Private Medical Insurance

Private Medical Insurance is an add-on to your Free NHS care.

What is private medical insurance?

Private health insurance helps pay for private tests and treatment covered by your policy. You pay a monthly amount, called a premium.

Can I keep using NHS care?

Yes. You can still use your NHS GP and NHS services. Private health insurance works alongside NHS care. You do not give up your NHS care by taking out a policy.

NHS care remains available: you can continue using NHS services under the usual eligibility rules. Most NHS care is free at the point of use, although charges apply for some services.
Private cover is an extra choice: your policy can help pay for particular private appointments, tests or treatment.
You do not need insurance to use the NHS : you can also choose to pay for a private appointment or treatment yourself, without insurance.

Do I need Private Medical Insurance?

The main appeal of private healthcare is the greater choice of where and when you are treated, and the speed and convenience of getting treatment.

The NHS is struggling:

England's NHS waiting list for planned treatment tops 7 million cases^*.
More than 100,000 people have been waiting more than a year to start treatment^*.
Roughly one in three people on the waiting list has been waiting longer than the NHS 's own 18-week target^*.

We're lucky enough in the UK to have the NHS , but it struggles with funding, queues and wait times — and treatment plans can be conservative, focused on the cost of delivery.

NHS waiting-time data

NHS waiting times: England

Reporting month: September 2026

These are historical NHS figures, not a prediction of your own wait or how quickly private treatment would be available.

Completed RTT pathway median waiting times in weeks
How the pathway ended	England
With a hospital admission (admitted)	5.00 weeks
Without a hospital admission (non-admitted)	5.00 weeks

What does median mean? It is the middle waiting time: half the recorded pathways had shorter waits and half had longer waits.

Source: test — September 2026.

What do these figures measure?

Referral-to-treatment (RTT) measures time from referral along a consultant-led NHS pathway. These figures describe pathways completed during the reporting month, not people still waiting at the end of it.

Admitted: the pathway ended with inpatient or day-case treatment.
Non-admitted: the pathway ended without that admission, including some decisions not to treat.

They are not first outpatient appointment waits. Buying a new insurance policy will not usually cover a condition or symptoms you already have, including a condition you are currently waiting to have treated.

Why do people buy private health insurance?

Depending on the cover you choose, benefits can include:

Specialist appointments: help paying to see a private specialist about a condition covered by your policy.
Tests and investigations: cover for scans or tests to help find out what is wrong, if your policy includes them.
Hospital treatment: help with the cost of covered operations, hospital stays and nursing care.
Choice of hospitals and specialists: access to the hospitals and clinicians recognised by your policy.
Convenient appointment options: more options for arranging covered private care, subject to availability. Shorter waits are not guaranteed.
Additional services: some policies include remote GP appointments, physiotherapy or other benefits.

The important question is which of these benefits you want your own policy to include.

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What does it usually not cover?

Private health insurance is mainly designed to help with new illnesses or injuries that can respond to treatment. Insurers often call these acute conditions.

Check the exclusions carefully. A newly purchased individual policy will usually not cover:

Existing conditions or symptoms: something you had before cover began, even if it had not yet been diagnosed. These are called pre-existing conditions.
Routine care for long-term conditions: ongoing monitoring or management of conditions such as diabetes is usually outside the main purpose of cover.
Emergency care: it is not a replacement for NHS emergency services.
Routine pregnancy and childbirth: these are generally excluded.
Everything without a limit: hospital lists, benefit limits and your share of the cost still apply, even with more extensive cover.

The exact exclusions depend on the policy and how your medical history is assessed. Buying insurance when you already need treatment will not usually cover that existing problem.

What level of cover do I need?

Start with what you would like help paying for. Do you mainly want cover for hospital treatment, or would you also like private specialist appointments and tests before treatment?

First, three useful terms

Outpatient: An appointment, test or treatment without being admitted to hospital.
Day-patient: You are admitted for treatment and recovery, but do not stay overnight.
Inpatient: You are admitted to hospital and stay overnight.

A key choice is whether you want help paying for private appointments and tests before hospital treatment, as well as treatment itself.

