Private Medical Health Insurance
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Private medical insurance (PMI, sometimes known as health insurance) is designed to give you the peace of mind that allows you to be the absolute Best you that you can be. How does it do that, you might ask? Well, by covering your private healthcare costs so you don’t have to, it ensures that you’re seeing the Best, the quickest, and the most convenient medical care for you without leaving you worried over how you’re going to pay for it.
Say, for example, that you’d gotten sick and were concerned about how long your symptoms were lasting. If you were trying to get seen on the NHS, you might be waiting for a really long time; weeks, if not months. By that time, it’s possible that your symptoms would’ve subsided – but it’s equally possible that they would’ve gotten worse. But if you had a private medical insurance policy, you wouldn’t have to worry about that, because you could’ve made the appointment and been seen on that very same day.
How exactly does private medical insurance work?
Speak to your GP about your health
Every private medical insurance claim starts with speaking to your GP, who can diagnose your problem and refer you to a specialist or private consultant. Use their advice and recommendations to find the right private healthcare provider for you and your needs
Get quick, specialist care
Skip the long waiting lists everyone associates with the NHS by seeking out private healthcare. Get prompt consultations, diagnostic tests, surgeries, and hospital stays in private facilities or dedicated private wards, all without any of the fuss or delays that come with public healthcare
Claim again when you need to
Illnesses and injuries are a part of life; they happen over and over again. That’s why your private medical insurance is here for you throughout your life: so every time you need to get your health checked or treatments covered, you can do so without worrying about the wait, the quality of service, or the cost
Do I need private medical insurance?
According to a report published by NHS England, over 5,000 people were hospitalised with the flu in late 2022, increasing by almost 2,000 in just a week. And that’s just the flu; across the UK, about 6 million people were hospitalised for one reason or another in that same year. If you’re worried about long NHS waiting times, private medical insurance (PMI) is a great investment in your health. It’s particularly valuable if you’re self-employed, a freelancer, or a business owner, since your income relies so heavily on staying healthy and being able to return to work as quickly as possible.
What does private medical insurance cover?
What is covered by private medical insurance?
Private medical insurance is designed to complement the NHS by covering short-term acute medical conditions. Usually, your private medical insurance will cover the cost of inpatient and day-patient care (for example, private hospital accommodation or operating theatre fees), but the care doesn’t stop there.
Your private medical insurance will cover the cost of diagnostic tests and scans (like consultations, blood tests, X-rays) as long as your GP has indicated that they’re necessary. You can also get the cost incurred from cancer treatment covered – be that chemotherapy, radiotherapy, surgical removal of tumours, or access to specialist drugs or targeted therapies not offered on the NHS.
Depending on your level of outpatient cover, you might also be able to get outpatient therapies (think physiotherapy or osteopathy) covered under your private medical insurance too.
What is not covered by private medical insurance?
All private medical insurance policies will exclude certain types of illnesses or treatments; for example, pre-existing conditions (AKA any health issues, injuries, or symptoms you had before you took out your policy) are never covered by any private medical insurance policy.
Chronic conditions, too, usually aren’t covered by private medical insurance. Anything that requires long-term management or monitoring (like diabetes) will be excluded from cover. Generally, any emergency care (including visits to A&E and ambulance trips) aren’t covered by PMI because the NHS handles all that.
Finally, routine and lifestyle care tends to be excluded from private medical insurance cover. That includes pregnancy and childbirth treatment; elective or cosmetic surgeries; routine dental check-ups and optical care – though you can get dental and optical care added onto your cover for an additional fee.
How much is private medical insurance?
Private medical insurance premiums are affected by a whole range of factors, including:
How much is income protection insurance?
Income protection insurance premiums are affected by a whole range of factors, which include:
Your age
The older you are when you purchase your cover, the more you’re likely to pay in premiums because there’s a higher risk that you’ll fall ill and need to claim.
Your job
If your job is considered to be ‘risky’, you’ll pay more in premiums. For example, if you’re a builder or a mechanic, you’re likely to pay more than an office worker would.
Cover length
Generally speaking, the longer your policy is, the more expensive it’ll be. If you’re looking to cut costs, taking out a short-term policy is a good idea — but check how much cover you need first.
The waiting period
The longer you can wait before receiving your payout, the cheaper your premium will be. Generally, waiting periods start from about 4 weeks and go all the way up to a full year.
Your lifestyle
If you smoke, drink, or have pre-existing health conditions, you might be more vulnerable to severe illnesses, so you’d be more likely to claim; making your cover more expensive.
