Private Health Insurance for Retirees in the UK
As an FCA-authorised broker that has helped arrange over 800,000 policies, WeCovr provides this expert guide to private medical insurance (PMI) for retirees in the UK. We’ll help you understand your options for continuing your health cover after leaving a company scheme, ensuring you can make an informed choice for your future.
WeCovr's guide to PMI options after leaving company cover
Retirement marks a significant and exciting new chapter in life. It’s a time for pursuing hobbies, travelling, and spending quality time with family. However, it also brings changes to your financial and healthcare arrangements. For many, leaving a job means losing access to a company private medical insurance (PMI) scheme.
This guide is designed to navigate you through the process of securing personal private health insurance in retirement. We'll explore why it's a valuable consideration, how to transition smoothly from your corporate plan, and what to look for in a policy that suits your new lifestyle.
Why Should Retirees Consider Private Health Insurance?
While the National Health Service (NHS) provides exceptional care to millions, it is currently facing unprecedented strain. For retirees, this can mean longer waits for consultations, diagnoses, and treatments, which can impact quality of life.
According to the latest NHS England data, the referral-to-treatment waiting list stood at approximately 7.54 million in April 2024. While the government and NHS are working hard to reduce this backlog, many people face waiting times that extend far beyond the 18-week target for non-urgent procedures.
Private medical insurance offers a solution by providing:
- Prompt Access to Treatment: Bypass long NHS waiting lists for eligible acute conditions, from diagnostic tests to surgery.
- Choice and Control: Select your preferred consultant, specialist, and hospital from a nationwide network.
- Comfort and Privacy: Recover in a private room with amenities like an en-suite bathroom, TV, and flexible visiting hours.
- Access to Advanced Treatments: Some policies offer cover for new drugs or treatments not yet available on the NHS due to funding decisions.
- Peace of Mind: Knowing you have a plan in place to handle unexpected health issues can significantly reduce worry.
For many retirees, the peace of mind that comes with fast access to high-quality care is the primary driver for investing in private health cover.
The Golden Rule: PMI is for Acute, Not Chronic, Conditions
Before we delve deeper, it's crucial to understand the fundamental principle of private medical insurance in the UK.
PMI is designed to cover acute conditions that arise after you take out your policy.
- An Acute Condition is an illness or injury that is sudden in onset, short in duration, and expected to respond fully to treatment. Examples include hernias, cataracts, joint replacements, and most infections.
- A Chronic Condition is an illness that is long-lasting and often has no known cure. It typically requires ongoing management rather than a one-off treatment. Examples include diabetes, arthritis, asthma, and high blood pressure.
- A Pre-existing Condition is any illness, injury, or symptom you had before your policy started, whether you were diagnosed or not.
Standard UK PMI policies do not cover pre-existing or chronic conditions. The NHS remains your point of care for these. The purpose of PMI is to restore you to your previous state of health following a new, acute medical issue.
Transitioning from Company Cover: Know Your Options
When you retire and leave your company's group PMI scheme, you generally have a 30-to-60-day window to make a decision without a gap in cover. Acting promptly is key. You have two main paths to take.
1. Continue with Your Current Insurer on a Personal "Switch" Plan
Most group insurers (like Bupa, AXA, and Aviva) will offer you the chance to continue your cover on an individual policy. This is often called a "switch" or "continuation" option.
Advantages:
- Continued Medical History: This is the biggest benefit. The insurer agrees to carry over your underwriting terms from the group scheme. This means any conditions that were covered previously will continue to be covered, and you won't have to go through new medical underwriting. This is known as Continued Medical Exclusions (CME) underwriting.
- Simplicity: The process is usually straightforward, involving a simple application form.
- No New Moratorium: You avoid the standard two-year waiting period for pre-existing conditions that comes with moratorium underwriting on a new policy.
Disadvantages:
- Cost: The premium offered might not be the most competitive on the market. Insurers know this is the easiest option for you.
- Lack of Flexibility: The personal policy offered may not be the best fit for your retirement needs or budget. You may be better served by a different provider or a different level of cover.
2. Shop for a New Policy on the Open Market
Your second option is to start fresh and compare policies from all leading UK providers. This allows you to find a plan that is perfectly tailored to your needs and budget.
Advantages:
- Better Value: You can often find a more competitively priced policy by comparing the whole market.
- Tailored Cover: You can choose the exact benefits you want, such as a specific hospital list, outpatient cover level, or cancer care package.
- Modern Benefits: Newer policies may include valuable digital tools, virtual GP services, and wellness incentives.
