TL;DR
As an FCA-authorised broker that has arranged over 900,000 policies, WeCovr provides expert guidance on private medical insurance in the UK. This article explores how PMI can support women's unique health needs, from maternity and menopause to gynaecological conditions and cancer care, helping you make an informed choice. Cover for maternity, menopause and female health needs Women's health is a journey with distinct stages and specific needs.
Key takeaways
- Pre-existing Conditions: Standard PMI policies do not cover health issues you had symptoms of, received advice for, or were treated for before you took out the policy. This could be anything from a diagnosed condition like asthma to undiagnosed joint pain you've seen a GP about.
- Chronic Conditions: PMI also does not cover chronic conditions. These are long-term illnesses that cannot be cured but can be managed, such as diabetes, high blood pressure, or Crohn's disease. The NHS provides management for these.
- Complications of Pregnancy and Childbirth: This is where PMI can be a lifesaver. If a serious and unexpected medical complication arises during pregnancy or delivery, a policy may cover the acute treatment required to resolve it.
- Maternity Cash Benefit (illustrative): Many leading insurers offer a fixed cash payment for each baby you have. This is a goodwill gesture and not intended to cover the costs of private birth. It's a lump sum (e.g., £100 - £500 per child) you can spend as you wish.
- Adding Your Newborn to the Policy: Most insurers allow you to add your newborn to your policy without medical underwriting, often within the first few months. This can provide cover for any new, acute conditions the baby might develop.
As an FCA-authorised broker that has arranged over 900,000 policies, WeCovr provides expert guidance on private medical insurance in the UK. This article explores how PMI can support women's unique health needs, from maternity and menopause to gynaecological conditions and cancer care, helping you make an informed choice.
Cover for maternity, menopause and female health needs
Women's health is a journey with distinct stages and specific needs. While the NHS provides essential care, growing pressures and waiting lists, particularly in specialisms like gynaecology, mean many women are seeking faster, more personalised support. Private Medical Insurance (PMI) can be a powerful tool to regain control over your healthcare choices.
However, the world of PMI can seem complex. What is actually covered? Is maternity care included? How can it help with menopause? This guide breaks down everything you need to know about PMI for women's health in the UK.
The Current Landscape of Women's Health in the UK
Understanding the current healthcare environment helps to see where PMI can offer the most value. While the NHS is a world-class service, it faces significant challenges.
According to NHS England data, the gynaecology waiting list is one of the longest, with hundreds of thousands of women waiting for appointments and treatment. In mid-2024, over 600,000 patients were on the gynaecology waiting list in England, with many waiting over 18 weeks for consultant-led treatment.
This isn't just an inconvenience; for conditions like endometriosis or severe menopause symptoms, long waits can mean months or even years of pain and diminished quality of life. PMI's primary benefit is bypassing these queues for eligible conditions, offering prompt access to specialists.
What is Private Medical Insurance (PMI)? A Vital Refresher
Before we dive into specifics, let's clarify what PMI is and, crucially, what it isn't.
Private medical insurance is a policy you pay for that covers the cost of private healthcare for 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 joint pain requiring a hip replacement, cataracts, or hernias.
The Golden Rule: Pre-existing and Chronic Conditions
This is the most important concept to understand in UK private health cover:
- Pre-existing Conditions: Standard PMI policies do not cover health issues you had symptoms of, received advice for, or were treated for before you took out the policy. This could be anything from a diagnosed condition like asthma to undiagnosed joint pain you've seen a GP about.
- Chronic Conditions: PMI also does not cover chronic conditions. These are long-term illnesses that cannot be cured but can be managed, such as diabetes, high blood pressure, or Crohn's disease. The NHS provides management for these.
PMI is designed for new, treatable health problems, ensuring you get diagnosed and treated quickly, so you can get back to your life.
PMI and Maternity Cover: Separating Myth from Reality
This is one of the most common areas of confusion. Many people assume a comprehensive PMI policy will cover the costs of a private birth.
In the UK, standard private medical insurance does not cover routine pregnancy and childbirth.
Insurers view a normal pregnancy as a natural life event rather than an unforeseen medical condition. The costs for private obstetric care, delivery suites, and hospital stays can run into tens of thousands of pounds, and this is not factored into standard PMI premiums.
So, How Can PMI Help with Maternity?
While routine care is excluded, some policies offer valuable benefits related to pregnancy:
- Complications of Pregnancy and Childbirth: This is where PMI can be a lifesaver. If a serious and unexpected medical complication arises during pregnancy or delivery, a policy may cover the acute treatment required to resolve it.
- Maternity Cash Benefit (illustrative): Many leading insurers offer a fixed cash payment for each baby you have. This is a goodwill gesture and not intended to cover the costs of private birth. It's a lump sum (e.g., £100 - £500 per child) you can spend as you wish.
- Adding Your Newborn to the Policy: Most insurers allow you to add your newborn to your policy without medical underwriting, often within the first few months. This can provide cover for any new, acute conditions the baby might develop.
