TL;DR
As an FCA-authorised broker that has helped arrange over 900,000 policies of various kinds, WeCovr understands the unique challenges of returning to the UK. This guide explains everything you need to know about securing private medical insurance after living abroad, ensuring a smooth transition for your health and wellbeing.
Key takeaways
- Bypass NHS Waiting Lists: This is the primary driver for most people buying PMI. Instead of waiting months for a diagnosis or treatment, you can often be seen by a specialist within days or weeks.
- Choice of Specialist and Hospital: PMI gives you control over your care. You can choose the consultant you want to see and select from a nationwide network of high-quality private hospitals.
- Privacy and Comfort: Private hospitals typically offer private en-suite rooms, more flexible visiting hours, and a quieter environment, which can significantly aid recovery.
- Access to Advanced Treatments: Some policies provide access to drugs or treatments that may not yet be available on the NHS due to cost or licensing restrictions (as guided by the National Institute for Health and Care Excellence, NICE).
- Peace of Mind: Knowing you have a plan in place for your health provides invaluable peace of mind during the potentially stressful period of resettling in the UK.
As an FCA-authorised broker that has helped arrange over 900,000 policies of various kinds, WeCovr understands the unique challenges of returning to the UK. This guide explains everything you need to know about securing private medical insurance after living abroad, ensuring a smooth transition for your health and wellbeing.
WeCovr explains how to get cover if you've lived abroad
Returning to the United Kingdom after a period overseas is an exciting time, but it also comes with a significant to-do list. Alongside finding a home, sorting out finances, and reconnecting with family and friends, arranging healthcare is a top priority. While the National Health Service (NHS) is a national treasure, many returning expats choose the security and speed of private medical insurance (PMI) to complement it.
The process of getting PMI as a returning expat has a few extra layers compared to someone who has always lived in the UK. Your lack of a recent UK medical history can affect how insurers assess your application. This guide will walk you through every step, demystifying the process and empowering you to make the best choice for your health.
Are You Eligible for NHS Treatment Upon Your Return?
Before diving into private options, it’s vital to understand your entitlement to NHS care. The key principle is being 'ordinarily resident' in the UK.
An individual is considered ordinarily resident if they are living in the UK on a "lawful and properly settled basis for the time being." For a returning British citizen, this generally means that once you move back with the intention of residing here permanently, you regain your right to NHS treatment.
Key points for returning expats:
- Intention to Reside: You must demonstrate that you intend to stay in the UK. This can be shown through actions like renting or buying a property, enrolling children in school, or securing employment.
- No Waiting Period: There is no formal qualifying period. Your entitlement usually begins from the day you arrive back in the UK to live permanently.
- Register with a GP: One of your first actions should be to register with a local GP surgery. You will need to provide proof of your new address (like a utility bill or tenancy agreement) and your identity.
While you are entitled to NHS care, you may face the same challenges as any other resident. NHS waiting times for elective procedures remain a significant concern. According to NHS England data, the median wait time for non-urgent consultant-led treatment has been fluctuating around 14 weeks, with over 300,000 patients waiting more than a year for treatment (NHS England, Performance Data 2024/2025 projections). It is this reality that drives many to seek private health cover.
Why Returning Expats Should Consider Private Medical Insurance
Private health insurance is not a replacement for the NHS, which provides excellent emergency and critical care. Instead, it works alongside it, offering you more choice, control, and convenience for non-emergency medical needs.
For a returning expat, the benefits are particularly compelling:
- Bypass NHS Waiting Lists: This is the primary driver for most people buying PMI. Instead of waiting months for a diagnosis or treatment, you can often be seen by a specialist within days or weeks.
- Choice of Specialist and Hospital: PMI gives you control over your care. You can choose the consultant you want to see and select from a nationwide network of high-quality private hospitals.
- Privacy and Comfort: Private hospitals typically offer private en-suite rooms, more flexible visiting hours, and a quieter environment, which can significantly aid recovery.
