Insurance information is general guidance only. Insurance products are regulated by the FCA. Policy terms vary between providers — always read the policy document before purchasing.
Contents
With NHS waiting lists at record levels, private health insurance is increasingly popular in the UK. Around 4 million people have individual private medical insurance, with millions more covered through employer schemes. Here is what it offers and whether it makes sense for you.
What Private Health Insurance Covers
Standard Cover
Cover
Detail
Inpatient treatment
Surgery, hospital stays, procedures
Day-case treatment
Procedures not requiring overnight stay
Diagnostic tests
MRI, CT scans, blood tests
Specialist consultations
Referrals to specialists
Cancer treatment
Chemotherapy, radiotherapy, surgery
Enhanced Cover (Often Optional)
Cover
Detail
Outpatient treatment
GP referrals, follow-up appointments
Mental health
Therapy, psychiatry (often limited)
Physiotherapy
Sessions with a physiotherapist
Dental
Check-ups, treatment, hygiene
Optical
Eye tests, glasses, contact lenses
Maternity
Pregnancy and birth (usually moratorium)
What Is NOT Covered
Excluded
Detail
GP services
Most policies require NHS GP referral
Emergency treatment
Use A&E/NHS
Pre-existing conditions
Usually excluded (see underwriting)
Cosmetic surgery
Unless medically necessary
Chronic condition management
Long-term conditions (diabetes, arthritis)
Pregnancy (standard plans)
Often excluded or limited
Organ transplants
Usually excluded
Typical Costs
Individual Plans
Age
Basic
Mid-Range
Comprehensive
25–30
£30–£50/month
£50–£80/month
£80–£120/month
30–40
£40–£65/month
£65–£100/month
£100–£150/month
40–50
£55–£90/month
£90–£140/month
£140–£200/month
50–60
£80–£130/month
£130–£200/month
£200–£300/month
60–70
£120–£200/month
£200–£300/month
£300–£450/month
Family Plans
Family Size
Basic
Comprehensive
Couple
£80–£150/month
£200–£350/month
Couple + 1 child
£100–£180/month
£250–£400/month
Couple + 2 children
£120–£200/month
£280–£450/month
Types of Underwriting
Type
How It Works
Pros
Cons
Moratorium
No medical questions; pre-existing conditions from last 5 years excluded
Quick, easy setup
Less comprehensive
Full medical
Detailed health questionnaire; insurer decides what to cover
Clearer about what’s covered
Time-consuming; may exclude more
Continued personal medical exclusions (CPME)
Switching from another insurer; maintains existing cover
Keeps previous cover
Must have existing insurance
NHS vs Private
Feature
NHS
Private
Cost
Free
£30–£300+/month
GP access
Through NHS GP
Usually need NHS GP referral
Waiting times
Can be 18+ weeks for elective treatment
Days to weeks
Choice of consultant
Limited
Full choice
Choice of hospital
Limited
Private hospitals, private NHS rooms
Accommodation
Shared ward
Private room
Emergency care
Excellent (and free)
Use NHS A&E
Continuity of care
Variable
Consistent named consultant
Reducing Costs
Strategy
Saving
Higher excess
£100–£500 excess reduces premiums significantly
Six-week wait option
Only use private if NHS wait exceeds 6 weeks
Guided/guided option
Insurer helps choose consultants (lower cost)
Hospital list
Choose a limited list of hospitals
No outpatient cover
Reduces premium but limits cover
Employer scheme
Often cheaper than individual (group rates)
Pay annually
5–10% discount vs monthly
Is It Worth It?
Consider Private Insurance If:
NHS waiting times concern you for non-emergency treatment
You want choice of specialist and hospital
Your employer offers it as a benefit
You need regular specialist care
You value private rooms and flexible appointment times
Mental health support with faster access
The NHS May Be Sufficient If:
You are generally healthy
Emergency/urgent care is your main concern (NHS excels here)
Budget is tight
You can accept NHS waiting times
You use NHS dental and optical services
Alternative Approaches
Approach
Cost
Benefit
Self-fund
Pay as needed
No premiums; full control
Health cash plan
£5–£30/month
Cashback on dental, optical, physio
NHS + savings fund
Premium in savings account
Builds fund for private treatment
How Much Does Private Health Insurance Cost?
Private health insurance premiums depend heavily on age, health history, level of cover, hospital list, and whether you include more specialist cover. Indicative 2025 UK premiums:
Profile
Monthly premium range
Notes
Single adult, age 30, healthy
£40–£90
Budget to mid-range cover
Single adult, age 40, healthy
£60–£140
Increases sharply with age
Single adult, age 50
£100–£250
Pre-existing exclusions likely
Couple, age 35 & 33
£100–£200
Moratorium underwriting
Family (2 adults + 2 children)
£150–£400
Children often at low/no extra cost
Comprehensive cover, age 45
£200–£450
Full hospital list, mental health, dental
Employer schemes are typically 30–50% cheaper because risk is spread across a workforce. If your employer offers private medical insurance as a benefit, it is nearly always worth taking.
Types of Underwriting Explained
How your policy is underwritten determines what pre-existing conditions are covered:
Underwriting type
How it works
Best for
Moratorium
Pre-existing conditions excluded for first 2 years; covered if symptom-free for 2+ years
Younger people with minor historic conditions
Full medical underwriting (FMU)
You declare all conditions at outset; exclusions listed specifically
Those who want certainty upfront
Continued personal medical exclusions (CPME)
When switching insurer — existing exclusions carried over
Avoiding reassessment when switching
Medical History Disregarded (MHD)
Usually only via employer groups — all conditions covered
Group schemes
What to Expect When You Make a Claim
GP referral: Most policies require an NHS GP referral letter before you can access private treatment
Insurer pre-authorisation: Call your insurer to pre-authorise the treatment and hospital — doing this ensures cover
Choose your specialist: Your insurer’s approved list or their online portal lists covered consultants
Treatment: Private hospital treatment with your own room and consultant
Invoices: In most cases your insurer pays the hospital and consultant directly; you pay your excess if applicable
Do not assume it’s covered without pre-authorisation. Emergency treatment can be arranged retrospectively, but routine treatment requires pre-approval.
Things Private Health Insurance Doesn’t Cover
Misunderstanding exclusions is the top cause of private health insurance disappointment:
What’s typically excluded
Why
Pre-existing conditions (moratorium period)
Underwriting risk
Chronic conditions (ongoing management)
Long-term cost
Emergency A&E treatment
NHS handles better
Pregnancy and childbirth (standard policies)
Specialist maternity cover needed
Cosmetic treatment
Not medically necessary
Experimental treatments
Not evidence-based
Organ donor operations
NHS service
Infertility treatment
Usually excluded or limited
Is Private Health Insurance Taxable?
Paid personally: The premium is paid from after-tax income; the benefit (treatment) is tax-free
Provided by employer: The premium counts as a taxable benefit in kind (P11D) — you’ll be taxed on the value of the benefit, typically meaning a few hundred pounds of extra tax per year. Still usually worth taking.
Self-employed: Premiums are NOT a business expense unless the policy is taken for employees (not just the director-owner)