing conditions.
- A chronic condition is an illness that is long-lasting and cannot be conventionally cured. It can be managed but not resolved. Examples include asthma, diabetes, epilepsy, and cystic fibrosis.
- A pre-existing condition is any illness, injury, or symptom for which your child had medication, advice, or treatment before the start date of the policy.
Here’s a breakdown of what is typically included and excluded:
| Covered by Standard PMI | Usually Excluded from Standard PMI |
|---|
| In-patient and Day-patient Treatment: Surgery, hospital accommodation, nursing care, specialist fees. | Pre-existing Conditions: Any medical issue that existed before the policy started. |
| Out-patient Diagnostics: Consultations, MRI/CT/PET scans, blood tests to diagnose a condition. | Chronic Conditions: Long-term illnesses like asthma, diabetes, or epilepsy. |
| Cancer Care: Comprehensive cover for chemotherapy, radiotherapy, and surgery is a core feature of most policies. | Routine Care & Emergencies: A&E visits, GP check-ups, vaccinations, dental, and optical care. |
| Therapies: Physiotherapy, osteopathy, and sometimes speech therapy, often following a procedure. | Developmental & Learning Issues: Conditions like ADHD, autism spectrum disorders, and dyslexia. |
| Mental Health Support (Often an Add-on): Access to therapists, psychologists, and psychiatrists. | Cosmetic Surgery: Procedures not deemed medically necessary. |
Important Note: The distinction between acute and chronic is fundamental. If your child develops an acute flare-up of a chronic condition, some policies might offer limited cover for getting the symptoms back under control, but they will not cover the ongoing management of the chronic illness itself.
The Application Process for Child Health Insurance Explained Step-by-Step
Applying for a child's health insurance policy is a structured process. Here’s how it works.
You will need to provide basic details for your child, including their full name, date of birth, and address. Crucially, you will need to have their medical history to hand. Be prepared to recall any consultations, treatments, or symptoms they have experienced.
Step 2: Choose an Underwriting Method
Underwriting is how an insurer assesses the risk and decides on the terms of your policy. There are two main types for personal health insurance:
-
Moratorium Underwriting:
- This is the most common and simplest option. You don't have to complete a detailed medical questionnaire upfront.
- Instead, the policy automatically excludes treatment for any pre-existing conditions your child has had in the five years before the policy start date.
- However, if your child remains symptom-free, treatment-free, and advice-free for that condition for a continuous two-year period after the policy begins, the exclusion may be lifted for future claims.
- Pros: Quick and easy to set up.
- Cons: Lack of initial certainty. A claim might be investigated at a later date to see if it relates to a pre-existing condition.
-
Full Medical Underwriting (FMU):
- With FMU, you complete a detailed health questionnaire for your child as part of the application.
- You must declare all previous medical conditions, treatments, and consultations.
- The insurer assesses this information and tells you from day one exactly what will be excluded from the policy.
- Pros: Complete clarity from the start. You know precisely what is and isn't covered.
- Cons: The application process takes longer, and any declared conditions will likely be permanently excluded.
An independent PMI broker like WeCovr can help you decide which underwriting method is best for your circumstances, ensuring there are no surprises when you need to make a claim.
Step 3: Customise Your Policy to Manage Costs
Several levers allow you to tailor your child’s policy to fit your budget:
- Excess: This is the amount you agree to pay towards the cost of a claim. For example, if you have a £250 excess and the treatment costs £2,000, you pay the first £250 and the insurer pays the remaining £1,750. A higher excess will lower your monthly premium.
- Hospital List: Insurers have tiered hospital lists. A comprehensive list including prime central London hospitals will be the most expensive. Choosing a more restricted list that still covers excellent hospitals near you can significantly reduce the cost.
- Out-patient Cover: You can choose a limit for out-patient diagnostics and consultations. A policy with full cover will be more expensive than one with a limit of, say, £1,000 per year.
- The Six-Week Option: This is a popular cost-saving feature. If the NHS can provide the required in-patient treatment within six weeks of it being recommended, you would use the NHS. If the NHS waiting list is longer than six weeks, your private policy kicks in. This can reduce your premium by up to 20-30%.
Step 4: Finalise and Review
Once you’ve chosen your provider and customised your cover, you'll submit the application. After approval, you have a 14-day "cooling-off" period during which you can cancel the policy and receive a full refund, provided you haven't made a claim.
How Much Does Child-Only Private Medical Insurance Cost in the UK?
The cost of a standalone child-only policy in the UK can vary significantly but typically ranges from £20 to over £70 per month.
The final premium depends on several key factors:
- Age of the Child: Premiums are generally low for young children and increase as they get older, particularly in their late teens.
- Location: Your postcode matters. Cover is more expensive in and around major cities, especially London, due to the higher cost of private treatment.
- Level of Cover: A comprehensive plan with full out-patient cover, mental health support, and a top-tier hospital list will cost more than a basic plan designed for in-patient care only.
