Private Health Insurance for Asthma Patients UK
As an FCA-authorised expert broker that has helped arrange over 800,000 policies, WeCovr understands the nuances of private medical insurance in the UK. This guide provides clear, authoritative advice for UK residents with asthma, explaining how PMI works, what is excluded, and where you might still find significant value.
Understanding exclusions and possible coverage options
When you live with a long-term condition like asthma, navigating the world of private medical insurance (PMI) can feel confusing. The single most important rule to understand is this: standard UK private health insurance is designed to cover acute conditions, not chronic ones.
An acute condition is a disease or injury that is sudden in onset, has a limited duration, and is expected to respond to treatment and be cured (like a broken leg or appendicitis). A chronic condition, such as asthma, is a long-term illness that can be managed but not usually cured.
Because asthma is a chronic and pre-existing condition for most applicants, it will be excluded from cover on a new private medical insurance policy. This means the policy will not pay for:
- GP or specialist consultations for your asthma.
- Routine check-ups and asthma reviews.
- Prescriptions for inhalers (preventer or reliever).
- Allergy testing related to your asthma triggers.
- Any planned hospital care for the direct management of your asthma.
However, an exclusion for asthma does not mean you cannot get a health insurance policy. It simply means the policy will not cover that specific condition. You can still receive fast access to private treatment for a vast range of other new, acute conditions that may arise after you take out your policy.
What is Asthma and Why is it Considered a Chronic Condition?
Asthma is a common long-term condition that affects the airways – the small tubes that carry air in and out of the lungs. When a person with asthma comes into contact with a trigger, their airways can become inflamed, swollen, and narrow, and produce extra mucus. This makes it difficult to breathe, leading to symptoms like coughing, wheezing, shortness of breath, and a tight chest.
According to NHS data, around 5.4 million people in the UK are currently receiving treatment for asthma. That's one in every 12 adults. It is a lifelong, or 'chronic', condition because there is currently no cure. It requires ongoing management through medication and lifestyle adjustments.
This is the fundamental reason why private health insurers in the UK exclude it from cover. Their business model is based on insuring against the risk of unforeseen, short-term medical problems, not the predictable costs of managing an ongoing illness.
| Feature | Acute Condition (e.g., Pneumonia) | Chronic Condition (e.g., Asthma) |
|---|---|---|
| Onset | Sudden | Gradual or can start at any time |
| Duration | Short-term | Long-term or lifelong |
| Outcome | Curable, full recovery expected | Manageable, but not typically curable |
| PMI Coverage | Covered | Excluded |
Understanding this distinction is the key to having realistic expectations about what private health cover can offer you as someone with asthma.
How UK Private Health Insurers View Asthma
When you apply for private medical insurance, the insurer needs to understand your medical history to determine what they can and cannot cover. This process is called underwriting. For someone with asthma, this will happen in one of two ways.
1. Moratorium Underwriting
This is the most common type of underwriting for individual policies because it's quick and requires no medical forms upfront.
- How it works: A moratorium policy automatically excludes any medical condition (including asthma) for which you have had symptoms, medication, or advice in the 5 years before your policy start date.
- The "2-year rule": The insurer may lift this exclusion for a specific condition if you complete 2 full, continuous years on the policy without experiencing any symptoms, taking medication, or seeking any advice for that condition.
- For asthma: Because asthma requires ongoing management (even just having a reliever inhaler on standby is considered 'treatment'), it is highly unlikely that the 2-year symptom-free period will ever be met. Therefore, with moratorium underwriting, your asthma will effectively be permanently excluded.
2. Full Medical Underwriting (FMU)
With FMU, you complete a detailed health questionnaire as part of your application, declaring your full medical history, including your asthma.
- How it works: The insurer's underwriting team reviews your health information. Based on your declared asthma, they will place a specific exclusion on your policy.
- The outcome: The insurer will write to you to confirm your policy terms, which will include an explicit clause stating that asthma and any related conditions are not covered.
