Private Health Insurance: Frequently Asked Questions
A working list of the questions we get most often. If yours isn’t here, call 0800 131 0400 or email info@insuredhealth.co.uk.
The basics
What is private health insurance?
A policy that pays for private medical treatment; consultations, scans, surgery, for new conditions that arise after the policy starts. Premiums are usually paid monthly or annually.
Is it the same as the NHS?
No. Private health insurance is a separate, privately funded layer. You can use both; keep your NHS GP and use private cover for faster diagnostic and elective treatment. The two systems run alongside each other.
Is private health insurance worth it?
It depends on your age, health, income, and how much you’d value faster diagnostic and elective treatment. For many working-age adults with modest medical concerns, it’s worth it. For young, healthy people on a tight budget, the answer is less clear.
Cost and pricing
How much does private health insurance cost in the UK?
A healthy 30-year-old on comprehensive cover might pay £40-£70/month. A 65-year-old on the same cover might pay £150-£250. Premiums depend on age, postcode, smoker status, cover level, hospital list and excess.
Can I lower my premium?
Yes; increase the excess, narrow the hospital list, drop unused add-ons, or step down a tier. Re-quoting the market on a CPME basis at renewal is the biggest single lever.
Why has my renewal gone up so much?
Three drivers: age, medical inflation (5-10% a year typical), and any claims you’ve made. Big jumps usually combine all three. Often worth challenging.
Cover and benefits
What’s covered as standard?
Inpatient surgery, outpatient consultations, diagnostics (MRI, CT, ultrasound), cancer treatment, mental health (with limits), and increasingly virtual GP services.
What’s not covered?
Pre-existing conditions, chronic conditions (diabetes, asthma, ongoing heart disease), routine GP appointments, routine maternity, cosmetic surgery, A&E.
Does it cover mental health?
Most modern policies do; typically 10-28 outpatient sessions per year plus inpatient treatment if needed. Pre-existing mental health is usually excluded.
Does it cover cancer?
Yes, almost universally. Many policies offer no upper limit on cancer treatment costs. Some restrict to NICE-approved drugs; others are broader.
Will it cover my pre-existing condition?
Usually not at first. Two routes: Full Medical Underwriting (clear exclusions stated upfront) or Moratorium (auto-exclusion that can lift after a symptom-free period). Group schemes with MHD include them.
Claiming and using cover
How do I make a claim?
See your NHS GP for a referral, call the insurer’s claims line to authorise, attend the appointment, then call again to authorise any next steps. Insurer pays the hospital directly.
Do I need a GP referral every time?
For most claims yes. Some insurers’ virtual GP services can substitute as the referral.
Can I choose my consultant?
Usually yes, from the insurer’s recognised list. Always check the consultant is fee-assured to avoid out-of-pocket charges.
How long does authorisation take?
Routine claims authorise on the call. Complex pre-existing-related claims can take days while medical records are reviewed.
Switching and renewing
Can I switch insurers without losing cover?
Yes, using CPME (Continued Personal Medical Exclusions). The new insurer accepts the same underwriting terms as your old policy, so accepted conditions stay accepted.
Do I lose my no-claims discount when I switch?
Most insurers honour your accumulated NCD when you switch. Always confirm with the new insurer.
When should I review my cover?
Every year at renewal, plus any time your circumstances change; new family member, new job, retirement, moving house.
Buying and brokers
Should I buy direct or through a broker?
Brokers compare the whole market in one conversation and don’t cost you anything (insurers pay a standard commission). Direct works if you have a strong preference for one insurer already.
Is the broker really free?
Yes. Insurers pay brokers a standard commission, set at the same rate across providers. There’s no fee to you.
Are brokers regulated?
In the UK, yes; insurance brokers must be authorised by the Financial Conduct Authority (FCA). Always check FCA authorisation before working with anyone.
Family and group cover
Can I add my partner and children?
Yes. Joint policies cover two adults; family policies add dependent children, often at a low or single child rate.
Can my employer add my family to the company scheme?
Yes, but it increases the benefit-in-kind on your P11D. Sometimes more tax-efficient to keep family on a separate personal policy.
What happens to children’s cover when they grow up?
Most insurers let children transfer to their own individual policy at 18, 21 or 24 (depending on whether they’re in education) without new underwriting.
Have a question we haven’t answered? Call 0800 131 0400 or email info@insuredhealth.co.uk.
