WeCovr's Step-by-Step Guide to Getting the Best Private Health Insurance Quote
Follow WeCovr's proven steps to secure the best private health cover at the best price
As an FCA-authorised broker that has helped arrange over 900,000 policies of various types via embedded and direct channels, WeCovr provides this definitive guide to navigating the UK private medical insurance market. Our goal is to empower you with the knowledge to find the best possible cover for your needs and budget, demystifying the process from start to finish.
Why Consider Private Health Insurance in the UK?
The UK is fortunate to have the National Health Service (NHS), a world-class institution providing free healthcare at the point of use. However, the system is facing unprecedented pressures. This is where private medical insurance (PMI) comes in. It's not a replacement for the NHS but a complementary service designed to offer you more choice, control, and convenience over your healthcare.
Key benefits of having private health cover include:
- Beating the Queues: Bypassing long NHS waiting lists for eligible treatments is the primary reason most people take out PMI.
- Choice and Control: You can often choose your specialist, consultant, and the hospital where you receive treatment.
- Comfort and Privacy: Treatment is typically provided in a private hospital with your own en-suite room, offering a more comfortable and restful recovery environment.
- Access to Specialist Care: Gain faster access to specialist consultations and advanced diagnostic scans like MRI and CT.
- Access to New Drugs and Treatments: Some policies offer access to cancer drugs and treatments not yet available on the NHS due to funding or approval delays.
PMI provides peace of mind, ensuring that should you fall ill with a new, acute condition, you can receive prompt, high-quality care without the stress of long waits.
Step 1: Understand the Fundamentals of UK Private Medical Insurance (PMI)
Before you can compare quotes, you must grasp what PMI is—and what it isn't. Misunderstanding these core principles is the biggest pitfall for new buyers.
What is PMI and What Does it Cover?
Private medical insurance is an insurance policy that covers the costs of private healthcare 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.
Examples of what a typical PMI policy covers:
- Inpatient and Day-Patient Treatment: This is the core of all PMI policies. It covers tests and surgery where you need to be admitted to a hospital bed, even if it's just for the day.
- Outpatient Consultations and Diagnostics: Most policies can be extended to cover specialist consultations and diagnostic tests (like MRI, CT, and PET scans) that don't require a hospital stay.
- Cancer Care: Comprehensive cancer cover is a cornerstone of PMI, often providing access to specialist treatments, therapies, and drugs that may not be available on the NHS.
- Mental Health Support: Many modern policies include cover for mental health treatment, from therapy sessions to psychiatric care.
- Therapies: Coverage for physiotherapy, osteopathy, and chiropractic treatment is a common feature, helping you recover from injuries.
The Crucial Distinction: Acute vs. Chronic Conditions
This is the single most important concept to understand in UK private medical insurance.
- Acute Condition: A condition that is short-lived and from which you are expected to make a full recovery. Examples include a hernia, cataracts, joint replacements, or appendicitis. PMI is designed to cover these.
- Chronic Condition: A condition that is long-lasting, has no known cure, and needs ongoing management. Examples include diabetes, asthma, high blood pressure, and arthritis. Standard PMI does not cover the routine management of chronic conditions.
While PMI won't cover the day-to-day management of a chronic illness, it may cover acute flare-ups. For example, it wouldn't cover your routine asthma inhalers, but it might cover a hospital admission for a severe, acute asthma attack.
The Golden Rule: Pre-existing Conditions are Not Covered
Along with chronic conditions, standard PMI policies do not cover medical conditions you had before you took out the policy. This includes any illness, disease, or injury for which you have experienced symptoms, received medication, or sought advice in the years leading up to your policy start date (typically the last 5 years).
This rule is fundamental to how the insurance model works. Trying to claim for a known, pre-existing condition is like trying to insure a house that is already on fire. We will explore how insurers handle this in Step 4 when we discuss underwriting.
Step 2: Define Your Personal Health and Lifestyle Needs
The "best" PMI policy is not one-size-fits-all. It's the one that is perfectly tailored to your unique circumstances. Take a moment to consider the following.
Who Needs Covering?
- Individual Policy: For a single person. This is the most straightforward option.
- Couple Policy: For you and your partner. It can sometimes be cheaper than two individual policies, but not always. It's crucial to compare.
- Family Policy: Covering you, your partner, and your children. Insurers often have offers like "free cover for newborns" or discounts for adding children, making this a cost-effective option for families.
What Level of Cover Do You Need?
PMI policies are typically structured in three tiers. Understanding these will help you balance your budget with your needs.
| Level of Cover | Description | Best For |
|---|---|---|
| Basic (or Core) | Covers the most expensive treatments: inpatient and day-patient care. It guarantees you'll be covered for surgery and hospital stays. It usually excludes outpatient diagnostics and consultations. | Those on a tight budget who want a safety net for major medical events and are happy to use the NHS for initial diagnosis. |
| Mid-Range | Includes everything in a Basic policy, plus a set limit for outpatient cover. This limit might be, for example, £1,000 per year for specialist consultations and scans. | The majority of UK consumers. It provides a good balance of comprehensive cover and manageable cost, ensuring faster diagnosis. |
| Comprehensive | Offers full cover for inpatient, day-patient, and outpatient treatments. Often includes additional benefits like dental, optical, and more extensive mental health cover. | Individuals and families who want the highest level of reassurance and minimal reliance on the NHS for any eligible condition. |
Consider Your Lifestyle and Future Plans
- Are you planning a family? Look for policies with good maternity cash benefits or those that make it easy to add a newborn.
