TL;DR
As an FCA-authorised expert with over 900,000 policies arranged, WeCovr helps you navigate the UK private medical insurance market. This guide and our simple calculator will help you understand the costs and find the right cover, giving you peace of mind and control over your health. Estimate your likely PMI premium with WeCovr's simple calculator Thinking about private health insurance but worried about the cost?
Key takeaways
- Inpatient vs. Outpatient Cover:
- Inpatient/Day-patient cover is the core of every PMI policy. It covers treatment where you are admitted to a hospital and require a bed (even for a day).
- Illustrative estimate: Outpatient cover is for tests and consultations that don't require a hospital bed. This includes initial consultations with a specialist, diagnostic scans like MRI and CT, and blood tests. Adding comprehensive outpatient cover will increase your premium, but you can often set a limit (e.g., £500, £1,000, or £1,500 per year) to manage the cost.
- Additional Therapies: Many policies allow you to add cover for treatments like physiotherapy, osteopathy, and chiropractic care. If you have an active lifestyle or a history of musculoskeletal issues, this can be a valuable addition.
- Mental Health Cover: With growing awareness of its importance, most providers now offer mental health cover. This can range from access to counselling sessions to full psychiatric inpatient treatment. Given potential NHS waiting times for services like CAMHS or talking therapies, this is an increasingly popular option.
As an FCA-authorised expert with over 900,000 policies arranged, WeCovr helps you navigate the UK private medical insurance market. This guide and our simple calculator will help you understand the costs and find the right cover, giving you peace of mind and control over your health.
Estimate your likely PMI premium with WeCovr's simple calculator
Thinking about private health insurance but worried about the cost? You're not alone. Understanding what you might pay is the first step towards deciding if private medical insurance (PMI) is right for you. Our easy-to-use cost calculator is designed to give you a reliable initial estimate in moments.
While every policy is tailored to the individual, our calculator provides a valuable starting point. It uses key information to generate a ballpark figure, helping you budget and explore your options with confidence.
Ready to get a clearer picture? Let’s break down what goes into the cost of private health cover in the UK.
What Determines the Cost of Private Health Insurance in the UK?
The premium you pay for PMI isn't a random figure. It's a carefully calculated price based on a range of risk factors and your chosen level of cover. Insurers use this information to predict the likelihood of you making a claim. Here are the main factors that will shape your personal quote.
1. Your Age
Age is the single most significant factor in determining your premium. As we get older, the statistical likelihood of needing medical treatment increases. Insurers price this heightened risk into the policy. Premiums for a person in their 60s can be three to four times higher than for someone in their 30s.
Illustrative Monthly Premiums by Age (Mid-Level Cover)
| Age Bracket | Typical Monthly Cost (Non-Smoker) |
|---|---|
| 25-30 | £35 - £55 |
| 35-40 | £50 - £80 |
| 45-50 | £70 - £110 |
| 55-60 | £100 - £160 |
| 65+ | £150 - £250+ |
Note: These are illustrative estimates for a healthy individual. Your actual quote will vary.
2. Your Location
Where you live in the UK has a direct impact on your premium. This is often called a "postcode lottery." The cost of private medical treatment, particularly for hospital stays and specialist consultations, is significantly higher in some areas, like Central London and the South East. Insurers pass this cost on through higher premiums for residents in those postcodes.
Example Monthly Premium by Location (40-year-old, mid-level cover)
| Location | Example Monthly Premium |
|---|---|
| Central London | £95 |
| Manchester | £75 |
| Rural Scotland | £60 |
3. The Level of Cover You Choose
This is where you have the most control. Policies are not one-size-fits-all. You can tailor your cover to balance your needs and budget.
-
Inpatient vs. Outpatient Cover:
- Inpatient/Day-patient cover is the core of every PMI policy. It covers treatment where you are admitted to a hospital and require a bed (even for a day).
- Illustrative estimate: Outpatient cover is for tests and consultations that don't require a hospital bed. This includes initial consultations with a specialist, diagnostic scans like MRI and CT, and blood tests. Adding comprehensive outpatient cover will increase your premium, but you can often set a limit (e.g., £500, £1,000, or £1,500 per year) to manage the cost.
-
Additional Therapies: Many policies allow you to add cover for treatments like physiotherapy, osteopathy, and chiropractic care. If you have an active lifestyle or a history of musculoskeletal issues, this can be a valuable addition.
-
Mental Health Cover: With growing awareness of its importance, most providers now offer mental health cover. This can range from access to counselling sessions to full psychiatric inpatient treatment. Given potential NHS waiting times for services like CAMHS or talking therapies, this is an increasingly popular option.
4. Your Policy Excess
An excess is the amount you agree to pay towards a claim. It works just like the excess on your car or home insurance. For example, if you have a £250 excess and make a claim for a £2,000 procedure, you would pay the first £250, and the insurer would pay the remaining £1,750.
