TL;DR
WeCovr helps UK customers save on PMI while getting the best cover from leading insurers As an FCA-authorised expert with over 900,000 policies of various types via embedded and direct channels issued, WeCovr specialises in navigating the complexities of the private medical insurance (PMI) market in the UK. Our mission is simple: to help you secure the best possible health cover from leading insurers at the most competitive price, ensuring peace of mind for you and your family. Understanding Private Medical Insurance in the UK Private Medical Insurance, often called private health cover or PMI, is an insurance policy designed to cover the costs of private healthcare for eligible medical conditions.
Key takeaways
- See Your GP: Your journey almost always starts with your NHS GP.
- Get a Referral: If your GP determines you need specialist consultation or diagnostic tests, they will provide a referral.
- Activate Your PMI: You contact your PMI provider with the referral details. They will confirm your cover is active and authorise the next steps.
- Receive Private Treatment: You can then arrange appointments with private consultants and book treatments at a private hospital, with the costs being settled directly by your insurer.
- Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include joint replacements, cataract surgery, or treatment for hernias.
WeCovr helps UK customers save on PMI while getting the best cover from leading insurers
As an FCA-authorised expert with over 900,000 policies of various types via embedded and direct channels issued, WeCovr specialises in navigating the complexities of the private medical insurance (PMI) market in the UK. Our mission is simple: to help you secure the best possible health cover from leading insurers at the most competitive price, ensuring peace of mind for you and your family.
Understanding Private Medical Insurance in the UK
Private Medical Insurance, often called private health cover or PMI, is an insurance policy designed to cover the costs of private healthcare for eligible medical conditions. It runs parallel to the National Health Service (NHS), offering policyholders more choice, flexibility, and faster access to treatment for specific health concerns.
While the NHS provides exceptional care to millions, it faces significant pressures. As of early 2025, NHS England figures show that waiting lists for routine treatments remain a major concern, with millions of people waiting for appointments. This has led many to consider private options to bypass lengthy queues and receive prompt medical attention.
How does PMI work alongside the NHS?
PMI is not a replacement for the NHS. The NHS remains the first port of call for accidents and emergencies, as well as for the management of long-term, chronic conditions. Private health cover is designed for non-emergency, treatable conditions.
Here’s a typical patient journey:
- See Your GP: Your journey almost always starts with your NHS GP.
- Get a Referral: If your GP determines you need specialist consultation or diagnostic tests, they will provide a referral.
- Activate Your PMI: You contact your PMI provider with the referral details. They will confirm your cover is active and authorise the next steps.
- Receive Private Treatment: You can then arrange appointments with private consultants and book treatments at a private hospital, with the costs being settled directly by your insurer.
The Critical Distinction: Acute vs. Chronic Conditions
This is the single most important concept to grasp when considering private health insurance. Standard UK PMI policies are designed to cover acute conditions that arise after your policy begins. They do not typically cover pre-existing or chronic conditions.
- Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include joint replacements, cataract surgery, or treatment for hernias.
- Chronic Condition: A disease, illness, or injury that has one or more of the following characteristics: it needs ongoing or long-term monitoring, has no known cure, is likely to recur, or requires palliative care. Examples include diabetes, asthma, arthritis, and high blood pressure.
- Pre-existing Condition: Any medical condition for which you have experienced symptoms, received medication, or sought advice before the start date of your policy.
Insurers exclude chronic and pre-existing conditions to keep premiums affordable. The purpose of PMI is to restore you to your previous state of health following a new, unexpected illness or injury, not to manage long-term incurable ailments.
| Condition Type | Covered by Standard PMI? | Example |
|---|---|---|
| Acute Condition | Yes | A bone fracture requiring surgery. |
| Chronic Condition | No | Ongoing management of Type 2 diabetes. |
| Pre-existing Condition | No | Sciatica for which you saw a GP last year. |
How WeCovr's Expert Broker Service Saves You Money
Navigating the PMI market alone can be daunting. With dozens of providers, hundreds of policy combinations, and confusing jargon, it's easy to either overpay or end up with inadequate cover. This is where an independent PMI broker like WeCovr adds immense value.
As your dedicated adviser, we work for you, not the insurance companies. Our service is provided at no cost to you, as we are compensated by the insurer you choose.
Here's our expert approach:
- Whole-of-Market Comparison: We have access to policies from the UK's leading and specialist insurers. We compare every relevant option to find the perfect match for your needs and budget, saving you hours of research.
- Tailored Policy Structuring: We don't believe in one-size-fits-all. We take the time to understand your health priorities, lifestyle, and financial situation. We then help you structure a policy by balancing core cover, optional extras, and cost-saving measures like excesses and hospital lists.
- Clarity and Impartial Advice: We cut through the jargon to explain your options in plain English. We highlight the key differences between policies, ensuring you understand exactly what is and isn't covered before you commit.