What are the benefits of private medical insurance?
There are a number of benefits to private medical insurance cover, including:
Faster healthcare that enables you to skip long NHS waiting times and access quicker GP consultations or specialist referrals
Broader range of treatments and services like advanced drugs, therapies, and treatments
Peace of mind and financial support
The ability to focus on recovery and your own well-being without worrying about expensive medical bills or the delays that are everywhere in the NHS
How much private medical insurance do I need?
Working out how much private medical insurance you might need is easy when you break it down into three quick steps:
Take stock of your healthcare needs and priorities to determine the type and level of coverage that best suits your requirements. Compare quotes from multiple insurance providers to find the most competitive rates and comprehensive coverage options
Thoroughly review the terms and conditions of your private medical insurance policy, paying close attention to coverage exclusions and limitations, as well as any additional fees or charges
Consider consulting with an insurance broker or financial advisor who can offer expert guidance and help you navigate the complexities of private medical insurance. Periodically review your private medical insurance policy to be sure it meets your needs
How much will my private medical insurance cover?
Exactly how much your private medical insurance will cover depends on your specific policy, but generally you’ll get unlimited annual coverage for eligible inpatient and day-patient treatments. That might mean surgeries, hospital stays, or cancer care. However, generally optional add-ons like outpatient care, alternative therapies, or dental cover will be subject to financial caps (for example, your specialist consultations coverage might only go up to £1,000 a year). Check your specific private medical insurance policy documents for more information.
What do I need to get a private medical insurance quote?
Once you’ve figured out how much private medical insurance coverage you want, we’ll need some information about you, your health, and how you want your policy structured.
Your personal
details
We’ll need info about you and your location, including your name, date of birth, and home address so we know exactly who we’re covering
Your income & cover details
Information about pre-existing conditions, recent doctor visits, or lifestyle factors (like if you smoke), as well as if you’d prefer moratorium or full medical underwriting
Your chosen waiting period
Lay out for us the specific level of protection you’re looking for, including outpatient cover limits, add-ons (like dental or optical care), and your chosen excess amount
Frequently Asked Questions
Sometimes referred to as ‘private health insurance’ or just ‘health insurance’, private medical insurance is a type of coverage designed to minimise your private healthcare costs. While the NHS is a great option for a lot of people, more and more Brits are turning to private healthcare every year for many reasons. With private medical insurance, the costs that are part and parcel of private medical treatment are reduced to something much more manageable; your insurer will foot the bill for your treatment and you’ll get the healthcare you need, when you need it.
It can be kind of tough to narrow down exactly who needs private medical insurance, but it’s a good idea if you’re looking to take some of the load off of the NHS’ plate. Private healthcare also allows for a lot more choice, both in terms of how you’re treated – which doctors you see, which medications you take, etc. – and when you’re treated; if you’d like a little more control over your health, private medical insurance is a great first step.
It’s pretty simple! If you have a private medical insurance policy, all you have to do is go see your GP about whatever injury, illness, or ailment you think you might have, and tell them that you have private medical insurance. If your GP then decides that you need treatment, they’ll refer you to a specialist. Before you see that specialist, you should contact your insurer to be sure that your claim will be eligible; only once you’ve gotten their approval can you start sorting out your specialist treatment. If you sort out costs before getting your insurer’s permission, you might end up lumped with the bill – which is the absolute opposite of what your policy is supposed to do – so make sure you follow all the regulations outlined in your policy document when it comes to claiming!
Pre-existing medical conditions – A.K.A. illnesses you had symptoms of or treatment for before you purchased your policy – are not covered by private medical insurance. You can generally still get private medical insurance if you have pre-existing conditions; it’s just that usually, these conditions are excluded from cover. If you’ve been without symptoms or treatment for a few years, some insurers might consider covering you for them – but that’s down to the specific policy and insurer, not industry standard.
Private medical insurance comes with a bunch of benefits, including 24/7 digital GP services available at your convenience, mental health services, and access to drugs and treatments not available on the NHS. Depending on the policy, you can also usually choose what hospital or treatment centre you want to be seen at – and you might even be able to get a private room, so you can recover with the comfort and dignity that comes from peace and quiet. The biggest benefit of private medical insurance, though, is the peace of mind that comes with knowing you’ll have access to the best and most convenient treatment possible if you need it – including breakthrough cancer drugs that the NHS unfortunately won’t be able to offer you.
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