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What Happens if a PMI Claim is Denied UK

What Happens if a PMI Claim is Denied UK 2026

Receiving a letter stating your private medical insurance claim has been denied can be disheartening, especially when you're focused on your health. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we believe that clarity is key. This guide explains why a private medical insurance claim in the UK might be rejected and what you can do about it.

WeCovr explains appeals and your rights

Navigating the world of private health insurance can feel complex. When a claim is denied, it's easy to feel lost. However, you have clear rights and there is a structured process for appealing a decision you believe is unfair.

This comprehensive article will walk you through:

  • The most common reasons insurers deny claims.
  • The immediate steps you should take after a denial.
  • How to launch a formal appeal with your insurer.
  • Your right to escalate the issue to the Financial Ombudsman Service.
  • Practical tips to minimise the risk of a claim denial in the first place.

Understanding this process empowers you to challenge a decision confidently and ensures you get the full benefit of the cover you've paid for.

Why Might a Private Health Insurance Claim Be Denied?

An insurer doesn't deny a claim lightly. The decision is almost always based on the specific terms and conditions of your policy. Here are the most common reasons you might face a rejection.

The Critical Distinction: Acute vs. Chronic Conditions

This is the single most important concept to grasp in UK private medical insurance.

  • Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery, returning you to your previous state of health. Examples include a hernia, cataracts, or a joint replacement. PMI is designed to cover acute conditions.
  • Chronic Condition: A disease, illness, or injury that has one or more of the following characteristics: it needs ongoing or long-term monitoring, it has no known cure, it is likely to recur, or it requires palliative care. Examples include diabetes, asthma, hypertension (high blood pressure), and eczema. Standard PMI policies do not cover the ongoing management of chronic conditions.

An insurer might pay for the initial diagnosis of a chronic condition, but they will not typically cover the long-term treatment, check-ups, or medication required to manage it. This responsibility remains with the NHS.

Pre-existing Conditions

Alongside chronic conditions, this is a leading cause of claim denials. A pre-existing condition is any disease, illness, or injury for which you have experienced symptoms, received medication, or sought advice or treatment before your policy started.

How insurers handle this depends on your underwriting type:

  1. Moratorium Underwriting: This is the most common type. The insurer doesn't ask for your full medical history upfront. Instead, they apply a "moratorium" period (usually two years). They will not cover any condition you had in the five years before your policy began. However, if you go for two continuous years on the policy without any symptoms, treatment, or advice for that condition, it may become eligible for cover.
  2. Full Medical Underwriting (FMU): You complete a detailed health questionnaire when you apply. The insurer assesses your medical history and explicitly lists any conditions that will be excluded from your cover from day one. This provides more certainty but can be a longer application process.

Example: You saw a doctor for back pain 18 months before buying a PMI policy. A year into your policy, the pain returns and you need a scan. Under a moratorium policy, this claim would likely be denied as it relates to a pre-existing condition that has not yet passed the two-year clear period.

General Policy Exclusions

Every policy has a list of standard exclusions. It's vital you read your policy documents to know what they are. Common exclusions include:

  • Emergency Services: Treatment in A&E is handled by the NHS.
  • Normal Pregnancy & Childbirth: While complications might be covered, routine maternity care usually is not.
  • Cosmetic Surgery: Procedures for purely aesthetic reasons are excluded. Surgery to restore appearance after an accident or illness (reconstructive surgery) may be covered.
  • Self-inflicted Injuries: This can include injuries from dangerous sports or substance abuse.
  • Experimental or Unproven Treatment: Insurers cover treatments that are evidence-based and widely recognised in the UK.
  • Certain Mental Health Conditions: While many modern policies offer some level of mental health support, comprehensive cover for long-term psychiatric conditions is often an optional add-on or excluded.

