WeCovr's Guide to Choosing the Right PMI Policy
Navigating the world of private medical insurance (PMI) in the UK can feel overwhelming. As an FCA-authorised broker that has helped arrange over 900,000 policies, the experts at WeCovr understand the landscape inside out. This guide provides clear, step-by-step advice to help you find the perfect private health cover.
Step-by-step advice from expert brokers
Choosing the right PMI policy is a significant decision. It's about investing in your health, gaining peace of mind, and ensuring you have access to prompt, high-quality medical care when you need it most. Our expert brokers have distilled the process into nine manageable steps to demystify private health insurance and empower you to make an informed choice.
Step 1: Understand What Private Medical Insurance Is (and Isn't)
Before diving into comparisons, it's crucial to grasp the fundamental purpose of PMI in the UK.
Private Medical Insurance is designed to cover the costs of private treatment for acute conditions that arise after you take out your policy.
An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Think of conditions like hernias, cataracts, or joint problems requiring replacement surgery.
The Crucial Distinction: Acute vs. Chronic Conditions
This is the single most important concept to understand. Standard UK private medical insurance does not cover chronic conditions.
- Acute Condition: Comes on suddenly, has a limited duration, and is treatable. Examples: Appendicitis, a broken bone, infections.
- Chronic Condition: A long-term condition that cannot be cured but can be managed. Examples: Diabetes, asthma, high blood pressure, arthritis.
PMI also does not cover pre-existing conditions. A pre-existing condition is any disease, illness, or injury for which you have experienced symptoms, received medication, or sought advice before your policy start date. We'll explore how insurers handle this in Step 4.
How PMI Works with the NHS
PMI is not a replacement for the National Health Service (NHS). It works alongside it. You will still use the NHS for:
- Accidents and Emergencies (A&E): Urgent and life-threatening situations are always handled by the NHS.
- GP Services: Your NHS GP remains your first point of contact for health concerns.
- Management of Chronic Conditions: Long-term illnesses are managed through the NHS.
PMI gives you a choice. For eligible acute conditions, you can bypass NHS waiting lists and receive treatment privately, often at a time and hospital convenient for you. With NHS waiting lists in England reaching 7.54 million cases in early 2025, this speed of access is a primary reason many people opt for private health cover.
Step 2: Assess Your Personal Needs and Budget
A PMI policy is not a one-size-fits-all product. The best policy for a single 25-year-old will be vastly different from one for a family of four. Take a moment to consider your specific circumstances.
Key Questions to Ask Yourself:
- Who needs cover? Just yourself, you and a partner, or your whole family?
- What is your budget? Be realistic about what you can comfortably afford each month. Premiums can range from £30 to over £150 per month depending on age, location, and level of cover.
- What are your health priorities? Are you concerned about access to cancer care, mental health support, or physiotherapy?
- What is your lifestyle? Are you very active and want cover for sports injuries? Do you value wellness rewards?
- Where do you live? Your postcode affects your premium, as medical costs vary across the UK.
Balancing Cost and Coverage
Finding the right balance is key. A cheaper policy might seem appealing, but it could have significant limitations, such as a restricted hospital list or no out-patient cover.
| Budget Level | Typical Monthly Premium (for a 40-year-old) | Core Features | Potential Limitations |
|---|---|---|---|
| Basic | £35 - £55 | In-patient & day-patient treatment, comprehensive cancer cover. | No or very limited out-patient cover, restricted hospital list, higher excess. |
| Mid-Range | £60 - £90 | All basic features, plus a set limit for out-patient diagnostics and consultations. | Out-patient limit may not cover all costs, some therapies might be excluded. |
| Comprehensive | £95+ | All features, with full or high-limit out-patient cover, plus options for mental health, dental, and therapies. | Higher premium cost. |
Note: These are illustrative costs and will vary significantly based on individual factors.
An expert broker at WeCovr can help you perform this needs analysis, ensuring you don't pay for features you don't need or miss out on cover that's vital for you.
