TL;DR
As an FCA-authorised expert broker that has helped arrange over 900,000 policies, WeCovr understands the unique challenges facing expats in the UK. This guide provides a definitive look at private medical insurance (PMI) options for international workers, helping you navigate the system and protect your health. Options for international workers living in the UK Moving to the UK is an exciting prospect, filled with new opportunities.
Key takeaways
- Seeing a General Practitioner (GP).
- Hospital treatment in case of an accident or emergency.
- Treatment for long-term conditions.
- Maternity services.
- Speed of Access: Get faster access to consultants, diagnostic tests, and eligible treatment.
As an FCA-authorised expert broker that has helped arrange over 900,000 policies, WeCovr understands the unique challenges facing expats in the UK. This guide provides a definitive look at private medical insurance (PMI) options for international workers, helping you navigate the system and protect your health.
Options for international workers living in the UK
Moving to the UK is an exciting prospect, filled with new opportunities. But navigating a new healthcare system can feel daunting. As an expat, you'll likely have access to the National Health Service (NHS), but you may also be considering private medical insurance (PMI) for faster access to treatment and greater choice.
This comprehensive guide will walk you through everything you need to know, from understanding the NHS to choosing the right private cover for your needs and budget. We'll explore what's covered, what's not, and how to make an informed decision for you and your family.
Understanding the UK Healthcare System: The NHS and PMI
Before diving into private options, it’s crucial to understand the UK's dual healthcare system. Most residents rely on the state-funded NHS, but a growing number supplement this with private cover.
Your Entitlement to the NHS as an Expat
If you're moving to the UK on a visa to work, study, or join family for more than six months, you will likely have paid the Immigration Health Surcharge (IHS) as part of your visa application.
Paying the IHS gives you the same access to NHS healthcare as a permanent UK resident. This includes:
- Seeing a General Practitioner (GP).
- Hospital treatment in case of an accident or emergency.
- Treatment for long-term conditions.
- Maternity services.
However, it's important to note that some services, like prescriptions in England, dental care, and optical services, often require a separate payment.
The Role of Private Medical Insurance (PMI)
Private medical insurance in the UK is not a replacement for the NHS. Instead, it works alongside it. Think of it as a way to bypass NHS waiting lists for non-emergency, specialist treatment.
The core benefits of having PMI include:
- Speed of Access: Get faster access to consultants, diagnostic tests, and eligible treatment.
- Choice and Control: Choose your specialist and the hospital where you receive treatment from a list provided by your insurer.
- Comfort and Privacy: Access to private rooms in hospitals, often with more flexible visiting hours and better facilities.
- Access to Specialist Drugs and Treatments: Some policies provide cover for new or specialist drugs that may not be available on the NHS due to cost.
Here’s a simple comparison:
| Feature | National Health Service (NHS) | Private Medical Insurance (PMI) |
|---|---|---|
| Cost | Free at the point of use (funded by taxes & IHS) | Monthly or annual premiums |
| Access | Via GP referral; subject to waiting lists | Fast access to specialists & diagnosis |
| Emergencies | Yes, A&E departments handle all emergencies | No, emergencies are always treated by the NHS |
| Choice of Hospital | Limited, usually your local NHS hospital | Choice from an approved hospital network |
| Accommodation | Usually a shared ward | Private room with en-suite facilities |
| Chronic Conditions | Yes, managed by your GP and NHS specialists | No, chronic conditions are not covered |
| Pre-existing Conditions | Yes, covered | No, generally excluded from cover |
Why Should Expats Consider Private Medical Insurance?
While the NHS provides excellent care, especially for emergencies and serious illness, its resources are stretched. For many expats, the benefits of PMI provide valuable peace of mind.
Bypassing NHS Waiting Lists
This is the number one reason people buy private health cover. According to the latest NHS England data, the referral-to-treatment (RTT) waiting list remains a significant challenge. As of mid-2024, millions of treatments were on the waiting list, with many people waiting over 18 weeks for routine procedures.
- Real-Life Example: Imagine you develop persistent knee pain that affects your mobility. An NHS GP might refer you to a specialist, but you could face a wait of several months for the appointment and then a further wait for an MRI scan and any subsequent surgery. With PMI, you could potentially see a specialist and have a scan within a week or two, with surgery scheduled shortly after.
Choice, Comfort, and Continuity
For those accustomed to private healthcare systems in their home countries, PMI offers a familiar level of service. The ability to choose your surgeon or be treated in a hospital near your home or work is a significant advantage. The comfort of a private room can also make a huge difference to your recovery experience.
Access to Advanced Cancer Care
Cancer cover is a cornerstone of most UK PMI policies. It often includes:
- Access to the latest licensed cancer drugs and treatments, even those not yet approved by the National Institute for Health and Care Excellence (NICE) for NHS use.
- A choice of where to have chemotherapy, including at home for some treatments.
- Support for mental health and wellbeing during treatment.
What Does UK Private Medical Insurance Actually Cover?