Failure to Follow the Correct Claims Procedure

Insurers have a clear process you must follow to have treatment approved. A misstep here is a common and avoidable reason for denial. The typical process is:

  1. Visit Your GP: You feel unwell, so you see your NHS or private GP.
  2. Get an Open Referral: Your GP determines you need to see a specialist and provides you with an "open referral" letter.
  3. Call Your Insurer for Pre-authorisation: This is the crucial step. Before you book any consultation or treatment, you must call your insurer. You give them the details from your GP referral, and they confirm that the condition and proposed treatment path are covered under your policy. They will give you an authorisation number and a list of approved specialists or hospitals.
  4. Book Your Appointment: You can now proceed with booking the consultation or treatment with an approved provider.

If you skip Step 3 and arrange treatment yourself, the insurer has the right to refuse payment.

Exceeding Your Policy Limits

Private health cover isn't a blank cheque. Your policy will have limits, which could be:

  • Annual Financial Limit: A total cap on the value of claims you can make in a policy year (e.g., £50,000 or "unlimited").
  • Treatment-Specific Limits: Limits on certain therapies, such as a set number of physiotherapy sessions or a cap on outpatient consultations.
  • Hospital List: Your policy will have a list of approved hospitals. Choosing a hospital not on your list (e.g., a premium central London hospital) could lead to the claim being denied or only partially paid.
Reason for DenialExplanationHow to Avoid It
Pre-existing ConditionYou had symptoms or treatment for the condition before your policy started.Disclose your full medical history (FMU) or understand the 2-year rule (Moratorium).
Chronic ConditionThe condition requires long-term management rather than a quick cure (e.g., diabetes).Understand that PMI is for acute conditions. Rely on the NHS for chronic care.
Policy ExclusionThe treatment is specifically listed as not covered (e.g., cosmetic surgery).Read your policy documents carefully before you buy and before you claim.
Incorrect ProcedureYou didn't get pre-authorisation from your insurer before treatment.Always call your insurer after getting a GP referral and before booking anything.
Policy Limits ExceededYou've gone over your annual benefit limit or used a non-approved hospital.Check your policy schedule for financial caps and your approved hospital list.

Your Immediate Steps After a Claim Denial

Seeing a rejection letter is stressful, but it's important to act methodically. A calm, organised approach will give you the best chance of a successful appeal.

  1. Read the Denial Letter Carefully: Don't just skim it. The letter must state the specific reason for the denial and reference the part of your policy wording they are relying on. Is it an exclusion? A pre-existing condition clause? Understanding their exact reasoning is the foundation of your appeal.

  2. Review Your Policy Documents: Find your policy schedule, key facts document, and the full policy wording. Locate the clause the insurer mentioned. Read it and the surrounding paragraphs to understand the context. Does their interpretation seem correct?

  3. Gather All Your Evidence: Create a file with every relevant document. This includes:

    • The claim denial letter.
    • Your original policy application form.
    • Your policy schedule and wording.
    • The GP referral letter.
    • Any letters or reports from your specialist consultant.
    • Results of any tests or scans.
    • A timeline of your symptoms and appointments.

  4. Contact Your Insurer for Clarification: Make a phone call. Be polite and calm. State your policy number and the claim number. Ask the representative to explain the decision in simple terms. Sometimes, a denial is due to a simple administrative error or a misunderstanding that can be cleared up quickly. Take notes during the call, including the date, time, and the name of the person you spoke to.

  5. Speak to Your PMI Broker: If you bought your policy through an expert broker like WeCovr, now is the time to call them. A good broker is your advocate. We understand the policy jargon and the insurers' processes. We can review the denial, advise you on the strength of your case, and help you draft your appeal. This support is invaluable and comes at no extra cost to you.

The Formal Appeals Process: A Step-by-Step Guide

If a quick phone call doesn't resolve the issue, you need to begin the insurer's formal internal complaints process. Every FCA-regulated insurer must have one.

Step 1: Write a Formal Complaint Letter or Email

This is your first official challenge. Your letter should be clear, concise, and professional.

