Readers Digest
Magazine subscription Podcast
HomeMoneyInsurance & Legal

Key Factors to Consider When Choosing Private Medical Insurance Policies

Key Factors to Consider When Choosing Private Medical Insurance Policies
If you’re considering private medical insurance (PMI) it’s important to do your research and to know what you want from your cover in order to find the best plan for you. It might seem overwhelming with so many options so we’ve put together a useful guide to the main factors to consider when shortlisting your PMI provider options.

What is private medical insurance?

Firstly, let’s look at exactly what PMI is. PMI, or private healthcare insurance, covers the cost of any medical treatments that you need following its purchase. Exactly what your policy covers depends on which one you choose and therefore what is important to you. Exclusions apply, and private medical insurance policies vary from basic level to fully comprehensive so it’s important to consider who the policy needs to cover, the type of cover you think you might need, specifics to you and your health, and your budget.

Who is the policy for?

You’ll find different types of private medical cover depending on your stage of life, and whether you are looking for individual cover or cover for your whole family. Let’s look at some options to consider when looking at private medical insurance comparisons:
Individual health insurance: If you are looking for cover for yourself, individual health insurance is a great option as it gives you the flexibility to tailor the policy to your personal needs and budget.
Family health insurance: When you have a family, you might consider the option of combining your PMI to cover everyone in your household in the event of anyone becoming sick or injured. This generally works out cheaper than buying each individual policy separately.
Senior and child health insurance: It’s possible to get health insurance that is specific to your time of life with bespoke features. Child health insurance gives you peace of mind that should your child fall ill, they will have access to the best treatment and medical plans available. Senior health insurance provides cover for acute conditions at a time of life when you might need this the most.

Type of cover

Once you know who you want to cover with your PMI, you’ll need to consider the type of policy you need. UK private medical insurance cover can be anything from a basic cover package to fully comprehensive. A basic level package generally covers inpatient care, some outpatient care, GP consultations and some cancer care. You will need to cover the cost of any diagnostic assessments prior to this if the NHS doesn't take care of it.
Having a package above the basic level allows you to consider factors such as where you would like treatment to take place, additional complementary therapies, as well as enhanced cancer care.
A comprehensive health insurance package gives you the highest level of protection, covering your treatment from the diagnostic stage to treatment and in some cases aftercare. This might include additional benefits such as dental insurance, physiotherapy, and mental health treatment options. With a comprehensive policy you’ll have the most choice and flexibility but please note that exclusions may still apply and cover varies according to the provider.


Every PMI comes with exclusions and these vary according to the insurance provider, so make sure you check the small print. Chronic conditions that are not curable and require long term monitoring and symptom relief are not covered by PMI and unproven treatments do not fall under private health insurance either. Common exclusions include pregnancy care, cosmetic surgery, diabetes and emergency care.

Pre-existing conditions

If you have pre-existing medical conditions, it’s important to declare these when taking out PMI as these may not be covered by your policy. However, in some cases it might be possible to cover conditions you’ve had in the past if you have been symptom free for a set amount of time.
It’s important to note that having a pre-existing condition doesn’t stop you taking out a health insurance policy. Your policy is valid for any medical conditions or injuries that develop after the policy has been approved. With this in mind, buying PMI before you are ill makes good sense.


Cancer will affect 50% of us and so it’s a factor to consider when buying PMI. The good news is that private health insurance does cover cancer care as long as it is not a pre-existing medical condition. Most policies include cancer care as standard but for others it is an optional extra. If this is something that you want included in your policy, review your options carefully to make sure you pick an option that gives you the peace of mind you need.


As with anything, when choosing your health insurance policy, your budget is going to be a factor. The levels of cover allow you to adjust your policy to your budget and with some policies you can choose to remove or cap outpatient care to reduce your premium. Shop around to find out ways you can reduce your premium by leaving out cover that you don’t see as a priority.

Excess payment

When you make a claim for cover, you pay an excess. The excess you pay varies according to the policy provider, and in many cases, you can decide what you want the excess to be. The amount of excess you pay affects the price of your cover. You can reduce your policy premium by opting for a higher excess payment.

Why buy PMI?

We are very fortunate to have the NHS in the UK, but it’s no secret that our health service is stretched at times and waiting lists can be long. PMI gives you the peace of mind that if you fall ill or injure yourself, you have choices other than what the NHS can offer.
PMI gives you control over your treatment with reduced waiting times and more of a say about when and where your treatment takes place. With PMI, you can benefit from the best bespoke medical care offering superior comfort, privacy and flexibility.
Image promoting private medical insurance with Usay Compare
If you're looking for private medical or life insurance, visit and fill in a simple form for a free quote.
Keep up with the top stories from Reader's Digest by subscribing to our weekly newsletter
This post contains affiliate links, so we may earn a small commission when you make a purchase through links on our site at no additional cost to you
Loading up next...
Stories by email|Subscription
Readers Digest

Launched in 1922, Reader's Digest has built 100 years of trust with a loyal audience and has become the largest circulating magazine in the world

Readers Digest
Reader’s Digest is a member of the Independent Press Standards Organisation (which regulates the UK’s magazine and newspaper industry). We abide by the Editors’ Code of Practice and are committed to upholding the highest standards of journalism. If you think that we have not met those standards, please contact 0203 289 0940. If we are unable to resolve your complaint, or if you would like more information about IPSO or the Editors’ Code, contact IPSO on 0300 123 2220 or visit