- Annual Reviews: The best policy for you today may not be the best next year. We proactively contact our clients before renewal to review their cover and re-broke the market, ensuring they continue to get the best value as their circumstances change and premiums inevitably rise.
Key Factors That Influence Your PMI Premium
The price of your private medical insurance premium is not arbitrary. It's calculated based on a range of risk factors. Understanding these can help you see where potential savings can be made.
| Factor | Impact on Premium | Why it Matters |
|---|---|---|
| Age | High | The likelihood of needing medical treatment increases significantly with age. This is the single biggest factor. |
| Location | Medium | Private medical costs, particularly in Central London, are higher than in other parts of the UK. |
| Level of Cover | High | A comprehensive policy with extensive outpatient cover and optional extras will cost more than a basic plan. |
| Policy Excess | High | A higher excess (the amount you pay towards a claim) will lower your monthly premium. |
| Hospital List | Medium | Choosing a limited list of hospitals, excluding expensive city-centre facilities, can reduce costs. |
| Underwriting Type | High | The method used to assess your medical history (e.g., moratorium or full medical underwriting) affects the premium. |
| Lifestyle | Medium | Smokers are considered higher risk and will pay more than non-smokers. |
Real-Life Example: The Impact of Policy Choices
Let's consider two individuals, both aged 40 and living in Manchester.
- Person A: Chooses a comprehensive policy with a £0 excess, full outpatient cover, mental health benefits, and access to all UK hospitals. Their estimated premium might be £95 per month.
- Person B: Opts for the same core cover but introduces a £500 excess, limits outpatient consultations to four per year, and chooses a guided hospital list. Their estimated premium could be reduced to £55 per month.
This illustrates how customising your policy—something a specialist broker excels at—can lead to substantial savings without compromising on essential cover.
Decoding Your PMI Policy: What's Included and Excluded?
Understanding the components of a PMI policy is key to making an informed decision. Policies are typically broken down into core cover and optional add-ons.
Core Cover (Usually Included as Standard)
- In-patient and Day-patient Treatment: This covers costs when you are admitted to a hospital bed, including surgery, accommodation, nursing care, and specialist fees. Day-patient treatment is similar but does not require an overnight stay.
- Cancer Cover: This is a cornerstone of modern PMI. It typically provides comprehensive cover for the diagnosis and treatment of cancer, including chemotherapy, radiotherapy, and surgery. Many policies also include access to novel or experimental drugs not yet available on the NHS.
- Diagnostics: Scans and tests like MRIs, CTs, and PET scans are often covered as standard when part of in-patient or day-patient care.
Common Optional Add-Ons
- Out-patient Cover: This is one of the most important options to consider. It covers diagnostic tests and consultations with a specialist that do not require hospital admission. You can often choose a limit (e.g., £1,000 per year) or a fully comprehensive option.
- Mental Health Cover: Provides cover for consultations with psychiatrists and psychologists, as well as in-patient treatment for acute mental health conditions. Given the growing awareness of mental wellbeing, this is an increasingly popular add-on.
- Therapies Cover: Includes treatment from physiotherapists, osteopaths, and chiropractors.
- Dental and Optical Cover: Provides a contribution towards routine check-ups, treatments, and prescription eyewear.
What is Almost Always Excluded?
It's just as important to know what PMI doesn't cover.
- Pre-existing Conditions: As explained earlier, any condition you had before taking out the policy.
- Chronic Conditions: Long-term illnesses like diabetes, asthma, and high blood pressure.
- Emergency Services: Any visit to an A&E department is handled by the NHS.
- Normal Pregnancy and Childbirth: Complications of pregnancy may be covered, but routine maternity care is not.
- Cosmetic Surgery: Procedures that are not medically necessary.
- Self-inflicted Injuries: Including those related to substance abuse or dangerous sports (unless specialist cover is purchased).
A Practical Guide to Cutting Your Private Health Cover Costs
Securing affordable private medical insurance is about being smart with your choices. Here are proven strategies that WeCovr uses to help our clients reduce their premiums:
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Increase Your Excess: Agreeing to pay a larger portion of the first claim in a policy year (e.g., £250, £500, or £1,000) is the most effective way to lower your monthly payments. You only pay the excess once per policy year, regardless of how many claims you make.
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Opt for a Guided Consultant List: Some insurers offer a "guided" option where they provide a shortlist of 3-5 approved specialists for your condition. Because the insurer has pre-negotiated rates with these consultants, they pass the savings on to you in the form of a lower premium.
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Choose a Reduced Hospital List: Unless you live in Central London or require access to very specific hospitals, you can often save money by choosing a hospital network that excludes the most expensive facilities.
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Consider the 6-Week Wait Option: This is a clever way to blend NHS and private care. With this option, if the NHS waiting list for your required in-patient procedure is longer than six weeks, your PMI policy will kick in to provide private treatment. If the wait is less than six weeks, you use the NHS. This can reduce your premium by 20-30%.