Step 3: Decode the Jargon: Key PMI Terminology Explained
The PMI market is full of specific terms. Understanding them is essential for comparing policies effectively.
| Term | Simple Explanation | Why It Matters |
|---|---|---|
| Underwriting | The process an insurer uses to assess your health and medical history to decide what they will and won't cover. | This determines whether your pre-existing conditions are excluded permanently or temporarily. |
| Excess | A fixed amount you agree to pay towards the cost of your treatment per claim or per policy year. | A higher excess lowers your monthly premium, but means you pay more when you claim. |
| Policy Limits | The maximum amount an insurer will pay out, either per year or per condition. | Most policies have an annual limit of £1m or more, but some cheaper plans may have lower limits. |
| Hospital List | A list of private hospitals and facilities where you are covered for treatment. | A more extensive list, especially with central London hospitals, will increase your premium. |
| In-patient | Treatment that requires you to be admitted to a hospital bed overnight. | This is the core of all PMI policies. |
| Day-patient | Treatment that requires a hospital bed for the day but you don't stay overnight (e.g., minor surgery). | Also a core component of all policies. |
| Out-patient | Consultations, diagnostic tests (like MRI scans), or treatment where you are not admitted to a hospital bed. | This is a crucial variable. Basic policies have little to no out-patient cover, while comprehensive ones have extensive cover. |
| No Claims Discount (NCD) | A discount on your premium that increases each year you don't make a claim. | It rewards you for staying healthy but can be reduced or lost if you claim, increasing future premiums. |
Step 4: Compare Underwriting Options: Mori vs. FMU
This is one of the most critical choices you'll make. It directly impacts what pre-existing conditions are covered.
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Moratorium Underwriting (Mori): This is the most common type. You don't declare your full medical history upfront. Instead, the insurer applies a general exclusion for any condition you've had in the 5 years before your policy started. However, if you then go for a set period (usually 2 years) without any symptoms, treatment, or advice for that condition, it may become eligible for cover. It's a "deal with it later" approach.
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Full Medical Underwriting (FMU): With FMU, you provide your complete medical history by filling out a detailed questionnaire. The insurer then assesses this information and gives you a definitive list of what is and isn't covered from day one. Any specific conditions are likely to be permanently excluded. It provides certainty from the start.
Moratorium vs. Full Medical Underwriting: A Head-to-Head Comparison
| Feature | Moratorium Underwriting | Full Medical Underwriting |
|---|---|---|
| Upfront Process | Quick and simple. No medical forms. | Longer application process. Requires a full health questionnaire. |
| Pre-existing Conditions | Automatically excluded for a set period (usually 5 years pre-policy). | Exclusions are decided at the start and are usually permanent. |
| Cover for Past Conditions | Possible to gain cover after a 2-year trouble-free period. | Pre-existing conditions are typically excluded for good. |
| Claims Process | Can be slower as the insurer may need to investigate your medical history at the point of claim. | Generally faster and more straightforward as exclusions are already defined. |
| Best For | People with a clean bill of health or minor past issues who want a quick start. | People who want absolute certainty about what is covered from day one. |
A WeCovr broker can discuss your medical history (in complete confidence) and advise which underwriting method is most suitable for your situation.
Step 5: Choose Your Level of Cover
Insurers typically offer three main tiers of private medical insurance in the UK.
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Basic (or Core) Cover: This is the entry-level option, designed to cover the most expensive treatments. It almost always includes:
- In-patient and day-patient treatment (hospital fees, surgeon fees, anaesthetist fees).
- Comprehensive cancer cover, including chemotherapy and radiotherapy.
- Some digital GP services and a health support helpline.
-
Mid-Range Cover: This builds on the basic plan by adding a layer of out-patient benefits. It typically includes:
- Everything in the Basic plan.
- A financial limit for out-patient diagnostics and consultations (e.g., up to £1,000 per year). This covers specialist appointments and tests needed to find out what's wrong.