- Access to Advanced Treatments: Some policies provide access to drugs or treatments that may not yet be available on the NHS due to cost or licensing restrictions (as guided by the National Institute for Health and Care Excellence, NICE).
- Peace of Mind: Knowing you have a plan in place for your health provides invaluable peace of mind during the potentially stressful period of resettling in the UK.
The Golden Rule of UK PMI: Acute vs. Chronic Conditions
This is the most critical concept to understand before you consider any policy. Standard private medical insurance in the UK is designed to cover acute conditions, not chronic ones.
- Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include joint replacements, cataract surgery, hernia repair, and treating infections.
- Chronic Condition: A disease, illness, or injury that has one or more of the following characteristics: it needs long-term monitoring, continues indefinitely, has no known cure, or is likely to recur. Examples include diabetes, asthma, high blood pressure, and arthritis.
The NHS provides ongoing management for chronic conditions. PMI steps in for the new, unexpected, and curable issues that arise after your policy begins.
Crucially, PMI also does not cover pre-existing conditions. These are any health issues you knew about, had symptoms of, or received treatment for before your policy started. We will explore how insurers handle this in the underwriting section below.
The Application Process for Returning Expats: Underwriting Explained
Because you've been living abroad, you likely won't have a continuous UK GP record for the past several years. This is the main difference in your application process. Insurers use a process called 'underwriting' to assess your health status and decide the terms of your cover.
There are two main types of underwriting. The one you choose has a significant impact on what is and isn't covered.
| Underwriting Type | How It Works | Pros | Cons | Best For... |
|---|---|---|---|---|
| Moratorium (Mori) | You don't declare your full medical history upfront. Instead, the policy automatically excludes any condition you've had symptoms of or treatment for in the last 5 years. If you then go 2 continuous years without any symptoms, treatment, or advice for that condition after your policy starts, it may become eligible for cover. | Quicker and simpler application process. Less intrusive. | Less certainty at the start. Claims can be slower as the insurer will investigate your medical history at the point of claim. | Those with a clean bill of health or minor past issues who want a fast application. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire, disclosing your entire medical history. The insurer assesses this information and tells you upfront exactly what will be excluded from your policy from day one. | Complete clarity from the start. You know precisely what is and isn't covered. Claims are often faster as the underwriting is done. | The application process is longer and more detailed. May require you to obtain medical records from your previous country of residence. | Those with a more complex medical history who want certainty, or anyone who prefers clarity over speed. |
Which is right for a returning expat?
This is a personal choice. If you are in good health and haven't needed medical care for years, a moratorium policy can be a simple and fast way to get cover.
However, if you have had any health niggles, consultations, or treatments while abroad, Full Medical Underwriting provides valuable certainty. It avoids the potential disappointment of having a claim rejected down the line because it relates to something you experienced in the five years before your policy began. An expert PMI broker can help you navigate this decision based on your personal circumstances.
Structuring Your PMI Policy: What Are Your Options?
Private health insurance isn't a one-size-fits-all product. Policies are modular, allowing you to build a level of cover that suits your needs and budget.
Here’s a breakdown of the typical components:
1. Core Cover (In-patient and Day-patient) This is the foundation of every PMI policy. It covers treatment where you are admitted to a hospital bed, either overnight (in-patient) or for the day (day-patient). This includes:
- Hospital accommodation and nursing care
- Surgeon and anaesthetist fees
- Specialist consultations while in hospital
- Diagnostics like MRI scans and CT scans while admitted
2. Out-patient Cover (Optional Add-on) This is one of the most important optional extras. It covers diagnostic tests and consultations with a specialist that do not require a hospital bed. Without this, you would rely on the NHS for the initial diagnosis phase before being able to use your PMI for treatment.
- Levels: Insurers typically offer different levels of out-patient cover, from a set monetary amount per year (e.g., £500, £1,000, £1,500) to a fully comprehensive option.