On a small screen, scroll the table sideways to compare all three options →

Three illustrative ways to choose cover
What you want help paying for	Hospital-focused cover	Hospital + limited outpatient cover	Hospital + wider outpatient cover
Covered hospital treatment and stays	Main focus	Main focus	Main focus
Specialist appointments before hospital treatment	May rely on NHS diagnosis or self-payment. Check the policy.	Selected appointments, usually up to a set limit.	A wider allowance, subject to the policy terms.
Tests and scans before admission	Check diagnostic benefits separately.	Check which tests are included and the limits.	Check which tests are included and the limits.
Main trade-off	Less private diagnostic cover.	Balance diagnostic cover and cost.	More extensive private diagnostic cover.
Premium, all else being equal	Generally lower.	Generally higher than hospital-only cover.	Generally higher with wider benefits.

These are examples of approaches to cover, not three standard products offered by every insurer. Compare cancer cover, mental health treatment, therapies, hospital choices and exclusions separately. More extensive cover does not mean every condition or treatment is covered.

How does private health insurance work?

Get medical advice. Start with your GP, or an appropriate service provided by your policy. You may need a referral to a specialist.
Contact your insurer before booking. Check that your condition, appointment or treatment is covered. Confirm which specialist and hospital you can use and obtain any required authorisation.
Arrange the agreed care. Follow the insurer's booking and claims process. Check again if a specialist recommends further tests or treatment.
Pay your agreed share. The insurer pays covered costs according to the policy. You pay any excess, co-payment or costs outside its limits.

An example: a new knee problem

Suppose you develop new knee symptoms after your cover starts. Your GP recommends seeing a specialist. You contact your insurer, which checks whether the condition and proposed appointment are covered.

If it approves the claim, you arrange an appointment with a recognised specialist. If a scan is recommended, you check that separately before booking. Your insurer pays the covered costs and you pay the share set out in your policy. Symptoms that started before cover began could be excluded.

What affects the price?

Your premium is the price of the insurance. It depends on several factors:

Your age and where you live: these can affect the price available to you.
The benefits you choose: wider cover will generally cost more, all else being equal.
Your hospital options: a more limited hospital list can change the price and where you can be treated.
Your excess: this is the amount you contribute towards covered treatment. Check whether it applies per claim or per policy year.
Other policy terms: these can include benefit limits, a no-claims discount and how the insurer assesses your medical history.

Premiums can change at renewal. Ask for a current personalised quote rather than relying on an example price.

How could I reduce the cost?

Choose an excess you could afford: a higher excess may reduce the premium, but leaves you paying more towards a claim.
Compare outpatient limits: a lower limit can reduce the cost, but you may need to use the NHS or pay yourself once it is reached.
Check the hospital list: make sure any cheaper option still gives you practical choices.
Choose useful extras: compare benefits you would value, rather than adding every option.
Compare payment options: ask whether annual and monthly payments cost different amounts in total.

Some policies also offer a co-payment, where you pay an agreed share of treatment costs. Ask how that share is calculated and whether there is a cap.

How does my medical history affect cover?

Underwriting is how an insurer assesses your medical history and decides the terms of your cover. Two common approaches are:

Full medical underwriting: you answer questions about your medical history before the policy starts. The insurer tells you about any exclusions it applies.
Moratorium underwriting: the policy applies rules to previous symptoms, advice, tests and treatment. The insurer may need medical information when you claim to decide whether those rules allow cover.

A moratorium does not mean existing conditions are automatically covered. Ask the insurer or adviser to explain the rules using your circumstances, and answer any questions fully and accurately.

Common questions

No. You can keep using your NHS GP. Some policies also provide a separate remote GP service; check what it includes and how referrals work.

A new individual policy will not usually cover an existing condition or symptoms. Ask specifically about this before buying. If you want to pay for treatment you already need, you can also ask the provider about self-pay options.

Yes. In England, patients have rights to choose a provider for many NHS referrals, subject to the rules for that care. Ask your GP or see the NHS guide to patient choice.

Many insurers offer options for couples and families. Compare who is included, the benefits and how any excess applies. Check whether you already have suitable cover through an employer.

Private health insurance by location

Ask us to explain your options

You do not need to know which policy you want before getting in touch. Ask us how cover works, what different options include or what to consider for your household.