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Most people shop for private medical insurance backwards. They request four quotes, sort by price, and pick whichever name they recognise. Six months later they discover the hospital they wanted isn’t on the list, or that the knee operation they assumed was covered requires a £700 scan paid upfront.
The order below is the one that saves money and avoids arguments. It takes an afternoon, plus two or three phone calls.
Step 1: Write down what you already have
Spend twenty minutes collecting your existing cover before you look at a single quote. Employer schemes, a partner’s scheme, a health cash plan, anything bundled with a packaged bank account.
- Employer PMI. Often continues for a set period if you leave, and some schemes let you convert to a personal policy without new underwriting.
- Health cash plans. Usually £15–£40 a month. They pay fixed sums for dental, optical and physiotherapy, not hospital treatment. Cheap, and they plug the small gaps.
- Standalone dental or vision plans. Frequently better value bought separately than as a rider bolted onto a medical policy.
If you’re weighing up a specialist add-on, get a realistic view of what it pays out before you bundle it in. This breakdown of what a vision plan actually covers for the money is a useful check on add-on value generally.
Step 2: Name the two or three events you want covered
Policies are sold on features. They’re used on events. Write yours down in plain English, then test each policy against them.
- “If I need a hip replacement, I don’t want to wait nine months.”
- “I want an MRI within a fortnight of a specialist saying I need one.”
- “If the word cancer appears, I want treatment without a fight.”
Cancer cover is where insurers separate most sharply. Some pay in full for life. Others cap it at a fixed period, or exclude drugs not yet approved by the regulator. Ask directly and get the answer in writing.
Step 3: Set the budget from the market, not from hope
Rough benchmarks: a healthy 35-year-old can find comprehensive individual cover for around £50–£80 a month. The same policy for a couple in their late fifties typically runs £200–£350. A stripped-back policy with a £1,000 excess can come in at £25–£35.
Age is the biggest single lever, and it only moves one way. Starting at 42 means more years of no-claims discount and a lower age band than starting at 47. If you’re past 40 and sitting on the fence, the fence gets more expensive every birthday.
Step 4: Compare the four numbers that actually set the price
Ignore the monthly figure until you’ve read the other three.
- The premium. The headline number, and the least informative one.
- The excess. £0, £250, £500, £1,000. Moving from £0 to £500 typically cuts premiums by 20–30%. Superb value if you claim less than once every two or three years, poor value if you claim annually.
- Co-insurance. Some policies pay 80% or 90% of outpatient bills and you cover the rest. On a £700 MRI, that’s £140 out of your pocket each time, before the excess.
- Outpatient and therapies limits. A £1,500 annual outpatient cap sounds generous until a consultation, an MRI and four physio sessions use it up by March.
The comparison trap isn’t unique to health cover. A cheap headline price often hides thin protection at claim time, which is exactly the pattern in renters insurance where a cheap policy quietly drops the cover you need.
Step 5: Read the hospital list and the clauses that cost money
Check two things first: is your local private hospital on the list, and is it covered at the tier you’re buying? Most insurers publish a searchable directory. Put your postcode in. If the nearest covered hospital is a 40-minute drive, the policy is worse than the quote suggests.
Full medical history vs moratorium underwriting
Full underwriting means disclosing your history upfront and getting exclusions confirmed in writing before you buy. Slower, and it occasionally means a condition is excluded permanently. Moratorium means the insurer reviews your records only if you claim, excluding anything you’ve had symptoms or treatment for in the previous five years. Moratorium is quicker and cheaper to start. Full underwriting buys certainty. If you’ve had a knee scope or a mole removed, pay for the certainty.
The six-week rule
Many policies only pay once the NHS wait exceeds six weeks from the point your GP refers you. Fine in a backlog. Useless when you want to skip a three-week wait for something minor. Ask whether the rule is waived for diagnostics, which is often where the real delay sits.
If you want a broader picture of how tiers differ and what each one costs, this guide to what private medical insurance costs and covers goes deeper into policy structures.
Step 6: Run one real claim through the policy
Take a plausible scenario and do the arithmetic on paper. Say, a torn meniscus: consultation £250, MRI £700, day-case arthroscopy £4,200.
On a policy with a £250 excess, 80% outpatient co-insurance and a £1,500 outpatient limit, you’d pay the £250 excess plus roughly £190 of the outpatient bill. Total out of pocket: about £440, with the £4,200 operation covered in full. A £0 excess version of the same policy costs you around £190 at claim time but maybe £400 more a year in premiums. A £1,000 excess with no co-insurance leaves you paying £1,000, having saved perhaps £600 over twelve months. Run it for the claim you’re genuinely likely to make, not the one in the brochure.
Step 7: Buy it, then diarise the renewal
Set two reminders: one a month before renewal, one at the 18-month mark. Insurers routinely quote existing customers more than new ones. The same loyalty penalty that makes car insurance savings disappear at renewal applies to health policies. Phone up, ask for the new-customer price, and be ready to move. Forty minutes of work, often 15–25% saved.
Re-check your excess at renewal too. Two claim-free years is the cheapest argument you’ll ever have for raising it.
Where a medical policy stops and other cover starts
Private medical insurance pays for treatment. It doesn’t pay to fly you home from Spain, cover a hospital stay in Florida, or refund a cancelled sailing. Those sit with travel cover, and the gaps are wider than most people assume. This look at what your health plan won’t cover at sea sets out the edges clearly.
Five questions to ask before you sign anything
- Is my local hospital on the list, at the tier I’m buying?
- Does the policy cover cancer treatment in full, for life, including drugs not yet approved?
- What is excluded for me specifically, and can I have that in writing?
- What happens to my premium next year if I claim this year?
- How much notice do I need to cancel, and does the price change at renewal?
Get every answer by email before you pay a first premium. Anyone reluctant to put an exclusion in writing has just told you something useful about how the claim will go.
