TL;DR
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr understands that moving home involves a long to-do list. This guide clarifies how private medical insurance (PMI) in the UK works for returning expats, ensuring you make informed choices for your health.
Key takeaways
- Initial Stand-Down Period: This is a fixed period at the very start of your policy (e.g., the first 14 to 30 days) during which you cannot make any claims, except perhaps for emergencies or accidents, depending on the policy terms.
- Moratorium Period: This is a specific type of underwriting that relates to pre-existing conditions. It's the most common form of underwriting for personal PMI policies in the UK.
- We listen: We take the time to understand your needs, budget, and concerns as a returning expat.
- We compare: We compare policies from across the market, explaining the differences in underwriting, cover levels, and hospital lists in plain English.
- We save you money: Our service is free to you, and we can often find policies and discounts you might not find by going direct. Plus, if you buy PMI or Life Insurance through us, you may get discounts on other types of cover you need.
Welcome back to the UK! As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr understands that moving home involves a long to-do list. This guide clarifies how private medical insurance (PMI) in the UK works for returning expats, ensuring you make informed choices for your health.
PMI for Expats Returning to the UK
Moving back to the UK after living abroad is an exciting time, but it comes with a unique set of administrative challenges. One of the most critical, yet often overlooked, is healthcare. While you may be eager to regain access to the NHS, you might also be considering private medical insurance (PMI) for faster access to treatment.
However, it's crucial to understand that new PMI policies don't always offer immediate cover. Insurers often impose initial waiting periods or "stand-down times" before you can make a claim. This is a standard practice designed to prevent people from taking out a policy only when they know they need immediate treatment.
For a returning expat, this means you could face a potential gap in private cover just when you need it most. Planning is essential. You need to factor in these waiting periods when arranging your return and setting up your new life in the UK.
Understanding Your NHS Entitlement as a Returning Expat
Before diving into private options, it’s vital to understand your position with the National Health Service (NHS).
To be eligible for comprehensive NHS treatment, you must be "ordinarily resident" in the UK. This means you are living in the UK on a lawful and properly settled basis for the time being. For most returning British citizens, you regain this status from day one of your return, provided you can prove your intention to reside here permanently.
What does "ordinarily resident" mean?
- Intention: You plan to live in the UK, not just visit.
- Settled purpose: Your move is for a settled reason, like work, family, or retirement.
- Lawful presence: You have the legal right to live in the UK.
Upon your return, one of your first steps should be to register with a local General Practitioner (GP). You will typically need to provide proof of address (like a utility bill or tenancy agreement) and your ID. Once registered, you are entitled to NHS care.
However, while you have access, the reality of NHS waiting times can be a concern. According to NHS England data, as of mid-2025, the elective care waiting list involves several million treatment pathways. This is where private medical insurance becomes a valuable consideration for many.
What is Private Medical Insurance (PMI)?
Private Medical Insurance, often called private health cover, is an insurance policy that pays for the cost of private medical treatment for acute conditions that arise after your policy begins.
It's designed to work alongside the NHS, not replace it. Think of it as a way to bypass long waiting lists and gain more control over your healthcare.
Key features of UK PMI include:
- Faster access to specialists and diagnostics: Get seen quickly for scans, consultations, and tests.
- Choice of consultant and hospital: Select from a list of approved specialists and facilities.
- Private, comfortable facilities: Often includes a private room during hospital stays.
- Access to treatments not always available on the NHS: Some policies cover drugs or therapies that have not yet been approved for widespread NHS use.
Critical Point: Standard UK private medical insurance is designed for new, treatable (acute) conditions. It does not cover chronic or pre-existing conditions. This is the single most important exclusion to understand.
The All-Important Difference: Acute vs. Chronic Conditions
Understanding this distinction is fundamental to knowing what PMI will and will not pay for.
| Feature | Acute Condition | Chronic Condition |
|---|---|---|
| Definition | A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. | A disease, illness, or injury that has one or more of the following characteristics: it needs ongoing or long-term monitoring, has no known cure, requires palliative care, or is likely to recur. |
| Examples | Joint replacement, cataract surgery, hernia repair, broken bones, appendicitis. | Diabetes, asthma, high blood pressure, arthritis, multiple sclerosis, eczema. |
| PMI Cover | Covered. The primary purpose of PMI is to treat these conditions quickly. | Not Covered. PMI is not designed for the long-term management of incurable conditions. |
Why PMI Policies Have Waiting Periods and Moratoriums
Insurers use waiting periods to protect themselves and their existing pool of customers from "adverse selection." This is where someone buys insurance knowing they have an immediate or upcoming health problem, claims for it, and then cancels the policy. This would drive up premiums for everyone.
