Planning a career break, sabbatical, or extended leave is an exciting prospect. But amidst the dreams of travel or personal projects, a crucial question arises: what happens to your private medical insurance? As an FCA-authorised broker that has helped arrange over 800,000 policies, WeCovr understands the importance of seamless health cover. This guide provides expert advice on maintaining your private medical insurance in the UK, ensuring you remain protected without jeopardising your cover history.
Options for continuing PMI during sabbaticals, career breaks, and extended leave periods without losing coverage history or triggering new moratoriums
Taking a break from your career shouldn't mean taking a break from your health security. If you leave a job where you enjoyed a company-paid private medical insurance (PMI) plan, you face a critical decision. Simply letting the cover lapse can have significant long-term consequences, particularly if you have a history of medical conditions.
A gap in your insurance record can force you into a new underwriting process when you eventually take out a new policy. This could mean that conditions you were previously covered for are now excluded. The primary goal is to maintain continuous cover. Fortunately, you have several robust options to explore to ensure your health remains a top priority, no matter where your career break takes you.
This article will walk you through the three main pathways:
- Continuing on your existing group scheme.
- Using a 'continuation option' to switch to a personal plan.
- Taking out a new individual policy.
We'll break down the pros and cons of each, helping you make an informed choice that safeguards your health and financial wellbeing.
Why Maintaining Continuous Health Insurance Coverage is Crucial
To understand the importance of continuous cover, you first need to understand how insurers assess risk. This process is called underwriting. When you lose your company health plan and later start a new one, the insurer will underwrite you as a new customer. This is where the problems can begin.
The Critical Point on Pre-existing Conditions: It is vital to remember that standard UK private medical insurance is designed to cover acute conditions – illnesses or injuries that are short-term and likely to respond to treatment. It does not cover chronic conditions (long-term illnesses like diabetes or asthma) or pre-existing conditions that you had before the policy started.
A gap in cover creates a window where any new health issue, or even a symptom you visit a GP for, can be classed as 'pre-existing' by a future insurer.
The Dangers of a Coverage Gap
- New Moratoriums: Most new personal policies are sold on a 'moratorium' basis. This means the insurer will not cover any medical condition you've had symptoms, treatment, or advice for in the five years before the policy start date. If you remain trouble-free for a continuous two-year period after your policy begins, that condition may become eligible for cover. A gap in cover resets this clock entirely.
- Development of New Conditions: During your career break, you might develop a new health concern. If you are uninsured at this time, that condition will be considered 'pre-existing' when you apply for a new policy later and will almost certainly be excluded from cover.
- Loss of 'Medical History Disregarded' (MHD) Terms: Some larger company schemes offer MHD underwriting, which is the most comprehensive type available. It covers pre-existing conditions. If you leave a scheme with this benefit, you will not be able to get it on an individual policy. Maintaining continuous cover, even on a lesser basis, is far better than starting from scratch.
Underwriting Types at a Glance
| Underwriting Type | How It Works | Key Implication for Career Breaks |
|---|
| Moratorium (Mori) | Automatically excludes conditions from the past 5 years. No medical questionnaire. | Starting a new policy after a break means a new 5-year look-back period. Any issues during your break are excluded. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire. The insurer decides what to cover or exclude from the start. | More transparent, but any conditions declared (including those from your break) will likely be permanently excluded. |
| Continued Personal Medical Exclusions (CPME) | When switching from another underwritten policy, your existing exclusions are carried over. | This is the goal. A 'continuation option' uses this, meaning no new exclusions are added. |
Losing your cover, even for a few months, can undo years of continuous protection. Your top priority should be to find a way to maintain your policy history.
Understanding Your Current Group PMI Scheme Before You Leave
The very first step, before you even hand in your notice, is to become an expert on your current company health plan. Do not assume anything. Your HR department and your policy documents are your best friends at this stage.
Key Questions to Ask Your HR Department:
- Is there a 'continuation option' for employees leaving the company? This is the most important question. Many group schemes have a built-in facility that allows leavers to switch to an individual policy with the same insurer, preserving their underwriting terms.
- Can I remain on the group scheme if I pay the full premium myself? This is less common, especially for smaller businesses, but some larger organisations may allow it for a set period, particularly for sabbaticals where you are technically still an employee.
- Who is the insurer? Knowing whether you're with Bupa, Aviva, AXA Health, Vitality, or another provider is crucial for your research.