3. Therapies Cover (Optional Add-on) This covers treatment from recognised practitioners like:
- Physiotherapists
- Osteopaths
- Chiropractors
- Acupuncturists
This is particularly valuable for musculoskeletal issues, which are a common reason for making a claim.
4. Mental Health Cover (Optional Add-on) Awareness of mental wellbeing has grown, and most insurers now offer a mental health add-on. This can cover consultations with psychiatrists and psychologists, and sometimes in-patient psychiatric care.
5. Other Options to Customise Your Plan
- Hospital List: Insurers have different tiers of hospitals. Choosing a more restricted local list instead of a nationwide list including central London hospitals can significantly reduce your premium.
- Excess: This is the amount you agree to pay towards a claim, similar to car insurance. A higher excess (e.g., £250 or £500) will lower your monthly premium.
- Six-Week Option: This is a popular way to reduce costs. The policy will only pay for in-patient treatment if the wait for that treatment on the NHS is longer than six weeks. If the NHS can treat you within that timeframe, you use the NHS.
Example Policy Structures
| Policy Tier | Core Cover | Out-patient Cover | Therapies | Key Benefit | Ideal For |
|---|---|---|---|---|---|
| Basic (Budget) | Yes | Limited (e.g., £500) or none | Often excluded | Affordable cover for major in-patient procedures. May have a 6-week wait option. | Younger individuals or those on a tight budget wanting a safety net for serious issues. |
| Mid-Range (Standard) | Yes | Mid-level (e.g., £1,500) | Included | Balanced cover for diagnosis and treatment without excessive cost. | The majority of people, offering a good blend of benefits and value. |
| Comprehensive (Premium) | Yes | Full cover | Included, often with higher limits | Maximum peace of mind, fast access to all stages of care, and often includes more extensive mental health cover. | Those who want the highest level of reassurance and minimal reliance on NHS waiting lists. |
How Much Does Private Health Cover Cost for a Returning Expat?
The cost of private medical insurance in the UK is highly individual. Insurers calculate your premium based on several risk factors.
| Factor | Impact on Premium | Why? |
|---|---|---|
| Age | High | The likelihood of needing medical treatment increases with age. This is the single biggest factor. |
| Location | Medium | Private hospital costs vary across the country. London and the South East are typically more expensive. |
| Level of Cover | High | The more comprehensive your policy (e.g., full out-patient, mental health), the higher the cost. |
| Policy Excess | High | Agreeing to pay more towards a claim (a higher excess) directly reduces your premium. |
| Hospital List | Medium | A more extensive hospital list, especially with prime London hospitals, increases the price. |
| No Claims Discount | High | Like car insurance, you build up a discount for every year you don't claim, which can reduce future premiums. |
| Smoker Status | Medium | Smokers are considered a higher health risk and will pay more than non-smokers. |
As a guideline, a healthy 40-year-old returning to the UK might expect to pay between £60 and £90 per month for a good mid-range policy. A 55-year-old might see quotes in the region of £90 to £140 per month for similar cover. These are purely illustrative; your actual quote will depend on the factors above.
The Value of an Independent PMI Broker
Navigating the market, comparing dozens of policies, and understanding the nuances of underwriting can be overwhelming, especially when you're also managing an international move. This is where an independent PMI broker like WeCovr adds immense value.
- Expert Knowledge: We understand the specific challenges faced by returning expats and know which insurers are best equipped to handle applications without a recent UK medical history.
- Market Comparison: We compare policies from a wide range of leading UK insurers to find the right cover for your needs and budget.
- No Extra Cost: Our service is free to you. We are paid a commission by the insurer you choose, but this does not affect the premium you pay.
- Application Support: We help you complete the paperwork correctly, especially for Full Medical Underwriting, ensuring the process is as smooth as possible.
- Ongoing Service: We are here to help at renewal or if you need to make a claim. Our high customer satisfaction ratings reflect our commitment to our clients.
