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What Happens if Your Health Insurer Refuses a Claim

What Happens if Your Health Insurer Refuses a Claim 2026

Receiving a letter stating your private medical insurance claim has been rejected can be incredibly stressful, especially when you're unwell. As an FCA-authorised broker that has arranged over 900,000 policies, WeCovr understands your frustration. This comprehensive guide explains why UK insurers might refuse a claim and what you can do about it.

WeCovr explains your rights and next steps after a rejected claim

A rejected claim isn't necessarily the final word. You have clear rights and a structured path to appeal the decision. The key is to act methodically, not emotionally. The process involves understanding the insurer's reasoning, reviewing your policy, gathering your evidence, and following a formal complaints procedure.

This article will walk you through each step, empowering you with the knowledge to challenge a decision you believe is unfair. We'll demystify the jargon and explain the common pitfalls so you can navigate the process with confidence.

Why Might a Health Insurance Claim Be Rejected?

Understanding the "why" behind a rejection is the first step to resolving it. Insurers don't refuse claims lightly; they follow the specific terms and conditions of your policy. Here are the most common reasons a claim might be turned down in the UK.

The Crucial Distinction: Acute vs. Chronic Conditions

This is the single most important concept to grasp about private medical insurance (PMI) in the UK. Standard policies are designed to cover acute conditions, not chronic conditions.

  • 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 a cataract, a hernia, or a joint needing replacement.
  • A chronic condition is an illness that continues for a long time, often for the rest of a person's life. It can be managed with treatment and medication, but it cannot be cured. Examples include diabetes, asthma, high blood pressure, and Crohn's disease.
FeatureAcute ConditionChronic Condition
NatureSudden onset, short durationLong-lasting, often for life
Treatment GoalTo cure and return you to your previous state of healthTo manage symptoms and prevent complications
PMI CoverageGenerally CoveredGenerally Excluded
ExamplesAppendicitis, broken bone, infectionsDiabetes, asthma, arthritis, hypertension

A claim might be rejected if the insurer's medical team determines that your condition has become chronic. For instance, they might initially cover diagnostic tests and consultations for a new symptom, but if it's diagnosed as a long-term manageable condition like arthritis, they will cease cover for its ongoing management.

Pre-existing Conditions

A pre-existing condition is any disease, illness, or injury for which you have experienced symptoms, received medication, advice, or treatment before your policy start date. Standard UK PMI policies almost always exclude pre-existing conditions, at least for an initial period.

How insurers handle this depends on your type of underwriting:

  1. Moratorium Underwriting: This is the most common type. It automatically excludes any condition you've had in the five years before your policy began. However, if you then go for a continuous two-year period after your policy starts without any symptoms, treatment, or advice for that condition, it may become eligible for cover. This is often called the "2-year rule."

  2. Full Medical Underwriting (FMU): With FMU, you complete a detailed health questionnaire when you apply. You must declare your entire medical history. The insurer then assesses your health and explicitly states what is and isn't covered from the outset. It provides certainty but can lead to permanent exclusions for certain conditions.

Underwriting TypeHow It WorksProsCons
MoratoriumAutomatically excludes conditions from the last 5 years. Cover may be added after a 2-year symptom-free period.Quicker application process, no initial medical forms.Less certainty at the point of claim; a condition you thought was old may be linked to a new symptom.
Full Medical (FMU)You declare your full medical history upfront. The insurer gives you a clear list of what is excluded.Complete certainty from day one about what is covered.Longer application process. Can lead to permanent exclusions.

A claim will be rejected if it relates to a condition that is excluded under the terms of your underwriting.

Non-Disclosure or Misrepresentation

When you apply for private health cover, you have a "duty of fair presentation." This means you must answer all questions from the insurer honestly and completely.

A claim can be rejected if the insurer discovers you failed to disclose relevant medical information, even if it was an honest mistake. This is called non-disclosure or misrepresentation.

Examples of Non-Disclosure:

  • Forgetting to mention a consultation with a physiotherapist for a bad back two years ago.
  • Downplaying recurring headaches as "just stress" when you've seen a GP about them.
  • Not declaring a medication you were prescribed, even if you only took it for a short time.

If the non-disclosed information would have affected the insurer's decision to offer you cover (or the terms they offered), they have the right to reject a related claim or, in serious cases, void the policy entirely. This is a key area where using an expert PMI broker like WeCovr can be invaluable, as we guide you through the application to ensure it's accurate.

