TL;DR
As an experienced UK broker that has helped arrange cover for over 900,000 individuals and families, WeCovr understands that navigating the world of private medical insurance can feel complex, especially as you enter your 60s and beyond. This guide is designed to provide clear, practical answers about securing the right private health cover for your needs. A practical guide to private health insurance over 60, including private medical insurance for over 60s Entering your 60s is often a time of reflection.
Key takeaways
- Speed of Access: Get fast-tracked for diagnostic tests like MRI and CT scans, consultations with specialists, and subsequent treatment.
- Choice and Control: You can often choose the specialist who treats you and the hospital where you receive care.
- Comfort and Privacy: Treatment is typically in a private hospital room with an en-suite bathroom.
- Access to Specialist Drugs: Gain access to breakthrough cancer drugs and treatments that may not yet be available on the NHS due to funding or approval delays.
- Peace of Mind: Knowing you have a plan in place to deal with health concerns swiftly can significantly reduce anxiety for you and your family.
As an experienced UK broker that has helped arrange cover for over 900,000 individuals and families, WeCovr understands that navigating the world of private medical insurance can feel complex, especially as you enter your 60s and beyond. This guide is designed to provide clear, practical answers about securing the right private health cover for your needs.
A practical guide to private health insurance over 60, including private medical insurance for over 60s
Entering your 60s is often a time of reflection. You might be planning for retirement, enjoying more free time, or simply becoming more mindful of your health. With NHS waiting lists remaining a significant concern, many people in this age group are exploring private medical insurance (PMI) for the first time.
PMI offers a way to bypass long waits for diagnosis and treatment, giving you control, choice, and peace of mind when you need it most. This guide will walk you through the essential considerations: the costs involved, what is and isn't covered, and the crucial role of underwriting in determining your policy's value.
Why Consider Private Health Insurance in Your 60s?
While the NHS provides excellent care, particularly for emergencies, it is under undeniable pressure. For non-urgent, or 'elective', procedures, the wait can be substantial. According to recent NHS England data, the median waiting time for consultant-led elective care can stretch into many weeks or months.
Private medical insurance is designed to work alongside the NHS. It doesn't cover A&E visits or the management of long-term chronic illnesses. Instead, it provides prompt access to treatment for new, acute conditions that arise after your policy begins.
Key benefits of PMI for over 60s include:
- Speed of Access: Get fast-tracked for diagnostic tests like MRI and CT scans, consultations with specialists, and subsequent treatment.
- Choice and Control: You can often choose the specialist who treats you and the hospital where you receive care.
- Comfort and Privacy: Treatment is typically in a private hospital room with an en-suite bathroom.
- Access to Specialist Drugs: Gain access to breakthrough cancer drugs and treatments that may not yet be available on the NHS due to funding or approval delays.
- Peace of Mind: Knowing you have a plan in place to deal with health concerns swiftly can significantly reduce anxiety for you and your family.
How Much Does Private Health Insurance Cost for Over 60s?
Cost is naturally a primary concern. The price of private medical insurance is based on risk, and as we age, the statistical likelihood of needing medical treatment increases. This means premiums for over 60s are higher than for younger individuals.
However, the cost is not arbitrary. It is influenced by several key factors you can control:
- Age: The single biggest factor. Premiums increase with each birthday.
- Location: Treatment costs vary across the UK, with central London being the most expensive. Your postcode affects your premium.
- Level of Cover: A comprehensive plan with full out-patient cover will cost more than a basic plan covering only in-patient treatment.
- Excess: This is the amount you agree to pay towards a claim. A higher excess will significantly lower your monthly premium.
- Hospital List: Insurers offer tiered hospital lists. Choosing a policy that uses a more limited network of local hospitals will be cheaper than one with access to every private hospital in the country.
- No-Claims Discount: If you don't claim, you can build up a discount over time, reducing future premiums.
