TL;DR
As an FCA-authorised expert broker that has helped arrange over 900,000 policies, WeCovr understands that navigating the world of private medical insurance in the UK can feel complex. That's why we've created a simple tool to help you get an instant estimate of your potential monthly costs. WeCovr introduces a quick tool to estimate your monthly PMI costs Figuring out how much private health insurance might cost is often the first, and most significant, question people have.
Key takeaways
- Basic Cover: This is the entry-level option, usually covering only in-patient and day-patient treatment. This means you are covered for treatments that require a hospital bed, either overnight (in-patient) or for the day (day-patient). Diagnostic tests and consultations leading up to the hospital stay may not be included.
- Intermediate Cover (illustrative): This level builds on the basic plan by adding some out-patient cover. This could include a set number of specialist consultations or a fixed financial limit (e.g., up to £1,000) for diagnostic tests and therapies that don't require a hospital bed.
- Comprehensive Cover: This is the most extensive level of cover. It typically includes full in-patient and out-patient cover, meaning consultations, diagnostics, and treatments are all included. It often comes with higher limits for therapies (like physiotherapy), more extensive mental health support, and additional benefits like dental and optical cover.
- Moratorium Underwriting (Most Common): This is the simpler of the two options. You don't have to provide a full medical history upfront. Instead, the insurer automatically excludes any pre-existing conditions you've had symptoms, treatment, or advice for in the five years before your policy starts. However, if you then go two full, continuous years on the policy without any symptoms, treatment, or advice for that condition, the insurer may agree to cover it in the future. It’s a "wait and see" approach.
- Full Medical Underwriting (FMU): With FMU, you complete a detailed medical questionnaire when you apply. You disclose your full medical history, and the insurer gives you a clear decision from day one about what is excluded. This provides certainty, as you know exactly where you stand. It can sometimes lead to lower premiums if you have a clean bill of health, but the application process is longer.
As an FCA-authorised expert broker that has helped arrange over 900,000 policies, WeCovr understands that navigating the world of private medical insurance in the UK can feel complex. That's why we've created a simple tool to help you get an instant estimate of your potential monthly costs.
WeCovr introduces a quick tool to estimate your monthly PMI costs
Figuring out how much private health insurance might cost is often the first, and most significant, question people have. Prices can seem to vary wildly, making it difficult to budget or even decide if it's a viable option for you and your family.
To demystify the process, WeCovr has launched a new Private Health Insurance Calculator. This intuitive online tool is designed to give you a quick, straightforward estimate of your monthly premiums in under a minute.
By answering a few simple questions, our calculator provides a reliable ballpark figure, empowering you with the knowledge you need before diving deeper. It's a no-obligation first step towards understanding how affordable peace of mind can be. The estimate acts as your starting point, preparing you for a more detailed conversation with one of our expert advisors who can then tailor a precise quote to your unique circumstances.
Why Do Private Health Insurance Costs Vary So Much?
The premium you pay for private medical insurance isn't a one-size-fits-all figure. It's a carefully calculated price based on a range of personal and policy-related factors. Insurers use this information to assess the statistical risk of you needing to make a claim. Understanding these factors is key to knowing what drives your quote up or down.
Here are the main elements that influence your premium:
Your Age
Age is one of the most significant factors. As we get older, the statistical likelihood of needing medical treatment increases. Therefore, premiums for private health cover are generally lower for younger individuals and rise with age. Insurers update their pricing based on age bands, so you can expect a gradual increase in cost as you move into a new band, typically every five or ten years.
Illustrative Monthly Premium by Age (for a basic policy)
| Age Group | Estimated Monthly Premium |
|---|---|
| 25-30 | £30 - £45 |
| 40-45 | £55 - £70 |
| 55-60 | £80 - £110 |
| 65+ | £120 - £180+ |
| Note: These are illustrative figures for a non-smoker with basic cover outside London. Actual costs will vary. |
Your Location (Postcode)
Where you live in the UK has a direct impact on your premium. The cost of private medical treatment varies significantly by region. Central London, for example, is home to some of the most advanced but also most expensive private hospitals and consultants in the country. If you live in or near a major city with high private healthcare costs, your premium will reflect that. Conversely, living in a region with lower treatment costs will often result in a cheaper policy.
Your Chosen Level of Cover
This is where you have the most control over the cost. Private health insurance policies are typically offered in tiers, from basic to fully comprehensive.
- Basic Cover: This is the entry-level option, usually covering only in-patient and day-patient treatment. This means you are covered for treatments that require a hospital bed, either overnight (in-patient) or for the day (day-patient). Diagnostic tests and consultations leading up to the hospital stay may not be included.
- Intermediate Cover (illustrative): This level builds on the basic plan by adding some out-patient cover. This could include a set number of specialist consultations or a fixed financial limit (e.g., up to £1,000) for diagnostic tests and therapies that don't require a hospital bed.
- Comprehensive Cover: This is the most extensive level of cover. It typically includes full in-patient and out-patient cover, meaning consultations, diagnostics, and treatments are all included. It often comes with higher limits for therapies (like physiotherapy), more extensive mental health support, and additional benefits like dental and optical cover.
