Private medical insurance: the questions people actually ask.

Healthy is when it is cheapest to buy and when you can get the widest cover, because nothing is excluded yet. Whether it is worth it depends on what quick access to diagnosis and treatment is worth to you, set against a premium that for a healthy 30 year old on core cover is around £33 a month on figures published by Which? in July 2026. The question to ask is not whether you expect to claim this year, but whether you would want to wait months for a scan or an operation if you did. Our cost guide sets out the figures by age.

No. Private medical insurance sits alongside the NHS and is designed to cover acute conditions, the sort that respond to treatment and get better. Emergencies, accident and emergency care, long-term chronic condition management and most of general practice stay with the NHS. What the policy buys is choice and speed for the things in between: consultant appointments, diagnostic scans, surgery and treatment for eligible conditions, at a time and place you choose.

Every policy covers inpatient treatment: surgery and care that needs a hospital bed. What varies is everything around it, in particular outpatient cover (consultations, scans and tests before you are admitted), the hospital list you can use, cancer cover, mental health, therapies such as physiotherapy, and the excess you pay towards a claim. Two policies with the same headline price can differ a great deal underneath. Our guide to what is not covered is the quickest way to understand the shape of it.

On figures published by Which? in July 2026, core cover for a healthy person is around £33 a month at 30, £56 at 50 and £81 at 60, with comprehensive cover roughly 70% more. Age is the biggest factor, then where you live, the hospital list, the level of outpatient cover and the excess. These are averages, not quotes; a conversation with us gets you like for like quotes across our panel. Figures and assumptions are in the cost guide.

For a single predictable operation, self-paying is a legitimate choice: a private hip or knee replacement is published at roughly £12,000 to £16,000 by the largest hospital groups. The case for insurance is the bills you cannot predict or cap, and cancer is the clearest example, where a course of radiotherapy is published at over £16,000 and a year of a modern immunotherapy drug runs to tens of thousands of pounds at list price. Most people insure for the second kind of bill and would self-pay for the first if they had to.

Almost always, yes. What varies is whether that particular condition is covered. On a moratorium policy, conditions from the last five years are excluded but can become eligible for cover again after two trouble-free years. On full medical underwriting, you declare your history and the insurer tells you on day one what is excluded, which can be nothing for a resolved condition. Company schemes can sometimes cover pre-existing conditions entirely. The detail is in our pre-existing conditions guide.

Moratorium is quick to set up and suits people with little or no medical history, because it needs no questionnaire, but you only learn whether a condition is covered when you claim. Full medical underwriting takes longer to arrange and suits anyone with a history, because exclusions are fixed and known from the start, and a resolved condition may attract no exclusion at all. Neither is better in the abstract; the right one depends on your history. Our underwriting guide compares them properly.

No. Insurers do not examine you. Moratorium underwriting asks no health questions at all at the outset; full medical underwriting asks you to complete a questionnaire about your history, and occasionally the insurer will write to your GP with your consent. What matters on either route is answering accurately, because the policy is only as good as the information it was arranged on.

Yes. Family policies cover named family members under one plan, and insurers price children very differently from each other, so the cheapest insurer for one person is often not the cheapest for a family. Each person is underwritten individually, so a parent's condition does not affect a child's cover. Some insurers also offer discounts for additional family members.

Yes, and for directors and business owners it is often the better route. Premiums paid by a company are normally an allowable business expense, treated as a benefit in kind for the individual, and company schemes are priced on a different basis from personal policies. From around 20 to 25 employees, medical history disregarded underwriting becomes available, which covers pre-existing conditions outright. Tax treatment depends on individual circumstances and may change; nothing here is tax advice.

See your GP first, or the digital GP service most policies include, and get a referral to a specialist. Before you book anything, contact the insurer for pre-authorisation: they confirm the treatment is eligible and give you a claim number. Then see the consultant, who bills the insurer directly. The order matters. Treatment arranged before the insurer has authorised it may not be paid, however eligible it would otherwise have been.

In almost all cases, yes. Insurers require a referral from a GP, or on some policies from the insurer's own clinical team, before they will authorise specialist treatment. The referral is the start of the claim. Most policies now include a digital GP service precisely so that a referral is easy to get quickly.

The excess is the amount you pay towards claims in a policy year, typically between £0 and £1,000. A higher excess lowers the premium. The right level is the amount you would be comfortable paying in a year when you do claim; for many people £250 or £500 is a sensible middle. Check whether the excess applies per policy year or per claim, because the difference matters if you claim more than once.

Within the hospital list on your policy, yes. A full or open list includes almost every private hospital in the country, including the central London names, and costs more. A guided or essential list directs you to a panel of hospitals and consultants chosen by the insurer and costs less. For many people outside London the guided list includes every hospital they would use anyway, which makes it one of the better ways to reduce the premium without reducing the cover.

First find out why: most declined claims come down to a condition being pre-existing, chronic, or treatment arranged without authorisation. If you think the insurer has got it wrong, complain to the insurer in writing; it must respond within eight weeks. If you are still unhappy you can take it to the Financial Ombudsman Service, free of charge. As your adviser we help with this; it is part of what we are for.

Because most of the increase has nothing to do with you. Premiums rise with age, because claims do; with medical inflation, which has run at around 10% a year recently; and with the insurer's overall claims experience. Your own claims can add to that on some policies. A rise in the low teens is normal at the moment; a larger one is worth a conversation before you renew. Our renewals guide explains what is normal and what is not.

Usually, if it is done on switch terms. Insurers offer continued moratorium or continued personal medical exclusions to people coming from another policy, so that the position you have built up carries across rather than starting again. It has to be done on a matching basis, the new insurer can add exclusions after its switch declaration, and there must be no gap in cover. Done properly it is routine; done casually it can cost you cover you had. Our switching guide goes through it.

No. Insurers do not charge a different premium for policies arranged through an adviser; the price is the same as going direct. We are paid commission by the insurer when a policy is arranged, at no additional cost to you. What you get for that is someone who knows how each insurer treats a given history and can place you accordingly, and someone to call when there is a claim or a renewal.

We are not tied to any insurer. We advise from a panel of leading UK insurers, currently Aviva, AXA Health, Bupa, The Exeter, Vitality and WPA, and we recommend the policy that fits you from across that panel. We do not cover the whole market, and our Terms of Business set this out before you deal with us.

One named adviser, from the first conversation through to arranging cover and at every renewal after it. That person knows your history and your policy, which matters most at the moments you need help: a claim, a renewal, a change in circumstances. We are a small specialist practice by design, not a call centre.

Yes. Private Health Partners Ltd is authorised and regulated by the Financial Conduct Authority, number 1057326; you can check our entry on the Financial Services Register. Clients have access to the Financial Ombudsman Service, and policies arranged through us are protected by the Financial Services Compensation Scheme.

Yes. We advise on private medical insurance for individuals, families and businesses, and nothing else. Specialising is how we keep our knowledge of each insurer's underwriting, pricing and claims behaviour current enough to be useful.