As FCA-authorised expert brokers who have helped arrange over 800,000 policies, we at WeCovr know that navigating the UK private medical insurance market can feel complex. This guide simplifies everything you need to know about finding the right individual policy in 2025, ensuring your health is in safe hands.
Tailored PMI for single adults — cover types, pricing and best providers
Choosing private medical insurance (PMI) is a significant decision, especially for an individual. You're not just buying a policy; you're investing in peace of mind, rapid access to medical care, and control over your health journey. In 2025, with the healthcare landscape continually evolving, understanding your options is more crucial than ever.
This guide is designed for single adults in the UK. We'll break down the types of cover available, explain how your premiums are calculated, compare the leading providers, and show you how to get the best possible value for your money.
What is Private Health Insurance and Why Consider It in 2025?
Private health insurance is a policy that covers the cost of private medical treatment for acute conditions. An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery.
The core benefit? Bypassing potential NHS waiting times for eligible treatments.
The UK Healthcare Landscape in 2025
The National Health Service (NHS) is a world-class institution, but it's facing unprecedented pressure. According to the latest data from NHS England, the waiting list for routine hospital treatment remains stubbornly high, with millions of people waiting for procedures. As of mid-2024, the referral-to-treatment waiting list stood at approximately 7.5 million.
For an individual, this can mean long, anxious waits for diagnostics, consultations, and surgery, potentially impacting your work, finances, and overall quality of life.
Key Benefits of Individual Private Health Cover
Opting for PMI offers several compelling advantages:
- Speed of Access: Get prompt appointments for specialist consultations, diagnostic tests like MRI and CT scans, and surgery.
- Choice and Control: You can often choose your specialist or surgeon and select a hospital from a pre-approved list, including one that is convenient for you.
- Comfort and Privacy: Treatment is typically in a private hospital with your own en-suite room, offering a more comfortable and peaceful environment for recovery.
- Access to Specialist Drugs & Treatments: Some policies provide access to new-generation drugs or treatments that may not yet be available on the NHS due to funding decisions.
- Peace of Mind: Knowing you have a plan in place to deal with unexpected health issues can significantly reduce stress and anxiety.
Understanding Cover Types: What Does Individual PMI Include?
PMI policies are built in layers. You start with a core foundation and then add optional extras to tailor the cover to your specific needs and budget.
Core Cover: The Foundation of Your Policy
Nearly all private health insurance policies include in-patient and day-patient treatment as standard.
- In-patient Treatment: This is when you are admitted to a hospital and need to stay overnight for one or more nights for treatment, such as for a hip replacement or heart surgery.
- Day-patient Treatment: This involves a planned medical procedure or surgery where you are admitted to a hospital but do not need to stay overnight. Examples include cataract surgery or an endoscopy.
Core cover almost always includes costs for surgery, hospital accommodation, nursing care, specialist fees, and anaesthetics. Comprehensive cancer cover is also often included as part of the core package, though the level of cover can vary significantly between providers.
Out-patient Cover: The Most Popular Add-on
Out-patient cover is arguably the most important optional extra. It covers medical care where you don't need to be admitted to a hospital. This includes:
- Specialist Consultations: Seeing a consultant cardiologist or dermatologist after a GP referral.
- Diagnostic Tests and Scans: MRI, CT, PET scans, X-rays, and blood tests to find out what's wrong.
Without out-patient cover, you would rely on the NHS for diagnosis and then use your PMI only for the subsequent in-patient treatment. Adding it creates a fully private healthcare journey from start to finish.
| Cover Level | What's Typically Included | Best For |
|---|
| Core (In-patient Only) | Surgery, hospital stays, nursing care, cancer treatment. | Individuals on a tighter budget who are happy to use the NHS for diagnosis. |
| Comprehensive (In- & Out-patient) | All core benefits plus specialist consultations and diagnostic scans. | Individuals wanting a complete private pathway, from initial diagnosis to treatment. |
Most insurers offer different levels of out-patient cover, such as a cap of £500, £1,000, or unlimited cover per year. Choosing a lower limit is a great way to reduce your premium while still having valuable cover.
Beyond out-patient cover, you can add other modules:
- Therapies Cover: This covers treatments like physiotherapy, osteopathy, and chiropractic care, often up to a set number of sessions per year. It's invaluable for sports injuries or musculoskeletal problems.
- Mental Health Cover: This has become an increasingly important option. It can provide cover for consultations with a psychiatrist or psychologist and may include in-patient care for psychiatric conditions.
- Dental & Optical Cover: This helps with the costs of routine dental check-ups, treatments, and eye tests or new glasses. It's often less comprehensive than dedicated dental plans but can be a convenient addition.
A Critical Note: What PMI Does Not Cover
Understanding the exclusions is just as important as knowing what's included. UK private medical insurance is designed for a specific purpose, and it does not cover everything.
