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Guide to PMI sponsored by Bupa

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Bupa is a leading provider of private medical insurance (PMI) with over 14 million customers in over 190 countries worldwide.

PMI from Bupa

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Private Medical Insurance : What do you need?

What kind of medical insurance do you need?

There are many types of Private Medical Insurance Policy, from full cover to limited cover, from the packaged family plan to specialist cover. We seek to help guide you on what is available. But it comes down to your personal choice, and perhaps cost.
Stop a moment and think why you are considering Private Medical Insurance. Is it to avoid NHS waiting lists? Is it to protect your family by providing for private healthcare? Is it to get a choice of where you get treated?
On costs, are you looking for the widest individual health insurance cover possible? Do you have a rough idea of what you can afford each month and seek to tailor the choice to that budget? See our suggestions for reducing the cost.
Think of us as a huge market showcase, laying out the wares of those who offer Private Medical insurance UK.
In our Product Library, our aim is to profile each product. This uses information from the companies concerned and other publicly available information. We provide a thumbnail sketch of each product. Insurance products tend to have pages of terms, conditions, and lots of other details, so you should check out the full policy wording and carefully read any documents the insurers provide. It is tempting to skip reading the full policy wording or other documents, but they are there to be read. If you don't understand anything, make the insurer explain it.
We have broken down the hundreds of private health insurance policies on offer into specific groups to help you navigate your way through.
We do not recommend any particular medical insurance product or provider. We do not make judgements as to whether or not a private health insurance policy, or any feature in it, is "good" or  "bad". Neither do we suggest which policy is best suited to you.
Our Product Profiles are totally independent. They are not written, or edited by, any insurer or other provider. We do not give them ratings or stars.


Basis of cover

The two bases of covers are:

  • Moratorium
  • Full Medical History Underwriting




Step One

  • You do not provide details of your medical history.

  • You fill in a form or talk to an underwriter on the phone


Step Two

  • The insurer asks any extra questions


Step Three

  • The insurer may contact your GP for more information.


Step Four

  • The insurer quotes you a price

  • The insurer excludes ALL pre-existing  medical conditions  and conditions related them, it does not list them individually.


It  must tell you if some or all such conditions may become eligible for cover after  there has been a continuous period, stipulated by the insurer,  often 2 years, during which time there has not been treatment, symptoms,  medication, tests and or advice for that condition (or a related  one).


It must not suggest that you forgo medical  treatment in an attempt to achieve this;


Some conditions, e.g. chronic conditions which require  continuous treatment and or monitoring, are not likely to be  eligible for such delayed medical insurance cover because of the need to remain  free of treatment, medication, tests and advice;  -this will usually be current or recent problems or conditions


if you choose this option you will only be asked to provide basic information about  you and any members of your family you wish to insure. You will not be asked to  disclose details of your medical history, but it relies on you to understand that if  you have any medical conditions these will be excluded from cover. Also, if you  can satisfy the criteria (usually two years) outlined in the above section, for a pre-existing condition, then treatment for that condition will automatically be covered  should it later recur, subject to the policy terms and conditions.


The ABI now has two common definitions which private healthcare insurers must now use or move to use from 2008



Chronic condition 

  • A disease, illness, or injury that has one or more of the following  characteristics: 

  • it needs ongoing or long-term monitoring through consultations,  examinations, check-ups, and / or tests

  • it needs ongoing or long-term control or relief of symptoms

  • it requires your rehabilitation or for you to be specially trained to cope  with it 

  • it continues indefinitely

  • it has no known cure

  • it comes back or is likely to come back.


Pre-existing condition 

  • Any disease, illness or injury for which: 

  • you have received medication, advice or treatment

  • or you have experienced symptoms


Whether the condition has been diagnosed or not in the xxx years before  the start of your cover.


Full Medical History Underwriting

Step One

  • You provide details of your medical history.

  • You may have to fill in a form or talk to an underwriter on the phone


Step Two

  • The insurer asks any extra questions


Step Three

  • The insurer may contact your GP for more information.


Step Four

  • The insurer quotes you a price

  • The insurer advises what medical conditions  and conditions related to them, it will not cover-this will usually be current or recent problems or conditions

  • The insurer advises if these exclusions are permanent or only for the first X years of the policy 


Although this option involves more of your time when completing your application, it does mean that, when you receive your policy documentation, you will know  which conditions are excluded from cover.


What private medical insurance does not cover

Some illnesses and self-inflicted conditions are not covered by private medical insurance UK. Most insurers will not cover you for illnesses that you already have (pre-existing conditions) or chronic (long term) conditions that cannot be cured. 

Almost all policies will exclude

  • Accident and emergency admission

  • Accident and emergency outpatient treatment

  • GP  services

  • NHS  prescriptions

  • Normal pregnancy


Most policies exclude a range of treatments and conditions;

  • Non-emergency treatment outside the UK

  • Drug abuse

  • Alcohol abuse

  • Self inflicted injuries


  • Cosmetic surgery

  • Cosmetic dentistry

  • Fertility/infertility

  • Sex changes

  • Organ transplant

  • Kidney dialysis

  • Outpatient drugs and dressings

  • Mobility aids

  • Experimental treatment and drugs

  • Rehabilitation

  • War risks

  • Dangerous/ hazardous pursuits ,hobbies, sports,  and work 

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