- Excess Level: A policy with a £500 excess will be cheaper than one with a £100 or £0 excess.
Here is an illustrative table of potential monthly costs for a child living outside London. These are examples only and actual quotes will vary.
| Child's Age | Basic Cover (In-patient, £500 excess) | Comprehensive Cover (Full out-patient, £100 excess) |
|---|
| 5 years old | £25 - £35 | £45 - £60 |
| 10 years old | £28 - £40 | £50 - £65 |
| 15 years old | £35 - £50 | £60 - £80+ |
Key UK Providers for Child-Only Health Insurance
The UK private medical insurance market is mature, with several excellent providers offering cover for children. However, their approaches differ. Some specialise in standalone child policies, while others require a parent to be on the policy.
| Provider | Standalone Child-Only Policy? | Noteworthy Feature |
|---|
| Bupa | Yes | A leading brand with extensive networks and strong cancer and mental health cover options. |
| AXA Health | Yes | Known for excellent digital GP services and a clear, guided hospital selection process. |
| Aviva | Yes | Often provides great value for money with its "Expert Select" model, guiding you to high-quality consultants. |
| Vitality | No (Usually requires an adult on the policy) | Focuses on rewarding healthy behaviour with discounts and perks, which can be great for active families. |
| The Exeter | Yes | A friendly society known for its straightforward policies and excellent customer service. |
Navigating the subtle differences between these providers is where expert advice is invaluable. A broker can quickly identify which insurers offer standalone policies and which provide the best value for the specific cover you need.
Adding a Child to an Existing Policy vs. a Standalone Policy
If you or your partner already have private medical insurance, you face a choice: add your child to your policy or buy a separate one for them?
Adding a Child to a Parent's Policy:
- Pros: Often more cost-effective and administratively simple. Your child typically inherits the same level of cover as you. If it's a company policy, your employer might subsidise the cost.
- Cons: Less flexibility. You can't choose a different level of cover for your child. Some company schemes may not permit adding family members.
Buying a Standalone Child-Only Policy:
- Pros: Complete flexibility to design a policy tailored to a child's needs. It can be purchased by a parent, grandparent, or legal guardian. This is the only option if the parents do not have or want their own PMI.
- Cons: Can sometimes be more expensive than a family plan. Requires managing a separate policy.
While private medical insurance is a fantastic safety net, fostering a healthy lifestyle is the best preventative medicine.
- A Balanced Diet: Encourage a diet rich in fruits, vegetables, lean proteins, and whole grains. Limit processed foods, sugary drinks, and snacks. Making mealtimes a positive family occasion can help build healthy eating habits for life.
- Prioritise Sleep: Children need more sleep than adults. According to the NHS, children aged 6-12 need 9-12 hours of sleep per night, while teenagers need 8-10 hours. A consistent bedtime routine in a screen-free environment is crucial for both physical and mental recovery.
- Stay Active: The UK Chief Medical Officers' guidelines recommend that children and young people (aged 5-18) should engage in moderate-to-vigorous intensity physical activity for an average of at least 60 minutes per day. This could be anything from organised sports to playing in the park or cycling.
- Nurture Mental Wellbeing: Create an environment where your child feels safe to talk about their feelings. Watch for changes in behaviour, sleep, or appetite that might signal stress or anxiety. Spending quality time together and maintaining open lines of communication is key.
As a WeCovr client, you get complimentary access to our partner AI-powered nutrition app, CalorieHero, to help you and your family make healthier food choices. Furthermore, customers who purchase private medical or life insurance through us are eligible for discounts on other insurance products, helping protect your family in every way.
Can I get private health insurance for a child with a pre-existing condition like asthma?
Generally, no. Standard UK private medical insurance (PMI) is designed to cover new, acute conditions that arise after the policy begins. Pre-existing and chronic conditions, such as asthma, diabetes, or anything your child received treatment or advice for before taking out the cover, are typically excluded. The policy is there for unforeseen health issues, not for managing ongoing or past ones.
At what age can a child have their own health insurance policy?
A child can be covered by private medical insurance from birth. However, most insurers require a newborn to be added to a parent's policy for the first few months. Standalone "child-only" policies are typically available for children from the age of three months upwards, allowing a parent, grandparent, or legal guardian to purchase cover specifically for the child.
Does child health insurance cover mental health treatment?
Many modern PMI policies offer mental health cover, but it is often an optional add-on that increases the premium. Given the long NHS waiting times for Child and Adolescent Mental Health Services (CAMHS), many parents consider this a vital benefit. Cover can range from a set number of therapy sessions to more comprehensive psychiatric support, so it's important to check the policy details carefully.
Ready to find the right health cover for your child?
The world of private medical insurance can be complex, but you don't have to navigate it alone. Our friendly experts at WeCovr are here to help you compare the UK's leading providers, tailor a policy to your child's needs, and find the best possible value.
Get your free, no-obligation quote today and secure peace of mind for your family's future.