What private medical insurance is for
Private medical insurance, often called health insurance or PMI, pays for treatment in private hospitals and clinics. It can give you more control over when you are treated, which specialist you see and where you stay. Many people value a private room and the chance to fit treatment around work and family.
PMI works alongside the NHS. You still use NHS emergency care, and your NHS GP usually refers you before the policy pays for a specialist. It covers a different need from life insurance or critical illness cover, which pay money to you rather than paying for treatment.
Some people buy a personal policy, and others get health cover through work. If you are leaving a job with company cover, you may be able to continue on a personal basis with the same insurer and keep your existing terms. Ask about this before your workplace cover ends.
What policies usually cover and exclude
Core cover normally includes in-patient and day-patient treatment, such as surgery and the hospital stay that goes with it. Cancer cover is a major part of most policies, though the level of cover varies. Outpatient cover, for consultations and scans before any admission, may be included or offered as an option with a limit.
Policies are built for acute conditions, meaning illnesses or injuries that respond to treatment and lead to recovery. Chronic conditions that need ongoing management, such as diabetes or asthma, are generally excluded, as are emergencies, normal pregnancy and cosmetic procedures.
- Usually covered: surgery, hospital stays, specialist fees, many cancer treatments
- Often optional: outpatient consultations, therapies, mental health, dental and optical
- Usually excluded: pre-existing conditions, chronic conditions, emergency care
Moratorium or full medical underwriting
With moratorium underwriting, you skip the detailed health questions. The insurer excludes conditions you have had symptoms of, treatment for or advice about in a set period before you join. Those conditions may become eligible later if you go a continuous stretch without symptoms, treatment or advice. It is quick to set up, but you may only learn what is covered when you claim.
With full medical underwriting, you disclose your medical history at the start. The insurer then tells you in writing which conditions are excluded. It takes longer, though you know where you stand from day one. We will explain both and help you pick the route that suits your health history.
Ways to shape the cost
Age, where you live and your level of cover drive the premium. Treatment in central London tends to cost more, so policies often price it separately. You can reduce the cost with a higher excess, a capped outpatient limit or a narrower list of hospitals.
Some policies offer an option where you use the NHS if it can treat you within a set number of weeks, and the policy pays for private treatment only if the wait is longer. That can lower the premium a good deal. Premiums usually rise each year with age and medical costs, so we suggest reviewing your cover at each renewal.
Making a claim on your health insurance
When you notice a new symptom, see your GP first, either your NHS GP or the remote GP service that comes with many policies. If they refer you to a specialist, call your insurer before you book anything. The insurer will confirm whether the condition is covered and give you an authorisation number.
The insurer usually settles bills directly with the hospital and specialist. You pay any excess you chose, and anything above your policy limits. Keeping your insurer informed at each stage, from first consultation to follow-up scans, helps avoid surprise bills later.
How Hi Tomorrow helps
Health insurance policies differ in many small ways, from cancer cover to mental health limits. We ask what matters most to you, then compare options from the insurers we work with and explain where each one is stronger or more limited.
If you are thinking of switching from an existing policy, talk to us first. Moving insurers can mean losing cover for conditions that started while you were insured, and some insurers offer terms that carry your existing exclusions over. We will check before you make any change.