Hints and tips for buying private health insurance

Thinking about getting private medical insurance (PMI)?

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The cover

The more cover you have, the more it costs. This applies to the number of sections taken, limits and extras bought.

Your health

Your health dictates whether you can buy individual insurance and the price you will pay. Insurers consider your current health status, medical history, age, gender, residence and occupation before they decide whether to offer you a policy.

If you have or had a serious health condition - cancer or diabetes, for example - an insurer can reject you based on pre-existing conditions.

If you suffer from less severe conditions, such as hypertension or knee problems, an insurer may offer you a policy with a temporary or permanent exclusion, meaning your specific condition won't be covered.

Some insurers may cover the condition but drastically increase the price of the policy.

Typically, the young and healthy find the best deals on individual coverage, while older and sicker individuals pay much more. 

Calculate all your health costs

Very low premiums may be attractive at first, but what really matters is the combination of premium plus your likely out-of-pocket spending on health care below the deductible. Remember: you pay all of those costs from your own pocket. So while it's tempting, don't shop on premium alone.

Add up all of your potential costs under a policy, including deductibles, co-payments, co-insurance and any other cost-sharing obligations.

The costs to you include low limits. For example, if you have an operation that costs £5000, there may be a limit generally or on that type of procedure of £3000 - the extra £2000 comes out of your pocket. 

You do not get money back if the cost of the operation is below the limit.

Understand what a policy covers and what it doesn't

Individual policies vary hugely on what they do and do not cover.

Read the fine print

There is a wide range of products in the individual market, from catastrophic-only coverage to comprehensive health plans to products that cover only a specific disease, like cancer. What is important is that you look carefully at what each policy covers and what it does not.

Do not just rely on our product summary or the list of benefits on the insurer's website.
Before you buy, look at a full policy wording. This is where all the good stuff about what is covered, and the bad stuff about what is not, lurks.

If you need help - ask. Better to ask now rather than when you claim.

When does it stop?

If you are young this will not matter. But if you are around or over 60, check to see how long the company will allow you to have cover. Age limits are increasing, but some still refuse to renew anyone after 65 or 70.

Can I add a spouse if I get married or a child if I give birth or adopt?

Some private medical insurance UK policies will require you to re-apply for coverage - including new medical underwriting - if your family situation changes. Ask if there are circumstances under which you would need to re-apply.

Thinking about getting private medical insurance (PMI)?

Download our free PDF guide



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