Private Health Care Plans UK
As an FCA-authorised expert with over 800,000 policies arranged, WeCovr helps you navigate the world of private medical insurance in the UK. This guide breaks down private health care plans to give you the clarity and confidence to choose the right cover for you and your family.
Breaking down the main types of private health plans in the UK and what they cover
Private health care plans, often called Private Medical Insurance (PMI), are designed to work alongside the NHS. They offer you faster access to eligible medical treatment for acute conditions, from diagnosis to recovery, in comfortable private facilities.
With NHS waiting lists reaching record levels in recent years – with millions of treatment pathways waiting to begin according to NHS England data – more people than ever are considering private options. But what do these plans actually involve? Let's explore the different types and what they mean for your health.
What is Private Medical Insurance (PMI)? A Simple Explanation
Think of PMI as a health safety net. You pay a monthly or annual premium to an insurance company. In return, if you develop a new, eligible medical condition (an 'acute' condition), the insurer pays for your private treatment.
Key concepts to understand:
- Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and return you to your previous state of health. Examples include cataracts, joint replacements, or hernia repairs.
- Chronic Condition: A long-term condition that cannot be cured, only managed. Examples include diabetes, asthma, and high blood pressure.
Crucially, standard UK private health insurance is designed to cover acute conditions that arise after your policy begins. It does not cover chronic conditions or pre-existing conditions.
PMI gives you more choice and control over your healthcare:
- Choice of hospital from a list provided by your insurer.
- Choice of consultant to oversee your treatment.
- Faster treatment by bypassing long NHS waiting lists.
- A private, en-suite room for a more comfortable recovery.
The Core Tiers of Private Health Cover: From Basic to Comprehensive
Private health plans in the UK are generally structured in three main tiers. The more you pay in premiums, the more extensive your cover becomes.
1. Basic or Budget Health Plans
This is the entry-level option, designed to be affordable while still providing a valuable safety net.
What's typically covered?
- Inpatient and Day-patient Treatment: This is the core of all PMI policies. It covers costs if you are admitted to a hospital for treatment and need a bed overnight (inpatient) or for the day (day-patient). This includes surgery, hospital accommodation, and nursing care.
- Cancer Cover: Most basic plans include some level of cancer treatment, often covering surgery and radiotherapy. However, access to the latest expensive cancer drugs may be limited or require an add-on.
- Some Outpatient Diagnostics: A basic plan might cover diagnostic tests like MRI or CT scans if they are recommended by a specialist following a GP referral, but it often won't cover the initial specialist consultation itself.
Who is it for? Basic plans are ideal for individuals and families who want peace of mind against the cost of major, unexpected medical procedures without the higher price tag of a comprehensive policy. It’s a way to ensure you can get key treatments done quickly, privately, and in a comfortable setting.
2. Mid-Range Health Plans
This is the most popular type of plan in the UK, offering a balance between comprehensive cover and affordability.
What's typically covered?
- Everything in a Basic Plan: You get full inpatient and day-patient cover as standard.
- Enhanced Cancer Cover: Mid-range plans usually offer more extensive cancer care, including chemotherapy and access to a wider range of approved drugs.
- Significant Outpatient Cover: This is the main difference from a basic plan. Mid-range policies include cover for a set number of specialist consultations and diagnostic tests before you are admitted to hospital. This could be a fixed monetary amount (e.g., up to £1,000 per year) or a set number of consultations.
Who is it for? If you want the reassurance of knowing that the entire diagnostic process, from seeing a specialist to getting scans and tests, is covered as well as the treatment itself, a mid-range plan is an excellent choice.
3. Comprehensive Health Plans
As the name suggests, this is the highest level of cover available, offering the most extensive benefits and the highest limits.
What's typically covered?
- Everything in a Mid-Range Plan: Full inpatient and day-patient treatment.
- Full Outpatient Cover: Comprehensive plans typically have no, or very high, annual limits on outpatient consultations, diagnostic tests, and scans.
