TL;DR
As an FCA-authorised broker that has helped secure over 900,000 policies, WeCovr understands that navigating the world of private medical insurance in the UK can be complex. This guide compares Private Medical Insurance (PMI) with Income Protection, helping you decide which is right for your health and financial security. Comparing PMI with protection insurance alternatives When planning for your future, you might wonder about the best way to protect yourself and your family.
Key takeaways
- Private Medical Insurance (PMI) is about your health. It pays for private medical treatment to help you get better, faster.
- Income Protection (IP) is about your finances. It provides a replacement income if you're unable to work due to illness or injury.
- Speed of Access: Get diagnosed and treated faster. NHS waiting lists for non-urgent procedures can be long. According to NHS England data, the median wait time for consultant-led elective care was around 15 weeks in mid-2024, with many waiting much longer.
- Choice and Control: You can often choose your specialist, consultant, and the hospital where you receive treatment.
- Comfort and Privacy: Treatment is usually in a private hospital, often with a private en-suite room, more flexible visiting hours, and better food choices.
As an FCA-authorised broker that has helped secure over 900,000 policies, WeCovr understands that navigating the world of private medical insurance in the UK can be complex. This guide compares Private Medical Insurance (PMI) with Income Protection, helping you decide which is right for your health and financial security.
Comparing PMI with protection insurance alternatives
When planning for your future, you might wonder about the best way to protect yourself and your family. Two key types of insurance often come up: Private Medical Insurance (PMI) and Income Protection (IP).
Many people think they do the same job, but they are fundamentally different.
- Private Medical Insurance (PMI) is about your health. It pays for private medical treatment to help you get better, faster.
- Income Protection (IP) is about your finances. It provides a replacement income if you're unable to work due to illness or injury.
Think of it this way: PMI helps you get the treatment you need, while IP helps you pay your bills while you recover. Let's delve into each one to see how they work and who they're for.
What is Private Medical Insurance (PMI)?
Private Medical Insurance, often called private health cover, is a policy that pays for the cost of private medical treatment 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.
Critical Constraint: PMI does not cover chronic or pre-existing conditions. A chronic condition is one that is long-lasting and requires ongoing management, such as diabetes, asthma, or high blood pressure. A pre-existing condition is any illness or injury you had symptoms or treatment for before your policy started. Standard UK PMI is designed for new, treatable health issues.
Key Benefits of Private Medical Insurance
The main reason people in the UK opt for PMI is to gain more control over their healthcare and bypass potential NHS waiting lists.
- Speed of Access: Get diagnosed and treated faster. NHS waiting lists for non-urgent procedures can be long. According to NHS England data, the median wait time for consultant-led elective care was around 15 weeks in mid-2024, with many waiting much longer.
- Choice and Control: You can often choose your specialist, consultant, and the hospital where you receive treatment.
- Comfort and Privacy: Treatment is usually in a private hospital, often with a private en-suite room, more flexible visiting hours, and better food choices.
- Access to Specialist Treatments: Some policies provide access to drugs or treatments that may not be available on the NHS due to funding decisions.
- Digital GP Services: Most modern policies include 24/7 access to a virtual GP, allowing you to get medical advice quickly from home.
What Does PMI Typically Cover?
Cover is usually split into three categories:
| Cover Type | Description | Example |
|---|---|---|
| In-patient | Covers costs when you are admitted to hospital and stay overnight. This includes surgery, hospital fees, and specialist consultations. | A planned knee replacement surgery requiring a two-night hospital stay. |
| Day-patient | Covers treatment where you are admitted to hospital for a day but do not stay overnight. | A colonoscopy or cataract surgery. |
| Out-patient | Covers diagnostic tests, consultations, and therapies that don't require hospital admission. This is often an optional add-on. | Seeing a specialist for back pain, followed by MRI scans and physiotherapy. |
Most basic policies cover in-patient and day-patient treatment as standard. Comprehensive policies will also include extensive out-patient cover, along with therapies like physiotherapy, osteopathy, and mental health support.
What is Income Protection (IP) Insurance?
Income Protection Insurance is a different beast entirely. It’s a financial safety net. If you become ill or suffer an injury that stops you from working, an IP policy pays you a regular, tax-free monthly income.
This income is designed to replace a portion of your lost earnings, helping you cover essential living costs like:
- Mortgage or rent payments
- Utility bills
- Food and groceries
- Childcare costs
- Loan repayments
Unlike PMI, Income Protection doesn't pay for medical treatment. It gives you the financial stability to focus on your recovery without worrying about how you'll pay the bills. This is especially vital for the self-employed or those with limited sick pay from their employer.
Key Features of Income Protection
Understanding a few key terms is crucial when considering an IP policy.
- Level of Cover: You can typically insure up to 50-70% of your pre-tax gross income. Insurers cap it to ensure you have a financial incentive to return to work.
- Deferred Period: This is the agreed waiting period between when you stop working and when the policy starts paying out. Common options are 4, 8, 13, 26, or 52 weeks. The longer the deferred period, the lower your premium. You should aim to match it to any sick pay you receive from your employer.
