
As an FCA-authorised expert PMI broker that has helped arrange over 900,000 policies, WeCovr understands the unique needs of modern families. This guide explains private medical insurance for foster families and legal guardians in the UK, helping you navigate coverage options for the children in your care.
Navigating the world of private medical insurance (PMI) can be complex, and for foster families and legal guardians, an extra layer of questions often arises. The primary challenge lies in how UK health insurance providers define a 'dependant child'. While biological and legally adopted children are almost always straightforward to include on a family policy, the situation for fostered children, those under a special guardianship order, or other non-biological children can vary significantly between insurers.
The key question insurers will ask is about legal and financial dependency. A foster placement is technically temporary, even if it's long-term, which can make some insurers hesitant. However, many leading providers have adapted their policies to reflect the reality of modern family structures. The crucial first step is always transparency. You must be clear about the child's legal status when applying for cover. An experienced broker can be invaluable in finding an insurer with a flexible and inclusive definition of 'family'.
While the NHS provides excellent care, the reality of long waiting lists can add significant stress, particularly for a child who may have already experienced instability or trauma. Private medical insurance is designed to work alongside the NHS, offering you and your family more choice, control, and faster access to specialist care when you need it most.
According to the latest NHS England statistics, the referral to treatment (RTT) waiting list stood at approximately 7.54 million in early 2025. For children, prompt diagnosis and treatment are vital for their development and wellbeing.
Key benefits of PMI for foster families include:
PMI gives you the peace of mind that you can access high-quality care quickly, allowing you to focus on what matters most: providing a stable and nurturing home for the child in your care.
This is the most critical area for foster carers and guardians. The term 'dependant child' is not standardised across the UK private medical insurance market. Each insurer sets its own rules, which is why you can be accepted by one and declined by another for the same child.
Typically, an insurer will want to establish:
Let's break down the common scenarios:
The table below gives a general overview of how different legal statuses might be viewed.
| Child's Legal Status | Likelihood of PMI Coverage | Key Considerations for Insurers |
|---|---|---|
| Biological Child | Guaranteed | Lives with you and is financially dependent. |
| Legally Adopted Child | Guaranteed | Treated identically to a biological child. |
| Child under a SGO | Very High | Permanent legal order granting parental responsibility. |
| Step-Child | Very High | Generally accepted as a dependant if living with you. |
| Foster Child | Variable | Depends entirely on the insurer. Long-term placements are more likely to be accepted. Requires full disclosure. |
Crucial Advice: Never assume. Always declare the child's exact legal status. Hiding this information could invalidate your entire policy at the point of a claim. Working with an expert PMI broker like WeCovr is the safest way to ensure you apply to the right insurer from the start.
Understanding what private medical insurance doesn't cover is just as important as knowing what it does. This is vital for all families, but especially for foster families, as children entering care may have a complex or unknown medical history.
The single most important rule to remember is:
Standard UK private medical insurance is designed for new, unexpected, acute conditions that arise after your policy has started.
It is not designed to cover:
Here are some common exclusions found on most UK PMI policies:
| Category | Examples | Why is it Excluded? |
|---|---|---|
| Chronic Conditions | Diabetes, asthma, high blood pressure, arthritis, Crohn's disease. | PMI is for curative treatment, not long-term management. These fall under the care of the NHS. |
| Pre-existing Conditions | A knee injury from two years ago, previous consultations for anxiety, past treatment for eczema. | The policy is designed to cover future, unforeseen risks, not known past issues. |
| Emergency Services | A&E visits, ambulance services, treatment for a heart attack or stroke. | These are handled by the NHS emergency services, which provide immediate, critical care. |
| Normal Pregnancy & Birth | Routine maternity care. | PMI is for unexpected illness, not planned life events. Some high-end policies cover complications. |
| Cosmetic Surgery | Procedures for aesthetic reasons. | Not medically necessary. Reconstructive surgery after an accident or illness may be covered. |
| Self-inflicted Injuries | Injuries resulting from substance abuse or dangerous hobbies (unless declared and accepted). | These are not considered unforeseen medical events in the same way as an illness. |
For foster families, the "pre-existing conditions" clause is paramount. If a child has a known medical history, it's essential to understand how this will be treated by the insurer before you buy.