- What is the name of the group scheme and what is my policy number? You will need this information when speaking to the insurer or a broker.
- Can I have a copy of the full policy wording and table of benefits? This document details exactly what is and isn't covered, which is essential for comparing your options.
Being proactive can save you a significant amount of money and stress. Going into conversations with your HR team or a broker armed with this information will make the process much smoother.
Option 1: Continuing Your Group Health Insurance Policy
This is often the 'gold standard' solution if it's available. Some employers, particularly for formal sabbaticals where you remain an employee on unpaid leave, may allow you to continue as a member of their group scheme, provided you cover the cost.
How it works: Your employer will calculate the total monthly or annual premium for your cover (including the portion they usually pay) and arrange for you to pay it directly to them or, in some cases, the insurer.
Benefits of Staying on the Group Scheme:
- Perfect Continuity: You experience zero gap in cover. Your underwriting history remains completely intact.
- Comprehensive Cover: Group schemes, especially from large companies, often have very generous benefits and 'Medical History Disregarded' underwriting that you cannot buy on the individual market.
- Simplicity: There is no new application process, no medical questionnaires, and no new exclusions. It's simply a change in who pays the bill.
Potential Downsides:
- Availability: This option is not always offered. Many companies cease all benefits the day an employee leaves.
- Cost: You will be paying the full 'group rate' premium, which could be substantial without your employer's subsidy.
- Limited Duration: This arrangement may only be offered for a fixed period, such as 12 months.
| Feature | Staying on Group Scheme | Starting a New Individual Policy |
|---|
| Underwriting | No change. All history preserved. | New underwriting (Moratorium or FMU). |
| Pre-existing Conditions | Coverage for pre-existing conditions continues (if on MHD). | New exclusions for recent conditions. |
| Application Process | Simple administrative change. | Full new application required. |
| Benefit Level | Often more comprehensive. | May need to reduce cover to manage cost. |
| Best For | Short-term sabbaticals where you remain an employee. | When no other continuation option exists. |
Expert Tip: If your company agrees to this, get the terms in writing. Ensure you are clear on the cost, payment method, and the process for notifying them of your return to work.
Option 2: Switching to a Personal PMI Policy with a 'Continuation Option'
This is the most common and effective solution for most people leaving a company health scheme. A 'continuation option' (sometimes called a 'switcher' or 'leaver' scheme) is a facility offered by an insurer that allows you to move seamlessly from your company's group plan to a new, individual plan without further medical underwriting.
How it works: You are essentially carrying your underwriting history with you. The insurer agrees to continue your cover on a Continued Personal Medical Exclusions (CPME) basis. This means any exclusions you had on your group policy will carry over, but crucially, no new ones will be added for conditions that may have developed while you were on the group plan.
Key Steps to Using a Continuation Option:
- Identify your Insurer: Find out who provides your group cover (e.g., Aviva, Bupa, AXA).
- Act Quickly: You usually have a limited time window (often 30-90 days) after leaving your job to exercise this option. Don't delay!
- Contact a Broker or the Insurer: An expert PMI broker like WeCovr can manage this entire process for you. They know the specific 'switcher' products each insurer offers and can ensure you get the best terms. Alternatively, you can contact the insurer's dedicated leaver department directly.
- Choose Your Plan: You will be offered a choice of their individual plans. You can often tailor the cover level (e.g., hospital lists, excess) to suit your new budget, while still keeping your continuous cover history.
Advantages of a Continuation Option:
- No New Medical Underwriting: This is the single biggest benefit.
- Peace of Mind: You know you are covered for any conditions that arose while you were in your previous job.
- Flexibility: You can adjust your cover level and premium to match your new circumstances.
Finding the right continuation plan can be complex. Working with an independent broker gives you a view of the entire market and ensures the advice is tailored to your specific situation, at no extra cost to you.
Option 3: Taking Out a New Individual Private Medical Insurance Policy
If your employer doesn't offer a continuation option and their insurer doesn't have a suitable switcher plan, your final choice is to take out a brand-new individual policy from the open market.
While this ensures you have cover, it comes with the significant drawback of fresh underwriting.
This means:
- Any consultations, symptoms, or treatments you've had in the last five years will now be taken into account.
- Conditions that were previously covered under your old group scheme could now be excluded.
You will typically be offered two main underwriting choices:
1. Moratorium (Mori) Underwriting
This is the most common type for new policies. It's quick and doesn't require a medical questionnaire.