Maternity Cover: NHS vs. PMI
| Feature | Standard NHS Care | Standard UK PMI |
|---|---|---|
| Routine Antenatal Care | Fully covered | Not covered |
| Routine Scans | Fully covered | Not covered |
| Labour and Delivery | Fully covered | Not covered |
| Complications (e.g., Ectopic Pregnancy) | Fully covered | Often covered (for the acute treatment) |
| Postnatal Check-ups | Fully covered | Not covered |
| Maternity Cash Benefit | Not applicable | Often included (a fixed sum per baby) |
| Choice of Obstetrician | Limited | Not covered for routine care |
Real-life example: Sarah has a PMI policy. Her pregnancy is routine and all her care is with the NHS. After delivery, her insurer pays her a £250 maternity cash benefit. Six months later, her baby develops a severe skin condition. Because she added him to her policy at birth, the PMI covers a private dermatology consultation and treatment, avoiding a long NHS wait.
Navigating Menopause with Private Health Cover
Menopause is finally being recognised as a major health event that affects nearly every woman. Symptoms can range from mild to debilitating, impacting work, relationships, and mental wellbeing.
Accessing specialist menopause care on the NHS can be challenging, with long waits to see gynaecologists or endocrinologists. This is where PMI provides significant advantages.
How PMI Supports Menopausal Women
If you develop symptoms of menopause after your policy starts, PMI can cover:
- Specialist Consultations: Get a fast-tracked referral to a private gynaecologist, endocrinologist, or other specialist with expertise in menopause. This allows for a thorough assessment of your symptoms.
- Diagnostic Tests: Your policy can cover blood tests to check hormone levels or scans like a DEXA scan to assess bone density, a key concern due to the risk of osteoporosis post-menopause.
- Mental Health Support: Menopause can trigger anxiety, low mood, and "brain fog." Many PMI policies include a set number of counselling or therapy sessions, providing crucial support without a long wait.
- HRT Consultations: A private specialist can discuss and prescribe Hormone Replacement Therapy (HRT). Note: While the consultation is usually covered, the ongoing cost of the prescription medication itself may fall under your outpatient benefit limit or be excluded, depending on the policy.
Potential Menopause Support Through PMI
| Service | How PMI Can Help |
|---|---|
| Initial GP Visit | Covered by NHS (or private GP benefit if included) |
| Specialist Referral | Bypasses NHS wait times for a private consultant |
| Hormone Tests | Covered under diagnostics |
| HRT Discussion & Prescription | Consultation is covered; prescription costs may have limits |
| Bone Density (DEXA) Scan | Covered if clinically indicated |
| Mental Health Support | Access to therapy/counselling often included as a benefit |
| Associated Conditions (e.g., Heart Palpitations) | Fast access to cardiology for investigation if needed |
An expert PMI broker like WeCovr can help you compare policies to find one with strong pathways for menopause support and generous outpatient limits for diagnostics.
Cover for Common Female Health Conditions
Beyond maternity and menopause, women face a range of specific gynaecological conditions. PMI can provide invaluable peace of mind by ensuring swift diagnosis and treatment.
Crucial reminder: For any of these conditions, PMI will only provide cover if the symptoms and diagnosis occur after the policy has started. If you have been diagnosed or are awaiting tests for endometriosis before buying a policy, it will be considered a pre-existing condition and excluded from cover.
Conditions Where PMI Can Make a Difference:
- Endometriosis: This painful condition can take an average of 8 years to diagnose via the NHS. With PMI, you can get a rapid referral to a gynaecologist, followed by diagnostic imaging (MRI) and procedures like a laparoscopy for both diagnosis and treatment.
- Polycystic Ovary Syndrome (PCOS): While the chronic management of PCOS falls to the NHS, PMI can cover the initial diagnostic process, including consultations and ultrasound scans, to get a definitive answer quickly.
- Fibroids: PMI can cover consultations, scans, and various treatment options, from medication to surgical procedures like myomectomy (fibroid removal) or hysterectomy, performed in a private hospital of your choice.
- Ovarian Cysts: If you develop symptoms, PMI can ensure you get an urgent ultrasound and specialist opinion to determine the nature of the cyst and cover its surgical removal if necessary.
- Pelvic Inflammatory Disease (PID): Cover for diagnosis and the acute treatment course needed to clear the infection.
- Cervical Abnormalities (e.g., CIN): If smear test results require further investigation, PMI can cover a private colposcopy and any subsequent treatment like LLETZ.
Cancer Cover for Women: A Cornerstone of PMI
Comprehensive cancer cover is one of the most valuable components of any good private medical insurance policy. For women, this provides a safety net against the most common female cancers.
According to Cancer Research UK, breast, lung, bowel, and uterine cancers are the four most common cancers in females in the UK.
What Does PMI Cancer Cover Typically Include?
If you are diagnosed with cancer after your policy starts, a comprehensive plan will typically cover:
- Full Diagnostics: All the tests, scans, and biopsies needed to confirm the diagnosis and stage the cancer.