Disadvantages:
- New Underwriting: You will have to be underwritten again. This means any health conditions you've experienced in recent years will likely be excluded as pre-existing.
- Potential for More Exclusions: If you've developed health issues while on the company scheme, a new policy will almost certainly exclude them.
Which Path is Right for You?
| Consideration | Choose a "Switch" Plan if... | Choose a New Policy if... |
|---|---|---|
| Your Health | You have developed medical conditions while on the company plan that you want to keep covered. | You are in excellent health with no new conditions in the last 5 years. |
| Your Budget | You prioritise continuity of cover over getting the lowest possible price. | Finding the most cost-effective plan is your top priority. |
| Your Needs | The insurer's personal plan aligns well with the cover you want for retirement. | You want to customise your benefits, perhaps by adding or removing options. |
| Hassle Factor | You prefer the simplest, quickest option with the least amount of paperwork. | You are happy to complete a health questionnaire and compare options. |
A specialist PMI broker like WeCovr can be invaluable here. We can get a quote for your existing insurer's "switch" plan and compare it against new policies from across the market, giving you a clear, unbiased view of the best path forward at no cost to you.
Understanding Underwriting for Retiree Health Insurance
Underwriting is the process an insurer uses to assess your health risk and decide what it will and will not cover. For retirees, understanding the different types is essential.
| Underwriting Type | How it Works | Best For... |
|---|---|---|
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire. The insurer reviews your medical history and applies specific exclusions for any pre-existing conditions. | Individuals who want absolute clarity from day one about what is and isn't covered. |
| Moratorium (Mori) | You don't declare your medical history upfront. Instead, the insurer automatically excludes any condition you've had symptoms of, or received treatment for, in the 5 years before the policy started. This exclusion can be lifted if you go 2 continuous years on the policy without any symptoms, treatment, or advice for that condition. | Healthy individuals with no recent medical issues who want a quicker application process. |
| Continued Medical Exclusions (CME / Switch) | Only available when switching from a group scheme to a personal plan with the same insurer. Your existing underwriting and exclusions are simply carried over to the new policy. | Anyone leaving a company scheme who has pre-existing conditions they wish to keep covered. |
For most people leaving a company scheme, a CME/Switch plan is the safest bet if they have any ongoing or recent health concerns. If you are in perfect health, exploring a new policy with Moratorium or FMU underwriting could save you money.
How to Build the Right PMI Policy for Your Retirement
A modern private health insurance policy is not a one-size-fits-all product. You can customise it by adjusting several key components to balance cover with cost.
1. Core Cover: Inpatient and Day-Patient Treatment
This is the foundation of every PMI policy. It covers treatment when you are admitted to a hospital bed, either overnight (inpatient) or for the day (day-patient). This includes:
- Hospital accommodation and nursing care
- Surgeons' and anaesthetists' fees
- Specialist consultations while in hospital
- Diagnostic tests like MRI scans, CT scans, and X-rays while in hospital
2. Outpatient Cover Options
This is one of the most significant variables affecting your premium. Outpatient cover pays for diagnostic tests and consultations that do not require a hospital bed.
- Full Outpatient Cover: Covers all eligible consultations and tests up to the policy limits. This is the most expensive option.
- Limited Outpatient Cover: You can choose a financial limit, for example, £500, £1,000, or £1,500 per year. This is a popular way to reduce costs. Once you reach the limit, you would need to use the NHS or self-pay for further outpatient care.
- No Outpatient Cover: The most basic option. You would use the NHS for all initial consultations and diagnostic tests. Your PMI would only kick in if you need to be admitted for surgery or treatment.
3. Choosing Your Hospital List
Insurers group hospitals into tiers, which affects your premium.
- Local/Trust Hospital Lists: Include a network of private hospitals and NHS private patient units in your local area. A more restricted list means a lower premium.
- National Hospital Lists: A comprehensive list of private hospitals across the UK, offering you a wide range of choices.
- Premium/London Lists: Includes top-tier private hospitals, particularly those in Central London, which are more expensive. Choosing a list that excludes these can lead to significant savings.
4. Setting a Policy Excess
An excess is a fixed amount you agree to pay towards the cost of your first claim each year. For example, if you have a £250 excess and your first claim is for £3,000, you pay the first £250, and the insurer pays the remaining £2,750.
- Higher Excess = Lower Premium: Choosing an excess of £100, £250, £500 or even £1,000 can make your monthly payments much more affordable.
