
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.
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:
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.
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. |
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:
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. |
Let's consider two individuals, both aged 40 and living in Manchester.
This illustrates how customising your policy—something a specialist broker excels at—can lead to substantial savings without compromising on essential cover.
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.
It's just as important to know what PMI doesn't cover.
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:
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.
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.
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.
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%.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.






