Annual Health Insurance Reviews Why and How to Re-Assess your PMI
As an FCA-authorised broker that has helped arrange over 800,000 policies, WeCovr understands the UK private medical insurance market inside and out. This guide will help you navigate your annual PMI review, ensuring you have the right cover at the best possible price for your needs in 2025.
Guide to annual checks on premium changes, hospital networks, updated exclusions, and switching opportunities
Think of your private medical insurance (PMI) policy like your car. You wouldn't drive it for years without an annual MOT, and your health cover deserves the same diligent attention. Each year, your renewal notice arrives, and it's tempting to simply file it away. However, taking the time for an annual review can save you a significant amount of money, improve your level of cover, and ensure your policy still fits your life.
This guide will walk you through exactly why and how to conduct a thorough annual review of your private health cover.
Why Your PMI Policy Needs an Annual MOT
Letting your policy auto-renew without a check-up is a common but costly mistake. The private health cover you bought last year may no longer be the best or most cost-effective option for you today. Here are the core reasons why an annual review is essential.
- Rising Premiums: It's the one thing you can count on. Your premium will almost certainly increase at renewal. This isn't just a random price hike; it's driven by specific factors like your age and rising healthcare costs, which we'll explore in detail. A review helps you understand if this increase is fair and what your options are.
- Changes in Your Life: Have you moved house? Started a family? Changed jobs? Your PMI needs can change dramatically. The hospital list that was perfect in your old town might be useless in your new one. A review ensures your policy adapts with you.
- Market Competition: The UK private medical insurance market is highly competitive. Insurers are constantly updating their products, launching new benefits, and offering introductory discounts to attract new customers. Staying with one provider for years without shopping around could mean you're missing out on better deals.
- Policy Updates: Insurers can and do change their terms. The list of hospitals you can use might be altered, or new exclusions could be added to the small print. An annual check ensures you're not caught by surprise when you need to make a claim.
According to the latest NHS England statistics, the median waiting time for non-urgent, consultant-led treatment was around 14 weeks, with over 300,000 patients waiting more than a year. This stark reality continues to drive demand for private medical insurance in the UK, making it more important than ever to ensure your policy is fit for purpose.
Decoding Your Renewal Notice: What to Look For
Your renewal pack is the starting point for your review. It can seem dense, but it contains all the crucial information. Here’s what to zero in on:
- The New Premium: The most obvious change will be the price. Locate the new annual or monthly premium and compare it directly to what you paid last year.
- The Certificate of Insurance: This document summarises your level of cover. Check the core components:
- Out-patient limit: Is it still appropriate? Have your needs changed?
- Excess level: Is the amount you're willing to pay per claim still comfortable?
- Hospital list: What is the name of your hospital network?
- Notice of Changes: Insurers are required to inform you of any significant changes to your policy. This is often a separate leaflet or a highlighted section in the main booklet. Pay close attention to any amendments to benefits, exclusions, or hospital networks.
Don't just glance at the headline price. A small premium increase might mask a significant reduction in benefits, like the removal of a key local hospital from your list.
Key Area 1: Analysing Premium Increases
"Why has my premium gone up again?" It's the most common question we hear. The increase isn't arbitrary; it's a combination of three main factors.
| Factor | Description | Typical Impact on Premium |
|---|---|---|
| Age-Related Increase | As we get older, we are statistically more likely to claim. Insurers price this risk in, with premiums increasing at each birthday. The jumps often become steeper after ages 50, 60, and 70. | 3-5% per year |
| Medical Inflation | This is the rising cost of providing private healthcare. It includes new, expensive drugs, advances in diagnostic technology (like MRI scanners), and higher staffing and energy costs for hospitals. Industry analysts often place UK medical inflation between 8% and 12% annually. | 8-12% per year |
| Claims History | If you made a claim in the previous year, your insurer might apply an additional loading, which can affect your no-claims discount (NCD). | Varies significantly |
Real-Life Example: Sarah's Renewal
Sarah, a 45-year-old, saw her premium increase by 15% at renewal, from £80 per month to £92. Here's the likely breakdown:
- Ageing: +4% (£3.20)
- Medical Inflation: +10% (£8.00)
- Change in NCD: +1% (£0.80)
- Total Increase: +15% (£12.00)
By understanding why her premium has risen, Sarah is in a much better position to negotiate with her current insurer or compare quotes from others.