Key elements to include:

  • Your Details: Full name, address, and policy number.
  • Clear Subject Line: "Formal Complaint Regarding Denied Claim [Your Claim Number]".
  • The Problem: State clearly that you are complaining about the decision to deny your claim and that you wish to appeal.
  • A Factual Timeline: Briefly outline the sequence of events, from your first symptoms to the claim denial. Use dates where possible.
  • Your Argument: This is the most important part. Explain, point by point, why you believe the decision was wrong.
    • Refer directly to your medical evidence (e.g., "My consultant, Dr. Smith, stated in her letter of [Date] that the condition is acute and not related to any previous issues.").
    • Refer to your policy wording if you believe it has been misinterpreted.
  • The Resolution You Want: State what you want to happen (e.g., "I request that you reconsider your decision and authorise payment for the treatment.").
  • Attachments: Mention that you have attached copies of all your supporting documents.

Send this letter by email (so you have a time-stamped record) and also consider sending a copy by recorded delivery.

Step 2: The Insurer's Acknowledgement and Investigation

Under Financial Conduct Authority (FCA) rules, the insurer should acknowledge your complaint promptly (usually within 5 working days). They will then assign your case to a complaint handler or manager who was not involved in the original decision. They will review all the evidence from you and their own files.

Step 3: The Insurer's "Final Response"

The FCA gives insurers up to eight weeks to provide you with a "final response". This letter will detail the outcome of their investigation and state one of three things:

  1. Complaint Upheld: They agree with you, overturn the original decision, and will pay the claim.
  2. Complaint Partially Upheld: They may agree with part of your complaint and offer a compromise, such as a partial payment (an "ex-gratia" payment).
  3. Complaint Not Upheld: They stand by their original decision and provide a detailed explanation of why.

Crucially, if they do not uphold your complaint, the final response letter must inform you of your right to take your case to the Financial Ombudsman Service, and include a leaflet explaining how to do so.

Escalating Your Complaint: The Financial Ombudsman Service (FOS)

If you're unhappy with the insurer's final response, or if they haven't given you one within eight weeks, your next stop is the Financial Ombudsman Service (FOS).

What is the FOS?

The FOS is a free and independent service that settles disputes between consumers and businesses that provide financial services, including insurance companies. They are not a consumer champion or an industry watchdog; their role is to be an impartial referee.

How Does the FOS Process Work?

  1. Submitting Your Complaint: You can fill out a form on the FOS website. You will need to provide your details, the insurer's details, and explain your complaint, attaching the insurer's final response and your evidence. You must do this within six months of the date on the final response letter.
  2. Investigation: An FOS case handler will look at both sides of the story. They will consider the law, industry regulations, your policy terms, and what is considered fair and reasonable in the circumstances of your case. They may ask you or the insurer for more information.
  3. The Decision: The handler will first give their initial assessment. If you and the insurer both agree, the case is closed. If not, the case is passed to an ombudsman for a final, legally binding decision.
  4. The Final Decision: If you accept the ombudsman's final decision, it is binding on the insurer. They must do what the ombudsman says. This could include paying the original claim, adding interest, and even paying you compensation for distress or inconvenience. If you do not accept the decision, you can still take your case to court, but the FOS process ends.

According to the FOS's latest annual data (2022/23), they received 1,281 new complaints about private medical insurance. The overall uphold rate for general insurance complaints was 34%, meaning just over a third of complaints were found in the consumer's favour. This shows that escalating a complaint can often lead to a positive outcome.

Real-Life Scenarios: Understanding Claim Denials in Practice

Let's look at some examples to see how these rules apply in the real world.

  • Scenario 1: The Pre-authorisation Mistake

    • Patient: Mark, 45.
    • Situation: Mark's GP refers him for an MRI on his shoulder. His friend recommends a clinic, so Mark books and pays for the scan himself, planning to claim it back.
    • Outcome: The insurer denies the claim.
    • Reason: Mark failed to get pre-authorisation. The insurer had no opportunity to confirm the scan was medically necessary or direct him to a facility within their approved network. The denial is correct based on the policy terms.