Crucially, standard UK PMI policies do not cover:
- Pre-existing Conditions: Any disease, illness, or injury for which you have had symptoms, medication, advice, or treatment before your policy started. Most policies will exclude these for a set period (usually two years) and may cover them later if you remain symptom-free. We'll explore this further in the underwriting section.
- Chronic Conditions: Long-term conditions that cannot be cured but can be managed. Examples include diabetes, asthma, high blood pressure, and most forms of arthritis. PMI is for acute conditions. If you develop a chronic condition after taking out a policy, your insurer will typically cover the initial diagnosis and stabilisation, but ongoing management will revert to the NHS.
- Emergency Services: A&E visits are handled by the NHS. You would never call your insurer in a medical emergency.
- Normal Pregnancy & Childbirth: While complications of pregnancy may be covered, routine maternity care is not.
- Cosmetic Surgery: Procedures that are not medically necessary.
- Self-inflicted Injuries and treatment related to substance abuse.
An expert broker like WeCovr can help you understand the specific exclusions of each policy, ensuring there are no surprises when you need to make a claim.
How is Your PMI Premium Calculated? Key Pricing Factors
Insurers use several factors to determine your monthly or annual premium. Understanding these levers is key to tailoring a policy that fits your budget.
- Age: This is the most significant factor. The older you are, the higher the statistical likelihood of needing medical treatment, so premiums increase with age.
- Location: Your postcode matters. Premiums are generally higher in major cities, especially London, due to the higher cost of private medical treatment in those areas.
- Level of Cover: A basic, core-only policy will be the cheapest. Adding comprehensive out-patient cover, therapies, and mental health support will increase the price.
- Excess: This 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 rest. Choosing a higher excess (£250, £500, or even £1,000) will significantly lower your premium.
- Hospital List: Insurers have tiered lists of hospitals. A policy that includes premium central London hospitals will cost more than one with a standard nationwide list. If you don't live near London, opting for a more restricted list is an easy way to save money.
- Underwriting Type: The method the insurer uses to assess your medical history affects your cover and sometimes the price.
Example Monthly Premiums for an Individual
These are illustrative costs for a non-smoker with a £250 excess and comprehensive cover. Prices vary widely.
| Age | Location (Manchester) | Location (Central London) |
|---|
| 30 | £55 - £75 | £70 - £95 |
| 40 | £70 - £90 | £90 - £120 |
| 50 | £95 - £130 | £120 - £170 |
| 60 | £150 - £210 | £190 - £260 |
Choosing the Right Underwriting for Your Policy
When you apply for PMI, the insurer needs to know about your medical history to determine what they will and won't cover. There are two main ways they do this.
Moratorium (Mori) Underwriting
This is the most common type for individuals. It's quick and easy as you don't need to complete a detailed medical questionnaire.
- How it works: The insurer automatically excludes any medical condition you've had in the 5 years before your policy starts.
- The "2-Year Rule": If you then go for a continuous 2-year period after your policy start date without having any symptoms, treatment, medication, or advice for that condition, the insurer may add it to your cover.
- Downside: There can be ambiguity. A claim might be delayed while the insurer investigates whether the condition is new or pre-existing.
Full Medical Underwriting (FMU)
This involves full disclosure from the outset.
- How it works: You complete a detailed health questionnaire, declaring your full medical history. The insurer's underwriting team assesses it and tells you exactly what is covered and what is excluded from day one.
- Upside: You have complete certainty about what your policy covers. This can make the claims process much smoother.
- Downside: It takes more time to set up, and any conditions you declare will likely be permanently excluded.
| Feature | Moratorium Underwriting | Full Medical Underwriting (FMU) |
|---|
| Application Process | Quick and simple, no health forms. | Detailed health questionnaire required. |
| Initial Certainty | Lower. Cover for past conditions is unclear. | High. Exclusions are clearly stated upfront. |
| Claims Process | Can be slower as insurer may need to check medical history. | Generally faster as cover is pre-agreed. |
| Cover for Past Conditions | May become eligible for cover after a 2-year clear period. | Conditions are usually excluded permanently. |
| Best For | Healthy individuals with no recent medical issues. | People who want absolute clarity and have a complex medical history. |
The Best UK Private Health Insurance Providers for Individuals in 2025
The UK market is dominated by a few excellent, established providers. While the "best" is subjective and depends on your needs, here's a look at the major players.
| Provider | Best For | Key Features |
|---|
| Aviva | Comprehensive cancer cover and digital GP services. | "Healthier Solutions" policy with strong core benefits; extensive hospital list; highly-rated Aviva Digital GP app. |
| AXA Health | Flexible options and strong mental health support. | "Personal Health" policy with guided options; focus on wellbeing; access to dedicated heart and cancer nurses. |
| Bupa | Brand recognition and extensive direct-access services. | "Bupa By You" policy; large network of hospitals and clinics; direct access to some services without a GP referral. |
| The Exeter | Flexibility and tailored underwriting for older applicants. | "Health+" policy; community-rated pricing for members over a long period; known for excellent service. |
| Vitality | Wellness rewards and incentives for staying healthy. | "Personal Healthcare" policy; rewards active members with discounts, coffee, and cinema tickets; can reduce future premiums. |
An independent PMI broker like WeCovr can provide a detailed comparison of quotes from all these leading providers, ensuring you get the policy that's truly the best fit for you, at no extra cost.