Policy Exclusions and Limits

Every PMI policy contains a list of general exclusions—treatments and conditions that are never covered. It's vital to read your policy documents to understand these.

Common General Exclusions:

  • Routine pregnancy and childbirth
  • Cosmetic surgery (unless for reconstruction after an accident or eligible surgery)
  • Treatment for addictions (drugs, alcohol)
  • Self-inflicted injuries
  • Experimental or unproven treatments
  • Professional sports injuries
  • Screening and preventative check-ups (unless the policy has a specific wellness benefit)

Beyond general exclusions, your policy will have limits. These are caps on how much the insurer will pay.

Common Policy Limits:

  • Annual Overall Limit: A maximum total amount the policy will pay out per person, per year (e.g., £1 million or 'unlimited').
  • Outpatient Limit: A cap on costs for consultations and diagnostics that don't require a hospital bed. This could be a financial limit (e.g., £1,000 per year) or a limit on the number of sessions. This is a very common reason for rejection, as people often reach their outpatient limit without realising.
  • Therapy Limits: Specific limits for treatments like physiotherapy or osteopathy (e.g., up to 8 sessions per year).

If your claim is for an excluded treatment or exceeds your policy's financial limits, it will be refused.

Treatment Not Deemed Medically Necessary

Insurers cover treatments that are established, effective, and necessary for your condition. They may reject a claim for a procedure or therapy if they, or their panel of medical experts, deem it to be:

  • Experimental: Not yet proven to be effective or approved by bodies like NICE (the National Institute for Health and Care Excellence).
  • Not the standard procedure: If your specialist recommends a highly unusual or costly treatment when a standard, equally effective alternative exists.
  • Lifestyle-based: Such as cosmetic surgery for aesthetic reasons.

The insurer's decision is usually based on established medical practice in the UK.

Administrative Errors

Sometimes, a rejection is simply down to a mistake or missing information. These are usually the easiest issues to resolve.

  • Incorrect policy number on the form.
  • Missing referral letter from your GP.
  • Incomplete information from your specialist.
  • The provider's invoice was sent to the wrong department.

Always check for simple administrative errors first, as a quick phone call can often sort them out.

Your Step-by-Step Guide to Challenging a Rejected Claim

If your claim has been rejected and you believe the decision is wrong, follow this structured process. Keep records of every conversation and piece of correspondence.

Step 1: Don't Panic – Read the Rejection Letter Carefully

The first thing to do is take a deep breath and read the letter or email from your insurer thoroughly. By law, they must give you a clear reason for the rejection and reference the specific clause or exclusion in your policy that applies. Identify exactly why they have made this decision. Is it a pre-existing condition? Have you hit an outpatient limit? Do they consider the condition chronic?

Step 2: Review Your Policy Documents

Find your policy documents, including the main Terms and Conditions booklet and your Insurance Product Information Document (IPID). The IPID is a short, plain-language summary of your cover. Compare the insurer's reason for rejection with the wording in your policy. Does it match up? Is there any ambiguity? You are checking to see if their interpretation seems fair and correct based on the contract you signed.

Step 3: Gather Your Evidence

This is the most critical step. To build a strong case, you need evidence. Collect everything related to your claim and your policy:

  • The rejection letter from your insurer.
  • Your policy documents, schedule, and original application form.
  • All correspondence with the insurer.
  • A timeline of your condition: Note down when symptoms started, when you saw your GP, and when you were referred to a specialist.
  • Letters from your GP or Specialist: This can be powerful evidence. For example, if the insurer claims your condition is pre-existing, a letter from your specialist confirming it's a new and distinct medical issue can overturn the decision. You can ask your specialist to write a letter of support for your appeal.
  • Your medical records: You have the right to request your medical records from your GP or hospital through a Subject Access Request (SAR). This is free of charge.

Step 4: Contact Your Insurer's Claims Department

Start with an informal approach. Call the claims department and ask them to explain the decision again. It's possible there has been a simple misunderstanding that can be cleared up over the phone.

  • Be polite, calm, and clear.
  • Have your policy number and evidence in front of you.
  • Explain why you disagree with their decision.
  • Take detailed notes: the date, time, and name of the person you spoke with, and a summary of the conversation.
  • Follow up the call with an email summarising what was discussed and agreed upon. This creates a written record.