Health and Wellness: Staying Healthy During Your Transition
Moving countries can be stressful, which can take a toll on your physical and mental wellbeing. Proactively managing your health during this period is crucial.
- Prioritise Sleep: Jet lag and the stress of moving can disrupt your sleep patterns. Aim for 7-9 hours of quality sleep per night. Establish a regular sleep routine, avoid caffeine late in the day, and create a restful bedroom environment.
- Maintain a Balanced Diet: It can be tempting to rely on takeaways and convenience food when you’re busy unpacking. Try to incorporate plenty of fruits, vegetables, lean proteins, and whole grains into your diet. Good nutrition is fundamental to both physical energy and mental resilience.
- Stay Active: Regular physical activity is a powerful stress-reliever. Even a brisk 30-minute walk each day can boost your mood and improve your health. Explore local parks or join a gym to help build a new routine.
- Reconnect and Build a Support Network: Loneliness and isolation can be challenges when you first return. Make a conscious effort to reconnect with old friends and family. Join local community groups, sports clubs, or hobby classes to meet new people.
To support your wellness journey, WeCovr provides all our health and life insurance clients with complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app. It’s a simple way to monitor your diet and make healthier choices as you settle back into UK life.
Furthermore, clients who purchase a private medical insurance policy through WeCovr are often eligible for discounts on other types of cover, such as life insurance or income protection, helping you build a comprehensive financial safety net for your family.
Frequently Asked Questions (FAQ) for Returning Expats
Here are answers to some of the most common questions we receive from expats returning to the UK.
1. Do I need international health insurance once I move back to the UK? No, once you become ordinarily resident in the UK again, a domestic UK private medical insurance policy is the correct and more cost-effective choice. International policies are designed for those living abroad and are significantly more expensive. They are not suitable for UK residents.
2. Can I get cover for a health condition I developed while living abroad? No, standard UK private medical insurance does not cover pre-existing conditions. Any condition you have received diagnosis, treatment, or advice for before your policy starts will be excluded, either permanently (with Full Medical Underwriting) or for a set period (with a Moratorium). PMI is for new, eligible conditions that arise after you take out the policy.
3. How do I prove my medical history to a UK insurer if my records are overseas? If you opt for Full Medical Underwriting, you may need to provide records from your doctor or hospital abroad. Insurers are experienced in handling this. They may ask you to request the records yourself, or in some cases, they may be able to request them on your behalf with your consent. For a Moratorium policy, this is not required upfront.
4. What happens if I need medical care before I’ve had a chance to register with a GP? Upon your return to the UK as a resident, you are entitled to emergency NHS care via A&E regardless of your GP registration status. For non-emergencies, you should register with a GP as a priority. Some areas have walk-in centres for urgent but non-life-threatening issues. Your PMI policy will require a GP referral for most specialist consultations, making GP registration essential.
5. How long does it take to get a PMI policy in place? The timeline depends on the type of underwriting. A policy with Moratorium underwriting can often be set up on the same day or within 24-48 hours. A policy with Full Medical Underwriting will take longer, typically 1-3 weeks, as it involves a detailed assessment of your health questionnaire and potentially obtaining further medical information.
Your Next Step
Returning to the UK is a major life event. Securing the right private health cover provides the reassurance that you and your family can access high-quality medical care quickly, allowing you to focus on building your new life back home.
The UK PMI market is complex, but you don’t have to navigate it alone. Our expert advisors at WeCovr are here to provide clear, independent advice tailored to your unique situation as a returning expat.
Contact WeCovr today for a free, no-obligation quote and discover how affordable peace of mind can be.
Sources
- NHS England: Waiting times and referral-to-treatment statistics.
- Office for National Statistics (ONS): Health, mortality, and workforce data.
- NICE: Clinical guidance and technology appraisals.
- Care Quality Commission (CQC): Provider quality and inspection reports.
- UK Health Security Agency (UKHSA): Public health surveillance reports.
- Association of British Insurers (ABI): Health and protection market publications.