  • Scenario 2: The Successful Pre-existing Condition Appeal

    • Patient: Chloe, 35.
    • Situation: Chloe's claim for gynaecological surgery is denied. The insurer states it's a pre-existing condition, citing a GP visit for "period pain" four years before her policy started.
    • Action: Chloe appeals. She gets a letter from her specialist consultant explicitly stating that her current diagnosis (e.g., endometriosis) is a separate and distinct issue from the common period pain she saw her GP for years ago.
    • Outcome: The insurer reviews the new medical evidence, agrees the conditions are unrelated, and upholds her appeal, authorising the surgery.

  • Scenario 3: The Chronic Condition Clarification

    • Patient: David, 60.
    • Situation: David is diagnosed with Type 2 Diabetes after his insurer authorises a series of diagnostic tests. He then submits a claim for his ongoing medication and quarterly check-ups.
    • Outcome: The claim is denied.
    • Reason: Diabetes is a chronic condition. The policy correctly covered the acute phase of diagnosis to find out what was wrong. However, the long-term management of the condition is not covered and must be handled by the NHS. The denial is correct.

How to Minimise the Risk of a Claim Being Denied

Prevention is always better than cure. By being proactive and informed from the start, you can significantly reduce the chances of ever having to deal with a denied claim.

  1. Be 100% Honest on Your Application: Whether it's a full health questionnaire or questions for a moratorium policy, answer everything truthfully and completely. Forgetting to mention a past consultation or treatment, even if it seems minor, can be classed as "non-disclosure" and could invalidate your entire policy.
  2. Understand Your Underwriting: Ask your broker to explain the difference between Moratorium and Full Medical Underwriting and choose the one that's right for you. FMU provides more certainty on what's covered from day one.
  3. Read Your Policy (Especially the Exclusions): Before you sign up, read the Key Facts and the list of exclusions. Are you a keen rugby player? Check the dangerous sports clause. Planning a family? Check the maternity cover. Knowing what isn't covered is as important as knowing what is.
  4. Save the Claims Number: Put your insurer's pre-authorisation phone number in your mobile contacts. Make it a habit: GP referral first, then phone call to the insurer, always.
  5. Use an Expert PMI Broker: This is perhaps the most effective preventative measure. A specialist broker like WeCovr doesn't just sell you a policy. We take the time to understand your health, lifestyle, and budget. We then compare the market, explain the crucial differences between providers, and guide you to a policy that genuinely fits your needs, dramatically reducing the risk of a future mismatch between your expectations and the reality of the cover.

WeCovr's Added Value: More Than Just Insurance

Choosing WeCovr as your health insurance partner provides benefits that go beyond just finding a policy.

  • Expert, Impartial Advice: Our team are specialists in the private medical insurance UK market. We provide clear, simple guidance to help you navigate your options, at no cost to you.
  • Claim Advocacy: While we can't guarantee outcomes, we can provide invaluable support if you run into issues like a denied claim, helping you understand the process and formulate your appeal.
  • Integrated Wellness: We believe in proactive health. That's why WeCovr clients get complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, helping you build healthy habits.
  • Customer Satisfaction: Our clients consistently give us high ratings on independent review sites, reflecting our commitment to service and support.
  • Multi-Policy Discounts: When you protect your health with us, we can offer you exclusive discounts on other vital cover, such as life insurance or income protection, making it simpler and more affordable to get fully protected.

What is the difference between an acute and a chronic condition for PMI?

An acute condition is an illness or injury that is expected to respond quickly to treatment and lead to a full recovery (e.g., a bone fracture, appendicitis, or cataract surgery). UK private medical insurance is designed to cover these. A chronic condition is a long-term illness that has no known cure and requires ongoing management (e.g., diabetes, asthma, high blood pressure). Standard PMI policies do not cover the long-term management of chronic conditions.

Can I get private health insurance if I have a pre-existing condition?

