As an FCA-authorised expert with over 800,000 policies of various kinds issued, we at WeCovr understand that navigating the world of private medical insurance in the UK can be complex. This guide is designed specifically for the UK's self-employed workforce, offering clarity on costs, benefits, and how to secure the right cover.
Pricing PMI when you don't have an employer scheme
When you're self-employed, you are your own HR department. Unlike employees who might get private health insurance as a company perk, you're responsible for sourcing and funding your own cover. This might seem daunting, but it also gives you complete freedom to choose a policy that perfectly matches your needs and budget, without being tied to a one-size-fits-all corporate plan.
This article will walk you through every aspect of pricing and choosing a Private Medical Insurance (PMI) policy as a sole trader, freelancer, or limited company director in the UK.
What is Private Medical Insurance (PMI) and Why Should the Self-Employed Consider It?
Private Medical Insurance, often called private health cover, is an insurance policy designed to cover the costs of private healthcare for acute conditions that arise after you take out the policy. An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery.
Crucial Point: Standard UK PMI policies do not cover pre-existing or chronic conditions. A pre-existing condition is any ailment you had before the policy began. A chronic condition is one that is long-lasting and cannot be cured, only managed (e.g., diabetes, asthma, hypertension). PMI is for new, treatable health issues.
For the self-employed, the main benefit of PMI is speed. The inability to work due to illness directly impacts your income. PMI helps you bypass long waiting lists, get diagnosed quickly, and receive treatment promptly, so you can get back to running your business.
The NHS Context:
According to NHS England data, the referral-to-treatment (RTT) waiting list stood at approximately 7.5 million cases in mid-2024. Many patients wait several months for specialist consultations and non-urgent surgery. For a self-employed individual, a long wait can mean significant lost earnings and stress.
Key Benefits of PMI for the Self-Employed:
- Speed of Access: Get fast-track appointments with specialists and schedule surgery at your convenience.
- Choice and Control: Choose your specialist, consultant, and hospital from a list provided by your insurer.
- Comfort and Privacy: Recover in a private room, often with an en-suite bathroom, more flexible visiting hours, and better food options.
- Access to Specialist Drugs & Treatments: Some policies offer cover for drugs or treatments not yet available on the NHS due to cost or pending approval.
- Peace of Mind: Knowing you have a plan in place to protect your health and your business can significantly reduce anxiety.
Key Factors Influencing Your PMI Premium as a Self-Employed Person
Your monthly premium isn't a random number. It's calculated based on several risk factors. Understanding these allows you to tailor a policy to your budget.
1. Your Age
This is one of the most significant factors. As we get older, the statistical likelihood of needing medical treatment increases. Therefore, premiums rise with age. Insurers typically have pricing bands (e.g., 30-34, 35-39), and your premium will adjust as you move into a new band.
2. Your Location (Postcode)
Where you live matters because the cost of private medical treatment varies across the UK. Private hospitals in Central London are the most expensive, so premiums for people living in and around the capital are higher. If you live in a region with lower treatment costs, your premium will be cheaper.
3. Your Chosen Level of Cover
Insurers offer tiered plans, allowing you to balance cost against the comprehensiveness of your cover.
| Level of Cover | What It Typically Includes | Best For |
|---|
| Basic (Core) | In-patient and day-patient treatment: Covers tests and surgery when you are admitted to a hospital bed. Also includes cancer care as standard. | Those on a tight budget wanting cover for major medical events. |
| Mid-Range | Everything in Basic, plus some out-patient cover: Usually a set limit (e.g., £500 - £1,500) for specialist consultations, diagnostic tests, and scans. | A good balance of cost and comprehensive cover for diagnosis and treatment. |
| Comprehensive | Everything in Mid-Range, plus full out-patient cover: No annual limit on out-patient consultations or diagnostics. Often includes extras like mental health support, therapies (physio, osteo), and sometimes dental/optical cover. | Those wanting maximum peace of mind and cover for every step of the journey, from diagnosis to recovery. |
4. The Policy Excess
An excess 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.
The rule is simple: a higher excess leads to a lower monthly premium.
Common excess levels are £0, £100, £250, £500, and £1,000. Choosing a higher excess that you can comfortably afford is an excellent way to make your policy more affordable.
5. Your Hospital List
Insurers group hospitals into tiers based on cost.