Step 5: Make a Formal Complaint

If the informal call doesn't resolve the issue, you need to raise a formal complaint. Every insurer must have a clear, documented complaints procedure. You can usually find this on their website.

Write a formal complaint letter or email. In it, you should:

  1. State clearly at the top that this is a "Formal Complaint."
  2. Include your name, address, and policy number.
  3. Outline the facts of the case chronologically and concisely.
  4. Explain why you believe the claim rejection is wrong, referencing your policy wording and the evidence you have gathered.
  5. Be specific about what you want – for the insurer to reconsider and pay the claim.
  6. Attach copies of all your evidence (don't send originals).

Under rules set by the Financial Conduct Authority (FCA), the insurer has eight weeks from the date they receive your complaint to provide you with a "final response."

Step 6: Escalate to the Financial Ombudsman Service (FOS)

If you are unhappy with the insurer's final response, or if they fail to provide one within eight weeks, you can take your case to the Financial Ombudsman Service (FOS).

  • What is the FOS? The FOS is a free, independent, and impartial service that settles disputes between consumers and financial services businesses, including insurance companies.
  • How does it work? You submit your complaint to the FOS online or by post. An adjudicator will review the evidence from both you and the insurer. They don't just look at the legal technicalities; they also consider what is "fair and reasonable" in all the circumstances.
  • What can they do? If the FOS agrees with you, their decision is binding on the insurer. They can order the company to pay your claim, pay interest, and even pay you compensation for any distress or inconvenience caused.

According to the FOS's annual complaints data for 2022/2023, they received 1,323 new complaints about private medical and dental insurance, and the uphold rate (the percentage of cases decided in the consumer's favour) was 28%. This shows that nearly a third of escalated complaints are successful, so it is well worth pursuing if you have a strong case.

The Role of a PMI Broker in Preventing and Resolving Claim Issues

Navigating the world of private medical insurance UK can be complex. This is where an independent PMI broker like WeCovr can be a powerful ally.

1. Prevention: Getting it Right from the Start

The best way to avoid a rejected claim is to have the right policy in the first place.

  • Expert Advice: We help you compare different policies and providers to find cover that genuinely matches your needs and budget.
  • Understanding the Fine Print: We explain the key exclusions, limits, and underwriting terms in plain English, so there are no surprises later.
  • Application Support: We assist you with the application form, ensuring you answer all questions accurately. This significantly reduces the risk of a claim being rejected for non-disclosure.

2. Support: Having an Expert in Your Corner

If you buy a policy through WeCovr and face a claim issue, you're not on your own.

  • Advocacy: We can act as an intermediary between you and the insurer. We have dedicated broker support contacts at major insurance companies that you as an individual cannot access.
  • Guidance: We can help you understand the insurer's decision and guide you through the complaints and appeals process, leveraging our experience to help build your case.

Using a broker costs you nothing extra—our commission is paid by the insurer—but the expertise and support can be priceless, especially when things go wrong.

Proactive Health Management: Reducing Your Need to Claim

While having robust private health cover provides peace of mind, the ultimate goal is to stay healthy. A proactive approach to your wellbeing can reduce your reliance on medical services and, therefore, the need to claim.

  • Balanced Diet: Following principles like the NHS Eatwell Guide, which promotes a diet rich in fruits, vegetables, whole grains, and lean proteins, can significantly lower your risk of developing chronic diseases. To support our clients, WeCovr provides complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, to help you make informed dietary choices.
  • Regular Physical Activity: The NHS recommends adults get at least 150 minutes of moderate-intensity activity (like brisk walking or cycling) or 75 minutes of vigorous-intensity activity (like running) a week. Regular exercise boosts cardiovascular health, strengthens bones, and improves mental wellbeing.
  • Prioritise Sleep: Most adults need 7-9 hours of quality sleep per night. Poor sleep is linked to a host of health problems, including a weakened immune system, high blood pressure, and mental health issues.
  • Manage Stress: Chronic stress can have a physical impact on your body. Techniques like mindfulness, meditation, yoga, or simply spending time in nature can help manage stress levels effectively.

By taking care of your health, you not only improve your quality of life but also make your health insurance more affordable in the long run. As a bonus, WeCovr clients who purchase PMI or Life Insurance are often eligible for discounts on other types of cover, rewarding you for taking a comprehensive approach to your protection.