Applying for PMI for your family, including a non-biological child, requires a careful and methodical approach. Follow these steps to ensure a smooth process and a policy that truly meets your needs.
Before you start getting quotes, have the following details ready:
This is not a sales pitch; it's a practical necessity. Given the complexities around insuring foster children, going direct to an insurer can be a minefield. You might spend hours completing an application only to be rejected based on their internal definition of a 'dependant'.
An FCA-authorised broker like WeCovr:
Underwriting is how insurers assess risk and decide what they will and won't cover. For a family policy, you have two main choices. This decision is particularly important when medical history might be unclear.
| Underwriting Type | How it Works | Pros for Foster Families | Cons for Foster Families |
|---|---|---|---|
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire for each family member. The insurer reviews this and states any specific exclusions on your policy documents from day one. | Clarity. You know exactly what is and isn't covered from the start. | Difficult. Can be challenging if the child's full medical history is unknown. May lead to more initial exclusions. |
| Moratorium Underwriting (Mori) | No initial health questionnaire. The policy automatically excludes any condition that existed in the 5 years prior to joining. This exclusion is reviewed after a 2-year continuous period on the policy. | Simple & Fast. Easy to set up without needing a complete medical history. | Uncertainty. You may not know if a condition is covered until you make a claim. The "2-year rule" can be complex. |
For a foster child with a patchy medical history, Moratorium underwriting is often the more practical option, as it bypasses the need for a detailed initial questionnaire. However, you must be comfortable with the ambiguity it creates. Your broker can help you weigh the pros and cons for your specific situation.
When you apply, you have a duty to disclose all 'material facts'. A material fact is anything that could influence an insurer's decision to offer you cover. The legal status of a child is always a material fact.
Never be tempted to list a foster child as a 'son' or 'daughter' without clarifying their legal status. If this is discovered later, the insurer has the right to cancel the policy, refuse a claim, and you could find it difficult to get insurance in the future. Honesty is always the best policy.
A common question from foster carers is whether they can use their fostering allowance to pay for private medical insurance. The fostering allowance is provided to cover the costs of caring for a child, including their health and wellbeing.
The short answer is: it depends on your local authority.
Our advice: Have an open conversation with your supervising social worker. Explain why you are considering PMI and ask for their guidance. They may be supportive, but you should not assume that the cost will be covered or subsidised by the allowance. Plan for PMI to be a cost you will cover yourself.
For many foster families, the most compelling reason to consider PMI is the mental health support it can unlock. Looked-after children are more likely to have experienced trauma, neglect, or instability, which can have a significant impact on their emotional wellbeing.
While NHS CAMHS provides essential support, it is under immense pressure, with long waiting lists for assessment and therapy in many parts of the UK. Private medical insurance can offer a vital alternative route to care.
What can PMI mental health cover include?
Many modern PMI policies also come with valuable added benefits that can be used without needing a GP referral:
When comparing policies, pay close attention to the mental health cover. Check the limits, the types of therapy covered, and whether you can access services directly.
Choosing the right private health cover is a major decision. At WeCovr, we go beyond simply finding you a policy. We provide ongoing support and additional benefits to help your family thrive.
We are here to act as your advocate, ensuring the process is as simple and transparent as possible.
Providing a healthy and stable environment is the cornerstone of great foster care. While PMI is a tool for when things go wrong, focusing on daily wellness can make a huge difference to a child's physical and emotional health.
Children thrive on predictability. A consistent routine around meals, homework, and bedtime can create a sense of safety and security.
Good nutrition is fundamental to physical health and mood.
Exercise is a powerful tool for managing stress and improving mood.
Creating an environment where a child feels heard and valued is crucial.
Providing the best possible care for a child is your priority. Navigating the private medical insurance market to support that goal is ours. Let WeCovr help you find a policy that gives you peace of mind and your family fast access to the best care.
Get a free, no-obligation quote today and let our experts find the right private medical insurance for your unique family.