There are two main types of waiting periods you'll encounter:
- Initial Stand-Down Period: This is a fixed period at the very start of your policy (e.g., the first 14 to 30 days) during which you cannot make any claims, except perhaps for emergencies or accidents, depending on the policy terms.
- Moratorium Period: This is a specific type of underwriting that relates to pre-existing conditions. It's the most common form of underwriting for personal PMI policies in the UK.
Underwriting Explained: Moratorium vs. Full Medical Underwriting
When you apply for PMI, the insurer assesses your health risk. This process is called underwriting. As a returning expat, you'll likely be offered one of two main types.
| Underwriting Type | How it Works | Pros | Cons |
|---|---|---|---|
| Moratorium Underwriting (Mori) | You don't declare your full medical history upfront. Instead, the policy automatically excludes any condition you've had symptoms of, or received treatment for, in the past 5 years. This exclusion can be lifted for a specific condition if you go 2 continuous years on the policy without any symptoms, treatment, or advice for it. | Quick and easy to set up. No lengthy medical questionnaires. | Lack of certainty. You won't know for sure if a condition is covered until you make a claim. The claims process can be slower as the insurer investigates your history then. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire, declaring your full medical history. The insurer then reviews this and tells you upfront exactly what is and isn't covered. They may apply specific exclusions to your policy from the start. | Complete clarity. You know precisely what is excluded from day one. Claims are often processed faster. | Longer application process. Requires you to recall your medical history accurately. Some conditions may be permanently excluded. |
For many returning expats, a moratorium policy is often the simplest way to get cover in place quickly. However, you must be aware of its limitations, especially concerning any health issues you've had while living abroad.
Real-Life Example: Sarah, the Returning Expat
- Situation: Sarah, 45, returns to the UK after 10 years in Dubai. She had some knee pain two years ago and saw a physiotherapist.
- Action: She takes out a PMI policy with moratorium underwriting on 1st January 2026.
- Scenario 1: In March 2026, her knee pain returns. She wants to see a specialist. The insurer will likely decline the claim because it's a pre-existing condition for which she received advice within the last 5 years.
- Scenario 2: In April 2026, she develops acute appendicitis. This is a new condition. Her PMI policy will cover the private surgery, subject to her policy's terms and excess.
- Future Cover for her Knee: If Sarah goes two full years on the policy (until 1st January 2028) without any treatment, symptoms, or advice for her knee, it will then become eligible for cover under her moratorium policy.
A Practical Plan for Expats Returning to the UK
Navigating health cover during your move requires careful timing. Here is a step-by-step guide.
- Before You Move:
- Research PMI options: Start looking into UK private medical insurance providers and policies 2-3 months before your return. An expert broker like WeCovr can do the legwork for you, comparing the market to find a policy that suits your needs and budget.
- Gather medical records: If possible, get a summary of your medical history from your doctors abroad. This will be invaluable, whether for an FMU application or if you need to make a claim on a moratorium policy later.
- Upon Arrival:
- Register with a GP immediately: This is your gateway to the NHS. Do not delay. You will need proof of your new UK address.
- Finalise your PMI application: Once you have a UK address and bank account, you can activate your chosen PMI policy. Be prepared for the initial stand-down period.
- During the Waiting Period:
- Rely on the NHS: For any health concerns that arise during the initial 14-30 day stand-down period, your first port of call will be your NHS GP. For emergencies, go to A&E.
- Focus on wellness: Use this transition time to establish healthy routines. Moving can be stressful, which can impact your immune system.
Wellness Tips for a Smooth Transition
Making a transatlantic move is demanding. Prioritising your health can make the process smoother and help you avoid needing medical care during any initial waiting periods.
- Sleep: Jet lag and the stress of moving can disrupt your sleep. Aim for 7-9 hours per night. Establish a regular sleep schedule, avoid caffeine in the evening, and create a relaxing bedtime routine.
