TL;DR
As an FCA-authorised expert with over 900,000 policies arranged, WeCovr helps individuals find the best private medical insurance in the UK. This guide explores your options for single person PMI, ensuring you can make an informed choice about your health and wellbeing. Finding cover as an individual and what to look for in solo health insurance policies Navigating the world of private medical insurance (PMI) on your own can feel daunting.
Key takeaways
- Speed of Access: Bypass long waiting lists for eligible consultations, diagnostic tests (like MRI and CT scans), and surgical procedures. This can mean getting a diagnosis and starting treatment in weeks, not months.
- Choice and Control: You can choose your specialist, consultant, and hospital from a list provided by your insurer. This allows you to select a medical professional with a specific expertise or a hospital that is convenient for you.
- Enhanced Comfort: Receive treatment in a private hospital room, which usually includes an en-suite bathroom, better food options, and more flexible visiting hours. This can make a significant difference to your comfort and recovery.
- Access to Specialist Drugs and Treatments: Some advanced cancer drugs or innovative treatments may not be available on the NHS due to cost or NICE (National Institute for Health and Care Excellence) approval delays. PMI can provide funding for these, offering access to cutting-edge medical care.
- An acute condition is 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, hernia repair, and treatment for most cancers.
As an FCA-authorised expert with over 900,000 policies arranged, WeCovr helps individuals find the best private medical insurance in the UK. This guide explores your options for single person PMI, ensuring you can make an informed choice about your health and wellbeing.
Finding cover as an individual and what to look for in solo health insurance policies
Navigating the world of private medical insurance (PMI) on your own can feel daunting. Unlike corporate schemes where options are pre-selected, an individual policy gives you complete control. This means you can tailor your cover to your exact needs and budget, but it also means you need to understand what you're buying.
This comprehensive guide will walk you through everything you need to know about single person private health cover. We'll explore why it's becoming an increasingly popular choice, what to look for in a policy, how to manage costs, and which providers lead the market. Our goal is to demystify the process, giving you the confidence to secure the right protection for your health.
Why Consider Private Health Cover as an Individual?
While the NHS remains a cornerstone of UK healthcare, providing exceptional care to millions, it is facing unprecedented pressure. For individuals seeking quicker access to treatment and more control over their healthcare journey, private medical insurance offers a compelling alternative.
According to the latest data from NHS England, the waiting list for routine hospital treatment stood at over 7.5 million cases in 2024. The median waiting time can be several months, a period of uncertainty and discomfort that many wish to avoid.
Here are the primary benefits of a single person PMI policy:
- Speed of Access: Bypass long waiting lists for eligible consultations, diagnostic tests (like MRI and CT scans), and surgical procedures. This can mean getting a diagnosis and starting treatment in weeks, not months.
- Choice and Control: You can choose your specialist, consultant, and hospital from a list provided by your insurer. This allows you to select a medical professional with a specific expertise or a hospital that is convenient for you.
- Enhanced Comfort: Receive treatment in a private hospital room, which usually includes an en-suite bathroom, better food options, and more flexible visiting hours. This can make a significant difference to your comfort and recovery.
- Access to Specialist Drugs and Treatments: Some advanced cancer drugs or innovative treatments may not be available on the NHS due to cost or NICE (National Institute for Health and Care Excellence) approval delays. PMI can provide funding for these, offering access to cutting-edge medical care.
PMI isn't about replacing the NHS. It's about working alongside it. The NHS will always be there for emergencies (A&E), but for planned, acute care, private health cover gives you a valuable alternative route.
The Golden Rule: What PMI Covers (and What It Doesn't)
This is the most critical aspect to understand before you consider buying any private medical insurance policy. Misunderstanding this can lead to disappointment and frustration.
UK private medical insurance is designed to cover acute conditions that arise after your policy has started.
- An acute condition is 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, hernia repair, and treatment for most cancers.