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Review Your Cover Annually: Don't let your policy auto-renew without a review. Insurers often offer their most competitive rates to new customers. An annual market comparison by a broker can often find you the same or better cover for less.
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Maintain a Healthy Lifestyle: Many leading insurers now offer rewards and premium discounts for members who demonstrate a healthy lifestyle through fitness trackers and health apps. Non-smokers will always pay less than smokers.
Understanding Underwriting: The Key to Your Cover
Underwriting is the process an insurer uses to assess your medical history and decide which conditions, if any, to exclude from your policy. There are two main types in the UK.
Moratorium (MORI) Underwriting
This is the most common and straightforward method. You are not required to disclose your full medical history upfront. Instead, the insurer automatically excludes any condition you have had symptoms, treatment, or advice for in the five years prior to the policy start date.
However, if you remain symptom-free and require no treatment or advice for that condition for a continuous two-year period after your policy starts, the exclusion may be lifted, and it could become eligible for cover.
Full Medical Underwriting (FMU)
With FMU, you complete a detailed health questionnaire, disclosing your entire medical history. The insurer's underwriting team then reviews this information and tells you from day one exactly what is covered and what is permanently excluded. The premium for an FMU policy may be slightly lower initially, but the exclusions are fixed and will not be lifted over time.
| Feature | Moratorium (MORI) Underwriting | Full Medical Underwriting (FMU) |
|---|---|---|
| Application Process | Quick and simple. No medical forms. | Longer. Requires a full health questionnaire. |
| Clarity on Cover | Ambiguous at first. Cover is determined at the point of a claim. | Clear from day one. You receive a list of specific exclusions. |
| Pre-existing Conditions | Automatically excluded for a set period (usually 5 years). | Assessed individually and typically excluded permanently. |
| Claim Process | Can be slower as insurer needs to check medical history at the time of claim. | Generally faster as exclusions are already defined. |
| Best For | People with a clean bill of health or minor past issues who want a quick start. | People with a complex medical history who want certainty about their cover. |
Choosing the right underwriting is a crucial decision. A WeCovr adviser can explain the pros and cons of each method based on your personal circumstances.
The WeCovr Advantage: More Than Just Insurance
We believe in providing holistic value to our clients, extending beyond just finding the right policy. When you partner with WeCovr for your private health cover, you gain access to exclusive benefits designed to support your overall wellbeing.
- Complimentary Access to CalorieHero: All our clients receive free access to our proprietary AI-powered calorie and nutrition tracking app, CalorieHero. It's a powerful tool to help you manage your diet, achieve your fitness goals, and maintain a healthy lifestyle, which can positively impact your long-term health and insurance costs.
- Discounts on Other Insurance: We value your loyalty. Clients who take out PMI or Life Insurance with us are eligible for exclusive discounts on other products, including income protection and critical illness cover, helping you build a comprehensive financial safety net for less.
- Exceptional Customer Service: Our commitment to our clients is reflected in our consistently high satisfaction ratings on independent review platforms. We pride ourselves on providing clear, empathetic, and expert advice throughout your journey with us.
Frequently Asked Questions (FAQ) about UK Private Medical Insurance
Is private medical insurance worth it in the UK?
Whether PMI is worth it depends on your individual circumstances, priorities, and budget. For many, the key benefits are peace of mind, faster access to treatment for eligible conditions, more choice over where and when you're treated, and access to a private room. If bypassing long NHS waiting lists for procedures like hip replacements or cataract surgery is important to you, PMI can be highly valuable.
How much does private health cover cost per month?
The cost of PMI varies widely based on factors like age, location, level of cover, and chosen excess. A basic policy for a young, healthy individual might start from as little as £30 per month. A comprehensive policy for a 50-year-old could be £100 per month or more. The best way to get an accurate figure is to get a tailored quote based on your specific needs.
Does private medical insurance cover pre-existing conditions?
No, standard private medical insurance policies in the UK do not cover pre-existing conditions. A condition is considered pre-existing if you have experienced symptoms or sought advice, medication, or treatment for it before your policy start date. PMI is designed to cover new, acute medical conditions that arise after you join.
Can I buy PMI if I already have a medical condition?
Yes, you can still buy PMI even if you have a pre-existing condition. That specific condition (and any related conditions) will be excluded from cover, but you will be covered for any new, independent acute conditions that occur after your policy begins. This is why it's so important to have an open discussion with a broker to understand what will and won't be covered.
Ready to Find the Best Private Medical Insurance?
Take the guesswork out of choosing private health cover. Let a WeCovr expert do the hard work for you. We'll compare the UK's leading insurers to find you the right policy at the best price, completely free of charge.
Get your free, no-obligation quote today and discover how much you could save.