Yes, you can still get private health insurance. How your pre-existing conditions are handled depends on the underwriting method. With 'Moratorium' underwriting, any condition you've had in the last 5 years is excluded for an initial period (usually 2 years). With 'Full Medical Underwriting', you declare your conditions upfront, and the insurer will tell you precisely what is excluded from the start. A broker can help you find the best option for your circumstances.

Do I always need a GP referral for a PMI claim?

Generally, yes. The standard process for almost all UK private health insurance providers is to get a referral from your GP before they will pre-authorise treatment with a specialist. Some modern policies offer direct access to certain services like physiotherapy or mental health support without a GP referral, but this is an exception. You should always check your policy terms and call your insurer to confirm the correct procedure.

How long do I have to make a complaint to the Financial Ombudsman?

You must refer your complaint to the Financial Ombudsman Service (FOS) within six months of the date on your insurer's 'final response' letter. If you do not receive a final response within eight weeks of making your formal complaint, you can also take your case to the FOS at that point.

Ready to find a private medical insurance policy that truly protects you and comes with expert support? The team at WeCovr is here to help. We compare leading UK providers to find the right cover for your needs and budget, all at no cost to you.

Get your free, no-obligation PMI quote today and gain complete peace of mind.

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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!

There is no need to wait until the renewal of your current policy.
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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Life Insurance and Private Medical Insurance cover you for two different purposes, so you will need to assess your needs but may wish to consider holding the two policies. Private Medical Insurance covers you if you get sick or need treatment and want or need to go privately. Life Insurance covers you in the case of death, giving a payout to family/those left behind.

Health insurance covers conditions that develop after your policy starts. Pre-existing conditions are typically not covered, and insurers may exclude related issues. Some policies may cover symptoms of pre-existing conditions under specific circumstances. Always review your policy's exclusions. Coverage for pre-existing medical conditions may be available if you currently hold a medical insurance policy or are transitioning from a company scheme. However, if you have never had medical insurance before or if your policy is not active at the moment, pre-existing conditions will not be covered. This limitation exists because health insurance is primarily intended to protect against unexpected health issues. To simplify, it's akin to getting into a car accident and then trying to obtain insurance coverage afterward to repair the vehicle — insurance companies typically do not cover such claims. Nevertheless, there is an option to gain coverage for pre-existing conditions after a two-year waiting period, subject to specific rules and conditions.

If you prefer to get straight into treatment in the private sector without the long waiting times with the NHS, or you just prefer the private sector anyway, without having to pay it all yourself, then you would need to have Private Medical Insurance to cover it. Sometimes treatments and drugs that are not covered by the NHS can be covered by Private Medical Insurance.

It's free to use WeCovr to find health insurance - we never charge you for quotes. Health or private medical insurance is an investment that can pay for itself the first time you might need medical treatment.

It depends on your personal choice and preferences. If you are prepared to limit yourself to NHS-covered treatments only and can or want to endure long waiting times to get into treatment, then yes, NHS might work for you. Your cover there is free. If you don't want to be exposed to long waiting times or if your treatment is not covered by the NHS, then you would benefit from Private Medical Insurance.

Private Medical Insurance is an important financial product that insurance companies take a lot of care and diligence so speaking to real human beings ensures that they understand your requirements fully so that you can get the right cover.

All of our partners are carefully vetted and authorised by the FCA, which means they are held to the highest standards that the FCA expects from them and treat all customers fairly!

Our revenue comes from commissions paid by the insurance providers when a policy is taken out through us. Essentially, when you choose to secure a policy from one of the providers we work with, they compensate us for facilitating the transaction. It's important to note that this commission does not impact the premium you pay. We remain committed to providing transparent and unbiased quotes to help you find the best insurance options tailored to your needs.

The cost of private health insurance depends on several factors, including your age, location, smoking status, and the type of policy you choose. Your health insurance policy is tailored to your needs, and the cost can vary based on the level of cover you require, such as the amount of excess and specific treatment allowances.