Crucially, standard UK PMI policies DO NOT cover:
- Pre-existing conditions: Any illness, disease, or injury for which you have experienced symptoms, received medication, or sought advice before the start of your policy.
- Chronic conditions: Illnesses that cannot be cured and require long-term management, rather than a short course of treatment. Examples include diabetes, asthma, high blood pressure, and arthritis.
While the day-to-day management of a chronic condition is not covered, an acute flare-up or a new, related condition might be. For example, your policy won't cover your insulin for diabetes, but it might cover a new kidney problem that develops years later, subject to your policy's terms.
Understanding Underwriting: How Insurers Assess Your Health History
When you apply for cover, an insurer needs to know about your medical history to exclude pre-existing conditions. There are two main ways they do this:
| Underwriting Type | How it Works | Pros | Cons |
|---|---|---|---|
| Moratorium (Most Common) | You don't declare your full medical history upfront. The insurer applies a blanket exclusion for any condition you've had in the last 5 years. This exclusion can be lifted if you go 2 continuous years without any symptoms, treatment, or advice for that condition after your policy starts. | Quick and easy application process. No need to fill out long medical questionnaires. | "Wait and see" approach. You may not know for certain if a condition is covered until you make a claim. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire, declaring your entire medical history. The insurer then reviews this and states exactly what is and isn't covered from day one. | Provides complete clarity from the outset. You know precisely what exclusions are on your policy. | Application process is longer and more intrusive. Exclusions are often permanent and cannot be reviewed later. |
An expert broker, like WeCovr, can help you decide which underwriting method is best for your personal circumstances.
Core Components of a Single Person Health Insurance Policy
A PMI policy is built from a combination of core cover and optional extras. Understanding these building blocks allows you to create a policy that perfectly balances protection and price.
1. Core Cover (The Foundation)
This is the standard, non-negotiable part of every policy. It typically covers the most expensive aspects of private treatment.
- In-patient Treatment: Covers costs when you are admitted to a hospital bed overnight. This includes surgery fees, consultant fees, hospital accommodation, and nursing care.
- Day-patient Treatment: Covers procedures where you are admitted to hospital for a day but do not need to stay overnight (e.g., a colonoscopy or minor surgery).
- Comprehensive Cancer Cover: This is a vital part of most core policies and is a primary reason many people take out PMI. It usually covers the diagnosis and treatment of cancer, including surgery, radiotherapy, and chemotherapy. Many policies also fund expensive drugs not routinely available on the NHS.
2. Out-patient Cover (The Most Important Add-on)
This is usually an optional extra, but it's one we highly recommend considering. Out-patient cover pays for treatment where you aren't admitted to a hospital bed.
- Specialist Consultations: The first step to a diagnosis is often a consultation with a specialist. This covers the cost of that appointment.
- Diagnostic Tests & Scans: Pays for MRI, CT, and PET scans, X-rays, and blood tests that are crucial for a swift diagnosis.
Without out-patient cover, you would have to rely on the NHS for your initial diagnosis, which could involve a long wait. Only then could you use your PMI for the in-patient treatment. Most people choose a level of out-patient cover, ranging from a few hundred pounds per year to a fully comprehensive option.
3. Other Key Policy Options
- Mental Health Cover: Support for mental health is increasingly important. This add-on can provide access to psychiatrists, psychologists, and therapy sessions. Cover varies significantly between providers, so it's important to check the details.
- Therapies Cover: This option covers treatments like physiotherapy, osteopathy, and chiropractic care, which are essential for recovery from injuries or surgery.
- Hospital List: Insurers group hospitals into tiers. A basic list includes a good range of local private hospitals. A more comprehensive list might add major national groups and central London hospitals. The more extensive the hospital list, the higher the premium.
- Dental and Optical Cover: This is rarely included as standard. It's an optional add-on that provides cashback for routine check-ups, glasses, and dental treatment. It is often better value to purchase this as a separate 'cash plan' policy.