PMI is designed to cover the diagnosis and treatment of acute conditions.
What is an acute condition? An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include joint replacements, cataract surgery, and hernia repairs.
Policies are usually structured with core cover and optional extras.
Core Coverage (Typically Included as Standard)
- In-patient and day-patient treatment: This covers costs when you are admitted to a hospital bed for treatment, including surgery, accommodation, and nursing care.
- Specialist consultations: Fees for seeing a specialist after a GP referral.
- Diagnostic tests and scans: Such as MRI, CT, and PET scans.
- Comprehensive cancer cover: Including surgery, radiotherapy, and chemotherapy.
Optional Extras (Add-ons to Enhance Your Policy)
- Out-patient cover: This is one of the most popular add-ons. It covers diagnostic tests and consultations that do not require a hospital bed. Without this, you would rely on the NHS for your initial diagnosis phase.
- Therapies cover: Pays for a set number of sessions with specialists like physiotherapists, osteopaths, and chiropractors.
- Mental health cover: Provides access to psychiatrists, psychologists, and therapists. This has become an increasingly important and sought-after benefit.
- Dental and optical cover: Contributes towards routine check-ups, treatments, and eyewear.
| Cover Level | In-Patient/Day-Patient | Out-Patient Scans | Out-Patient Consultations | Therapies |
|---|---|---|---|---|
| Basic (Core) | ✅ Covered | ✅ Covered | ❌ Not Covered | ❌ Not Covered |
| Mid-Range | ✅ Covered | ✅ Covered | ✅ Covered (up to a limit) | ✅ Covered (limited) |
| Comprehensive | ✅ Covered | ✅ Covered | ✅ Covered (in full) | ✅ Covered (generous) |
What is NOT Covered by UK PMI? The Exclusions Explained
This is the most critical part of any private medical insurance policy to understand. UK PMI is not "all-inclusive" health cover. It has specific and important exclusions.
Critical Point: Pre-existing and Chronic Conditions
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Pre-existing Conditions: Standard UK PMI does not cover medical conditions you had before you took out the policy. This includes any ailment for which you have experienced symptoms, sought advice, or received treatment in the years leading up to your policy start date (usually the last 5 years).
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Chronic Conditions: UK PMI does not cover the routine management of chronic conditions. A chronic condition is an illness that cannot be cured but can be managed, such as diabetes, asthma, high blood pressure, or Crohn's disease. The NHS will always manage your care for these conditions.
PMI is designed for new, acute conditions that arise after your policy begins.
Other Common Exclusions
- Emergencies: All emergency treatment (e.g., heart attacks, strokes, serious accidents) is handled by NHS A&E departments.
- Normal Pregnancy & Childbirth: Routine maternity care is not covered, though some policies may cover complications.
- Cosmetic Surgery: Procedures for purely aesthetic reasons are excluded.
- Organ Transplants: These are typically handled by the NHS.
- Drug & Alcohol Abuse Treatment: Often excluded, although some high-end plans may offer limited support.
How Underwriting Affects Cover for Pre-existing Conditions
When you apply for PMI, the insurer "underwrites" your application to decide what they will and will not cover. For expats, there are two main types of underwriting.
1. Moratorium (Mori) Underwriting
This is the most common and simplest option. You don't need to declare your medical history upfront. Instead, the insurer applies a "moratorium period," typically two years.
- How it works: For the first two years of your policy, the insurer will not cover any condition you had in the five years before your policy started.
- Becoming eligible: A pre-existing condition may become eligible for cover if, after your policy has started, you go for a continuous two-year period without experiencing symptoms, needing treatment, or seeking medical advice for it.
- Best for: People who want a quick and easy application process and have had no recent health issues.
2. Full Medical Underwriting (FMU)
With FMU, you complete a detailed medical questionnaire, declaring all your past health conditions. The insurer then reviews your history and issues a policy with specific, named exclusions for your pre-existing conditions.
- How it works: You know from day one exactly what is and isn't covered. Those exclusions are usually permanent.
- Best for: People who want absolute clarity on their cover from the outset or who have historical conditions they want to be sure are assessed.
A knowledgeable PMI broker, such as WeCovr, can explain these options in detail and help you decide which is right for your circumstances.
| Underwriting Type | Application Process | Handling of Pre-existing Conditions | Certainty of Cover |
|---|---|---|---|
| Moratorium (Mori) | Quick and simple, no forms | Automatically excluded for 2 years. May become eligible later. | Less certainty at first; claims can be slower as history is checked. |
| Full Medical (FMU) | Detailed medical questionnaire | Assessed upfront and explicitly excluded from cover. | Full certainty from day one. Claims process is often faster. |
International Health Insurance vs. UK Private Medical Insurance
Expats often wonder whether they need a local UK PMI policy or a global International Private Medical Insurance (IPMI) plan. The difference is significant.
- UK Private Medical Insurance (PMI): Provides cover only for treatment within the UK. It is designed to supplement the NHS and focuses on acute conditions. It is the more affordable option.