Choosing a higher excess is one of the most effective ways to reduce your monthly premium.
Impact of Excess on a £80/month Premium (illustrative estimate)
| Excess Level | New Estimated Monthly Premium | Potential Annual Saving |
|---|---|---|
| £0 | £80 | £0 |
| £250 | £68 | £144 |
| £500 | £60 | £240 |
| £1,000 | £52 | £336 |
5. Your Chosen Hospital List
Insurers have different lists of hospitals where you can receive treatment. A more limited list, perhaps focusing on hospitals in your local area, will result in a lower premium. A comprehensive national list, including the prestigious and expensive private hospitals in Central London, will cost more.
6. Underwriting Method
Underwriting is how an insurer assesses your medical history to decide what they will and won't cover. This is a critical aspect to understand.
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Moratorium Underwriting: This is the most common type. It's simple and doesn't require you to complete a long medical questionnaire. With a moratorium, the insurer will automatically exclude any medical conditions you've had symptoms, treatment, or advice for in the five years before your policy starts. However, if you remain free of symptoms, treatment, or advice for that condition for a continuous two-year period after your policy begins, the exclusion may be lifted.
-
Full Medical Underwriting (FMU): With FMU, you provide detailed information about your medical history upfront. The insurer then reviews this and tells you exactly what is and isn't covered from day one. This gives you more certainty but takes longer to set up.
A Crucial Note: Pre-existing and Chronic Conditions
It is vital to understand that standard UK private medical insurance is designed to cover acute conditions that arise after you take out the policy. An acute condition is one that is curable with treatment.
PMI does not cover pre-existing conditions or chronic conditions. A chronic condition is one that cannot be cured but can be managed, such as diabetes, asthma, or high blood pressure. Treatment for these conditions will continue to be managed by the NHS.
7. Lifestyle Choices: Smoking and Vaping
Insurers consider smokers and vapers to be at a higher risk of developing health problems, from respiratory issues to cancer. Because of this, premiums for smokers and vapers are typically 30% to 50% higher than for non-smokers. Quitting is not only the best thing you can do for your health, but it will also significantly reduce your insurance costs.
How to Make Private Health Insurance More Affordable
Feeling that the costs are adding up? Don't worry. There are several practical ways to bring your premium down to a more comfortable level. An expert broker at WeCovr can walk you through these options to tailor a policy that fits your budget perfectly.
- Increase Your Excess: As shown above, opting for a £250 or £500 excess can lead to substantial savings.
- Choose the '6-Week Wait' Option: This is a clever compromise. With this option, if the NHS waiting list for the inpatient treatment you need is less than six weeks, you use the NHS. If the wait is longer than six weeks, your private policy kicks in. This can reduce your premium by up to 25%.
- Limit Your Hospital List: If you are happy to be treated at local private hospitals rather than having access to every facility in the country, you can opt for a more restricted hospital list and lower your cost.
- Adjust Your Outpatient Cover: Capping your outpatient cover at £1,000 or choosing a policy that only covers diagnostics after a specialist referral can make a big difference.
- Pay Annually: Most insurers offer a small discount (around 5%) if you pay for your policy in one lump sum each year instead of by monthly direct debit.
- Review Your Cover Regularly: Your needs change over time. A yearly review with a broker ensures you're not paying for cover you no longer need.
- Use an Independent Broker: A broker like WeCovr compares quotes from a wide range of leading UK insurers. We do the shopping around for you, finding the best combination of price and cover, all at no cost to you.
What Does Private Health Insurance Typically Cover?
Understanding what's included and what's not is key to avoiding surprises when you need to make a claim.
| Typically Included in a PMI Policy | Typically Excluded from a PMI Policy |
|---|---|
| Inpatient & Day-patient Treatment: Surgery, hospital accommodation, nursing care. | Chronic Conditions: Ongoing management of diabetes, asthma, etc. |
| Cancer Care: A core benefit, including surgery, chemotherapy, radiotherapy, and specialist drugs. | Pre-existing Conditions: Any illness you had before the policy. |
| Specialist Consultations: Access to leading consultants for diagnosis. | Routine GP & A&E visits: These remain with the NHS. |
| Diagnostic Tests: MRI, CT, and PET scans, X-rays, and blood tests. | Normal Pregnancy & Childbirth: Complications may be covered. |
| Mental Health Support: Access to counsellors, therapists, or psychiatrists (if chosen). | Cosmetic Surgery: Unless medically necessary for reconstruction. |
| Therapies: Physiotherapy, osteopathy, and chiropractic care (if chosen). | Self-inflicted Injuries: Injuries from dangerous sports or risky hobbies may be excluded. |
Why Consider Private Health Insurance in 2025?
The NHS is a national treasure, but it is under immense pressure. According to the latest NHS England data, the total waiting list for consultant-led elective care stands at several million people. Many have been waiting over a year for treatment. This is where private medical insurance UK provides a valuable alternative.