How to Customise Your Policy and Manage Your Premiums
One of the great advantages of a single person policy is the ability to adjust it to fit your budget. Here are the most effective ways to manage the cost of your private medical insurance UK:
- Choose an Excess: An excess is the amount you agree to pay towards a claim each year. For example, if you have a £250 excess and your treatment costs £3,000, you pay the first £250 and the insurer pays the remaining £2,750. A higher excess (£500 or £1,000) will significantly lower your monthly premium.
- Add a 6-Week Option: This is a very popular cost-saving feature. If the NHS can provide the in-patient treatment you need within six weeks of when it is recommended, you agree to use the NHS. If the wait is longer than six weeks, your private cover kicks in. As this reduces the risk for the insurer, it can cut your premium by 20-30%.
- Limit Your Out-patient Cover: Instead of unlimited out-patient cover, you could choose a capped limit (e.g., £1,000 per year). This still gives you excellent access to diagnostics but at a lower cost.
- Select a Guided Hospital List: Some providers offer a "guided" or "expert select" option. This means that for a given condition, the insurer will offer you a choice of 2-3 pre-vetted specialists and hospitals known for their excellent outcomes. This lack of full choice is rewarded with a lower premium.
| Cost-Saving Tactic | How it Reduces Your Premium | Potential Saving | Key Consideration |
|---|---|---|---|
| Increase Your Excess | You share a small part of the cost of a claim. | 15-40% | You must be able to afford the excess amount if you need to make a claim. |
| Add a 6-Week Option | You use the NHS if its waiting list is short, reducing the likelihood of a private claim. | 20-30% | Only applies to in-patient treatment; your out-patient diagnostics are unaffected. |
| Limit Hospital Choice | Restricting yourself to local hospitals or a guided list lowers the insurer's potential costs. | 10-20% | You may not be able to access a specific hospital or consultant in London. |
| Reduce Out-patient Cover | Capping the amount you can claim for diagnostics and consultations lowers the insurer's risk. | 10-25% | A complex diagnosis could exceed your limit, leaving you to self-fund the rest. |
Comparing the Best UK PMI Providers for Individuals
The UK market is home to several outstanding insurers, each with its own unique strengths. While the "best" provider is always subjective and depends on your individual needs, here's a look at the leading names.
| Provider | Key Feature / Unique Selling Point | Best For... | Indicative Monthly Cost* |
|---|---|---|---|
| AXA Health | Excellent core cover and a large, established hospital network. Their "Personal Health" plan is clear and flexible. | Individuals seeking straightforward, high-quality cover with a strong reputation and access to the latest medical technology. | £50 - £85 |
| Aviva | Strong brand, comprehensive cancer cover ("Cancer Care Promise"), and a well-regarded digital GP service. | Those who value the security of a large, trusted insurer and want market-leading cancer protection. | £45 - £80 |
| Bupa | The UK's most well-known health insurer with a vast network, including their own clinics and hospitals. | People looking for a premium service with direct access to support for cancer and mental health without needing a GP referral. | £55 - £95 |
| Vitality | A unique "shared value" model that rewards healthy living with premium discounts, cinema tickets, and coffee. | Active, engaged individuals who want to be rewarded for staying healthy and are motivated by incentives and wearable tech integration. | £40 - £75 |
| The Exeter | A smaller, mutual (not-for-profit) society known for its flexible underwriting and community-rated pricing for older members. | Self-employed individuals or those with a more complex medical history who may benefit from a more personal underwriting approach. | £48 - £82 |
| WPA | A not-for-profit insurer with a focus on high customer satisfaction and transparent "Shared Responsibility" pricing. | Individuals who value exceptional customer service, ethical company structure, and freedom of choice in specialists. | £45 - £80 |
*Indicative costs are for a healthy 35-year-old non-smoker with a £250 excess and £1,000 out-patient cover. Prices are for illustration only and will vary.
The Smart Choice: Using an Expert PMI Broker
Trying to compare all these providers, options, and pricing structures on your own can be overwhelming. This is where an independent PMI broker like WeCovr provides invaluable assistance.
