TL;DR
As a self-employed professional, you are your business's most valuable asset. But what happens if you fall ill or need surgery? With WeCovr, a leading UK insurance specialist, you can explore private medical insurance options designed to get you back to work faster.
Key takeaways
- Minimise Downtime: According to NHS England data, the median waiting time for consultant-led elective care can be many weeks, and for some specialities, much longer. PMI can reduce this wait from months to weeks, or even days.
- Fast-Track Diagnosis: Symptoms can be just as debilitating as a confirmed condition. PMI often provides faster access to diagnostic scans (MRI, CT, PET) and specialist consultations, giving you clarity and a treatment plan sooner.
- Control and Choice: Private health cover allows you to choose your specialist and the hospital where you're treated. It also offers flexibility with appointment times, letting you schedule treatment around your business commitments.
- Access to Advanced Treatments: Some policies provide access to new drugs or treatments that may not yet be available on the NHS due to cost or other factors.
- Peace of Mind: Knowing you have a plan in place to deal with health issues removes a significant source of stress, allowing you to focus on running your business.
As a self-employed professional, you are your business's most valuable asset. But what happens if you fall ill or need surgery? With WeCovr, a leading UK insurance specialist, you can explore private medical insurance options designed to get you back to work faster. This guide demystifies private health cover for the UK's freelancers, contractors, and sole traders.
Costs, cover options and how to choose the right private health policy
For the UK's 4.2 million self-employed workers, time is quite literally money. An unexpected illness or injury can mean more than just a health scare; it can mean a significant loss of income. While the NHS provides excellent care, long waiting lists for diagnosis and treatment can put your livelihood at risk.
This is where private medical insurance (PMI) steps in. It's a policy designed to work alongside the NHS, giving you fast access to private healthcare when you need it most. This comprehensive guide will walk you through everything you need to know about securing the right private health policy for your needs.
Why Should the Self-Employed Consider Private Health Insurance?
The primary reason to consider PMI is to protect your income. As a self-employed individual, you don't have the safety net of statutory sick pay or a supportive employer. Any time spent unable to work is time you're not earning.
The Business Case for PMI:
- Minimise Downtime: According to NHS England data, the median waiting time for consultant-led elective care can be many weeks, and for some specialities, much longer. PMI can reduce this wait from months to weeks, or even days.
- Fast-Track Diagnosis: Symptoms can be just as debilitating as a confirmed condition. PMI often provides faster access to diagnostic scans (MRI, CT, PET) and specialist consultations, giving you clarity and a treatment plan sooner.
- Control and Choice: Private health cover allows you to choose your specialist and the hospital where you're treated. It also offers flexibility with appointment times, letting you schedule treatment around your business commitments.
- Access to Advanced Treatments: Some policies provide access to new drugs or treatments that may not yet be available on the NHS due to cost or other factors.
- Peace of Mind: Knowing you have a plan in place to deal with health issues removes a significant source of stress, allowing you to focus on running your business.
A Real-Life Scenario: Imagine you're a self-employed IT contractor who develops persistent knee pain. Your GP suspects a torn meniscus and refers you to an NHS orthopaedic specialist. The waiting list for an initial consultation is 18 weeks, and the wait for a potential MRI scan and subsequent surgery is even longer. You're losing income every day you can't comfortably travel to client sites.
With a PMI policy, you could see a private specialist within a week, have an MRI a few days later, and be scheduled for surgery the following week at a private hospital, getting you back on your feet and earning again in a fraction of the time.
How Does Private Medical Insurance Work for the Self-Employed?
PMI is a straightforward insurance product. You pay a monthly or annual premium to an insurer. In return, if you develop an eligible medical condition after taking out the policy, the insurer pays for your private diagnosis and treatment.
Crucially, UK private medical insurance is designed to cover acute conditions.
- An acute condition is an illness, disease, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include cataracts, joint replacements, hernia repairs, and most forms of cancer treatment.
- A chronic condition is a long-term illness that cannot be cured, only managed. Examples include diabetes, asthma, high blood pressure, and arthritis. Standard PMI policies do not cover the routine management of chronic conditions.
The Claims Process is Simple:
- Visit Your GP: You feel unwell and see your NHS GP as usual. The NHS remains your first port of call.
- Get a Referral: Your GP determines you need to see a specialist and provides an open referral letter.
- Contact Your Insurer: You call your insurer's claims line, explain the situation, and provide the referral.
- Get Authorisation: The insurer confirms your cover is active and authorises the specialist consultation and any necessary tests.