- Specialist Fees: The full cost of your consultant surgeon, oncologist, and anaesthetist.
- Hospital Stays and Surgery: Including procedures like lumpectomy, mastectomy, and reconstructive surgery following breast cancer.
- Chemotherapy and Radiotherapy: Access to advanced treatments and the latest licensed drugs, sometimes including those not yet available on the NHS due to cost.
- Targeted Therapies: Access to newer, more advanced biological therapies and immunotherapies.
- Holistic Support: Many policies include benefits like wigs, prostheses, home nursing, and psychological support for you and your family.
This level of cover offers choice, comfort, and access to the very latest treatments at a time when you need it most.
Beyond the Core: Wellness, Mental Health, and Added Benefits
Modern PMI is about more than just treating illness; it's about promoting and maintaining good health. The best PMI providers include a suite of added-value benefits that are particularly useful for women.
- Mental Health Support: Access to a set number of counselling sessions can be vital for dealing with postnatal depression, work-related stress, or the emotional impact of menopause.
- Virtual GP Services: Speak to a GP via phone or video call 24/7, often with same-day appointments. This is incredibly convenient for busy women and mothers.
- Wellness Programmes: Many insurers, like Vitality, offer rewards for healthy living, such as discounted gym memberships, health screenings, and fitness trackers.
- Physiotherapy: Get fast access to physiotherapy for musculoskeletal issues, pelvic floor dysfunction after childbirth, or recovery from surgery.
As a WeCovr client, you also get complimentary access to our AI-powered nutrition app, CalorieHero, to help you manage your diet and wellness goals. Furthermore, clients who purchase PMI or Life Insurance through us are often eligible for discounts on other types of cover, such as home or car insurance.
Choosing the Right PMI Policy for Your Needs
With so many options, how do you choose the right policy? Working with an independent broker like WeCovr is the easiest way to compare the market, but here are the key factors to consider:
-
Underwriting Type:
- Moratorium: Simpler to set up. The insurer won't ask for your full medical history upfront. Instead, they will generally exclude any condition you've had in the 5 years before the policy start date.
- Full Medical Underwriting (FMU): You declare your full medical history on an application form. The insurer then tells you exactly what is and isn't covered from day one. This provides more certainty.
-
Level of Cover:
- Comprehensive: Covers inpatient, day-patient, and outpatient diagnostics and treatment in full or up to a high limit.
- Mid-Range: Usually covers inpatient care in full but places a limit on outpatient services (e.g., £1,000 per year).
- Basic/Budget: Covers inpatient and day-patient treatment only, meaning you would use the NHS for diagnosis and then switch to private for treatment.
-
Excess: This is the amount you agree to pay towards any claim. A higher excess (e.g., £500) will lower your monthly premium.
-
Hospital List: Insurers offer different tiers of hospital lists. A national list is cheaper than one that includes prime central London hospitals.
-
Outpatient Limits: For women's health, diagnostics are key. A policy with a low outpatient limit might not be sufficient to cover the consultations and scans needed to diagnose a complex gynaecological issue.
Major UK PMI Provider Comparison
This table gives a general overview. Features and benefits vary hugely between specific plans.
| Provider | Key Strengths for Women's Health | Typical Approach to Maternity |
|---|---|---|
| Bupa | Strong mental health support, comprehensive cancer cover, direct access pathways for some conditions. | Maternity cash benefit. Cover for specified complications. |
| AXA Health | Excellent doctor-led service (Doctor@Hand), strong focus on wellbeing and mental health support. | Maternity cash benefit. Cover for specified complications. |
| Aviva | Good value, comprehensive cancer cover with advanced options, often includes a generous maternity cash benefit. | Generous maternity cash benefit. Cover for specified complications. |
| Vitality | Unique wellness programme rewards healthy living, good for proactive health management. Broad cover. | Maternity cash benefit. Cover for specified complications. |
Our high customer satisfaction ratings reflect our commitment to helping clients find the perfect fit from these top providers and more, ensuring the policy you choose truly meets your needs.
Is pregnancy considered a pre-existing condition for PMI?
Can I get private health insurance if I am already menopausal?
Does private medical insurance in the UK cover fertility treatments like IVF?
How much does PMI for a woman in the UK typically cost?
Take the Next Step with WeCovr
Navigating the private medical insurance market can be daunting, but you don't have to do it alone. At WeCovr, our expert advisors specialise in helping you compare plans from the UK's leading insurers to find cover that protects you at every stage of life.
We provide independent, no-obligation advice to ensure your policy aligns with your health needs and budget.
Contact WeCovr today for your free, personalised quote and take control of your health journey.
Sources
- Department for Transport (DfT): Road safety and transport statistics.
- DVLA / DVSA: UK vehicle and driving regulatory guidance.
- Association of British Insurers (ABI): Motor insurance market and claims publications.
- Financial Conduct Authority (FCA): Insurance conduct and consumer information guidance.