- Payment Term: This is how long the policy will pay out for.
- Short-term: Typically pays out for 1, 2, or 5 years per claim.
- Long-term: Can pay out right up until you retire or return to work. This offers the most comprehensive protection but is more expensive.
- Definition of Incapacity: This is one of the most important parts of the policy. It defines what "unable to work" means.
- Own Occupation: The best definition. The policy pays out if you are unable to do your specific job.
- Suited Occupation: Pays out if you cannot do your own job or a similar one for which you are qualified.
- Any Occupation: The most restrictive. Only pays out if you are so incapacitated you cannot do any kind of work.
Always aim for an 'Own Occupation' policy if possible, as it offers the strongest level of protection. An expert PMI broker like WeCovr can help you find policies with this superior definition.
Head-to-Head Comparison: PMI vs. Income Protection
To make the choice clearer, here is a direct comparison of the two types of insurance.
| Feature | Private Medical Insurance (PMI) | Income Protection (IP) |
|---|---|---|
| Primary Purpose | To cover the costs of private medical treatment for acute conditions. | To provide a replacement income if you can't work due to any illness or injury. |
| What it Pays For | Hospital bills, surgeon fees, specialist consultations, diagnostic scans. | Your living expenses (mortgage, bills, food) via a monthly income. |
| Payout Method | Pays the medical provider (hospital, clinic) directly. | Pays a regular, tax-free monthly sum directly to your bank account. |
| Key Benefit | Fast access to treatment, bypassing NHS waiting lists. | Financial security and peace of mind during a period of incapacity. |
| Main Exclusions | Chronic conditions, pre-existing conditions, emergencies, cosmetic surgery. | Pre-existing conditions may be excluded; claims during the deferred period. |
| Cost Influences | Age, location, level of cover, excess, smoker status. | Age, occupation, health, deferred period, percentage of income covered. |
| Tax Treatment | Premiums are not tax-deductible. Payouts (to providers) are not taxed. | Premiums are not tax-deductible. Payouts are tax-free. |
Real-Life Scenarios
Let's see how each policy would work in practice.
Scenario 1: Sarah, the Accountant with Knee Pain
Sarah is a 45-year-old accountant. She develops severe knee pain that makes walking difficult. Her GP refers her to an NHS specialist, but the waiting list for an initial consultation is four months, and the wait for surgery could be over a year.
- With PMI: Sarah uses her private medical insurance. She sees a private consultant within a week. An MRI scan is done a few days later, confirming she needs a partial knee replacement. The surgery is scheduled and completed in a private hospital just six weeks after her initial GP visit. Her PMI provider pays the hospital and surgeon fees directly, totalling over £13,000.
- With Income Protection: Sarah's IP policy would not help her get treated faster. However, if her knee pain became so severe that she had to take three months off work before the surgery, her IP policy (after her chosen 4-week deferred period) would start paying her a monthly income to cover her bills.
Scenario 2: David, the Self-Employed Builder with a Back Injury
David is a 38-year-old self-employed builder. He injures his back while lifting heavy materials and is told by his doctor he cannot work for at least six months. As he's self-employed, he has no sick pay.
- With PMI: David's PMI could get him quick access to physiotherapy or a consultation with a spinal specialist. This might speed up his recovery. However, it wouldn't help him pay his mortgage.
- With Income Protection (illustrative): This is where IP is a lifesaver. David has an IP policy with a 4-week deferred period. After one month off work, his policy starts paying him £2,000 a month (60% of his average earnings). This continues for the six months he is unable to work, ensuring he and his family can cope financially.
How Much Does Private Health Insurance Cost in the UK?
The cost of private health cover varies widely. It's a highly personalised product. The main factors that determine your premium are:
- Age: This is the single biggest factor. Premiums increase as you get older because the risk of health issues rises.
- Location: Living in areas with expensive private hospitals, like Central London, will increase your premium.
- Level of Cover: A basic policy covering only in-patient care will be much cheaper than a comprehensive one with full out-patient, mental health, and dental cover.
- Excess (illustrative): This is the amount you agree to pay towards a claim. A higher excess (e.g., £500) will lower your monthly premium.
- Underwriting:
- Moratorium: Simpler to set up. The insurer automatically excludes treatment for any condition you've had in the last 5 years.
- Full Medical Underwriting: You declare your full medical history. The insurer may place specific exclusions on your policy, but you have certainty from day one.
- Lifestyle: Smokers typically pay more than non-smokers.
Here are some illustrative monthly costs for a non-smoker with a £250 excess. These are examples only; your quote will be specific to you.
| Age | Basic Cover (In-patient only) | Comprehensive Cover (incl. Out-patient) |
|---|---|---|
| 30 | From £35/month | From £60/month |
| 45 | From £55/month | From £90/month |
| 60 | From £95/month | From £150/month |
How Much Does Income Protection Insurance Cost?
Like PMI, Income Protection cost is also highly individual. The key drivers are different, with occupation playing a much larger role.