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Comprehensive Cover: This is the most extensive level of cover, offering broad protection and peace of mind. It includes:
- Everything in the Mid-Range plan.
- Full or very high-limit out-patient cover.
- Often includes cover for therapies (like physiotherapy) and mental health treatment as standard.
Step 6: Customise Your Policy with Add-ons
Once you've chosen your core level of cover, you can tailor your policy with optional extras. This allows you to build a plan that perfectly matches your priorities without paying for things you don't value.
Common PMI Add-ons:
- Therapies Cover: Covers treatments like physiotherapy, osteopathy, and chiropractic care. Essential for active people or those with musculoskeletal concerns.
- Mental Health Cover: Provides access to private psychiatrists, psychologists, and therapists. With growing awareness of mental wellbeing, this is an increasingly popular and valuable add-on.
- Dental and Optical Cover: Contributes towards the costs of routine check-ups, dental treatments, and new eyewear. This is often more of a cashback benefit than true insurance.
- Travel Cover: Some insurers allow you to add a European or Worldwide travel insurance policy to your PMI plan.
- Protected No Claims Discount: For an extra fee, you can protect your NCD, allowing you to make one or two claims without it being reduced.
Step 7: Select Your Hospital List
Insurers group hospitals into bands or lists, which directly affects your premium.
- Local/Regional Lists: These lists include a selection of private hospitals in your local area but exclude the more expensive national centres and those in Central London. This is a great way to reduce your costs if you are happy to be treated locally.
- National Lists: These offer a wide choice of hospitals across the UK, including well-known groups like Nuffield Health, Spire, and Circle Health Group. They typically exclude the very high-cost hospitals in Central London.
- Premium / London Lists: These give you access to virtually any private hospital in the UK, including the prestigious and highly specialised facilities in Central London (e.g., The London Clinic, The Cromwell). This is the most expensive option.
Consider where you would want to be treated. If you live outside a major city, a local list might be perfectly adequate and save you a significant amount of money.
Step 8: Decide on Your Excess
The excess is the amount you contribute towards a claim. For example, if your excess is £250 and your eligible treatment costs £3,000, you pay the first £250 and your insurer pays the remaining £2,750.
- How it affects your premium: The higher your excess, the lower your monthly premium.
- Typical options: £0, £100, £250, £500, £1,000.
- Per claim vs. per year: Most policies apply the excess per policy year. This means you only pay it once per year, regardless of how many claims you make. Some cheaper policies might apply it per claim, which can become expensive if you need multiple treatments.
Choosing a higher excess (e.g., £500) is a very effective way to make your private health cover more affordable, especially if you see it as protection for major issues rather than minor ones.
Step 9: Compare Providers (But Let a Broker Do the Hard Work)
The UK PMI market is competitive, with several excellent providers, each with its own strengths.
| Provider | Known For | WeCovr's Expert Take |
|---|---|---|
| AXA Health | Strong clinical support, extensive network, and advanced digital health tools. | A solid choice for comprehensive cover and those who value a digitally-led health journey. |
| Aviva | An established "big four" insurer offering flexible and often price-competitive options. | A great all-rounder, particularly strong for family policies and its extensive "Expert Select" hospital network. |
| Bupa | A household name with a huge hospital and clinic network and a focus on direct care pathways. | A premium brand known for its comprehensive benefits and seamless customer experience. |
| Vitality | A unique wellness-focused approach that rewards members for healthy living. | Perfect for active individuals who want to engage with their health and earn rewards like cinema tickets and coffee. |
| WPA | A not-for-profit provider known for outstanding customer service and flexible underwriting. | Highly rated for its personal touch, making it a favourite among the self-employed and small businesses. |
While you can research these yourself, a specialist PMI broker like WeCovr does this for you. We have access to the whole market and can quickly identify the provider and policy that offers the best value for your specific needs, at no extra cost to you. Our expert knowledge means we can highlight the subtle but important differences in policy wording that you might miss.