- Receive Treatment: You attend your private appointments and treatment.
- Direct Settlement: The hospital and specialists bill your insurer directly. You only need to pay any excess you have on your policy.
Understanding Your Cover Options: Core vs. Comprehensive
No two PMI policies are identical. They are built from a 'core' level of cover, which you can then enhance with optional extras to suit your budget and needs.
| Feature | Core Cover (Essential) | Comprehensive Cover (Enhanced) |
|---|---|---|
| In-patient Care | ✅ Included (Hospital bed, surgery, nursing) | ✅ Included |
| Day-patient Care | ✅ Included (Procedures where you don't stay overnight) | ✅ Included |
| Cancer Cover | ✅ Included (Often extensive cover for surgery, chemotherapy, radiotherapy) | ✅ Included (Potentially with more drug options) |
| Out-patient Care | ❌ Not included (or very limited) | ✅ Included (Specialist consultations, diagnostic scans) |
| Therapies | ❌ Not included | ✅ Included (Physiotherapy, osteopathy, chiropractic) |
| Mental Health | ❌ Not included | ✅ Often included or available as an add-on |
Building Your Policy with Optional Extras
- Out-patient Cover: This is the most significant optional extra. It covers the costs of specialist consultations and diagnostic tests that don't require a hospital bed. Without it, you would need to pay for these initial appointments yourself before your in-patient cover kicks in. You can choose different levels, such as a monetary limit (£500, £1,000) or unlimited cover.
- Therapies: Essential for many musculoskeletal issues that affect self-employed workers. This add-on covers a set number of sessions with a physiotherapist, osteopath, or chiropractor.
- Mental Health Cover: The pressures of running a business can take their toll. This valuable add-on provides cover for consultations with psychiatrists and psychologists, as well as in-patient psychiatric care if needed.
- Dental and Optical Cover: This is usually a less comprehensive add-on that provides a contribution towards routine check-ups, glasses, and some dental treatments. Often, a standalone dental plan offers better value.
An expert adviser at WeCovr can help you navigate these options, ensuring you only pay for the cover you actually need.
How Much Does Private Health Insurance Cost for the Self-Employed?
The cost of your premium is highly personal. It's calculated based on a range of risk factors.
Key Factors Influencing Your Premium:
- Age: This is the single biggest factor. The older you are, the higher the statistical likelihood of claiming, so the premium increases.
- Location: Treatment costs vary across the UK. Living in or near Central London, for example, will result in a higher premium than living in a rural area.
- Level of Cover: A comprehensive policy with unlimited out-patient cover will cost significantly more than a core-only policy.
- Excess: The amount you agree to pay towards the cost of any claim. A higher excess will lower your monthly premium.
- Hospital List: Insurers have different tiers of hospital networks. A policy that includes all private hospitals, including prime London ones, is more expensive than one with a more limited local network.
- Underwriting Type: The method used to assess your medical history.
Example Monthly PMI Premiums
These are illustrative costs for a non-smoker on a mid-range policy with a £250 excess. Costs are reviewed annually and will vary between insurers.
| Age | Location | Example Monthly Premium |
|---|---|---|
| 30 | Manchester | £45 - £60 |
| 40 | Bristol | £60 - £80 |
| 50 | London | £95 - £130 |
| 60 | Edinburgh | £150 - £200+ |
The Secret to Saving Money: How to Customise Your Policy
While PMI is an investment, there are several smart ways to manage the cost without sacrificing essential protection.
1. Choose the Right Excess
An excess is the portion of a claim you pay yourself. This can be per claim or per policy year. Opting for a higher excess (e.g., £500 instead of £100) can reduce your premium by as much as 20-30%. It’s a trade-off between a lower fixed cost (premium) and a higher potential one-off cost (excess).
- Adviser Tip: A £250 or £500 excess often hits the sweet spot, offering significant premium savings without making the policy prohibitive to use.
2. Select a Suitable Hospital List
Insurers typically offer 3-4 tiers of hospital access. Unless you have a specific reason to require treatment at a top HCA hospital in Central London, choosing a 'National' or 'Local' list that excludes these high-cost facilities can dramatically lower your premium.
3. Consider the '6-Week Wait' Option
This is a clever cost-saving feature. If you add this to your policy, your private cover will only kick in if the NHS waiting list for the in-patient treatment you need is longer than six weeks. If the NHS can treat you within six weeks, you use the NHS. This can reduce your premium by up to 25% but means you might not always get to use your private cover.
