Private Health Insurance Plans UK Compared
As an FCA-authorised broker that has arranged over 800,000 policies, WeCovr is here to demystify private medical insurance in the UK. This guide compares policy types and explains what’s included, helping you make an informed choice for your health and wellbeing.
WeCovr's overview of different policy types and whats included
Navigating the world of private medical insurance (PMI) can feel overwhelming. With so many providers, policy levels, and optional extras, how do you know which plan is right for you? This comprehensive guide breaks down everything you need to know, from the basic building blocks of a policy to the finer details that can make all the difference. We’ll explore the different types of cover available, what they typically include, and how you can tailor a plan to suit your exact needs and budget.
Understanding the Basics: What is Private Medical Insurance (PMI)?
In simple terms, private medical insurance is a policy you buy to cover the costs of private healthcare for eligible conditions. Its primary purpose is to help you bypass potential NHS waiting lists and receive faster access to specialist consultations, diagnostic tests, and treatment in a private hospital or clinic.
According to recent NHS England data, the waiting list for routine consultant-led treatment remains a significant concern for millions. PMI offers a parallel route, giving you more choice and control over when and where you are treated.
The Crucial Difference: PMI vs. The NHS
PMI is not a replacement for the National Health Service. The NHS remains a cornerstone of UK healthcare, providing excellent emergency care and managing chronic conditions for everyone. You will still need the NHS for:
- Accidents and Emergencies (A&E): If you have an accident, you should go to your local A&E.
- Chronic Conditions: Long-term illnesses that require ongoing management, like diabetes, asthma, or high blood pressure.
- GP Services: Your NHS GP is usually your first point of contact.
PMI works alongside the NHS, stepping in for non-emergency, acute conditions.
The Golden Rule: Acute vs. Chronic & Pre-existing Conditions
This is the most important concept to grasp in UK private health insurance.
- Acute Conditions: These are diseases, illnesses, or injuries that are likely to respond quickly to treatment and lead to a full recovery. Think of conditions like cataracts, joint problems requiring a hip replacement, or hernias. PMI is designed specifically for these.
- Chronic Conditions: These are illnesses that are long-lasting and often cannot be cured, only managed. Examples include diabetes, arthritis, asthma, and multiple sclerosis. Standard UK PMI policies do not cover the treatment of chronic conditions.
- Pre-existing Conditions: This refers to any illness, disease, or injury for which you have experienced symptoms, received medication, or sought advice before your policy start date. These are also typically excluded from cover, at least for an initial period. We’ll explore how underwriting affects this later.
The Core Components of a UK Health Insurance Plan
Every PMI policy is built from a few key components. Understanding these will help you compare plans effectively.
| Component | What It Covers | Real-Life Example |
|---|---|---|
| In-patient Cover | This is the foundation of most policies. It covers costs when you are admitted to a hospital bed overnight. This includes surgeon and anaesthetist fees, hospital accommodation, nursing care, and medication. | You need a knee replacement and stay in a private hospital for three nights post-surgery. Your in-patient cover pays for the operation and your hospital stay. |
| Day-patient Cover | Covers procedures where you are admitted to hospital for treatment but do not need to stay overnight. This is often included as standard with in-patient cover. | You undergo a colonoscopy or cataract surgery and go home the same day. Day-patient cover handles the costs. |
| Out-patient Cover | This is a crucial, often optional, component. It covers diagnostic tests and consultations with a specialist before you are admitted to hospital. Without it, you would rely on the NHS for your initial diagnosis. | Your GP refers you to a cardiologist for chest pains. Out-patient cover pays for the private consultation, an ECG, and a follow-up appointment. |
Most policies will have limits on out-patient cover, either as a total monetary value per year (e.g., £1,000) or a set number of consultations.
A Deep Dive into UK PMI Policy Types
Insurers package their cover into different levels to suit various needs and budgets. Here are the main types you'll encounter.
Comprehensive Policies
As the name suggests, this is the highest level of cover. It provides extensive protection for in-patient, day-patient, and out-patient treatments.
- Who is it for? Individuals and families who want complete peace of mind and minimal reliance on the NHS for diagnostics and treatment.
- What’s typically included? Full in-patient and day-patient cover, plus a generous or unlimited out-patient allowance. It often includes additional benefits like mental health support and therapies cover as standard.
- What to watch for: These are the most expensive plans. Check the limits on specific benefits like mental health or therapies.