Comparison of Cover Levels
| Feature | Basic Cover | Intermediate Cover | Comprehensive Cover |
|---|---|---|---|
| In-patient/Day-patient Care | ✅ Yes | ✅ Yes | ✅ Yes |
| Cancer Cover (Core) | ✅ Yes | ✅ Yes | ✅ Yes |
| Out-patient Consultations | ❌ No | ✅ Limited (e.g., up to £1,000) | ✅ Yes (Often in full) |
| Out-patient Diagnostics | ❌ No | ✅ Limited | ✅ Yes (Often in full) |
| Physiotherapy & Therapies | ❌ No | ✅ Limited | ✅ Yes (Higher limits) |
| Mental Health Cover | ❌ Limited/Optional | ✅ Optional Add-on | ✅ Often included |
| Dental & Optical | ❌ No | ❌ Optional Add-on | ✅ Optional Add-on |
The Policy Excess
An excess is a fixed amount you agree to pay towards the cost of your treatment if you make a claim. For example, if your policy has a £250 excess and your private surgery costs £5,000, you would pay the first £250, and the insurer would cover the remaining £4,750.
Choosing a higher excess is a simple way to reduce your monthly premium. Insurers reward you for sharing a small part of the risk. Excesses typically range from £0 to £1,000. Selecting a higher amount that you know you can afford can make your policy significantly more budget-friendly.
Your Underwriting Choice
Underwriting is the process an insurer uses to assess your medical history and decide what they will and won't cover. This is a crucial choice that affects both your premium and your future claims.
- Moratorium Underwriting (Most Common): This is the simpler of the two options. You don't have to provide a full medical history upfront. Instead, the insurer automatically excludes any pre-existing conditions you've had symptoms, treatment, or advice for in the five years before your policy starts. However, if you then go two full, continuous years on the policy without any symptoms, treatment, or advice for that condition, the insurer may agree to cover it in the future. It’s a "wait and see" approach.
- Full Medical Underwriting (FMU): With FMU, you complete a detailed medical questionnaire when you apply. You disclose your full medical history, and the insurer gives you a clear decision from day one about what is excluded. This provides certainty, as you know exactly where you stand. It can sometimes lead to lower premiums if you have a clean bill of health, but the application process is longer.
Moratorium vs. Full Medical Underwriting
| Feature | Moratorium Underwriting | Full Medical Underwriting |
|---|---|---|
| Application Process | Quick and simple, no medical forms. | Longer, requires a full health questionnaire. |
| Exclusions | Automatic exclusion of conditions from the last 5 years. | Specific exclusions are listed in your policy documents. |
| Clarity | Less certainty at the start. | Full clarity on what's covered from day one. |
| Claim Process | Can be slower as insurer investigates medical history at the point of claim. | Generally faster as underwriting is done upfront. |
Your Lifestyle (Smoker Status)
Insurers view smoking as a significant health risk. According to the NHS, smoking is linked to a wide range of serious health conditions, including cancer, heart disease, and respiratory illnesses. Because of this increased risk, smokers will almost always pay a higher premium for private medical insurance than non-smokers.
Understanding What Private Health Insurance Covers (and What It Doesn't)
A common misconception is that private health insurance is a replacement for the NHS. It's not. It's designed to work alongside the NHS, offering you more choice, comfort, and faster access to treatment for specific types of conditions. The fundamental principle of UK PMI is that it covers acute conditions.
What is Typically Covered by UK PMI?
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 conditions that have a clear start and end point.
Your private medical insurance UK policy is designed to cover the diagnosis and treatment of these conditions that arise after you join.
Key benefits often include:
- Prompt access to specialist consultations
- Advanced diagnostic tests like MRI and CT scans
- Private hospital accommodation with an en-suite room
- Surgery and other treatments as an in-patient or day-patient
- Comprehensive cancer care, including chemotherapy, radiotherapy, and surgical procedures
- Mental health support (often included in comprehensive plans or as an add-on)
- Post-treatment therapies such as physiotherapy or osteopathy
The Critical Exclusions: Pre-existing and Chronic Conditions
This is the most important distinction to understand. Standard private health insurance in the UK is not designed to cover chronic conditions or pre-existing conditions.
- Pre-existing Condition: Any illness or injury for which you have experienced symptoms, received medication, or sought advice before taking out your policy. These are typically excluded, either permanently (with FMU) or for a set period (with Moratorium).
- Chronic Condition: A condition that is long-term and cannot be cured, only managed. It is ongoing and requires continuous monitoring or treatment.
Acute vs. Chronic Conditions: Key Differences
| Characteristic | Acute Condition | Chronic Condition |
|---|---|---|
| Onset | Sudden | Gradual |
| Duration | Short-term | Long-term or lifelong |
| Prognosis | Curable, return to previous health | Manageable, but not curable |
| PMI Coverage | ✅ Covered | ❌ Not Covered |
| Examples | Cataracts, hernia, joint replacement, appendicitis. | Diabetes, asthma, high blood pressure, arthritis, Crohn's disease. |
The NHS provides excellent care for chronic conditions, and PMI is not intended to replace this vital service.