- Think of it as a way to self-insure for smaller claims while protecting yourself against the cost of major surgery.
5. Cancer Cover: A Vital Component
Cancer care is a cornerstone of modern PMI. Most policies offer comprehensive cover as standard, but it's essential to check the details. This typically includes:
- Surgery, chemotherapy, and radiotherapy.
- Access to specialist cancer centres.
- Cover for advanced, targeted therapies that may not be available on the NHS.
- Support services like helplines and nutritional advice.
Some insurers may offer a reduced level of cancer cover or the option to remove it entirely for a lower premium, but this is a decision that requires very careful consideration.
A Look at Leading UK PMI Providers for Retirees
The UK private medical insurance market is home to several excellent providers, each with unique strengths. Here’s a brief overview of what to look for.
| Provider | Key Strengths & Focus for Retirees |
|---|---|
| AXA Health | Known for comprehensive cover and strong customer service. Offers a "Guided" option where they help you choose from a smaller list of specialists, which can reduce premiums. Good digital tools and mental health support. |
| Aviva | A major, trusted brand offering a wide range of customisation. Their "Expert Select" hospital list is a popular cost-saving option. Known for their straightforward claims process and comprehensive cancer cover. |
| Bupa | The UK's largest health insurer with a vast network of hospitals and clinics. Offers direct access to services without a GP referral for certain conditions (e.g., mental health, cancer). Their "Bupa from Home" service is extensive. |
| The Exeter | A mutual society (owned by its members) with a strong focus on older applicants. They have a track record of being more flexible with underwriting for those with some pre-existing conditions and are well-regarded for their personal service. |
| Vitality | Unique for its focus on wellness and prevention. They reward members with discounts and perks for staying active (e.g., tracking steps, regular health checks). This can be a great motivator for retirees looking to maintain a healthy lifestyle. |
This table is for illustrative purposes. The "best" provider depends entirely on your individual circumstances, health, budget, and priorities.
Healthy Living in Retirement: More Than Just Insurance
A PMI policy is a safety net, but the best strategy is to stay as healthy as possible. Retirement offers a golden opportunity to focus on your wellbeing.
- Stay Active: Regular, gentle exercise like walking, swimming, or yoga is proven to benefit cardiovascular health, mobility, and mental wellbeing. The UK Chief Medical Officers recommend at least 150 minutes of moderate-intensity activity a week.
- Eat a Balanced Diet: A diet rich in fruits, vegetables, whole grains, and lean protein supports everything from your immune system to your energy levels.
- Prioritise Sleep: Good quality sleep is vital for physical and mental recovery. Aim for 7-9 hours per night and maintain a regular sleep schedule.
- Stay Socially Connected: Joining clubs, volunteering, or spending time with friends and family is crucial for mental and emotional health, reducing the risk of loneliness and depression.
As a WeCovr client, you get complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, to help you stay on top of your dietary goals. Furthermore, customers who purchase private medical or life insurance through us are often eligible for discounts on other types of cover, such as travel or home insurance.
How WeCovr Can Help You Secure the Right Cover
Navigating the private health insurance market, especially with the unique considerations of retirement, can feel overwhelming. This is where an independent, expert broker like WeCovr adds immense value.
- We Listen: We start by understanding your situation, including your history with a company scheme, your health, your budget, and what matters most to you.
- We Compare: We have access to policies from all the UK's leading insurers. We'll analyse the "switch" offer from your current provider and compare it against the best new policies on the market.
- We Explain: We cut through the jargon. We’ll explain the differences in underwriting, hospital lists, and outpatient limits in plain English, so you can make a confident choice.
- We Support You: Our service doesn't end once you've bought a policy. We're here to help with queries and support you at renewal time each year to ensure your policy remains the best fit.
- No Extra Cost: Our service is completely free for you to use. We are paid a commission by the insurer you choose, which is already built into the premium, so you pay the same price as going direct, but with the added benefit of our expert, impartial advice.
Retirement should be a time of enjoyment and security. Let us handle the complexities of finding the right private medical insurance, so you can focus on what truly matters.
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Ready to explore your options? Get a free, no-obligation quote from WeCovr today and let our experts find the perfect private health insurance plan for your retirement.
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.
By tapping the button below, you can book a free call with them in less than 30 seconds right now:
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Who Are WeCovr?
WeCovr is an insurance specialist for people valuing their peace of mind and a great service.👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.
Just a quick and simple form and an easy conversation with one of our experts and your valuable insurance policy is in place for that needed peace of mind!