- How it works: The policy automatically excludes treatment for any medical condition for which you have sought advice, experienced symptoms, or received treatment in the 5 years prior to the policy start date.
- The "2-Year Rule": If you then go for 2 continuous years on the policy without needing treatment, advice, or having symptoms of that condition, it may become eligible for cover.
- The Risk: Aches, pains, or minor ailments you had investigated during your previous employment could now lead to exclusions on your new policy.
2. Full Medical Underwriting (FMU)
This involves a more detailed upfront process.
- How it works: You complete a full health questionnaire, declaring your medical history. The insurer's underwriting team reviews it and offers terms.
- Clarity: The major benefit is that you know from day one exactly what is and isn't covered. Your policy documents will list any specific exclusions.
- The Downside: It's more intrusive, and you must be scrupulously honest. Any undeclared condition could invalidate your policy.
| Feature | Moratorium Underwriting | Full Medical Underwriting (FMU) |
|---|
| Application | Quick, no forms | Long questionnaire, requires medical details |
| Clarity on Cover | Ambiguous initially; exclusions are determined at the point of claim | Clear from the start; exclusions are listed in writing |
| Pre-existing Conditions | Automatically excluded for a period | Assessed individually; may be permanently excluded |
| Best For | People with a clean bill of health seeking a quick start | People who want absolute certainty about their cover from day one |
If you find yourself in this situation, using a PMI broker is more important than ever. An expert at WeCovr can compare the best PMI providers, help you navigate the complexities of underwriting, and find the policy that offers the most comprehensive cover for your specific health profile and budget.
How to Choose the Right PMI Policy for Your Career Break
Whether you're using a continuation option or starting fresh, you'll need to make decisions about the level of cover you need. A career break is a perfect time to re-evaluate your priorities.
1. Assess Your Needs and Budget
Your income may be different during your break, so budget is key. Think about:
- Core Cover: All policies cover inpatient treatment (when you need a hospital bed). Most cover day-patient treatment too.
- Outpatient Cover: This is a crucial add-on. Do you want cover for specialist consultations, diagnostic tests, and scans? You can often choose a limit (e.g., £500, £1,000, or unlimited) to manage the premium.
- Therapies: Do you want cover for physiotherapy, osteopathy, or chiropractic treatment?
- Mental Health: This is an increasingly important benefit. Cover can range from basic counselling sessions to full psychiatric inpatient care.
2. Ways to Manage Your Premium
- Excess: This is the amount you agree to pay towards any claim. A higher excess (£250, £500, £1,000) will significantly lower your premium.
- Hospital List: Insurers have tiered hospital lists. Choosing a list that excludes the most expensive central London hospitals can reduce your premium.
- 6-Week Option: This is a popular cost-saving measure. If the NHS can provide the inpatient treatment you need within six weeks of it being recommended, you would use the NHS. If the wait is longer, your PMI policy kicks in. This can reduce premiums by up to 25%.
3. Leverage Expert Broker Services
Navigating these options alone can be daunting. A specialist broker offers:
- Market-wide Comparison: They compare policies from all leading UK insurers.
- Expert Guidance: They explain the jargon and help you find the best value.
- No Fee: Brokers are paid by the insurer, so their service is free for you.
- Added Value: At WeCovr, we also provide clients with complimentary access to our AI-powered calorie and nutrition tracker, CalorieHero, and offer discounts on other insurance products like life or income protection when you take out a PMI policy.
Special Considerations for Your Sabbatical or Career Break
Travel Insurance vs. PMI
A common point of confusion is cover while abroad. Standard UK private medical insurance is not travel insurance.
- UK PMI: Designed for treatment within the United Kingdom. Some policies include a very limited benefit for emergency overseas treatment, but this is not a substitute for proper travel insurance.
- Travel Insurance: Essential for any trip abroad. For a long sabbatical, you will need a specialist 'long-stay' or 'backpacker' policy. This covers medical emergencies, cancellations, lost baggage, and personal liability.
Do not rely on your PMI for medical cover while travelling. You need both.
Focusing on Your Wellbeing
A career break is a fantastic opportunity to invest in your health.
- Stay Active: Regular exercise is proven to boost mood and reduce the risk of many health conditions. Find an activity you enjoy, whether it's hiking, yoga, or joining a local sports club.
- Prioritise Sleep: Aim for 7-9 hours of quality sleep per night. A consistent sleep schedule helps regulate your hormones, improve cognitive function, and strengthen your immune system.