- Mental Health Cover: While some mid-range plans offer limited mental health support, comprehensive plans provide more extensive cover for therapy, psychiatric treatment, and even inpatient care for mental health conditions.
- Therapies: This includes treatments like physiotherapy, osteopathy, and chiropractic care, often with generous limits.
- Optional Add-ons Included: Often, benefits that are optional extras on other plans, such as dental and optical cover, may be included as standard or have much higher limits.
Who is it for? Comprehensive plans are for those who want the ultimate peace of mind and the widest possible range of benefits, from mental health support to alternative therapies.
Comparison of UK Private Health Plan Tiers
| Feature | Basic Plan | Mid-Range Plan | Comprehensive Plan |
|---|---|---|---|
| Inpatient/Day-patient Care | ✅ Yes | ✅ Yes | ✅ Yes |
| Core Cancer Cover | ✅ Yes (often for surgery/radiotherapy) | ✅ Yes (often includes chemotherapy) | ✅ Yes (most extensive drug lists) |
| Outpatient Consultations | ❌ No, or very limited | ✅ Yes (up to a set limit, e.g. £1,000) | ✅ Yes (often unlimited) |
| Outpatient Diagnostics (Scans) | ❌ No, or very limited | ✅ Yes (up to a set limit) | ✅ Yes (often unlimited) |
| Mental Health Support | ❌ Rarely included | ➕ Often available as an add-on | ✅ Often included as standard |
| Therapies (Physio etc.) | ❌ Rarely included | ➕ Often available as an add-on | ✅ Often included as standard |
| Monthly Premium | £ | ££ | £££ |
Navigating these tiers can be complex. An expert PMI broker like WeCovr can compare plans from across the market to find the perfect balance of cover and cost for your specific needs, at no cost to you.
Understanding Underwriting: The Engine of Your Policy
Underwriting is the process an insurer uses to assess your medical history and decide the terms of your policy. There are two main types in the UK.
1. Moratorium Underwriting (The "Wait and See" Approach)
This is the most common and straightforward type of underwriting.
- How it works: You don't have to declare your full medical history when you apply. Instead, the insurer applies a general exclusion for any medical conditions you've had in the last five years.
- The "Moratorium" period: This exclusion is not permanent. If you go for a set period (usually two years) after your policy starts without experiencing any symptoms, needing treatment, or seeking advice for that condition, it may become eligible for cover.
- Pros: Quick and easy application process.
- Cons: There can be uncertainty about what is covered. A claim might be delayed while the insurer investigates your medical history to see if the condition is pre-existing.
Real-life example: Sarah takes out a policy with moratorium underwriting. Three years ago, she had physiotherapy for knee pain. If her knee pain returns in the first two years of her policy, it won't be covered. However, if she remains symptom-free for two full years, and the pain then returns in the third year, her policy may cover the treatment.
2. Full Medical Underwriting (The "Declare Everything" Approach)
This method involves a more detailed application process but provides greater certainty from day one.
- How it works: You complete a detailed health questionnaire, disclosing your full medical history. The insurer then reviews this information and tells you upfront exactly what will be excluded from your policy.
- The exclusions: These exclusions are typically permanent and are listed clearly on your policy documents.
- Pros: You know exactly what is and isn't covered from the start. The claims process is often faster because the insurer already has your medical history.
- Cons: The application process is longer and more intrusive.
Real-life example: David applies for a policy with full medical underwriting. He declares that he had surgery for a shoulder injury four years ago. The insurer reviews this and places a permanent exclusion on his right shoulder. A year later, he develops a hernia. Because this is an unrelated new condition, the claims process is very quick and straightforward.