- Clarity: The main advantage of FMU is clarity. You know from day one exactly what is and isn't covered, with no ambiguity.
Here's a comparison for an applicant with asthma:
| Underwriting Type | Application Process | Outcome for Asthma | Best For |
|---|---|---|---|
| Moratorium | Quick, no forms. Insurer finds out about your history at the point of a claim. | Automatically excluded as a pre-existing condition. Unlikely to ever be covered. | Someone who wants a fast application and is happy for recent conditions to be excluded. |
| Full Medical Underwriting (FMU) | Longer, requires filling out a detailed health questionnaire. | Explicitly excluded in the policy terms from the start. | Someone who wants complete certainty about what is and isn't covered from day one. |
An expert PMI broker, like WeCovr, can talk you through both options and help you decide which underwriting method is more suitable for your personal circumstances.
Can Private Health Insurance Cover Asthma at All? The Important Nuances
While the routine management of your asthma is excluded, a PMI policy can still be incredibly valuable. The benefits lie in two key areas: covering unrelated conditions and potentially covering diagnostics for new symptoms.
Unrelated Acute Conditions are Covered
This is the primary reason people with chronic conditions buy private health insurance. Having asthma does not stop you from developing other health problems. Should you need treatment for a new, eligible condition, your policy will give you fast access to private care.
Examples of what your PMI policy WOULD cover:
- Joint replacement: If you need a hip or knee replacement due to arthritis.
- Cancer care: Comprehensive cover for diagnosis and treatment (chemotherapy, radiotherapy, surgery) if you are diagnosed with cancer after your policy begins.
- Hernia repair: Quick access to surgery.
- Cardiology: Investigations and treatment for a new heart condition.
- Mental health: Access to therapists or psychiatrists for conditions like anxiety or depression (subject to policy limits).
- Diagnostic scans: Quick access to MRI, CT, and PET scans for eligible conditions.
For many, the peace of mind of knowing they can bypass lengthy NHS waiting lists for these major treatments is worth the investment.
Diagnostics for New Symptoms: A Grey Area
This is a more nuanced but potentially valuable benefit. Imagine you develop a new and persistent cough that feels different from your usual asthma symptoms. You and your GP are concerned it could be something more serious.
In this scenario, your PMI policy may cover the costs of the initial investigation to find the cause.
- Your GP refers you to a private respiratory specialist.
- The specialist recommends a chest X-ray and a CT scan to rule out other conditions.
- Your PMI policy would likely cover these diagnostic tests.
- Scenario A: The tests reveal a new, acute condition (e.g., a lung infection or, in a worse-case scenario, lung cancer). Your PMI would then cover the subsequent treatment for that new condition.
- Scenario B: The tests conclude that the new cough is simply an unusual manifestation of your asthma. At this point, PMI cover would cease, and you would revert to the NHS for any further asthma management.
Even in Scenario B, the ability to get a diagnosis quickly and rule out serious illness provides immense peace of mind.
Real-Life Scenarios: PMI for Asthma Patients in Action
Let's look at how this works in practice.
Scenario 1: Routine Management
- Person: Ben, 35, has had mild asthma since he was a teenager.
- Situation: He attends his annual asthma review with the NHS nurse and gets his prescription for his Ventolin (reliever) and Clenil Modulite (preventer) inhalers.
- PMI Role: None. This is routine, chronic care and is correctly managed by the NHS. His PMI policy does not cover these costs.
Scenario 2: An Unrelated Injury
- Person: Chloe, 45, has well-controlled asthma.
- Situation: She tears a ligament in her shoulder while gardening. The NHS waiting list for specialist consultation and potential surgery is 9 months.
- PMI Role: Full coverage. Chloe uses her PMI. She sees a private orthopaedic consultant within a week, has an MRI scan three days later, and undergoes keyhole surgery a fortnight after that. Her asthma is irrelevant to this claim.