Real-Life Scenarios: When Claims Get Complicated

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

Scenario 1: The Pre-existing Grey Area

  • The Case: John, 45, takes out a PMI policy with moratorium underwriting. A year later, he develops severe sciatic pain and his specialist recommends an MRI and injections. The insurer rejects the claim, stating it's pre-existing because John's GP records show a visit for "minor backache" three years ago.
  • The Appeal: John, with help from his broker, obtains a letter from his specialist. The letter clarifies that the previous issue was a simple muscular strain, whereas the new problem is a distinct pathological issue—a slipped disc—and is therefore an entirely new, acute condition.
  • The Outcome: Faced with clear clinical evidence from a specialist, the insurer reconsiders and approves the claim for the MRI and subsequent treatment.

Scenario 2: The Outpatient Limit Misunderstanding

  • The Case: Sarah, 38, has a policy with a £1,000 annual limit for outpatient services. She sees a specialist (£250), has an MRI scan (£500), and then has a follow-up consultation (£250). Her specialist recommends a course of six physiotherapy sessions. The insurer pays for the consultations and scan but rejects the physiotherapy claim.
  • The Reason: Sarah has already used her full £1,000 outpatient limit (£250 + £500 + £250). The physiotherapy, being an outpatient treatment, is therefore not covered.
  • The Lesson: This wasn't an unfair rejection, but a misunderstanding of the policy terms. It highlights the importance of tracking your usage against your policy limits, especially on more basic plans. A good broker would have highlighted this limit at the point of sale.

Scenario 3: The Acute vs. Chronic Debate

  • The Case: David, 55, is diagnosed with ulcerative colitis. His PMI provider authorises the initial diagnostic tests and treatment to bring the flare-up under control. After three months, they write to him to state that the condition is now considered chronic and stable, and they will no longer cover its ongoing management or medication.
  • The Challenge: David feels this is unfair as he still needs regular check-ups. He complains, arguing the condition isn't fully "managed."
  • The Outcome: This is a complex area. The insurer is acting within the standard rules of UK PMI by ceasing cover once a condition is deemed chronic. The FOS, if involved, would look at whether the insurer's decision was clinically reasonable and if they communicated the change in cover clearly and fairly. In most cases, the insurer's decision would likely be upheld, as PMI is not designed for long-term chronic care.

Can my insurer cancel my policy if I make a complaint?

Absolutely not. You have a regulatory right to complain about a service you are unhappy with. Your insurer cannot penalise you, increase your premiums, or cancel your policy simply because you have made a complaint or escalated it to the Financial Ombudsman Service. If they attempted to do so, the FOS would take an extremely dim view of their conduct.

How long does the health insurance complaints process take?

The process has defined timelines. Once you make a formal complaint, the insurer has up to eight weeks to issue a final response. If you are not satisfied and escalate your case to the Financial Ombudsman Service (FOS), the timeline can vary. Simple cases might be resolved in a few months, but more complex cases requiring detailed medical evidence can take significantly longer, sometimes up to a year.

What's the difference between a pre-existing condition and a chronic condition?

This is a crucial distinction. A pre-existing condition is defined by when you had it – it's any medical issue you had symptoms, treatment, or advice for before your policy started. A chronic condition is defined by what it is – a long-term illness that can be managed but not cured, like diabetes or asthma. A condition can be both (e.g., asthma you had before the policy started), or it could be a new chronic condition diagnosed after your policy began. Standard UK private medical insurance generally excludes cover for both.

Do I have to pay to use the Financial Ombudsman Service?

No, the service provided by the Financial Ombudsman Service (FOS) is completely free for consumers to use. Its operating costs are funded by levies on the financial firms it covers. This ensures everyone has access to an independent dispute resolution service, regardless of their financial situation.

Take the Next Step with Confidence

A rejected health insurance claim can be a major setback, but it doesn't have to be the end of the story. By understanding your rights, following a methodical process, and gathering the right evidence, you can successfully challenge an unfair decision.

The best way to protect yourself is to get expert advice from the very beginning. At WeCovr, we help you navigate the complexities of the private medical insurance UK market to find a policy that's right for you. We're here to provide clarity and support for the lifetime of your policy.

Ready to find the right private health cover? Speak to one of our friendly, expert advisors today for a free, no-obligation quote and personalised recommendation.

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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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