- International Health Insurance (IPMI): Provides comprehensive health cover across the globe (you can often choose to include or exclude the USA to manage costs). These plans are designed for globally mobile people, are often more comprehensive (sometimes covering chronic conditions and wellness), and are significantly more expensive.
| Feature | UK PMI | International IPMI |
|---|---|---|
| Geographic Scope | UK only | Global or specified region |
| Cost | More affordable | Significantly more expensive |
| Primary Purpose | Supplements the NHS, fast access for acute conditions | Primary health cover, often replaces state systems |
| Chronic Conditions | Not covered | Often covered (subject to underwriting) |
| Portability | No, UK-based | Yes, moves with you to other countries |
Who needs which?
- Choose UK PMI if you plan to reside in the UK for the foreseeable future and are happy to use the NHS for emergencies and chronic care management.
- Choose International IPMI if your job requires frequent international travel, you may relocate to another country within a few years, or you require comprehensive global cover.
How to Choose the Best PMI Policy as an Expat
With so many options, it's easy to feel overwhelmed. Follow these steps to find the right policy.
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Assess Your Needs and Budget: Decide what's most important to you. Is it comprehensive cancer care? Fast access to a physiotherapist? Or just a basic plan for surgical procedures? Your priorities will determine your ideal level of cover.
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Understand Cost-Saving Options:
- Excess: This is the amount you agree to pay towards the cost of any claim. A higher excess (e.g., £500) will lower your monthly premium.
- Hospital List: Insurers offer tiered hospital lists. A policy covering only local hospitals will be cheaper than one with access to premium central London facilities.
- 6-Week Wait Option: This popular option can reduce your premium by 20-30%. If the NHS waiting list for your eligible treatment is less than six weeks, you use the NHS. If it's longer, your private cover kicks in.
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Compare the Market: Don't just go with the first provider you find. The UK private medical insurance market is competitive, with major players like Aviva, AXA Health, Bupa, and Vitality all offering different strengths.
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Use an Expert Broker: The easiest way to compare the market and get tailored advice is to use an independent broker. An FCA-authorised broker like WeCovr works for you, not the insurer. We can:
- Compare policies from a wide range of leading insurers.
- Explain the fine print in simple terms.
- Help you choose the right underwriting method.
- Ensure the policy meets your specific needs as an expat.
- All at no extra cost to you.
The Cost of Private Health Insurance for UK Expats
The cost of a policy varies widely based on several factors:
- Age: The older you are, the higher the premium.
- Location: Premiums are typically higher in London and the South East.
- Cover Level: Comprehensive plans cost more than basic ones.
- Excess: A higher excess lowers the premium.
Here are some illustrative examples of monthly premiums for a non-smoker on a mid-range policy with a £250 excess.
| Age Bracket | Example Monthly Premium (Outside London) | Example Monthly Premium (London) |
|---|---|---|
| 30-39 | £55 - £75 | £70 - £90 |
| 40-49 | £70 - £100 | £90 - £125 |
| 50-59 | £100 - £150 | £130 - £190 |
Disclaimer: These are guide prices only. Your actual quote will depend on your individual circumstances and chosen level of cover.
Wellness Benefits and Added Value
Modern PMI is about more than just treating illness; it's about promoting good health. Many insurers now include valuable wellness benefits as standard:
- Digital GP: 24/7 access to a GP via phone or video call.
- Mental Health Support: Helplines and access to therapy sessions.
- Gym Discounts and Health Rewards: Some providers, like Vitality, reward you for staying active with things like free cinema tickets or coffee.
At WeCovr, we believe in adding extra value for our clients. When you take out a health or life insurance policy with us, you get:
- Complimentary access to CalorieHero: Our AI-powered calorie and nutrition tracking app to help you manage your diet and health goals.
- Discounts on other insurance policies: We can help you save money on other essential cover you might need as an expat, like life or income protection insurance.
Frequently Asked Questions (FAQs) for Expats
Can I get PMI in the UK if I have a pre-existing medical condition?
Do I still need to pay the Immigration Health Surcharge (IHS) if I have private medical insurance?
Can I add my partner and children to my private health insurance policy?
Ready to Secure Your Health in the UK?
Navigating the UK health insurance market can be complex, but you don't have to do it alone. As an expat, getting the right advice is key to finding cover that offers both value and peace of mind.
Contact WeCovr today for a free, no-obligation quote. Our friendly, expert advisors will compare the UK's leading insurers to find the perfect private medical insurance policy for your needs and budget, ensuring a smooth and healthy start to your new life in the UK.
Sources
- Office for National Statistics (ONS): Mortality, earnings, and household statistics.
- Financial Conduct Authority (FCA): Insurance and consumer protection guidance.
- Association of British Insurers (ABI): Life insurance and protection market publications.
- HMRC: Tax treatment guidance for relevant protection and benefits products.