- Local/Trust Hospital Lists: Restrict you to specific local hospitals or NHS private wings, offering the lowest premiums.
- National Lists: Give you access to a wide range of private hospitals across the UK, but usually exclude the most expensive ones in Central London.
- Premium/London Lists: Give you unrestricted access to all hospitals, including top-tier facilities in London. This is the most expensive option.
If you don't live near London or are happy to be treated elsewhere, choosing a national or local list can save you a significant amount of money.
6. Underwriting Type
This is how an insurer assesses your medical history to decide what to cover.
- Moratorium Underwriting: This is the most common type. You don't declare your full medical history upfront. Instead, the insurer automatically excludes any condition for which you have had symptoms, advice, or treatment in the 5 years before your policy started. However, if you then go for 2 continuous years on the policy without needing treatment, advice, or medication for that condition, the insurer may reinstate cover for it. It's simple and quick.
- Full Medical Underwriting (FMU): You complete a detailed health questionnaire when you apply. The insurer reviews your medical history and lists any specific conditions that will be permanently excluded from cover. While it involves more paperwork initially, it provides absolute clarity from day one about what is and isn't covered.
7. Lifestyle Factors
Your lifestyle choices, particularly smoking, have a direct impact on your premium. Insurers view smokers and recent ex-smokers as higher risk, and their premiums can be up to 50% higher than for non-smokers.
Average Cost of Private Health Insurance for the Self-Employed in the UK
To give you a clearer picture, here are some estimated monthly costs for a non-smoker with a £250 excess. These are indicative figures from 2024/2025 market analysis; your actual quote will depend on all the factors discussed above.
| Age Bracket | Basic Cover (Est. Monthly Cost) | Mid-Range Cover (Est. Monthly Cost) | Comprehensive Cover (Est. Monthly Cost) |
|---|
| 25-34 | £30 - £45 | £50 - £70 | £80 - £110 |
| 35-44 | £40 - £60 | £65 - £90 | £100 - £140 |
| 45-54 | £55 - £80 | £85 - £120 | £130 - £180 |
| 55-64 | £80 - £120 | £120 - £170 | £180 - £250+ |
Disclaimer: These prices are estimates for guidance purposes only. The only way to know your exact premium is to get a personalised quote based on your unique circumstances.
Is Private Health Insurance a Tax-Deductible Expense for the Self-Employed?
This is a frequent and important question. The tax treatment of PMI depends on your business structure.
For Sole Traders and Partnerships
HMRC generally considers private health insurance a personal expense, not a business one. This means you cannot claim the cost of your PMI premiums as an allowable expense to reduce your income tax bill. You pay for it out of your post-tax income.
For Limited Company Directors
If you run your own limited company, the situation is different.
- For the Company: The company can pay for the director's PMI policy. The premium is considered an allowable business expense, so the company can deduct the cost from its pre-tax profits, reducing its Corporation Tax liability.
- For the Director: The PMI policy is treated as a 'benefit in kind'. This means HMRC sees it as part of your personal income. The value of the premiums will be added to your income for tax purposes, and you will pay income tax on it at your marginal rate (20%, 40%, or 45%). The company must report this on a P11D form. Additionally, the company will have to pay Class 1A National Insurance contributions (currently 13.8%) on the value of the benefit.
While it's not a straightforward "tax-free" perk, paying through a limited company can still be efficient, especially for higher-rate taxpayers. Always consult your accountant for advice tailored to your specific financial situation.
How to Reduce Your Private Health Insurance Costs
Here are seven practical steps you can take to make your private health cover more affordable without sacrificing essential protection.
- Increase Your Excess: As mentioned, opting for a higher excess (£500 or £1,000) is one of the most effective ways to lower your monthly premium.
- Choose a "6-Week Wait" Option: This is a brilliant cost-saving feature. If the NHS can provide the in-patient treatment you need within six weeks of when it should take place, you use the NHS. If the NHS waiting list is longer than six weeks, your private policy kicks in. Because this reduces the likelihood of the insurer having to pay for treatment, it can cut premiums by 20-30%.
- Select a Restricted Hospital List: Unless you have a strong reason to want access to premium London hospitals, choosing a national or even a local hospital list can offer substantial savings.
- Pay Annually: Most insurers offer a discount of around 5% if you pay for your entire year's premium in one go.