How to Get the Best Value from Your Private Health Insurance
You don't have to accept the first price you're quoted. There are several ways to secure excellent cover without breaking the bank.
- Use a Broker: This is the single most effective tip. An independent, FCA-authorised broker works for you, not the insurer. They will search the whole market, explain the differences between policies, and help you find the best price for the cover you need.
- Increase Your Excess: As mentioned, choosing a higher excess is a direct way to lower your premium. Consider what you could comfortably afford to pay in the event of a claim.
- Consider the '6-Week Option': This is a clever cost-saving feature. If the NHS can provide the in-patient treatment you need within six weeks of when it's recommended, you agree to use the NHS. If the wait is longer than six weeks, your private cover kicks in. This can reduce your premium by 20-30%.
- Review Your Hospital List: Be realistic about where you would want to be treated. Unless you live in or need regular access to London, you can save money by choosing a hospital list that excludes the most expensive facilities.
- Engage with Wellness Programmes: If you choose a provider like Vitality, actively engaging with their wellness programme by tracking your activity can earn you real-world rewards and help control your premium at renewal.
Enhancing Your Wellbeing: Beyond Insurance
While insurance is a safety net, the best strategy is always to proactively manage your health. Small, consistent lifestyle choices can have a huge impact on your long-term wellbeing.
- Balanced Diet: Focus on whole foods, including a variety of fruits, vegetables, lean proteins, and healthy fats. Good nutrition is the foundation of physical and mental resilience.
- Regular Activity: Aim for at least 150 minutes of moderate-intensity activity per week, as recommended by the NHS. This could be brisk walking, cycling, swimming, or dancing. Find something you enjoy to make it sustainable.
- Prioritise Sleep: Most adults need 7-9 hours of quality sleep per night. It's essential for cognitive function, immune response, and emotional regulation.
- Manage Stress: Incorporate stress-reducing activities into your routine, whether it's mindfulness, yoga, spending time in nature, or a creative hobby.
To support our clients' health goals, WeCovr provides complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero. We also offer discounts on other types of cover, such as life or income protection insurance, when you purchase a PMI policy with us.
How WeCovr Can Help You Find the Perfect Policy
Finding the right private medical insurance can feel overwhelming, but it doesn't have to be. As an FCA-authorised broker with high customer satisfaction ratings, WeCovr simplifies the entire process.
Our expert advisors provide impartial, whole-of-market advice tailored to your individual circumstances. We take the time to understand your needs, priorities, and budget before comparing policies from all the UK's leading insurers on your behalf. Our service is completely free to you, and there's no obligation to proceed.
Let us do the hard work so you can make an informed decision with confidence.
Do I need to declare my full medical history when applying for PMI?
It depends on the type of underwriting you choose. With 'Moratorium' underwriting, you don't need to declare your history upfront, but any conditions from the last 5 years are automatically excluded. With 'Full Medical Underwriting', you provide a full health declaration, and the insurer gives you a clear statement of what is and isn't covered from the start. An adviser can help you decide which is best for you.
Is private health insurance worth it for a single, healthy person?
Many healthy individuals choose PMI for the peace of mind and rapid access to care should they need it. An unexpected illness or injury could lead to long waits on the NHS, impacting your ability to work and enjoy life. Buying a policy when you are young and healthy is also the cheapest it will ever be, locking in cover before any new conditions arise.
What happens if I develop a chronic condition after my policy starts?
If a new condition arises after you've taken out your policy and it turns out to be chronic (like diabetes or Crohn's disease), your private medical insurance will typically cover the costs of the initial diagnosis and tests to stabilise your condition. However, the long-term, ongoing management of that chronic condition would then be passed to the NHS.
Does private health insurance in the UK cover mental health?
Mental health cover is increasingly available as an optional add-on or is sometimes included in more comprehensive policies. Cover levels vary, but it can provide access to talking therapies, consultations with psychologists or psychiatrists, and in-patient treatment. It's important to check the specifics of any policy, as there are often limits on the number of sessions or the total financial benefit available.
Ready to take control of your health? Get a free, no-obligation quote from WeCovr today and let our experts find the perfect private health insurance plan for you.