Using a specialist broker doesn't cost you anything extra; we are paid a commission by the insurer you choose. Our role is to work for you, not the insurance company.
Benefits of using WeCovr:
- Whole-of-Market Advice: We compare policies from all the leading UK insurers to find the best fit for your needs and budget.
- Expert Guidance: We explain the jargon and help you understand the crucial differences between policies, ensuring there are no hidden surprises.
- Save Time and Money: We do all the research and can often find deals or pricing structures not available to the public. Our clients enjoy high satisfaction ratings because we prioritise their needs.
- Support at Claim Time: Should you need to use your policy, we can offer guidance and support to help ensure the process is as smooth as possible.
Case Study: Sarah, the Freelance Designer
Sarah is a 38-year-old freelance graphic designer living in Manchester. She's active but has recently developed knee pain. Her GP suspects a torn meniscus and has referred her to an NHS orthopaedic specialist, but the waiting list for an appointment is four months, with a further wait for an MRI scan and potential surgery.
- Concern: Sarah's work depends on her being able to sit comfortably at a desk, and the pain is affecting her productivity. She's worried about the long wait and the impact on her income.
- Action (illustrative): She contacts WeCovr for advice. Her broker discusses her budget (around £60/month) and priorities (fast access to diagnostics and treatment for her knee).
- Solution (illustrative): The broker compares policies from Aviva, AXA, and Vitality. They recommend an Aviva policy with a £500 excess and the 6-Week Wait option. The policy includes £1,500 of out-patient cover, which is more than enough for her consultation and MRI scan.
- Outcome (illustrative): Sarah's policy costs her £58 per month. Within a week of taking it out, she has an appointment with a private specialist. An MRI scan a few days later confirms the torn meniscus. She has keyhole surgery two weeks after that in a private hospital near her home and is back to working comfortably within a month of her first call.
Beyond Insurance: The Rise of Wellness and Added Value
Modern health insurance is no longer just about covering you when you're ill; it's also about helping you stay well. Many providers now include fantastic wellness benefits and rewards as part of their offering.
- Vitality is the leader in this space, with its Active Rewards programme. By tracking your activity through a smartwatch or phone, you can earn points that translate into weekly coffees, cinema tickets, and significant discounts on your premium.
- Aviva and AXA Health offer apps with access to digital GPs, mental health support, and discounts on gym memberships and health tech.
At WeCovr, we believe in this holistic approach to health. That's why clients who purchase a PMI or life insurance policy through us receive complimentary access to CalorieHero, our proprietary AI-powered calorie and nutrition tracking app. We also offer our valued clients discounts on other types of cover, helping you protect all aspects of your life more affordably.
Maintaining a healthy lifestyle through a balanced diet, regular physical activity (aiming for 150 minutes of moderate-intensity exercise a week), and good sleep hygiene (7-9 hours per night) not only improves your quality of life but can also help keep your insurance premiums down in the long term.
Do I need private health insurance if I'm young and healthy?
What is the difference between moratorium and full medical underwriting?
Can I add my partner or family to my single policy later on?
Is dental and optical cover included in standard PMI?
Your Next Step to Personalised Health Cover
Choosing the right single person private medical insurance policy is one of the best investments you can make in your long-term health and wellbeing. It provides the security and peace of mind that comes from knowing you can access high-quality care quickly when you need it most.
Don't navigate the complexities of the market alone. Let our friendly, expert team at WeCovr do the hard work for you. We will listen to your needs, compare the UK's leading providers, and find you the perfect policy at a competitive price.
[Get Your Free, No-Obligation PMI Quote Today]
Sources
- Office for National Statistics (ONS): Mortality, earnings, and household statistics.
- Financial Conduct Authority (FCA): Insurance and consumer protection guidance.
- Association of British Insurers (ABI): Life insurance and protection market publications.
- HMRC: Tax treatment guidance for relevant protection and benefits products.