- Mindful Eating: Without the rush of a daily commute, you have more time to prepare nutritious meals. Focus on a balanced diet rich in fruits, vegetables, lean proteins, and whole grains.
- Leverage Your PMI's Wellness Benefits: Many modern PMI policies from providers like Vitality and Aviva include wellness programmes, discounts on gym memberships, and access to virtual GP and mental health support apps. Use them!
Real-Life Scenarios: Navigating PMI During a Career Break
Let's look at how three different people might handle this situation.
Scenario 1: Sarah, the Lawyer on Sabbatical
Sarah works for a large law firm with a comprehensive Bupa plan. She's taking a 6-month, pre-agreed sabbatical.
- Action: She speaks to HR, who confirm she can remain on the group scheme as long as she pays the full premium.
- Outcome: Sarah sets up a direct debit and enjoys seamless, top-tier cover throughout her break. Her underwriting is completely unaffected.
Scenario 2: David, the IT Manager Changing Careers
David leaves his mid-sized company to retrain as a landscape gardener. His company's AXA Health scheme does not allow leavers to remain on the group plan.
- Action: David contacts WeCovr within a week of leaving. The broker confirms that AXA offers a 'switcher' policy. They help David choose an individual plan with a £500 excess and a reduced hospital list to make it affordable.
- Outcome: David moves to his new personal policy on a CPME basis. No new underwriting is required, and he retains cover for a shoulder issue he had investigated two years ago.
Scenario 3: Chloe, the Teacher Taking a Gap Year
Chloe leaves her teaching job, which had a basic group plan with a small insurer. There is no continuation option. She plans to travel through Southeast Asia for 10 months.
- Action: Chloe realises she needs a new policy. She works with a broker to find the best value individual plan on the market. She chooses a moratorium policy from Vitality because she is in good health and likes their wellness rewards.
- Critical Extra Step: The broker also stresses that this UK PMI will not cover her travels. Chloe takes out a separate, comprehensive 12-month long-stay travel insurance policy.
- Outcome: Chloe is fully insured, with one policy for her health back in the UK and another for emergencies while abroad. She understands that her new PMI policy has a new moratorium period.
What happens to my private health insurance if I'm made redundant?
If you are made redundant, your situation is the same as if you had resigned. Your cover under the company's group scheme will cease on your last day of employment. It is crucial to act quickly. Your best option is to see if your insurer offers a 'continuation option' or 'switcher' plan, which allows you to move to a personal policy without new medical underwriting. Contact your insurer or a specialist broker immediately to arrange this and avoid a gap in cover.
Can I just pause my private health insurance during my career break?
No, you generally cannot 'pause' a private health insurance policy in the UK. A policy is either active or it is cancelled. Attempting to pause it would be treated as a cancellation, creating a gap in cover. This would trigger new underwriting when you restart, potentially leading to new exclusions for any health issues that arose during the break. The correct approach is to maintain continuous cover, either by continuing your group plan or switching to a personal policy.
Does my UK PMI cover me if I travel abroad on my sabbatical?
No, your standard UK private medical insurance policy is not a substitute for travel insurance. UK PMI is designed for treatment within the UK. While some policies may offer a limited benefit for emergency overseas treatment, it is not comprehensive. For any travel outside the UK, especially for an extended period, you must purchase a separate, specialist travel insurance policy. This will cover you for medical emergencies, repatriation, cancellations, and other travel-related risks.
What is the difference between a 'continuation option' and just buying a new policy?
The key difference is the underwriting. A 'continuation option' allows you to switch from a group scheme to a personal policy with the same insurer without new medical underwriting. This means your cover history is preserved, and no new exclusions are added for conditions that developed while on the group plan. Buying a completely new policy means you will be fully re-underwritten, either via a moratorium or a full medical questionnaire. This will likely result in new exclusions for any medical conditions you've experienced in the past few years.
Your Next Step to a Secure Career Break
Planning a career break is an investment in yourself. Don't let a gap in health cover undermine that investment. By understanding your options and acting proactively, you can ensure you have the right protection in place, giving you the freedom to enjoy your time off with complete peace of mind.
The private medical insurance UK market can be complex, but you don't have to navigate it alone.
Ready to secure your health cover? Contact our friendly, expert team at WeCovr today. We'll compare the market for you, explain your options in simple terms, and handle the paperwork—all at no cost to you. Get your free, no-obligation quote and start your career break with confidence.