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Private medical insurance
Put your health and wellbeing first with private medical insurance from Switch Health.
Private medical insurance (PMI) enables you to access private medical treatment, specialist consultations and diagnostic tests, subject to the terms of your policy.
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What is private medical insurance?
Private medical insurance is a type of financial protection designed to contribute towards the cost of eligible private medical treatment.
Unlike paying for private healthcare directly, a private medical insurance policy can cover some or all of the eligible costs of treatment, depending on your level of cover, excess, exclusions and policy limits.
Your policy may give you access to private hospitals and specialists for eligible treatment, including consultations, diagnostic tests, inpatient treatment and day patient treatment.
Private medical insurance is primarily designed for acute medical conditions that require treatment. It does not cover emergency care, every healthcare needs, and common exclusions can include certain pre-existing conditions, cosmetic procedures and treatment that is not considered medically necessary.
The levels of cover and options available vary between health insurance providers, so it’s important to understand what your policy covers.
Why choose private medical insurance?
Faster access to treatment
According to the Office for National Statistics, 43.6% of people on an NHS waiting list reported their experience as ‘poor’.
Private medical insurance offers quicker access to eligible consultations, diagnostic tests and private treatment.
If you are referred for specialist treatment, private medical insurance can provide an alternative to waiting for an NHS appointment, subject to authorisation.
Greater choice of private healthcare
Depending on your policy, you may be able to choose from a network of private hospitals, consultants and treatment providers.
This can give you greater control over where private medical treatment takes place, depending on the hospital list and provider network associated with your policy.
Access to specialist consultations
Private medical insurance can cover specialist consultations following a GP referral.
Access to specialists opens doors to assessment, diagnosis and further treatment, depending on your level of cover.
Diagnostic tests
Your policy may include diagnostic tests, such as scans and other investigations required to diagnose a new medical condition.
Some policies include outpatient diagnostic tests within their core cover, while others place limits on outpatient benefits or offer additional cover at an extra cost.
Private rooms
Where inpatient treatment is covered, private medical insurance can provide access to private hospitals and a private room, depending on the terms of your policy and the hospital network available.
Mental health support
Mental health support is increasingly included within private medical insurance policies, although the level of mental health cover varies between providers.
Depending on your policy, benefits may include consultations, therapy or other mental health treatment.
Who is private medical insurance for?
Private medical insurance can be suitable for people at different stages of their personal and professional lives. The reasons for taking out cover vary, from wanting to avoid NHS waiting lists with faster access to diagnosis and treatment to protecting your family’s health or maintaining private healthcare provision after leaving an employer scheme.
Mid-career professionals
For professionals aged 35-54 without employer-provided benefits, private medical insurance can provide access to private diagnostics and treatment without relying solely on NHS waiting lists.
For those with international commitments, a private medical insurance policy with international cover can also provide greater flexibility when needing to access healthcare overseas.
Corporate leavers
If you are leaving a company that provided private medical insurance as part of its employee benefits package, arranging an individual policy can help you continue to access private healthcare.
Moving from a group PMI scheme to individual cover can provide continuity and familiarity, although the terms and treatment of any existing medical conditions should be considered carefully when switching.
Self-employed professionals and company directors
If you own and run your own company, whether on a self-employed basis or as a company director and do not have access to employer-provided health benefits, private medical insurance can help you look after your own health and well-being.
Private medical cover can provide faster access to consultations, diagnostics and treatment, helping minimise disruption when health issues arise. For business owners, the tax treatment of private medical insurance can also be an important consideration.
Families with children
Parents aged 30-45 can choose private medical insurance to provide health cover for themselves and their children.
Family health insurance can provide access to private medical treatment for your children, alongside benefits such as children’s mental health support. Depending on the policy conditions (including the age of your children), family members can often be covered under the same plan, making it easier to manage your family’s private healthcare.
Pre-retirees
For people aged 55-65, health risks and potential healthcare needs can become a greater consideration when planning for retirement.
Comprehensive private medical insurance can provide access to specialist consultations, diagnostic tests and treatment, including specialist pathways for conditions such as cancer and orthopaedic problems.
Taking out or reviewing private medical cover now can also be an opportunity to consider how your healthcare needs and budget may change as you approach retirement.
The cost of private medical insurance
The cost of private medical insurance is determined by factors specific to you and any family members you want to include and can be influenced by:
Age: premiums generally increase as you get older because the likelihood of needing medical treatment tends to increase
Location: private healthcare costs can vary significantly depending on where you live
Level of cover: more comprehensive health insurance plans generally cost more
Hospital access: broader hospital lists can increase premiums, particularly where private treatment costs are higher
Excess: choosing a higher excess can reduce your monthly premium and means paying more towards eligible treatment when you make a claim
Medical history: your underwriting method and previous medical conditions can affect the cover and price available
Lifestyle: insurers may consider certain lifestyle factors when calculating premiums
Optional benefits: additional benefits such as enhanced mental health cover or dental treatment can increase the cost
You can choose to pay your premium monthly or annually. Some providers may also offer other payment frequencies, such as six-monthly payments.