- Occupation: Insurers classify jobs into risk categories. An office worker (low risk) will pay much less than a scaffolder (high risk).
- Age: Premiums are lower when you're younger and healthier.
- Health: Your medical history and lifestyle (e.g., smoker status) are critical.
- Deferred Period: A 13-week deferred period will be significantly cheaper than a 4-week one.
- Benefit Amount: The more income you want to cover, the higher the cost.
- Payment Term: A long-term policy that covers you until retirement is more expensive than a short-term one that pays for a maximum of 2 years.
Here are some illustrative monthly costs for a non-smoker seeking £2,000/month of cover until age 67, with an 'Own Occupation' definition.
| Age & Occupation | 4-Week Deferred Period | 13-Week Deferred Period |
|---|---|---|
| 30-year-old Office Worker | From £25/month | From £18/month |
| 30-year-old Manual Labourer | From £50/month | From £38/month |
| 45-year-old Office Worker | From £55/month | From £40/month |
| 45-year-old Manual Labourer | From £100/month | From £75/month |
Do I Need PMI, Income Protection, or Both?
The right answer depends on your personal circumstances, priorities, and budget.
You might prioritise PMI if:
- Your main concern is avoiding long NHS waiting lists for diagnosis and treatment.
- You have generous sick pay from your employer or enough savings to cover your expenses for several months.
- You want the comfort and choice that private healthcare offers.
You might prioritise Income Protection if:
- You are self-employed or a contractor with no employee benefits.
- Illustrative estimate: Your employer offers only Statutory Sick Pay (SSP), which was just £116.75 per week in 2024 – not enough for most people to live on.
- You have dependents and a mortgage, and your primary fear is being unable to meet your financial commitments if you fall ill.
The "Belt and Braces" Approach: Having Both
For the most complete protection, having both policies is the ideal scenario. They work together perfectly:
PMI gets you diagnosed and treated quickly, minimising your time away from work. Income Protection secures your finances during your recovery, removing financial stress.
This combination ensures both your health and your wealth are protected.
What About Critical Illness Cover?
There's a third option in the protection family: Critical Illness Cover (CIC).
- How it works: CIC pays out a one-off, tax-free lump sum if you are diagnosed with one of a specific list of serious conditions defined in the policy (e.g., certain types of cancer, heart attack, stroke).
- How it differs from IP: CIC pays a lump sum for a specific diagnosis, regardless of whether you can work. IP pays a monthly income for any illness or injury that prevents you from working, including stress or a bad back, which are not covered by CIC.
| Insurance Type | What triggers a payout? | What does it pay? |
|---|---|---|
| PMI | Needing treatment for an acute medical condition. | The cost of the treatment. |
| Income Protection | Being unable to work due to any illness/injury. | A regular monthly income. |
| Critical Illness Cover | Diagnosis of a specific, defined serious illness. | A one-off lump sum. |
How to Choose the Right Policy: The Role of a Broker
The world of insurance is filled with jargon, complex terms, and dozens of providers. This is where an independent broker is invaluable.
Using a specialist broker like WeCovr costs you nothing, as we are paid by the insurer you choose. We work for you, not the insurance company.
Benefits of using WeCovr:
- Whole-of-Market Advice: We compare policies from all the UK's leading insurers to find the best fit for you.
- Expert Guidance: We explain the differences between policies, helping you understand crucial details like the definition of incapacity or out-patient limits.
- Personalised Recommendations: We take the time to understand your health, finances, and priorities to recommend the right level of cover.
- Hassle-Free Process: We handle the application process for you, saving you time and paperwork.
Enhancing Your Wellbeing with Your Insurance
Modern insurance is no longer just about claims; it's about promoting a healthy lifestyle to prevent illness in the first place. Many of the best PMI providers now include fantastic wellness benefits as standard:
- Discounted gym memberships and fitness trackers.
- 24/7 Virtual GP access.
- Mental health support, including therapy sessions.
- Rewards and points for healthy activities like walking or regular check-ups.
At WeCovr, we go a step further. All our clients who purchase a Private Medical Insurance or Life Insurance policy receive:
- Complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app to help you manage your diet and health goals.
- Exclusive discounts on other types of cover, making it more affordable to build a comprehensive protection portfolio.
We believe in supporting your health journey every day, not just when you need to make a claim. A balanced diet, 7-8 hours of quality sleep, and regular physical activity are the cornerstones of good health, and our tools are designed to help you achieve them.
Does private health insurance cover pre-existing conditions in the UK?
Is Income Protection insurance tax-deductible?
Can I have both Private Medical Insurance and Income Protection?
Why should I use a broker like WeCovr for my insurance?
Ready to find the right protection for you and your family? The choice between PMI and Income Protection is a crucial one, but you don't have to make it alone.
Contact the friendly experts at WeCovr today for a free, no-obligation quote. We'll compare the UK's top insurers to find a policy that perfectly fits your needs and budget.
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.