Treatment-Only Policies
These plans offer a middle ground. They cover the costs of treatment once a diagnosis has been made, but you would typically use the NHS for the initial specialist consultations and diagnostic tests.
- Who is it for? Those who are happy to use the NHS for diagnostics but want to skip the waiting list for the actual treatment.
- What’s typically included? Full in-patient and day-patient cover. Out-patient cover is either non-existent or very limited (e.g., covering only post-operative consultations).
- What to watch for: You could still face a lengthy wait for an initial diagnosis on the NHS before your private treatment can begin.
Diagnostics-Only Policies
A less common but available option, these policies are the inverse of treatment-only plans. They are designed to help you get diagnosed quickly, after which you would return to the NHS for treatment.
- Who is it for? People who want to quickly find out what's wrong but are comfortable receiving the subsequent treatment on the NHS.
- What’s typically included? A comprehensive out-patient package for consultations, scans (MRI, CT, PET), and tests.
- What to watch for: This type of policy does not cover the cost of any private treatment itself.
Budget or Basic Policies
These are entry-level plans designed to be more affordable. They offer a safety net for significant health issues but come with more limitations.
- Who is it for? Younger individuals, those on a tight budget, or people who only want cover for major, unexpected conditions.
- What’s typically included? In-patient and day-patient cover, but often with a restricted hospital list and limitations on certain treatments like cancer care. Out-patient cover is usually not included.
- What to watch for: The 'guided' or 'expert select' hospital lists can restrict your choice of facility. Cancer cover might be capped or only cover surgery and not chemotherapy.
Policy Type Comparison Table
| Policy Type | In-patient Cover | Out-patient Cover | Typical User | Cost |
|---|---|---|---|---|
| Comprehensive | Yes (Full) | Yes (Generous/Unlimited) | Wants maximum peace of mind | Highest |
| Treatment-Only | Yes (Full) | No / Very Limited | Wants to skip treatment queues | Medium |
| Diagnostics-Only | No | Yes (Full) | Wants a fast diagnosis | Medium-Low |
| Budget/Basic | Yes (Often limited) | No | Wants a basic safety net | Lowest |
Navigating these options can be complex. That's where an independent PMI broker like WeCovr comes in. Our experts compare the market for you, ensuring you find a policy that fits your needs and budget, at no extra cost to you.
Key Factors That Influence Your Policy and Premiums
Several factors determine the price of your private medical insurance UK premium. Understanding them allows you to adjust your policy to find the right balance between cost and cover.
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Age, Location, and Lifestyle:
- Age: Premiums increase with age as the statistical likelihood of needing treatment rises.
- Location: Treatment costs are higher in major cities, particularly London, so premiums are more expensive for those living in and around the capital.
- Lifestyle: Smokers will pay significantly more than non-smokers.
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Underwriting Options: This determines how the insurer deals with your past medical history.
- Moratorium (Most Common): You don't declare your full medical history upfront. Instead, the insurer automatically excludes any condition you've had symptoms of or treatment for in the last 5 years. However, if you go 2 full years on the policy without any symptoms, advice, or treatment for that condition, it may become eligible for cover.
- Full Medical Underwriting (FMU): You complete a detailed health questionnaire. The insurer reviews your medical history and explicitly lists what is excluded from your policy from day one. This provides certainty but can lead to permanent exclusions.
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Policy Excess: This is the amount you agree to pay towards the cost of a claim. It's similar to a car insurance excess. Choosing a higher excess (e.g., £250, £500, or £1,000) will lower your monthly premium. The excess is usually payable once per policy year.
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Hospital List: Insurers group private hospitals into bands based on cost.
- Comprehensive Lists: Include all private hospitals, including prime central London locations. This is the most expensive option.
- Standard Lists: Exclude the most expensive city-centre hospitals.
- Guided or Select Lists: A limited list of hospitals chosen by the insurer for their value and quality. Choosing a more restricted list significantly reduces your premium.
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No-Claims Discount (NCD): Similar to car insurance, you build up a discount for every year you don't make a claim, which reduces your renewal premium. Making a claim will typically reduce or reset your NCD.
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The 6-Week Option: This is a popular cost-saving feature. If you add it to your policy, you agree to use the NHS for in-patient treatment if the NHS waiting list for that procedure is less than six weeks. If the wait is longer, your private cover kicks in. This can reduce your premium by 20-30%.
Optional Extras: Tailoring Your Cover to Your Needs
Beyond the core components, you can add optional modules to enhance your private health cover.