To give you a realistic idea, here are some illustrative monthly costs for a non-smoker seeking mid-level cover.
| Age | Location | Excess | Estimated Monthly Premium |
|---|---|---|---|
| 60 | Manchester | £250 | £110 - £160 |
| 60 | Manchester | £500 | £95 - £135 |
| 65 | Reading | £250 | £150 - £210 |
| 65 | Reading | £500 | £130 - £180 |
Disclaimer: These are illustrative examples only. Your actual premium will depend on your specific circumstances and the insurer you choose. The best way to get an accurate figure is to get a personalised comparison.
Understanding Underwriting: The Most Important Choice for Over 60s
This is the most critical concept to grasp when buying PMI, especially with a longer medical history. Underwriting is how an insurer assesses your health and medical history to decide what they will and will not cover.
There are two main types of underwriting in the UK:
-
Moratorium (Mori) Underwriting: This is the most common and straightforward option. You don't have to declare your full medical history upfront. Instead, the insurer applies a general rule: they will not cover treatment for any medical condition for which you have had symptoms, treatment, or advice in the 5 years before your policy started. However, if you go 2 full years on the policy without any further symptoms, treatment, or advice for that condition, it may become eligible for cover. This is often called the "2-5-2" rule.
- Example: You had some physiotherapy for knee pain 3 years before taking out a moratorium policy. For the first 2 years of your policy, any issues with that knee will not be covered. If, after 2 years, your knee has been completely trouble-free, it would then become eligible for cover should a new problem arise.
-
Full Medical Underwriting (FMU): With FMU, you complete a detailed health questionnaire when you apply, disclosing your entire medical history. The insurer's underwriting team reviews this information and gives you a definitive decision from day one. They will explicitly state which conditions are excluded from cover.
- Example: On your FMU application, you declare high blood pressure and a history of sciatica. The insurer will likely place a permanent exclusion on both conditions, meaning you can never claim for them. However, you have complete certainty about what is covered from the start.
Moratorium vs. Full Medical Underwriting: Which is Better?
| Feature | Moratorium (Mori) | Full Medical Underwriting (FMU) |
|---|---|---|
| Application Process | Quick and easy, no medical forms. | Longer, requires a detailed health questionnaire. |
| Certainty of Cover | Less certainty at the start. Claims can be slower as the insurer may need to check your medical history. | Complete certainty from day one. You know exactly what is and isn't excluded. |
| Pre-existing Conditions | Excluded for an initial period (usually 2 years), but can become eligible for cover later. | Usually permanently excluded. |
| Best For | People with few or no recent health issues who want a quick start. | People who want absolute clarity on cover, or those switching from another insurer. |
Expert Broker Insight: For many over 60s, FMU can be the better option. It provides clarity and avoids the "grey areas" of a moratorium policy, where a claim could be unexpectedly declined if it's linked to a past issue. At WeCovr, our advisers can help you decide which underwriting method best suits your personal medical history.
What Does Private Health Insurance for Over 60s Typically Cover?
A private health insurance policy is built in layers. It starts with a core foundation, and you can add optional extras to create a plan that fits your needs and budget.
Core Cover (Usually Included as Standard)
- In-patient and Day-patient Treatment: This is the heart of any PMI policy. It covers costs when you are admitted to a hospital bed for treatment, including surgery, hospital fees, specialist fees, and nursing care.
- Cancer Cover: This is a huge reason people buy PMI. Cover is often comprehensive, including surgery, chemotherapy, and radiotherapy. Crucially, it often provides access to expensive new drugs and therapies not yet approved or funded by the NHS.
- Diagnostics and Scans: Core policies usually cover diagnostic tests like MRI, CT, and PET scans, provided they are related to an in-patient admission.
Popular Optional Extras
- Out-patient Cover: This is the most valuable add-on. It covers costs for treatment where you aren't admitted to a hospital bed. This includes:
- Specialist consultations (before and after surgery).
- Diagnostic tests and scans on an out-patient basis.
- This is often offered in different levels, from a limited number of consultations per year to full, unlimited cover.
- Therapies: Covers treatments like physiotherapy, osteopathy, and chiropractic care, often up to a set number of sessions per year.
- Mental Health Cover: Provides cover for consultations with psychiatrists and psychologists, and sometimes in-patient psychiatric treatment.