- Do you play sports? Check the policy's terms on sports-related injuries. Some amateur sports are covered as standard, but semi-professional or hazardous activities might be excluded.
- Is mental health a priority? Compare the mental health support offered. Some insurers provide access to therapy sessions without a GP referral.
Step 3: Master the Key Levers That Control Your Premium
Your monthly premium is not a fixed price. It's determined by a series of choices you make when building your policy. Understanding these levers is the key to getting the right price.
Your Excess: The Higher the Excess, the Lower the Premium
An excess is the amount you agree to pay towards a claim each year. It typically ranges from £0 to £1,000.
- Example: You have a policy with a £250 excess. You need a knee operation costing £5,000. You pay the first £250, and your insurer pays the remaining £4,750. You won't pay the excess again for any other claims in that policy year.
Choosing a higher excess (e.g., £500 or £1,000) can significantly reduce your monthly premium, making it a powerful cost-saving tool.
Hospital Lists: Choosing Your Network of Care
Insurers group private hospitals into tiers or "lists" based on cost, with central London hospitals being the most expensive.
- Local List: Restricts you to a specific list of hospitals in your local area. This is the cheapest option.
- National List: Gives you access to a wide range of private hospitals across the UK, but usually excludes the most expensive ones in central London.
- Premium / London List: Gives you unrestricted access to all hospitals in the insurer's network, including top HCA hospitals in London. This is the most expensive option.
If you live outside of London and are happy to be treated locally, choosing a national or local list is an excellent way to save money.
Outpatient Cover Limits: A Key Cost-Driver
As mentioned in Step 2, you can choose how much outpatient cover you want.
- Full Cover: No financial limit on eligible diagnostic tests and consultations.
- Limited Cover: A financial cap per year (e.g., £500, £1,000, or £1,500).
- No Cover: You rely on the NHS for diagnosis and only use your PMI for inpatient treatment.
Selecting a limit of around £1,000 is often the sweet spot for balancing cost and coverage.
Six-Week Option: Using the NHS to Your Advantage
The "six-week option" is a popular way to reduce your premium by 20-30%. If you add this to your policy, it means that for inpatient treatment, if the NHS can treat you within six weeks of when you are referred, you will use the NHS. If the NHS wait is longer than six weeks, your private cover kicks in.
This is a pragmatic compromise: you still get the main benefit of PMI (avoiding long waits) but at a much lower cost.
Personal Details: Age, Location, and Smoker Status
These factors are fixed, but it's important to understand their impact.
- Age: The single biggest factor. Premiums increase as you get older because the statistical risk of claiming increases.
- Location: Premiums are higher in major cities, especially London, due to the higher cost of private medical care.
- Smoker Status: Smokers pay more than non-smokers due to the associated health risks.
| Factor | Impact on Premium | How to Manage It |
|---|---|---|
| Excess | Higher excess = Lower premium | Choose an excess you can comfortably afford (£250-£500 is common). |
| Hospital List | National/local list = Lower premium | Unless you need access to London hospitals, choose a national list. |
| Outpatient Limit | Lower limit = Lower premium | A £1,000 limit often provides sufficient cover at a good price. |
| 6-Week Option | Adding it = Lower premium | A smart choice if your main goal is to avoid very long NHS waits. |
| Age / Location | Non-negotiable | Be aware of their impact on your quote. |
Step 4: Choose the Right Underwriting Method
Underwriting is how an insurer assesses your medical history to determine what will and won't be covered. This is where pre-existing conditions are formally excluded. There are two main types in the UK.
Moratorium (Mori) Underwriting: The Simple Approach
This is the most common type of underwriting for individuals and families.
- How it works: You don't declare your full medical history upfront. Instead, the insurer applies a general exclusion for any pre-existing conditions you've had in the 5 years before the policy start date.
- The "2-5-2" rule: A pre-existing condition may become eligible for cover if you serve a 2-year continuous period on the policy during which you are completely free of symptoms, treatment, medication, and advice for that condition.
- Pros: Quick and easy to set up. No medical forms are needed.
- Cons: There can be uncertainty at the point of claim, as the insurer will investigate your medical history then. This can sometimes lead to delays or disputes.
Full Medical Underwriting (FMU): The Detailed Approach
- How it works: You complete a detailed health questionnaire when you apply, declaring your full medical history. The insurer then assesses this and tells you from day one precisely what is and isn't covered, with specific exclusions written into your policy certificate.
- Pros: Complete clarity and certainty from the start. You know exactly where you stand.
- Cons: The application process is longer. The exclusions applied are usually permanent and will not be removed later.
