Private Medical Insurance Explained

Private Medical Insurance Explained

A plain-English guide to PMI in the UK — what it covers, how providers compare, and what to consider before taking out a policy.

Last updated June 2026 — That's Family Finance — Educational guide only

4.5m
People with private medical cover in the UK
£50–£200
Typical individual monthly premium
6
Major UK PMI providers compared below
4
Underwriting types to understand

What Does Private Medical Insurance Cover?

PMI funds private healthcare treatment outside the NHS. Cover is built around a core set of benefits — with optional add-ons depending on the provider and tier you choose.

Inpatient Treatment

Surgery, overnight stays, specialist consultations and nursing care at a private hospital of your choice.

Outpatient Care

Specialist consultations, follow-up appointments and diagnostic tests without an overnight stay.

Mental Health

Inpatient and outpatient psychiatric treatment, counselling and therapy. Now standard across most leading providers.

Cancer Care

Chemotherapy, radiotherapy, targeted drug therapies and oncology consultations. Covered comprehensively across all tiers.

Physiotherapy

Musculoskeletal treatment, post-operative rehabilitation and physio sessions, typically subject to an annual limit.

Diagnostics

MRI and CT scans, X-rays, blood tests and pathology. Fast access to results is one of the main reasons people take out PMI.

Dental, optical and routine GP appointments are generally not included in standard PMI and may be available as separate add-ons.

How Does PMI Work?

PMI operates on a direct-payment or reimbursement model. You pay a premium, and when you need treatment, you pre-authorise the claim with your insurer before proceeding.

1

Choose a policy

Compare providers, cover levels and excesses. An independent adviser can search the whole market on your behalf.

2

Pay your premium

Monthly or annually. Based on age, health history, cover level and voluntary excess. Annual payment is usually cheaper.

3

See your GP

Get a referral when you need treatment. Some insurers offer direct access for certain conditions, skipping the GP step.

4

Pre-authorise your claim

Contact your insurer before treatment. They confirm cover and in most cases pay the hospital or specialist directly.

5

Receive treatment

Access private facilities at a time that suits you, with a consultant of your choice — no NHS waiting list.

UK PMI Provider Comparison

A summary of the six largest PMI providers in the UK. Policy details, exclusions and pricing vary significantly by plan and individual circumstances.

Feature Bupa AXA Health Vitality Aviva WPA Cigna
Cancer cover Comprehensive Comprehensive Full Full Full Full
Mental health In & outpatient In & outpatient Strong Included Included Included
Outpatient cover Add-on Add-on Included Add-on Flexible Flexible
Dental add-on Yes Yes Yes Yes Yes Not standard
No-claims discount Up to 65% Up to 65% Rewards-based Up to 70% Available Available
Digital GP Bupa Blua Doctor at Hand Vitality GP DigiCare+ Included Included
Monthly cost* £60–£180 £55–£170 £50–£160 £55–£175 £60–£190 £65–£200

*Indicative monthly premiums for a non-smoking adult aged 30–45 with a standard excess. Actual premiums vary. Always obtain a personalised quotation.

PMI Underwriting Types

Underwriting determines how your policy handles pre-existing conditions. It is one of the most important things to understand before choosing a policy.

Individual

Moratorium

Excludes conditions from the past 5 years automatically. After 2 symptom-free years on the policy, those conditions may become covered. No medical questionnaire needed.

Individual

Full Medical Underwriting

You complete a health questionnaire upfront. Exclusions are specified clearly from day one. Can result in fewer exclusions than moratorium for those with a clean recent history.

Switching

CPME

Continued Personal Medical Exclusions. Used when switching providers — your existing exclusions carry across. No new exclusions added.

Group only

Medical History Disregarded

All pre-existing conditions covered from day one. Typically only available through employer group schemes with a minimum number of members enrolled.

Moratorium — full explanation +
The most common form of underwriting for individual policies. Any condition you have experienced, received treatment for, or taken medication for in the five years before your policy starts is automatically excluded. If you remain symptom-free and treatment-free for two consecutive years after the policy begins, that condition may then become eligible for cover. No medical questionnaire is required at the outset.
Full Medical Underwriting — full explanation +
You complete a detailed medical questionnaire at the start of the policy. The insurer reviews your full health history and specifies exactly which conditions are excluded from day one. This gives you greater certainty about what is and is not covered. For people with a clean recent health history, FMU can sometimes result in fewer exclusions than moratorium.
CPME — full explanation +
Used when switching providers. Your existing exclusions from your previous policy are carried across to the new policy on a like-for-like basis. This allows you to move to a different insurer without losing continuity of cover or acquiring new exclusions.
Medical History Disregarded — full explanation +
All pre-existing conditions are covered from day one, with no exclusions based on health history. MHD underwriting is typically only available through employer group schemes where a minimum number of employees are enrolled. It is the most comprehensive form of underwriting.