Moratorium vs. Full Medical Underwriting: Which is Right for You?
| Feature | Moratorium Underwriting | Full Medical Underwriting |
|---|---|---|
| Application Process | Quick and simple, no health forms. | Longer, requires a full health questionnaire. |
| Initial Certainty | Lower. Coverage for past conditions is unclear. | Higher. Exclusions are clearly stated from day one. |
| Cover for Pre-existing Conditions | Potentially, after a 2-year symptom-free period. | No. Pre-existing conditions are permanently excluded. |
| Claims Process | Can be slower as insurer may need to check your medical history. | Generally faster and more straightforward. |
| Best For | People with a clean bill of health or those who prefer a quick start. | People with a complex medical history who want absolute clarity. |
A Crucial Point: What Private Health Insurance Does Not Cover
It's just as important to understand what is excluded from a typical private health insurance UK policy as what is included. This prevents nasty surprises when you need to make a claim.
Standard Exclusions on Almost All UK PMI Policies:
- Pre-existing Conditions: Any illness or injury you had before taking out the policy. This is the most significant exclusion.
- Chronic Conditions: Long-term illnesses that require ongoing management rather than a cure, such as diabetes, asthma, arthritis, and high blood pressure. PMI is for acute conditions.
- Emergency Services: A&E visits are handled by the NHS. If you have a heart attack, stroke, or are in a serious accident, you should call 999. PMI can cover your recovery and rehabilitation afterwards.
- Normal Pregnancy and Childbirth: Routine maternity care is not covered, though some policies may cover complications.
- Cosmetic Surgery: Procedures that are not medically necessary.
- Self-inflicted Injuries: Including those related to substance abuse.
- Infertility Treatment: IVF and other fertility treatments are typically excluded.
Understanding these exclusions is vital. The role of PMI is not to replace the NHS, but to complement it by providing prompt treatment for new, curable conditions.
Tailoring Your Plan: Popular Add-ons and Options
Most insurers allow you to customise your policy with optional extras to build a plan that perfectly suits your needs and budget.
Mental Health Cover
Awareness of mental wellbeing has grown significantly, and insurers have responded.
- What it covers: Can include access to counselling, therapy sessions (e.g., CBT), psychiatric consultations, and even inpatient treatment for conditions like anxiety, depression, and stress.
- Why consider it: Provides fast access to professional support, which can be crucial for early intervention and recovery. NHS waiting lists for mental health services can be particularly long.
Dental and Optical Cover
This add-on helps with the routine costs of check-ups and treatments.
- What it covers: Contributes towards the cost of dental check-ups, hygienist visits, and treatments like fillings or crowns. It also helps pay for eye tests, glasses, and contact lenses.
- Why consider it: A simple way to budget for routine healthcare costs that are not covered by standard PMI or the NHS for most adults.
Therapies Cover
This is for treatments that help with musculoskeletal issues and recovery.
- What it covers: Physiotherapy, osteopathy, chiropractic treatment, and sometimes acupuncture.
- Why consider it: Essential for anyone with an active lifestyle or a history of sports injuries. Quick access to physiotherapy can dramatically speed up recovery from an injury or operation.
Travel Cover
Some insurers allow you to add a travel insurance component to your health plan.
- What it covers: Provides worldwide medical cover when you are on holiday.
- Why consider it: Can be a convenient way to consolidate your insurance policies, but it's important to compare it against standalone travel insurance to ensure it offers the best value and coverage for your trip.
How Are Your Private Health Insurance Premiums Calculated?
Insurers consider several factors to determine your monthly or annual premium. Understanding these can help you manage the cost.
- Age: The single biggest factor. Premiums increase as you get older because the statistical likelihood of needing treatment rises.
- Location: Where you live matters. Treatment costs, particularly in Central London, are higher than in other parts of the country, so premiums are adjusted accordingly.
- Level of Cover: A comprehensive plan with full outpatient cover and multiple add-ons will cost more than a basic inpatient-only plan.
- Excess: This is the amount you agree to pay towards a claim. For example, if you have a £250 excess and your treatment costs £3,000, you pay the first £250 and the insurer pays the remaining £2,750. Choosing a higher excess will lower your premium.
- Hospital List: Insurers have different tiers of hospitals. A plan that gives you access to every private hospital in the UK, including the most expensive ones in London, will cost more than a plan with a more limited local network.