Other Common Exclusions
Beyond chronic and pre-existing conditions, most policies will also exclude:
- Visits to A&E
- Normal pregnancy and childbirth
- Cosmetic surgery (unless medically necessary)
- Treatment for drug or alcohol addiction
- Organ transplants
- Self-inflicted injuries
How to Use the WeCovr PMI Cost Calculator: A Step-by-Step Guide
Our calculator is designed for simplicity and speed. In just four steps, you can get a clear indication of your potential PMI costs.
- Enter Your Basic Details: Start by providing your date of birth and your postcode. This allows the calculator to factor in your age and geographical location, two of the biggest drivers of cost.
- Select Your Desired Cover Level: Choose whether you're looking for a basic, mid-range, or comprehensive policy. This helps the tool understand the breadth of benefits you're interested in.
- Choose an Excess Amount: Select an excess level you'd be comfortable paying in the event of a claim. Remember, a higher excess will lower your monthly premium.
- Get Your Instant Estimate: The calculator will process your information and instantly display an estimated monthly premium.
This figure gives you a strong foundation for financial planning. The next step is to speak with a WeCovr advisor. They can refine this estimate into a precise quote by discussing other options, such as hospital lists and six-week wait options, ensuring the policy is perfectly aligned with your needs and budget.
Putting it into Practice: Sample PMI Cost Scenarios
To help you visualise how the different factors come together, here are some illustrative examples of what different people might pay for private health cover.
| Persona | Age | Location | Cover Level | Excess | Estimated Monthly Premium |
|---|---|---|---|---|---|
| The Young Professional (Single Person) | 28 | Manchester | Basic (In-patient only) | £500 | £35 - £50 |
| The Couple (Two Adults) | 45 | Bristol | Intermediate (with out-patient) | £250 | £130 - £170 (total) |
| The Family (Two Adults, Two Children) | 38 & 36 | Surrey | Comprehensive | £100 | £220 - £280 (total) |
Disclaimer: These figures are for illustrative purposes only and are based on 2025 market averages. Your actual quote will depend on the specific insurer, your full circumstances, and the final policy options you select.
The Added Value of WeCovr: More Than Just a Quote
Using a calculator is a great start, but finding the right policy involves more than just numbers. As an expert PMI broker, WeCovr provides a comprehensive service at no cost to you. We are paid by the insurer, so you get impartial advice without paying a penny extra.
Our role is to:
- Listen to your needs and understand what's important to you.
- Compare policies from a wide panel of the UK's leading insurers, including Bupa, AXA Health, Aviva, and Vitality.
- Explain the jargon and help you understand the fine print.
- Find the best PMI provider for your specific requirements and budget.
We are committed to our clients' long-term wellbeing. That’s why all our health and life insurance clients receive complimentary access to CalorieHero, our exclusive AI-powered calorie and nutrition tracking app. It's a fantastic tool to help you proactively manage your diet and health.
Furthermore, when you purchase a health or life insurance policy through WeCovr, you become eligible for discounts on other types of cover you might need, such as income protection or critical illness insurance. Our high customer satisfaction ratings reflect our commitment to providing ongoing value and support.
Wellness and Proactive Health: Reducing Your Long-Term Risk
While insurance is there for when things go wrong, taking proactive steps to stay healthy is the best strategy of all. A healthier lifestyle can reduce your risk of developing many acute conditions, which can, in turn, help keep your insurance costs manageable over the long term.
The Importance of a Balanced Diet
A healthy diet is the cornerstone of good health. The NHS 'Eatwell Guide' provides a clear framework for a balanced diet. Aiming for your 5 A DAY of fruit and vegetables, choosing wholegrain carbohydrates, and opting for lean proteins can have a huge impact. Tracking your intake with a tool like our CalorieHero app can make it easier to stay on course.
The Power of Regular Physical Activity
The UK Chief Medical Officers' guidelines recommend that adults aim for at least 150 minutes of moderate-intensity activity a week. This could be a brisk 30-minute walk five days a week, a couple of gym sessions, or a weekend cycle ride. Regular exercise strengthens your cardiovascular system, improves mental health, and helps maintain a healthy weight.
Prioritising Sleep
Sleep is not a luxury; it's a biological necessity. According to the Sleep Foundation, most adults need 7-9 hours of quality sleep per night. Good sleep hygiene—like maintaining a regular schedule and creating a restful environment—is crucial for immune function, cognitive performance, and emotional regulation.
Managing Stress
Chronic stress can take a toll on both mental and physical health. Finding healthy ways to manage stress is vital. This could involve mindfulness and meditation, engaging in hobbies you love, spending time in nature, or ensuring you have a strong social support network. Many comprehensive PMI policies now include access to mental health support lines and therapy sessions.
By investing in your health today, you are making the most valuable investment for your future.
Do I still need the NHS if I have private health insurance?
Can I add my family to my private health insurance policy?
Does private health insurance cover cancer?
Is private health insurance worth it in the UK?
Ready to take the next step?
Use the WeCovr Private Health Insurance Calculator today for your free, instant estimate. Then, speak to one of our friendly, expert advisors for a personalised quote that truly fits your needs.
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.