The Key Benefits of PMI:
- Speed of Access: Bypass long NHS waiting lists for diagnosis and treatment. This can mean getting a scan in days rather than months, and surgery in weeks rather than years.
- Choice and Control: You can often choose the specialist who treats you and the hospital where you are treated, at a time that suits you.
- Comfort and Privacy: Treatment is usually in a private room with an en-suite bathroom, more flexible visiting hours, and often a better food menu.
- Access to Specialist Drugs and Treatments: Some newer, innovative drugs or treatments may be available privately before they are approved for widespread use on the NHS.
- Peace of Mind: Knowing you have a plan in place to get fast medical care when you need it most can significantly reduce anxiety for you and your family.
Beyond Insurance: WeCovr's Commitment to Your Wellbeing
We believe that your health is your most valuable asset. That's why we go beyond just finding you the right insurance policy. We're committed to supporting your long-term wellness journey.
- Complimentary Access to CalorieHero: When you take out a private health or life insurance policy through WeCovr, you get complimentary access to CalorieHero, our powerful AI-driven calorie and nutrition tracking app. It's an easy and effective way to manage your diet, understand your nutritional intake, and build healthier habits for life.
- Discounts on Other Cover: We value your loyalty. As a WeCovr client, you'll be eligible for exclusive discounts when you take out other types of insurance with us, such as life insurance, income protection, or home insurance.
- A Focus on Proactive Health: Staying healthy is the best way to avoid needing medical treatment. We encourage a holistic approach to wellness:
- Balanced Diet: Focus on whole foods, fruits, vegetables, lean proteins, and healthy fats. Small, consistent changes are more sustainable than drastic diets.
- Regular Activity: Aim for at least 150 minutes of moderate-intensity activity per week, like brisk walking, cycling, or swimming. Find something you enjoy!
- Quality Sleep: Prioritise 7-9 hours of quality sleep per night. It's essential for mental and physical recovery.
- Stress Management: Incorporate mindfulness, meditation, or hobbies to manage stress levels, which has a direct impact on your physical health.
Comparing Top UK PMI Providers
The UK private health insurance market is competitive, with several excellent providers offering a range of policies. Some of the main names you'll come across include:
- Aviva: One of the UK's largest insurers, known for its comprehensive cover and strong digital tools.
- AXA Health: A global leader in insurance with a focus on high-quality medical networks and member support.
- Bupa: A household name in UK healthcare, offering a wide variety of plans and its own network of clinics and hospitals.
- Vitality: Unique for its focus on rewarding healthy living. Members can earn discounts and rewards for being active.
Each provider has its own strengths, specific policy wordings, and pricing structures. This complexity is why using a specialist PMI broker is so valuable. At WeCovr, we have deep knowledge of the market and can quickly identify which insurer offers the best value for your specific circumstances. Our high customer satisfaction ratings reflect our commitment to finding the perfect match for our clients.
Real-Life Cost Examples
To help you visualise the costs, here are a few illustrative examples. Remember, these are estimates and your own quote will be different.
Example 1: The Young Professional
- Person: Sarah, a 32-year-old non-smoking marketing manager living in Birmingham.
- Needs: A solid mid-range policy with good outpatient cover for quick diagnostics, but happy with a local hospital list.
- Chosen Policy (illustrative): Mid-level cover with £1,000 outpatient limit, £250 excess.
- Estimated Monthly Premium: £55 - £70
Example 2: The Family
- People: Mark (44) and Chloe (42), with two children, aged 8 and 11. They are non-smokers living in a suburb of Bristol.
- Needs: Comprehensive cover for the whole family for peace of mind, including mental health support.
- Chosen Policy (illustrative): Comprehensive family cover with full outpatient, therapies, a £500 excess, and a 6-week wait option to manage cost.
- Estimated Monthly Premium: £180 - £240 for the whole family.
Example 3: The Active Retiree
- Person: David, a 66-year-old retired teacher and non-smoker in Devon.
- Needs: A top-tier policy with no shortfalls. He wants full cancer care, a comprehensive hospital list, and no excess.
- Chosen Policy (illustrative): Comprehensive cover with unlimited outpatient, full therapies, and £0 excess.
- Estimated Monthly Premium: £200 - £280
Frequently Asked Questions
Can I get health insurance if I have a pre-existing condition?
Is private health insurance worth it in the UK?
How much does private health insurance cost per month in the UK?
Does private medical insurance cover cancer?
Ready to Find Your Perfect Health Cover?
Understanding the costs is the first step. The next is getting a personalised quote that reflects your unique needs and budget.
Let the expert team at WeCovr do the hard work for you. We'll compare policies from the UK's leading insurers to find you the best possible cover at the best price. Our advice is independent, our service is free, and there's no obligation.
Get your free, personalised health insurance quote today and take control of your health.
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.