- Dental and Optical Cover: This helps with the costs of routine check-ups, glasses, contact lenses, and dental treatment. It's often a cash-back benefit up to a set annual limit.
- Mental Health Support: While some basic mental health cover might be included in comprehensive plans, you can often upgrade it to cover more therapy sessions or even in-patient psychiatric treatment.
- Therapies Cover: This adds cover for services like physiotherapy, osteopathy, and chiropractic treatment. It's usually limited to a set number of sessions per year.
- Travel Cover: Some insurers allow you to add a European or worldwide travel insurance policy to your PMI plan.
- Advanced Cancer Cover: All PMI policies include cancer care, but the level varies. Standard cover includes surgery and radiotherapy. Comprehensive cancer cover will also include chemotherapy, experimental treatments, and palliative care, often with no financial or time limits.
The WeCovr Advantage: More Than Just a Comparison
Choosing the best PMI provider is about more than just price. It's about finding the right partner for your health. At WeCovr, we go beyond a simple comparison to add real value for our clients.
- Expert, Unbiased Advice: Our team are specialists in the UK PMI market. We listen to your needs and search policies from leading insurers to find the perfect fit. Our advice is always free.
- High Customer Satisfaction: We pride ourselves on the positive feedback we receive from customers, reflecting our commitment to clear, helpful, and professional service.
- Exclusive Member Benefits: When you arrange a policy through us, you gain complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, to support your health and wellness goals.
- Multi-Policy Discounts: Clients who purchase private medical or life insurance through WeCovr can also benefit from discounts on other types of cover, helping you protect more for less.
A Practical Guide to Making a Claim
The claims process is designed to be straightforward. Here’s a typical journey:
- See Your GP: You feel unwell or have an injury. Your first step is to visit your NHS GP.
- Get an Open Referral: If your GP feels you need to see a specialist, they will write you an 'open referral' letter. This recommends a type of specialist (e.g., an orthopaedic surgeon) rather than a specific named doctor.
- Contact Your Insurer: You call your insurer's claims line with your policy number and referral details.
- Get Authorisation: The insurer checks that your condition is covered by your policy. They will then provide you with a pre-authorisation number and a list of approved specialists and hospitals from your chosen hospital list.
- Book Your Appointment: You can now book your private consultation or treatment.
- Bills are Settled Directly: The hospital and specialists will usually send the bills directly to your insurer for payment. You only need to pay your chosen excess, if applicable.
Real-Life Example: Sarah's Knee Injury
Sarah, a 45-year-old teacher, injures her knee while hiking. Her GP suspects a torn meniscus and refers her to an orthopaedic specialist. The NHS waiting list for an MRI and consultation is four months.
Sarah has a comprehensive PMI policy. She calls her insurer, gets authorisation, and sees a private specialist within a week. An MRI a few days later confirms the tear. Arthroscopic surgery is scheduled for two weeks later at a private hospital near her home. Her policy covers the entire cost, minus her £250 excess. She is back to work far sooner than if she had waited for NHS treatment.
Proactive Health: Wellness Benefits and Healthy Living Tips
Modern private health insurance is not just about being there when you're ill; it's also about helping you stay healthy. Many top UK insurers now include valuable wellness benefits and reward programmes. These can include:
- Discounted gym memberships.
- Free coffee or cinema tickets for hitting activity goals.
- Wearable fitness tracker discounts.
- Online health assessments and GP services.
Engaging with these programmes can not only improve your wellbeing but sometimes lead to lower renewal premiums. Here are some simple tips to complement these benefits:
- Balanced Diet: Focus on whole foods—fruits, vegetables, lean proteins, and whole grains. Using an app like CalorieHero can help you understand your nutritional intake and make healthier choices.
- Regular Activity: Aim for at least 150 minutes of moderate-intensity activity, like brisk walking or cycling, per week, as recommended by the NHS.
- Prioritise Sleep: Strive for 7-9 hours of quality sleep per night. It's crucial for mental and physical recovery.
- Manage Stress: Incorporate mindfulness, yoga, or simple breathing exercises into your day to manage stress levels, a key factor in long-term health.
Frequently Asked Questions (FAQs) about UK PMI
Do I need to declare my full medical history to get private health insurance?
Will my PMI policy cover pre-existing or chronic conditions like diabetes?
Is private medical insurance worth the cost in the UK?
Ready to find the right health insurance plan for you?
Take control of your health today. Get a fast, free, no-obligation quote from WeCovr. Our expert advisors will compare leading UK providers to find you the best private health cover at the best price.
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!