Private health insurance covers you for conditions that arise after your policy begins. You pay a monthly fee and can make claims for private healthcare covered by your policy. One of the main benefits of private healthcare is quicker access to treatment compared to the NHS, along with access to new drugs or specialist treatments.

Most health insurance covers private hospital stays and may include outpatient treatments like scans, tests, or appointments. Policies vary in coverage, and exclusions often include emergency treatment, maternity care, cosmetic surgery, and ongoing conditions present before the policy started.

Unfortunately, you cannot pay extra to have a pre-existing condition covered as part of your health insurance policy. However, you have access to support from a nurse or digital GP. If you have questions about what is covered under your policy, please contact us for clarification.

Your health insurance policy begins once you've selected your policy and set up your payment. After setup, you'll receive your cover documents detailing what is and isn't covered. It's important to review these details carefully as policies differ.

An excess is the amount you contribute towards treatment when you make a claim. Choosing a higher excess can reduce your policy's monthly cost but requires a larger contribution when claiming. WeCovr's experts will offer you flexible excess options depending on your preferences.

To reduce health insurance costs, consider choosing a higher excess, which lowers the monthly premium. However, ensure the plan still meets your needs. Other factors affecting cost include lifestyle choices like smoking and potential savings for couples or family plans.

There is no age limit for taking out health insurance, but age influences the policy's cost. The benefits of health insurance are consistent regardless of age. If you're considering health insurance, you can get a quote from WeCovr's experts regardless of your age.

Let WeCovr's experts do the legwork for you and compare health insurance plans at no cost to you to find the best fit for your needs. Consider individual, couple, or family plans and review coverage details thoroughly before choosing. WeCovr provides transparent information on coverage options for easy comparison.

Yes, you can add your partner (if you live at the same address) or dependents to your policy at any time. The cost of couple's or family health insurance depends on factors like location, age, health, and chosen excess. Contact WeCovr or your insurer for assistance in adding someone to your policy.

While WeCovr's private health insurance plans are tailored for the UK, we offer global health insurance options for those living or working abroad. For holiday coverage, travel insurance is recommended.

Comprehensive cover provides extensive benefits, including full outpatient services such as consultations, diagnostic tests, physiotherapy, and mental health therapies. Our team at WeCovr can assist in understanding the various coverage levels available.

Private health insurance typically does not cover dental treatment. However, WeCovr's experts can guide you to dental insurance policies offered by our partner insurers. Reach out to us to explore these options.

Yes, private health insurance covers cancer treatment from diagnosis through treatment. At WeCovr, we can help you navigate the cancer cover options that suit your needs.

At WeCovr, you have flexibility in adjusting your cover. Speak to our experts within 21 days of receiving your paperwork or at policy renewal to make changes.

Accessing a private GP appointment is fast and convenient with WeCovr's services, available through your digital platform provided under your chosen insurance plan.

Yes, family members on the same policy can potentially have different levels of cover tailored to their individual needs.

WeCovr works with insurers offering a range of cover levels to accommodate different budgets and needs. Our experts can discuss these options with you.

Discovering healthcare facilities and specialists is easy with WeCovr's resources. Contact us for personalised assistance by tapping one of the buttons above or below and filling in a few details for personalised assistance.

Fee-assured consultants provides transparency and no hidden costs for clients.

WeCovr prioritises mental health support with comprehensive coverage and access to specialist advice and services.

Children up to a certain age can be included in your policy, and we offer discounts for family coverage.

Like most health insurance plans, premiums may increase annually due to factors such as age and medical cost inflation.

The cost of health insurance varies based on several factors. Connect with our experts by tapping a button below and get your own personalised quote.

Private health insurance offers quicker access to consultations, treatments, and personalised care compared to the NHS.

Yes, WeCovr's experts can guide you which health insurance plans include coverage for physiotherapy treatments.

Immediate access to certain services like our digital GP app is available upon enrolment.

You can obtain a range of suitable quotes easily by tapping one of the buttons above or below and filling in a few details for personalised assistance.