Scenario 3: An Acute Flare-Up
- Person: David, 50, has moderate asthma.
- Situation: He catches a severe chest infection, which triggers a sudden and life-threatening asthma attack requiring hospitalisation.
- PMI Role: Potentially covered. This is the most complex scenario. Some high-end policies may treat a single, unexpected, severe exacerbation of a chronic condition as an 'acute episode'. They might cover the private hospital stay and treatment needed to get him through the crisis. However, they will not cover any follow-up care or changes to his long-term asthma management plan. This type of cover is not standard and depends heavily on the insurer and the specific policy wording.
Choosing the Right Private Health Insurance with Asthma
If you've decided that the benefits of covering new, acute conditions are worthwhile, here are the steps to finding the right policy.
-
Be 100% Honest: Always declare your asthma and any other medical conditions fully and accurately during the application. Failing to do so is known as 'non-disclosure' and could lead to your policy being cancelled and any claims being rejected.
-
Focus on Core Benefits: Since your asthma will be excluded, concentrate on the other aspects of the policy. Look for policies with strong cancer cover, good mental health support, and a comprehensive list of included hospitals.
-
Explore Value-Added Benefits: Modern PMI is more than just hospital cover. Many policies include perks that are available to all members, regardless of exclusions.
- 24/7 Digital GP: Get immediate video consultations for any health worry, offering advice and reassurance.
- Wellness Programmes: Insurers like Vitality reward you for staying active with cinema tickets, coffee, and discounts. Regular exercise is often recommended for improving asthma control.
- Mental Health Support: Access to telephone counselling or therapy sessions without needing a GP referral.
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Speak to an Independent Broker: This is the single most effective way to navigate the market. An independent broker like WeCovr works for you, not the insurer. We can:
- Compare policies from all leading UK providers (like Bupa, AXA Health, Vitality, and The Exeter).
- Explain the fine print and how each insurer would treat your specific situation.
- Find the most competitive price for the level of cover you need.
- Help you with the application process, ensuring everything is declared correctly.
- This service comes at no extra cost to you.
Wellness, Diet, and Managing Your Asthma
While your PMI policy won't manage your asthma, taking control of your health can improve your quality of life and potentially reduce your reliance on medical care.
- Know Your Triggers: Work with your NHS GP or asthma nurse to identify what triggers your asthma. Common triggers include pollen, dust mites, animal fur, smoke, and cold air.
- Asthma Action Plan: Ensure you have a written asthma action plan. This will tell you what to do daily, what to do when your symptoms get worse, and what to do in an emergency.
- Healthy Weight: Being overweight can worsen asthma symptoms. A balanced diet and regular exercise can help you manage your weight. As a WeCovr client, you get complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, to support your health goals.
- Exercise: Contrary to old beliefs, regular physical activity can strengthen your lungs and improve asthma control. Activities like swimming, yoga, and walking are often recommended. Always use your reliever inhaler before exercise if advised by your doctor.
- Don't Smoke: Smoking is one of the worst things you can do for your lungs, especially if you have asthma.
By purchasing a policy through WeCovr, you may also be eligible for discounts on other types of insurance, such as life insurance or income protection, helping you build a complete financial safety net.
Do I need to declare my asthma when applying for private health insurance?
Will my private health insurance premiums be higher because I have asthma?
Can I get private health insurance if my asthma is very mild?
What is the difference between moratorium and full medical underwriting for an asthma patient?
Take the Next Step
Living with asthma means relying on the fantastic care of the NHS for your chronic condition management. Private medical insurance runs alongside this, offering you speed, choice, and peace of mind for new and unexpected health issues.
To explore your options and get a clear picture of how a policy could benefit you, speak to an expert.
Contact WeCovr today for a free, no-obligation quote. Our friendly, expert advisors will compare the UK's leading insurers to find the right private health cover for your unique needs and budget.
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
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