UK Private Health Insurance 2025: £28–£95/mo Guide

UK Private Health Insurance (2025): Compare Tiers, Excess & Exclusions

Private Medical Insurance (PMI) in the UK is designed to supplement the NHS, not replace it. In 2025, typical monthly premiums range widely—from ~£28–£95 for individual cover, depending on age, tier, and excess. Choosing the right options can trim costs by 15–30% without losing core benefits.

Tiered Benefits: What You Actually Get

Most UK insurers offer tiered packages—often called Core/Standard, Mid, and Comprehensive. The table below summarises common inclusions for adults (benefits differ by insurer; check policy docs).

Tier (2025)	Typical Monthly Cost(assumed)	In-/Day-patient	Out-patient	Cancer Pathway	Mental Health	Therapies (physio etc.)
Core / Budget	£28–£45	✔ Private surgery & scans	Limited or diagnostics-only	Yes (NHS-capped drugs)	Often excluded or limited	Small allowance (e.g., 6 sessions)
Mid	£45–£70	✔	Set limits (e.g., £1k–£1.5k)	Yes incl. specialist drugs (T&Cs)	Out-/day-patient up to limits	Larger allowance (e.g., 10–12)
Comprehensive	£70–£95+	✔ (private room frequently)	Full out-patient (often no cap)	Enhanced, some cover immunotherapy	Broader cover incl. in-patient psych	Broader rehab & therapies

Excess Choices: How the Franchise Changes Your Premium

Excess (the amount you pay toward a claim) is a powerful lever. Higher excess usually means a lower premium, but be sure it’s affordable at claim time.

• £0–£100 excess: Highest premium; minimal upfront cost when claiming.
• £250 excess: Balanced option—often cuts premiums by 8–12%.
• £500–£1,000 excess: Larger savings—commonly 12–25%, but greater claim-time cost.

Tip: Some policies apply the excess once per policy year; others per claim. That matters if you expect multiple treatments.

Pre-Existing Conditions & Common Exclusions

PMI is underwritten and usually restricts pre-existing conditions (PECs) at the start of cover. Two common methods are:

• Moratorium underwriting: Automatically excludes conditions you’ve had in the past 5 years, then may cover them after 2 consecutive years without symptoms/treatment.
• Full medical underwriting (FMU): You disclose your history; the insurer lists specific exclusions up front.

Typical exclusions include routine pregnancy, chronic conditions management, cosmetic surgery, and A&E emergencies (handled by NHS). Mental health and alternative therapies vary by tier and insurer.

Hospital Networks & Access

Insurers sell different hospital lists—from national networks to restricted “guided” options. Narrower networks can reduce premiums but may exclude premium facilities (e.g., central London hospitals). Always run a Find a Specialist/Hospital check for your preferred consultant and location.

• Nationwide/Open network: Widest choice; highest price point.
• Guided/Local networks: Lower premium; limited to approved partners.
• London upgrade: Some policies surcharge for top London hospitals.

Renewal Strategy: Keep Benefits, Cut Waste

PMI is an annual contract and can rise on renewal due to medical inflation and claims history. A proactive routine helps keep costs in check while preserving key access:

1. Re-shop annually (assumed 4–6 weeks pre-renewal): Ask your current insurer for a like-for-like quote; compare against market equivalents.
2. Tune optional add-ons: Consider dental/optical or health screening only if you’ll use them.
3. Adjust excess & hospital list: Move to a guided network or raise the excess if your consultant is in-network.
4. Consider “NCD”/claims impact: Some insurers use a no-claims style mechanic—understand how claims alter next year’s price.

Case Studies (2025)

1. 37-year-old in Manchester, Mid tier: £59/mo with £250 excess. Moving to a guided network cut premium to £51/mo (-13.6%) while keeping her consultant in-network.
2. 52-year-old in Surrey, Comprehensive tier: £96/mo with £100 excess. Switching to £500 excess dropped premium to £82/mo (-14.6%); adding mental-health upgrade (+£4) retained key cover at net £86/mo.
3. Family of 3 in Bristol, Core tier: £112/mo. Upgrading out-patient cap (+£6) and adding dental/optical (+£8) raised premium to £126/mo but avoided self-pay on expected orthodontics—projected net saving ~£180/year.

Frequently Asked Questions

Does private insurance replace the NHS?

Usually no—it supplements NHS care. PMI accelerates diagnostics and elective treatment, while emergencies and complex critical care often remain with the NHS.

Will choosing a higher excess lower my cost?

Often yes. Increasing the excess typically reduces the monthly premium by 8–25%, depending on insurer and starting tier. Ensure you can afford the amount at claim time.

Are chronic conditions covered?

Chronic condition management is often restricted. PMI is geared toward acute, treatable episodes. Review each policy’s chronic/acute definitions and cancer pathway in detail.

Can I claim immediately after buying a policy?

You can claim for new acute conditions once the policy is active, but pre-existing issues are usually excluded initially (moratorium) or specifically (FMU). Some benefits have waiting periods—check your documents.

Will my premiums rise with age?

Typically yes. Age-banding, medical inflation, and claims history can increase premiums at renewal. Re-shopping and adjusting excess/network can offset rises.

Key Takeaways

• Pick a tier that matches your expected use; avoid paying for benefits you won’t use.
• Use the excess and guided networks to cut premiums by double digits.
• Understand pre-existing rules (moratorium vs FMU) to avoid claim surprises.
• Confirm your consultant/hospital is on the policy’s hospital list before buying.
• Re-shop every year and tune add-ons to maintain value as needs change.

References

• NHS — Private healthcare and the NHS
• Financial Conduct Authority — Insurance guidance
• Association of British Insurers — Health Insurance

Related Guides

• (Internal) UK Life Insurance Minimum (2025)
• (Internal) UK Income Protection (2025)
• (Internal) UK Critical Illness Cover (2025)

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