Health insurance covers new conditions that arise after the policy starts. Pre-existing conditions and certain exclusions may apply.

WeCovr's experts help you arrange health insurance that simplifies access to private healthcare services, including consultations and treatments.

Outpatient cover includes consultations, physiotherapy, and mental health therapies outside hospital admissions.

Yes, you can use your health insurance cover immediately. You have access to a nurse through your helpline and can consult with a GP using the digital GP app. If you need to make a claim right away, we may require a medical report from your GP. Health insurance is designed to cover new conditions that arise after the policy has started.

No, health insurance does not cover A&E (Accident and Emergency) visits. Private hospitals do not typically have the facilities for handling A&E cases. In case of an emergency, please dial 999 or use the NHS emergency services. However, if you require follow-up treatment after an emergency situation, your private medical insurance may be able to assist.

Yes, many insurers offer rewards in leisure, wellbeing, and health. Speak to WeCovr's experts or visit your insurer's website for more details on member rewards.

You may continue your cover or get another own personal policy. If you continue your cover, existing or ongoing medical conditions might be covered depending on the level of cover you choose. Contact our friendly experts to discuss your options and find the right option for you.

You can tap one of the buttons above or below and fill in a quick form to arrange a call with us to discuss your options.

Your cover may be similar but not identical. We will help you find the right level of cover that suits your needs, and ongoing medical conditions may be covered. Contact our friendly advisers to explore all available options.

No, the price won't be the same as before since employers often contribute to the cost of employee cover. Additionally, different cover levels and medical histories may affect the price. Contact WeCovr's experts for detailed information.

You have a few weeks or months from leaving your job to decide to continue with your insurer or change to another one. Your policy may start the day after you left your work policy, and our experts can guide you through other available options.

After leaving your job, contact WeCovr's experts with your leave date to discuss available options.

Yes, ongoing treatment may be covered on your new personal policy, although it could affect the price. Contact our experts for personalised advice on your options.

Details on paying excess fees will be provided when you contact your insurer for treatment authorisation.

No, there is no excess fee for utilising these services.

Excess adjustments can be made at specific intervals during your policy term.

No claims discounts can impact renewal costs based on claims history.

Pre-existing conditions typically aren't covered but can be discussed with our healthcare specialists.

This involves health-related questions before policy enrolment to determine coverage.

Moratorium underwriting simplifies enrolment but may require health disclosures during claims.

Claims may require additional information if under moratorium underwriting.

Pre-existing conditions refer to medical issues existing before policy inception. A pre-existing condition is anything you've previously had medical treatment for, such as diabetes, heart disease, or asthma. Most insurance providers consider any condition you've had symptoms or treatment for in the past five years as pre-existing. Our experts at WeCovr can help you understand how pre-existing conditions affect your policy options.

While some insurance providers automatically renew your private healthcare cover, it's beneficial to compare policies when yours is about to end. This ensures you're still getting the best deal for the coverage you need. Our experts at WeCovr can assist you in finding the right policy for you.

Typically, you must be over 18 to take out your own policy, but minors can usually be included in a family policy. There may also be an upper age limit for private health insurance, and premiums typically increase with age. Our experts at WeCovr can provide guidance on age-related policy aspects.

Paying for health insurance annually often results in savings compared to monthly payments. However, this depends on your insurance provider. For help determining the most cost-effective option, consider consulting our experts at WeCovr.

If your employer offers private health insurance as part of your benefits package, you likely don't need additional cover. However, there may be limits on the cover you receive, and it may not extend to your entire family. Remember, any insurance you get through work only covers you while you're employed there.

If you don't have pre-existing conditions, a medical exam is usually not required. You'll just need to complete a medical history form and select your level of cover. However, if you're older, have a pre-existing condition, or lead an unhealthy lifestyle, a medical exam may be necessary. Our experts at WeCovr can clarify the requirements of different policies.

Many private health insurance providers now offer GP services, either digitally or face-to-face. This means you can often get a private GP appointment quickly, sometimes even on the same day. Our experts at WeCovr can help you find policies that offer GP services.