The WeCovr Advantage: More Than Just a Policy
Choosing WeCovr as your broker gives you more than just a price comparison. We're committed to your long-term health and wellbeing.
- Expert, Free Advice: Our service is completely free to you. We earn a commission from the insurer you choose, which is already built into the price of the policy. You pay the same price (or often less) than going direct, but with the added benefit of our expert guidance.
- Complimentary CalorieHero Access: All our PMI and Life Insurance clients receive complimentary access to our powerful AI-driven calorie and nutrition tracking app, CalorieHero. It's a fantastic tool to help you manage your diet and achieve your health goals.
- Multi-Policy Discounts: When you take out a PMI or Life Insurance policy with us, you become eligible for exclusive discounts on other types of cover you might need, helping you save money across the board.
- Trusted Support: With high customer satisfaction ratings, we pride ourselves on being there for our clients not just at the point of sale, but for annual reviews and any claims queries you might have.
Maintaining Your Health: Beyond Insurance
While PMI provides a safety net, the best strategy is always to proactively manage your health. Here are some tips to support your wellbeing.
Diet and Nutrition
A balanced diet is the cornerstone of good health. Focus on whole foods: fruits, vegetables, lean proteins, and whole grains. According to Public Health England's Eatwell Guide, your daily intake should consist of at least five portions of a variety of fruit and vegetables. Using an app like CalorieHero can help you track your intake and ensure you're getting the right balance of macronutrients and micronutrients.
The Importance of Sleep
The NHS recommends adults get 7 to 9 hours of quality sleep per night. Poor sleep is linked to a host of health issues, including a weakened immune system, weight gain, and poor mental health. Establish a routine: go to bed and wake up at the same time each day, avoid caffeine in the evening, and create a restful, dark, and quiet bedroom environment.
Staying Active
The UK Chief Medical Officers' guidelines recommend at least 150 minutes of moderate-intensity activity a week or 75 minutes of vigorous-intensity activity a week. This could be anything from a brisk walk or cycling to a HIIT class or team sport. Regular exercise is proven to reduce your risk of major illnesses, such as coronary heart disease, stroke, type 2 diabetes, and cancer.
Mental Wellbeing
Your mental health is just as important as your physical health. Practices like mindfulness, meditation, and spending time in nature can significantly reduce stress and anxiety. If you feel you're struggling, don't hesitate to speak to your GP or, if you have the right cover, use the mental health support services offered by your PMI provider.
The Claims Process: What to Expect
Making a claim on your PMI policy is usually a straightforward process.
- Visit Your GP: Your health journey starts with your NHS GP. They will assess your symptoms and, if necessary, provide you with an 'open referral' to see a specialist.
- Contact Your Insurer: Call your insurer's claims line with your policy details and the referral letter. They will check your cover and provide a pre-authorisation number.
- Book Your Appointment: You can now book your consultation or treatment with a specialist at a hospital on your approved list. You'll need to give them your pre-authorisation number.
- Receive Treatment: Attend your appointments and receive the necessary private treatment.
- Settle the Bill: The hospital will usually bill your insurer directly. You will only need to pay your excess (if applicable). The rest is handled for you.
A good broker like WeCovr can also provide support and guidance if you run into any issues during the claims process.
Does private medical insurance cover pre-existing conditions?
Is PMI worth it in the UK?
How much does private health insurance cost per month?
What is the difference between moratorium and full medical underwriting?
Ready to find the right private health cover for you?
Let WeCovr do the hard work. Our expert brokers compare policies from all leading UK insurers to find the perfect fit for your needs and budget.
Related guides
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
By tapping the button below, you can book a free call with them in less than 30 seconds right now:
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Who Are WeCovr?
WeCovr is an insurance specialist for people valuing their peace of mind and a great service.👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.
Just a quick and simple form and an easy conversation with one of our experts and your valuable insurance policy is in place for that needed peace of mind!