4. Limit Your Out-patient Cover
Instead of opting for expensive 'unlimited' out-patient cover, choosing a capped limit of £1,000 is often more than enough to cover the consultations and diagnostics for most conditions. This provides a great balance of cover and cost.
Underwriting Explained: Moratorium vs. Full Medical Underwriting
Underwriting is how insurers assess your medical history to decide what they will and won't cover. For personal policies, there are two main types.
| Feature | Moratorium (Mori) Underwriting | Full Medical Underwriting (FMU) |
|---|---|---|
| Application Process | Quick and simple, no health forms. | Requires a full health questionnaire. |
| Exclusions | Automatically excludes anything from the last 5 years. | Specifies exact exclusions from Day 1. |
| Clarity on Cover | You find out what's excluded when you claim. | You know exactly what's excluded upfront. |
| Lifting Exclusions | Pre-existing conditions may become eligible for cover after a 2-year trouble-free period. | Exclusions are typically permanent. |
| Best For | Younger, healthier people with no recent medical issues who want a fast application. | People with a known medical history who want absolute certainty about their cover. |
- Broker Insight: While Moratorium underwriting is popular for its simplicity, we often recommend Full Medical Underwriting for self-employed clients. Knowing precisely what you are and are not covered for from the outset provides the certainty you need when your business depends on your health.
Is Private Health Insurance a Tax-Deductible Expense for the Self-Employed?
This is a frequent and important question. The answer depends entirely on your business structure.
| Business Structure | Is the Premium a Business Expense? | Is it a Taxable Benefit? |
|---|---|---|
| Sole Trader | ❌ No | N/A |
| Partnership | ❌ No | N/A |
| Limited Company (Director) | ✅ Yes | ✅ Yes |
- For Sole Traders and Partnerships: PMI is considered a personal expense, paid for out of your post-tax income. It is not an allowable business expense and cannot be used to reduce your tax bill.
- For Limited Company Directors: The company can pay the premium, and this cost can be offset against the company's corporation tax bill. However, HMRC treats this as a 'benefit in kind'. This means the value of the premium must be declared on a P11D form, and the director will pay income tax on it. The company will also have to pay Class 1A National Insurance contributions on the value of the premium.
Disclaimer: This is for informational purposes only. You should always seek personalised advice from a qualified accountant regarding your specific tax situation.
Choosing the Best PMI Provider in the UK
The "best" provider is the one that offers the right combination of cover, service, and price for your unique circumstances. The main providers in the UK market each have their own strengths:
- Aviva: A major UK insurer with a strong reputation and a wide range of policy options.
- AXA Health: Known for excellent service, a comprehensive hospital list, and good mental health support.
- Bupa: The most recognised brand in UK health insurance, offering access to its own network of hospitals and clinics.
- The Exeter: A specialist friendly society known for its straightforward policies and positive feedback from members.
- Vitality: Unique in its focus on rewarding healthy living. Members can earn discounts and rewards for being active, which can help offset the cost of the premium.
The Power of an Independent Broker
Trying to compare these providers yourself can be overwhelming. This is where an independent broker like WeCovr provides invaluable help.
- Expert Advice at No Cost: Our service is completely free for you. We receive a commission from the insurer you choose, which is already built into the premium price.
- Whole-of-Market Comparison: We are not tied to any single insurer. We compare policies and prices from across the market to find the best fit for you.
- Tailored Solutions: We take the time to understand your needs as a self-employed professional and build a policy that reflects them.
- Ongoing Support: We don't just sell you a policy. We are here to help you at renewal to ensure you're still on the best deal, and we can even offer assistance during the claims process.
- Exclusive Perks: As a WeCovr client, you'll receive complimentary access to our AI calorie tracking app, CalorieHero, and can benefit from discounts on other insurance products like life or income protection cover.
Frequently Asked Questions (FAQ)
Can I get private health insurance if I have a pre-existing condition?
Does private medical insurance cover emergencies?
What happens to my policy if I stop being self-employed and take a job?
Is dental and optical cover included as standard?
Protect Your Health, Protect Your Business
For a self-employed professional, good health isn't a luxury; it's a business necessity. Private medical insurance provides a powerful tool to mitigate the financial risks of illness, giving you fast access to the care you need to get back to work.
By understanding your cover options, customising your policy, and working with an expert broker, you can find a policy that provides robust protection at a price that makes sense.
Take the first step towards securing your health and your income. Contact the friendly, expert team at WeCovr today for a free, no-obligation discussion and a personalised quote from the UK's leading insurers.