- Review Your Cover Level: Be realistic about what you need. Do you require full cover for therapies, or is your main concern getting rapid access to surgery? Paring back non-essential add-ons can make a big difference.
- Maintain a Healthy Lifestyle: Quitting smoking is the single biggest lifestyle change you can make to reduce your premium. Many insurers also offer rewards for staying active.
- Use an Expert PMI Broker: A specialist broker, like WeCovr, can be your most powerful tool. We compare policies from across the entire market to find the best fit for your needs and budget. Our service is free to you, and our expertise often uncovers deals and policy combinations you wouldn't find on your own.
Added Value: Wellness Programmes and Member Benefits
Modern private medical insurance UK providers are increasingly focused on preventative health, not just treatment. Many policies now come with fantastic wellness programmes designed to help you stay healthy.
These can include:
- Discounts on gym memberships and fitness trackers.
- Rewards for hitting activity goals (e.g., free coffee, cinema tickets).
- Digital GP services for 24/7 consultations via phone or video call.
- Mental health support lines and access to therapy sessions.
- Discounts on healthy food.
At WeCovr, we enhance this value further. When you purchase a PMI or Life Insurance policy through us, you receive:
- Complimentary access to CalorieHero, our exclusive AI-powered calorie and nutrition tracking app to support your health goals.
- Discounts on other insurance products, such as income protection or critical illness cover, helping you build a comprehensive financial safety net for less.
Choosing the Best PMI Provider in the UK
The UK market is home to several excellent and well-established insurers. The "best" one truly depends on your individual priorities—whether that's budget, comprehensive mental health cover, or the best wellness rewards.
The main providers you'll encounter include:
- Aviva: One of the UK's largest insurers, known for its comprehensive policies and strong hospital network.
- Bupa: A household name in UK healthcare, offering a wide range of plans and its own network of clinics and hospitals.
- AXA Health: A global insurance giant with a reputation for quality service and innovative health-tech features.
- Vitality: Famous for its wellness-focused approach, rewarding members for staying active with points and discounts.
- The Exeter: A specialist friendly society known for its excellent customer service and flexible underwriting, particularly for those with some medical history.
Comparing these providers and their dozens of policy variations can be overwhelming. This is where an independent broker adds immense value, providing a clear, unbiased comparison tailored to you.
Can I get private health insurance if I have a pre-existing condition?
Yes, you can still get a policy, but the pre-existing condition and any related ailments will be excluded from cover. With 'moratorium' underwriting, this exclusion might be lifted if you go two years without treatment or advice for it after your policy starts. With 'full medical underwriting', the exclusion is typically permanent. It's crucial to be honest about your medical history.
Is PMI worth it for a young, healthy self-employed person?
For many, yes. Firstly, your premiums will be at their lowest when you are young and healthy, making it very affordable. Secondly, it's a risk management tool. An unexpected illness or injury requiring surgery could put you on a long NHS waiting list, leading to months of lost income. The small monthly cost of PMI can be seen as an investment in protecting your ability to earn. Plus, you get access to valuable wellness benefits and 24/7 digital GP services.
How is PMI different from income protection insurance?
They serve two different but complementary purposes. Private Medical Insurance (PMI) pays the medical bills for your private diagnosis and treatment. Income Protection pays you a tax-free monthly income if you are unable to work due to any illness or injury. For a self-employed person, having both provides a powerful safety net: PMI helps you get better faster, and income protection replaces your lost earnings while you recover.
Will my private medical insurance premium increase every year?
It is very likely, yes. Premiums typically increase each year for two main reasons: your age (as you move into a higher-risk age bracket) and 'medical inflation' (the rising cost of healthcare, new technologies, and drugs). This is why it's wise to review your policy annually with a broker, who can check if your current plan is still the most competitive option or if switching insurers could save you money.
Take Control of Your Health and Your Business
Being self-employed means investing in yourself is investing in your business. Private medical insurance is a key part of that investment, providing the security and peace of mind you need to thrive. While the cost can seem like just another expense, the cost of not having it when you need it most can be far greater.
Ready to find a PMI policy that fits your self-employed life? The expert, FCA-authorised team at WeCovr is here to help. We'll do the hard work of comparing the market for you, explaining your options in plain English, and finding a policy that protects your health without breaking the bank.
Get your free, no-obligation quote from WeCovr today and see how affordable peace of mind can be.