- Nutrition: It's easy to rely on takeaways when your kitchen is full of boxes. Try to plan some simple, nutritious meals. Staying hydrated is also key. With WeCovr, you get complimentary access to our AI-powered calorie and nutrition tracker, CalorieHero, to help you stay on track.
- Activity: Unpacking is a workout, but also try to get outside for a walk each day. Gentle exercise boosts your mood, improves sleep, and supports your immune system. Explore your new neighbourhood on foot.
- Stress Management: You're not just moving house; you're moving your life. Acknowledge the stress. Practice mindfulness, connect with friends and family, and don't be afraid to ask for help.
Choosing the Right PMI Policy: What to Look For
When you compare private medical insurance UK policies, you'll notice they are not all the same. Working with a specialist PMI broker ensures you understand the key variables.
Here are the main components to consider:
| Policy Feature | Description | Key Considerations for Returning Expats |
|---|---|---|
| Level of Cover | Policies range from basic (in-patient only) to comprehensive (including out-patient consultations, diagnostics, and therapies). | Do you just want cover for major surgery, or do you want faster access to diagnostics like MRI/CT scans too? Comprehensive plans are more expensive but offer more complete peace of mind. |
| Excess | The amount you agree to pay towards the cost of a claim. It can range from £0 to £1,000+. | A higher excess will lower your monthly premium. Consider what you could comfortably afford to pay if you needed to make a claim. |
| Hospital List | Insurers have different lists of approved hospitals. Some lists are nationwide, while others might exclude pricier central London hospitals to reduce costs. | Check that the list includes reputable hospitals convenient for your new home and workplace. |
| Out-patient Limits | Comprehensive policies may still limit the value or number of out-patient consultations and tests you can have each year. | A limit of £1,000 might cover a couple of consultations and a scan, but more complex issues could exceed this. Unlimited options are available. |
| Additional Benefits | Many providers offer valuable extras, such as virtual GP services, mental health support lines, and wellness discounts. | A 24/7 virtual GP can be incredibly useful when you're settling in and might not know your local services well yet. |
How WeCovr Helps You Choose
The UK private health cover market is complex. As an independent and FCA-authorised broker, WeCovr provides impartial, expert advice to help you find the best PMI provider for your circumstances.
- We listen: We take the time to understand your needs, budget, and concerns as a returning expat.
- We compare: We compare policies from across the market, explaining the differences in underwriting, cover levels, and hospital lists in plain English.
- We save you money: Our service is free to you, and we can often find policies and discounts you might not find by going direct. Plus, if you buy PMI or Life Insurance through us, you may get discounts on other types of cover you need.
- We support you: We're here to help you through the application process and answer any questions you have about waiting periods and pre-existing conditions. Our high customer satisfaction ratings reflect our commitment to exceptional service.
Cost of Private Medical Insurance for Returning Expats
The price of PMI is highly personal and depends on several factors:
- Age: Premiums increase as you get older.
- Location: Premiums are often higher in London and the South East due to higher hospital costs.
- Level of Cover: A comprehensive plan costs more than a basic in-patient plan.
- Excess: A higher excess reduces your premium.
- Smoker Status: Smokers pay significantly more than non-smokers.
Below are some illustrative monthly premium examples for a non-smoker on a mid-range comprehensive policy with a £250 excess. These are for guidance only (as of late 2025).
| Profile | Location: Manchester | Location: Central London |
|---|---|---|
| Single Person, Age 35 | £55 - £70 | £75 - £90 |
| Couple, Both Age 50 | £160 - £190 | £210 - £250 |
| Family (2 Adults 40, 2 Children) | £200 - £240 | £260 - £310 |
The best way to get an accurate figure is to get a personalised comparison quote. A PMI broker can tailor the options to find a price point that works for you without sacrificing essential cover.
Am I covered by the NHS as soon as I return to the UK?
Will my new UK PMI policy cover a health condition I had while living abroad?
What is the point of a PMI waiting period?
Can I buy a short-term health insurance plan to cover the waiting period?
Take the Next Step with Confidence
Returning to the UK is a major life event. Arranging your health cover shouldn't add to the stress. By understanding how the NHS and private medical insurance work for returning expats, especially regarding waiting periods, you can plan effectively and ensure you're protected.
Let WeCovr help you navigate the complexities. Our expert, friendly team will compare the UK's leading insurers to find the right private health cover for you and your family, at no cost to you.
[Get Your Free, Personalised PMI Quote from WeCovr Today]
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.
