Insurance can be easier to understand when you know what each policy is designed to do—and what it might not cover. This guide explains key points to consider before speaking to a qualified professional.
What is private medical insurance?
Private medical insurance (PMI) may help pay for eligible private medical treatment, subject to policy limits, underwriting and exclusions. It normally complements rather than replaces NHS services.
What treatment might be covered?
Depending on the plan, cover may include eligible consultations, diagnostic tests, inpatient treatment and certain outpatient care. Cancer cover, mental health support and therapies vary by policy.
Pre-existing conditions and underwriting
Policies often exclude some pre-existing conditions, at least initially. Underwriting options differ, including full medical underwriting and moratorium approaches. Always check how each option affects claims.
Excesses, hospitals and outpatient limits
Choosing an excess or a restricted hospital list may change premiums. Some plans have outpatient limits or require referral pathways before treatment is authorised.
What PMI commonly does not cover
Common exclusions can include emergency treatment, chronic condition management, routine pregnancy care and cosmetic procedures, although details vary by provider and policy.
Comparing cover sensibly
Look at the full policy schedule, hospital network, treatment pathways, excesses, renewal pricing and support services. The cheapest premium may not provide the most appropriate cover.
Frequently asked questions
Does private medical insurance replace the NHS?
No. People can still use NHS services and PMI typically covers only eligible private treatment.
Will it cover an existing medical condition?
That depends on the insurer, underwriting basis and policy terms; some conditions may be excluded.
Do premiums increase as I get older?
Premiums may change with age, medical inflation, claims experience and insurer pricing, depending on the policy.
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Start an enquiry →Reviewed for general clarity: October 2026. Product terms and regulations may change. Check current policy documents and obtain appropriate advice before making decisions.