💡 What Is Private Medical Insurance (PMI)?

Private Medical Insurance is a paid-for policy that covers the cost of private healthcare , either partly or fully, depending on your level of cover.

It’s designed to complement, not replace, the NHS. With PMI, you often get:

• Faster access to treatment
• More choice over specialists and hospitals
• Private rooms, shorter waits, and greater flexibility

🏥 What Does PMI Typically Cover?

PMI usually covers the cost of diagnosis and treatment for acute conditions , illnesses that start suddenly and can be treated or cured.

That may include:

• Scans (MRI, CT)
• Specialist consultations
• Hospital stays and surgery (e.g. hernia repairs, knee operations)
• Cancer care (diagnosis and treatment)
• Mental health support (depending on policy)
• Physiotherapy and post-surgery rehab

📌 Example:
James injures his knee playing football. Through PMI, he sees a specialist within 5 days, gets an MRI the following week, and has surgery booked within 2 weeks , all in a private hospital. Without PMI, he’d face a 3-4 month wait.

🚫 What Doesn’t PMI Cover?

This part is crucial , PMI doesn’t cover everything. It’s NOT a replacement for emergency or long-term NHS care.

Common exclusions:

• Pre-existing conditions (unless declared and accepted)
• Chronic conditions (e.g. diabetes, asthma, arthritis)
• Emergency treatment (heart attacks, A&E visits)
• Maternity care (except in some premium policies)
• Cosmetic surgery (unless medically necessary)
• Organ transplants
• Self-harm or addiction-related treatments
• GP visits (some plans include them, but most don’t)

📌 Always check the exclusions list before buying.

 

🕒 What About Waiting Periods?

Even after you take out PMI, you may have waiting periods before certain treatments are covered.

Examples:

• Some policies only start full cover after 6 months
• Dental/mental health cover might kick in after 12 months
• Cancer treatment may have a 3-month exclusion for new diagnoses

➕ What Are “Top-Up” Options?

Many PMI providers offer optional extras for an additional cost. These are often called add-ons or modules.

You can add cover for:

• Outpatient treatment (like seeing specialists without going to hospital)
• Dental and optical care
• Mental health support
• Therapies (e.g. physio, acupuncture)
• Worldwide travel insurance
• 24/7 private GP access

✅ Tip: Don’t pay for add-ons you won’t use. Start with a basic plan and upgrade if needed.

💷 How Much Does PMI Cost?

Prices vary widely depending on:

• Your age (older = more expensive)
• Where you live (London and SE = higher costs)
• Your health and lifestyle (smoking adds cost)
• The level of cover (basic vs comprehensive)
• Whether you choose an excess (the amount you pay towards each claim)

📊 Example costs (per month):

• Age 30, non-smoker, basic plan: £20–£40
• Age 50, comprehensive plan with extras: £60–£150
• Family of 4, mid-level cover: £100–£250

📉 When Does PMI Save You Money?

PMI isn’t about saving money upfront , it’s about value when you need it.

It can save money if:

• You need elective (non-urgent) surgery like hip replacements, hernia repair, cataracts
• You need fast access to mental health support
• You lose income if you’re off work waiting for treatment
• You would otherwise pay for private care anyway

📌 Example:
Jenny pays £60/month for PMI. When she develops a benign growth on her back, she avoids a 6-month NHS wait and has surgery privately within 2 weeks , worth over £3,000.

 

🤔 Who Might Not Need PMI?

• You’re young, healthy, and happy using the NHS
• You’re on a tight budget and can’t afford monthly premiums
• You already get fast access through work or specialist NHS services
• You don’t need much choice over where or how you’re treated

🔍 How to Choose the Right PMI Policy

Here’s what to look for:

1. Level of cover
   Start with “inpatient only” (for surgery and hospital stays) or go full cover with outpatient, mental health, etc.

2. Excess
   A higher excess lowers your monthly cost. Common options: £100, £250, £500 per claim or per year.

3. Hospital list
   Some plans only cover specific hospitals. Check if your local or preferred ones are included.

4. Cancer cover
   Some policies offer enhanced cancer care. Others limit drug options or exclude it. Be clear on what’s included.

5. Underwriting type

• Moratorium: Your recent conditions are excluded initially, but may be covered later if they don’t come back.
• Full medical underwriting: You declare your full history and exclusions are agreed upfront.

✅ Tip: If you have a pre-existing condition, moratorium underwriting may allow eventual cover , check the fine print.

🧑‍💻 Where to Buy PMI?

You can:

• Go direct to providers like AXA Health, Bupa, Vitality, Aviva, WPA
• Use a comparison site (but they don’t show every insurer)
• Speak to a PMI broker , they can search the whole market and help tailor your cover

weSearch-uCompare connects you to FCA-authorised partners who can talk you through all your options , with no pressure to buy.