Although a lower monthly cost can be attractive, the cheapest health insurance policy is not necessarily the best option. A policy with a higher excess or restricted hospital list may cost less but provide less flexibility when you need to access private care.
Types of medical insurance plans
Private medical insurance can be arranged in different ways depending on who needs cover, where you live and the level of private healthcare you need.
Family health insurance
Family health insurance allows you to cover multiple family members under a single health insurance policy.
It can provide private health insurance cover for you, your partner and dependent children, although eligibility, age limits and pricing vary between insurers.
A family policy can make managing your family’s health cover simpler, but it is worth comparing the cost against buying separate policies for individual family members.
Child health insurance
Child health insurance is designed specifically around the healthcare needs of children.
Parents may choose to add children to a family health insurance policy or arrange private cover for a child separately, depending on the options available from the insurer.
Cover can include eligible private medical treatment, diagnostic tests, specialist consultations and hospital treatment.
Individual health insurance
Individual health insurance provides private medical cover for one person and can be tailored around their healthcare requirements.
It may be suitable if you want greater control over your level of cover, hospital list, excess and optional benefits without arranging cover for other family members.
Your premium will depend on several factors, including your age, location, lifestyle choices and chosen level of cover.
International health insurance
International health insurance is designed for people who live, work or spend extended periods outside the UK.
It differs from standard UK private medical insurance because it can provide healthcare cover across multiple countries, depending on the geographical area selected.
International health plans can be particularly relevant to expats, people working overseas and families living abroad.
Over 50s health insurance
Getting older means your likelihood of needing medical treatment can increase, making private medical insurance a valuable investment.
Pre-existing conditions and medical underwriting
Your medical history and the underwriting process offered by the insurer can affect the private medical insurance cover available to you.
Full medical underwriting
Full medical underwriting involves providing your medical history upfront when you apply for cover.
The insurer assesses the information you provide and determines whether any pre-existing conditions should be excluded or subject to specific terms.
One benefit of this approach is that you have clarity about what is covered when your policy starts.
Moratorium underwriting
Moratorium underwriting means you don’t need to provide any history of any health issues before taking out cover.
Instead, the insurer excludes any pre-existing condition you’ve suffered from within given period of time (usually five years). When you make a claim, the insurer will decide if it’s a pre-existing condition and whether it can be covered.
If you need help with an existing condition that hasn’t presented any symptoms or required treatment or medical advice in the past two years after taking cover out, you may be able to receive treatment under your private medical insurance plan.
The exact rules and time periods vary between insurers, so it’s important to understand how your policy treats pre-existing medical conditions.
Switching from an existing policy
If you already have private medical insurance, switching to a new insurance provider requires careful consideration.
A new insurer may treat existing medical conditions differently from your current health insurance provider, and conditions that are covered by your current provider could potentially be excluded under a new policy.
In some circumstances, insurers offer arrangements designed to maintain existing terms or continued personal medical exclusions, but this depends on the provider and your circumstances.
This is why comparing the monthly premium alone is not enough when deciding whether to switch.
Making a private medical insurance claim
If you need private medical treatment, you will need to follow your insurer’s claims process.
A GP referral may be required before you can access a specialist consultation or certain diagnostic tests. You may also need to contact your insurance provider for pre-authorisation before treatment begins.
Once your insurer has confirmed that the proposed treatment is covered, you can arrange an appointment with an approved specialist or treatment provider.
Following the correct process can help prevent unexpected costs, delays and frustration. If you arrange treatment outside your insurer’s approved network or without obtaining required authorisation, your claim may not be covered in full.
Your insurer will explain how to make a claim and what information they need.
Private medical insurance from Switch Health
Finding the right private medical insurance can involve comparing more than just the cost.
We help individuals and families understand their private health insurance options and compare policies from a range of health insurance providers.
We can help you choose the level of cover you need, your preferred hospitals, excess amounts, underwriting method and the benefits that matter most to you.
Whether you are buying private medical insurance for the first time or reviewing an existing health insurance policy, our friendly advisers can explain the differences between the options available and help you make an informed decision.
We can also help if your circumstances have changed, your premium has increased or you are considering switching from your existing provider.
Our advice is tailored to your circumstances rather than simply recommending the cheapest policy. We look at the cover available alongside the cost, helping you understand what you are paying for and whether the policy is appropriate for your requirements.