Comparing Moratorium vs. Full Medical Underwriting
| Feature | Moratorium (Mori) Underwriting | Full Medical Underwriting (FMU) |
|---|---|---|
| Application Process | Quick and simple. No health forms. | Longer. Requires a full health declaration. |
| Clarity at Outset | Less clarity. Exclusions are general. | Full clarity. Specific exclusions are listed on your certificate. |
| Pre-existing Conditions | Can potentially be covered after a 2-year clear period. | Usually permanently excluded. |
| Claim Process | Can be slower as insurer investigates history at claim time. | Generally faster as cover has already been agreed upon. |
| Best For | People with a clean bill of health or those who prefer a simple setup. | People with a complex medical history who want certainty from day one. |
An expert PMI broker, such as WeCovr, can provide invaluable guidance on which underwriting method is most suitable for your personal circumstances.
Step 5: Compare Quotes from the UK's Leading PMI Providers
You should never accept the first quote you see. The UK PMI market is competitive, and prices and benefits vary significantly between insurers.
Why Use an Independent PMI Broker like WeCovr?
While you can go directly to an insurer, using an independent, FCA-authorised broker like WeCovr offers several key advantages at no extra cost to you.
- Whole-of-Market Comparison: We compare policies from all the leading UK providers, not just one. This ensures you see the full range of options and find the best value.
- Expert Guidance: Our advisors are specialists in private medical insurance. They understand the complex jargon and can help you tailor a policy to your exact needs, ensuring you don't pay for cover you don't need or miss out on benefits you do.
- No Cost to You: Our service is free. We are paid a commission by the insurer you choose, which is already built into the premium, so you pay the same price (or often less) than going direct.
- Ongoing Support: We are here to help you at renewal and can assist with any complex claims queries, acting as your advocate.
A Snapshot of Leading UK Health Insurers
The UK market is dominated by a few excellent, established providers. Here are the main names you'll see when comparing quotes.
| Provider | Key Feature / Reputation |
|---|---|
| Bupa | One of the most recognised brands, with a large network and a strong focus on wellness. |
| AXA Health | Known for excellent customer service and comprehensive cover, particularly mental health. |
| Aviva | A major UK insurer offering strong core cover and good value, with a large hospital list. |
| Vitality | Unique in its focus on rewarding healthy living with discounts and perks. |
| WPA | A not-for-profit provider known for its flexible policies and high customer satisfaction. |
| The Exeter | A friendly society known for its straightforward products and excellent service. |
An independent broker will compare all these and more to find the right fit for you.
What to Look for Beyond the Headline Price
The cheapest policy is rarely the best. When comparing quotes, look closely at:
- Cancer Cover: Is it comprehensive? Does it cover targeted therapies and new drugs?
- Mental Health Cover: What are the limits? Does it cover inpatient and outpatient care?
- Hospital List: Does it include the hospitals you would want to use?
- No Claims Discount (NCD): How does it work? Some insurers have NCDs that can be lost after just one small claim. Others offer protected NCDs.
- Customer Service Ratings: Check independent review sites. WeCovr is proud of its high customer satisfaction ratings, reflecting our commitment to service.
Step 6: Review Your Quote and Policy Documents with an Expert
Once you have a recommended quote, it's time for the final checks. This is a critical step where a WeCovr advisor can add significant value.
Scrutinising the Details: What to Check
- The Policy Summary (IPID): This is a standardised, easy-to-read document that outlines the main features, benefits, and exclusions. Read it carefully.
- The Policy Wording: This is the full legal document. Pay close attention to the "General Exclusions" section.
- The Hospital List: Double-check that it meets your needs.
- Your Personal Details: Ensure your name, date of birth, and address are all correct.
The Role of a WeCovr Advisor
Your WeCovr advisor will walk you through these documents, highlighting the key points and answering any questions. They will:
- Confirm the cover matches the needs you discussed in Step 2.
- Explain how the underwriting (Mori or FMU) applies to you.
- Clarify any jargon or complex clauses.
- Ensure you understand the claims process and your excess.
This expert review ensures there are no surprises down the line and you are 100% confident in the policy you are purchasing.
Step 7: Finalising Your Policy and Enjoying Peace of Mind
Once you are happy, your advisor will help you finalise the application.
The Cooling-Off Period
By law, you have a 14-day cooling-off period after your policy starts. During this time, you can cancel the policy and receive a full refund, provided you haven't made a claim. This gives you a final chance to review everything and ensure you've made the right choice.
Your WeCovr Member Benefits
Choosing to arrange your policy through WeCovr comes with extra perks designed to support your overall well-being.
- Complimentary access to CalorieHero: All our health and life insurance clients receive free access to our AI-powered calorie and nutrition tracking app, helping you maintain a healthy lifestyle.
- Multi-policy Discounts: When you hold a health or life insurance policy with us, you become eligible for exclusive discounts on other types of cover you might need, such as home or travel insurance.
WeCovr's Private Health Insurance FAQs
We've compiled answers to some of the most common questions our advisors receive.
Ready to take the next step and find the best private health insurance for you? The journey to peace of mind starts with a clear, no-obligation quote.
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!