Added-Value Benefits

Most leading PMI policies now include wellbeing and support services beyond core medical cover. These vary by provider and policy tier.

24/7 GP Access

Phone or video consultations with a qualified GP at any time, without an appointment.

Mental Health Support

Counselling, CBT and psychiatric services — often with direct referral, no GP needed first.

Health Assessments

Annual health checks, blood screening and lifestyle assessments to identify issues early.

Second Medical Opinion

Access to a leading specialist for an independent second opinion on a diagnosis or treatment plan.

Wellness Rewards

Vitality offers gym discounts, fitness tracker deals and lifestyle rewards linked to activity levels.

Prescription Services

Some policies include private prescription services for faster access to medication.

Individual vs Group PMI

PMI can be arranged personally or through an employer. The two options differ significantly on underwriting, cost and flexibility.

Individual PMI

  • Full control over provider and cover level
  • Underwritten on your own health history
  • Pre-existing conditions typically excluded at outset
  • Premiums rise with age and claims history
  • Portable — stays with you regardless of employer
  • Can cover a partner or children on the same policy

Group PMI

  • Arranged by an employer as a workplace benefit
  • Often uses Medical History Disregarded underwriting
  • Pre-existing conditions may be covered from day one
  • Premiums typically paid by the employer (P11D benefit)
  • Cover ceases when you leave the employer
  • Less flexibility over provider and policy structure

Getting Independent Advice

PMI is not a straightforward product. Underwriting terms, exclusions, excess structures and provider strengths vary considerably — what suits one person may be wrong for another.

An independent adviser searches the whole market rather than recommending a single provider. They can assess your health history, identify the right underwriting approach, and find the policy that offers the best value for your circumstances.

That's Family Finance works with FCA-regulated advisers who are not tied to any insurer. Use the contact page to get in touch.

Frequently Asked Questions

What does private medical insurance cover? +
PMI typically covers inpatient treatment, outpatient consultations, diagnostic tests, cancer care, mental health treatment and physiotherapy. Dental, optical and routine GP appointments are generally not included as standard.
Is private medical insurance worth it in the UK? +
PMI gives faster access to specialists and treatment without NHS waiting times. Whether it is worth it depends on your health needs, budget and how much value you place on choice and speed of care. It is not a replacement for NHS cover but a supplement to it.
How much does private medical insurance cost? +
Premiums vary based on age, health history, level of cover and excess. Individuals typically pay between £50 and £200 per month. Family policies vary considerably. The figures in the provider table above are indicative only.
Can I get PMI with a pre-existing condition? +
Yes, though pre-existing conditions are usually excluded under standard underwriting. Medical History Disregarded underwriting — typically available through employer group schemes — may cover pre-existing conditions from day one.
What is moratorium underwriting? +
Moratorium underwriting automatically excludes conditions experienced in the five years before the policy starts. If you remain symptom-free for two consecutive years after the policy begins, that condition may become eligible for cover.
What is the difference between individual and group PMI? +
Individual PMI is purchased personally and underwritten on your own health history. Group PMI is arranged by an employer and often uses Medical History Disregarded underwriting, meaning pre-existing conditions may be covered from the outset.
Which is the best PMI provider in the UK? +
There is no single best provider. Bupa, AXA Health, Vitality, Aviva, WPA and Cigna each have different strengths. The right choice depends on your health priorities, budget and whether added-value benefits matter to you.
Does PMI cover mental health treatment? +
Most leading PMI policies now include mental health cover, including inpatient and outpatient psychiatric treatment. The extent varies by provider and policy level. Bupa and Vitality are generally regarded as strong in this area.

UK-Wide Coverage

That's Family Finance provides access to independent PMI advice for individuals, families and businesses across the UK — from London and Manchester to Edinburgh, Cardiff, Birmingham, Leeds and Bristol. The advisers we work with are not tied to any single provider and compare the whole market.

Related Guides

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What conditions are covered and how claims work

Income Protection

Replacing your income if you cannot work

Health Insurance

Overview of health cover options in the UK

Speak to an Independent Adviser

If you would like a personalised PMI recommendation, get in touch. The advisers we work with compare the whole market and are not tied to any single provider.

Get in Touch
Important information: That's Family Finance is an introducer and marketing service. Private medical insurance advice is provided by FCA-regulated advisers. This page is for information and educational purposes only and does not constitute financial advice. Premium costs shown are indicative only. Your eligibility for cover and the terms of any policy will depend on your individual circumstances and health history. Product details are based on our understanding at the time of publication and may be subject to change.