With private health insurance, you can often secure a GP appointment much quicker than with traditional methods, sometimes even on the same day. Our experts at WeCovr can help you find policies that offer quick GP appointment services.

Inpatient care refers to any treatment requiring a stay in a hospital or clinic for at least one night. Outpatient care refers to treatments or tests that don't require hospital admission, such as minor diagnostic tests or physiotherapy sessions. Our experts at WeCovr can help you understand the different types of care and find a policy that suits your needs.

Private health insurance covers your medical treatment if you fall ill, while critical illness cover provides additional financial help if you develop one of the critical illnesses listed in the policy, such as covering loss of income if you're unable to work. For assistance in understanding the differences and finding the right coverage, consult our experts at WeCovr.

Health insurance policies are designed for cover in the UK. For cover abroad, consider travel insurance for short trips or international health insurance for longer stays or if you have a holiday home overseas. Our experts at WeCovr can guide you in finding the appropriate coverage for your travel needs.

If your employer provides health insurance, it's considered a 'benefit in kind' and is not tax deductible. Your employer should calculate the tax you owe for your health insurance premiums and deduct it from your pay. There are some exceptions for small companies. For more information on tax implications, consider reaching out to our experts at WeCovr.

When you purchase a policy, you choose how much excess you pay, which is your contribution to the cost of treatment if you make a claim. The higher your excess, the lower your premium is likely to be. Our experts at WeCovr can help you understand how excess works and choose the right level for you.

These are two methods of underwriting a health insurance policy, relating to how insurance providers consider your pre-existing medical conditions when you take out cover. For help understanding the differences and choosing the right option for you, consult our experts at WeCovr.

Some private health insurance providers offer a no-claims discount, similar to car insurance. Every year you don't make a claim gives you an extra year of no-claims discount, potentially reducing your premium when you renew. Our experts at WeCovr can help you find policies that offer no-claims discounts.

To find the best health insurance for you, compare various policies to find one that offers the features you need at a price you can afford. Consider your personal circumstances and what you want from your policy. Our experts at WeCovr can assist you in evaluating your options and selecting the right coverage for you.

If you need treatment, a GP referral is not always necessary. However, this depends on how you plan to pay for your treatment. Most hospitals will allow you to book appointments with a consultant without a GP referral if you are paying out-of-pocket. If you have private medical insurance, you'll need to check the terms of your policy to see whether your insurer requires you to consult with a GP first (most insurers do). Some policies offer a direct booking system without a referral for certain conditions, such as counseling for mental health issues.

Yes, you can obtain financing for a loan to cover the cost of surgery. Many private healthcare companies have partnerships with finance companies to allow you to spread the cost of private treatment over time. You could also explore getting an ordinary loan from your bank if this option proves to be more cost-effective for you.

WeCovr has conducted extensive research into the cost of private health insurance in the UK. Click the link to find out more detailed information.

Yes, you can continue to receive treatment through the NHS even if you have private health insurance and have received private treatment in the past. This could be for rehabilitation after private surgery or for treatment that is not covered by your health insurance policy. For example, some cosmetic surgeries may be available through the NHS but are generally not covered by private medical insurance.

This is a difficult question to answer definitively. There are certain services that cannot be obtained privately, such as emergency treatment at an Accident and Emergency (A&E) department. Many NHS consultants also practice privately, so you could potentially see the same consultant regardless of whether you choose private or public healthcare. However, private healthcare typically offers shorter waiting times, guaranteed private rooms, and more relaxed visiting hours. Additionally, you may have access to treatments and drugs that are not routinely available through the NHS.

Yes, you can self-refer to a private specialist without the need for a GP referral. However, the British Medical Association believes that in most cases, it is best practice to start with your GP, as they are familiar with your medical history.

Yes, if you have a health concern and pay for private tests and scans but cannot afford to have private surgery, you should be able to have your test results transferred to an NHS provider for treatment.

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