- Dental and Optical: This is usually a lower-value benefit that provides a cash-back amount towards routine dental check-ups, treatments, and the cost of glasses or contact lenses.
What is NOT Covered? The Crucial Exclusions
Understanding exclusions is just as important as understanding what's covered. It prevents surprises at the point of claim.
The two most important exclusions in UK private medical insurance are:
- Pre-existing Conditions: As explained under underwriting, PMI is for new conditions that arise after you join. Any condition you had before taking out the policy will not be covered, either temporarily (Moratorium) or permanently (FMU).
- Chronic Conditions: UK PMI does not cover the routine management of long-term conditions that cannot be cured. This includes conditions like diabetes, asthma, high blood pressure, and most forms of arthritis. The NHS remains responsible for managing these. PMI is for acute conditions (e.g., joint replacement, cataract surgery, hernia repair) where treatment can lead to a full recovery.
Other standard exclusions include:
- Emergency treatment (A&E services remain with the NHS)
- Normal pregnancy and childbirth
- Cosmetic surgery (unless for reconstructive purposes after an accident or eligible surgery)
- Self-inflicted injuries
- Organ transplants
- Professional sports injuries
How to Reduce the Cost of Your Premium: 5 Key Levers
You have significant control over the price of your policy. By adjusting these five elements, you can tailor a policy to your budget without sacrificing essential cover.
- Increase Your Excess: Agreeing to pay the first £250, £500, or even £1,000 of a claim can reduce your premium by 20-40%. This is often the most effective way to manage cost.
- Choose a Guided Hospital List: All major insurers offer "guided" or "expert select" options where they provide a shortlist of high-quality specialists and hospitals for your specific condition. This helps them manage costs and they pass the savings to you in the form of a lower premium.
- Add a 6-Week Wait Option: This is a popular cost-saving feature. If the NHS can provide the in-patient treatment you need within six weeks, you agree to use the NHS. If the waiting list is longer than six weeks, your private policy activates. This can reduce your premium by around 20-30%.
- Limit Out-patient Cover: While full out-patient cover is excellent, it's also expensive. You could opt for a plan that limits out-patient cover to £1,000 per year or just covers diagnostics, which provides a good balance between cost and benefit.
- Build Your No-Claims Discount (NCD): Stay healthy and avoid making small claims. Your NCD can grow over several years, providing a significant discount on your renewal premiums.
Switching Your Existing PMI Policy Over 60
If you already have a policy, it's wise to review it every few years. The market is competitive, and you might find better value elsewhere. However, switching must be done carefully to avoid losing cover.
The best way to switch is on a "Continued Personal Medical Exclusions" (CPME) basis. This special type of underwriting allows you to transfer to a new insurer while keeping the same underwriting terms you had on your old policy.
This means that any conditions that were covered by your old insurer will remain covered by your new one. You don't have to go through medical underwriting again, and the "clock" on any moratorium doesn't reset.
Broker Warning: Never simply cancel an old policy and start a new one on a fresh moratorium basis. If you do, any medical condition that has arisen while you were on your old policy will now be classed as "pre-existing" and will be excluded by the new insurer for at least two years. Always use a specialist broker like WeCovr to manage a switch.
WeCovr: Your Partner in Health Insurance
Navigating these choices can be daunting, but you don't have to do it alone. As an independent and unbiased broker, WeCovr works for you, not the insurance companies.
- We compare the entire market from providers like Aviva, AXA Health, Bupa, The Exeter, and Vitality to find the policy that offers the best value for your specific needs.
- Our expert advice is completely free. We are paid a commission by the insurer you choose, so our service costs you nothing extra.
- We add extra value. Our clients gain complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, and can get exclusive discounts on other insurance products like life or income protection cover.
Our goal is to give you the clarity and confidence to make the right decision.
Frequently Asked Questions about PMI for Over 60s
Is there an age limit for getting private health insurance?
Will my private medical insurance premium increase every year?
Do I need a GP referral to use my private health insurance?
Is cancer cover a standard benefit in private health insurance?
Ready to explore your options? Get a free, no-obligation quote today and let one of our friendly, expert advisers help you find the perfect cover for your peace of mind.