- No Claims Discount: Similar to car insurance, many PMI providers offer a discount on your renewal premium for every year you don't make a claim.
- Medical History & Lifestyle: Your personal medical history (if you choose full medical underwriting) and lifestyle factors like smoking can also affect your premium.
An independent PMI broker, such as WeCovr, can run a detailed market comparison based on your specific details, helping you find the most competitive price for the cover you need.
Enhancing Your Wellbeing: More Than Just Insurance
Many modern private health insurance providers are evolving. They no longer just pay claims; they actively encourage a healthier lifestyle to help prevent illness in the first place.
Common wellness benefits include:
- Discounted Gym Memberships: Encouraging you to stay active.
- Wearable Tech Deals: Discounts on smartwatches to track your activity and sleep.
- Digital GP Services: 24/7 access to a GP via phone or video call, often included as standard. This is incredibly convenient for getting quick advice, prescriptions, or referrals.
- Mental Health Support Apps: Access to apps for mindfulness, meditation, and self-guided CBT.
- Healthy Living Rewards: Points-based systems that reward you for healthy behaviours, which can be exchanged for cinema tickets, coffee, or even lower premiums.
WeCovr's Added Value
At WeCovr, we believe in a holistic approach to your health. That's why, in addition to finding you the best PMI policy, we offer our clients extra benefits:
- Complimentary access to CalorieHero: Our proprietary AI-powered calorie and nutrition tracking app to help you manage your diet and achieve your health goals.
- Exclusive discounts: When you purchase a Private Medical Insurance or Life Insurance policy through us, you may be eligible for discounts on other types of cover you need, such as home or travel insurance.
Our commitment to our clients is reflected in our high satisfaction ratings on independent review websites.
Company Health Insurance Plans
Many UK businesses offer private health insurance as a valuable employee benefit.
- Group Schemes: These are policies taken out by an employer to cover their staff. Premiums are often lower per person than on an individual policy due to the group size.
- Underwriting for Groups: Many group schemes have more favourable underwriting terms. For example, a 'Medical History Disregarded' (MHD) option may be available for larger groups, which means even pre-existing conditions could be covered.
- A Key Benefit: For employees, it's a highly prized perk. For employers, it's a great tool for attracting and retaining talent, as well as reducing staff absence by providing faster access to treatment.
If you are a business owner looking to set up a scheme, or an employee wanting to understand your company's plan, an expert broker can provide invaluable guidance.
How to Choose the Best Private Medical Insurance UK Plan for You
Choosing a plan can feel overwhelming, but a structured approach makes it manageable.
- Assess Your Needs: What is most important to you? Is it fast access to cancer care? Mental health support? Or simply a safety net for major surgery?
- Set Your Budget: Be realistic about what you can afford to pay each month. Remember that premiums will rise with age.
- Consider the Excess: How much could you comfortably afford to pay towards a claim? A higher excess is a great way to reduce your premium.
- Review the Hospital List: Check that the hospitals included in the plan are convenient for you. If you want access to a specific hospital, make sure it's on the list.
- Read the Fine Print: Pay close attention to the policy details, especially the exclusions and the limits on outpatient cover.
- Seek Expert Advice: This is the most important step. The private health insurance market is complex, with dozens of providers and hundreds of policy combinations.
Using an FCA-authorised broker like WeCovr doesn't cost you anything extra. We get paid by the insurer, but our duty is to you, the client. We use our expertise and market knowledge to find you the best possible policy, saving you time, hassle, and potentially a great deal of money.
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Ready to explore your options and find a private health care plan that protects you and your family? The expert team at WeCovr is here to help. Get a free, no-obligation quote today and let us simplify your search for the right cover.
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
By tapping the button below, you can book a free call with them in less than 30 seconds right now:
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WeCovr is an insurance specialist for people valuing their peace of mind and a great service.👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.
Just a quick and simple form and an easy conversation with one of our experts and your valuable insurance policy is in place for that needed peace of mind!