Key Area 2: Checking Your Hospital List
One of the most valuable benefits of private health cover is the ability to choose where you are treated. However, the list of hospitals available to you is not set in stone.
Insurers negotiate contracts with hospital groups (like Nuffield Health, Spire Healthcare, and Circle Health Group). These contracts can change annually. An insurer might:
- Add new hospitals to expand its network.
- Remove hospitals, perhaps due to cost disagreements.
- Re-categorise a hospital, moving it to a more expensive tier that may not be included in your plan.
What to do:
- Find the name of your hospital list on your policy documents (e.g., "Key," "Expert," "Extended").
- Use the insurer's online hospital finder tool to check the latest version of that list.
- Check for your local private hospital and any specific hospitals or clinics in London or other major cities you might want access to.
Moving house is a critical trigger for this check. If you move from Manchester to Bristol, a policy with a strong northern hospital network is of little use. An annual review allows you to realign your cover with your new geography.
Key Area 3: Reviewing Policy Terms & Exclusions
The small print matters. While core benefits rarely change, insurers frequently tweak the detailed terms and conditions.
Crucial Point: Acute vs. Chronic Conditions
It is vital to understand that standard private medical insurance in the UK is designed to cover acute conditions. An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery.
PMI does not cover chronic conditions. A chronic condition is one that continues indefinitely and has no known cure. It can be managed but not cured. Examples include diabetes, asthma, arthritis, and high blood pressure.
Furthermore, PMI will not cover pre-existing conditions—any illness or injury you had before your policy began. This is the single most important concept to grasp when considering switching providers.
Common Exclusions to Look For:
When you review your policy, check the list of general exclusions. These typically include:
- Pre-existing conditions
- Chronic conditions
- Emergency treatment (A&E visits)
- Cosmetic surgery (unless for reconstructive purposes after an accident)
- Normal pregnancy and childbirth
- Alcohol or drug abuse treatment
- Self-inflicted injuries
Check if any new clauses have been added or if existing ones have been rephrased.
The Big Question: Should You Switch or Stay?
After reviewing your premium, hospital list, and terms, you may be tempted to switch providers to get a better deal. This can be a smart move, but it requires careful consideration, particularly regarding your medical history.
The Benefits of Switching
- Cost Savings: A new insurer might offer a significantly lower premium for a comparable level of cover, especially if they have a new customer discount.
- Better Benefits: You might find a policy that includes valuable extras your current one lacks, such as enhanced mental health support or a higher out-patient limit.
- Improved Hospital Access: A different provider may have a hospital network that better suits your current location or preferences.
The Risks of Switching: Understanding Underwriting
This is the most critical part of the decision. When you switch, the new insurer will need to underwrite you. This means they will assess your medical history to decide what they will and won't cover. Your conditions that were covered by your old policy may now be excluded by the new one.
There are two main ways to switch your underwriting:
| Underwriting Type | How It Works | Best For... | Key Consideration |
|---|---|---|---|
| Moratorium (Mori) | You don't declare your full medical history. The new insurer automatically excludes any condition you've had symptoms of, or sought advice for, in the last 5 years. This exclusion can be lifted if you remain symptom- and treatment-free for that condition for 2 continuous years after the policy starts. | People who are young, in good health, and have had no medical issues in the last 5 years. | Any recent health issue, even a minor one, will be excluded for at least 2 years. |
| Continued Personal Medical Exclusions (CPME) | This is designed for people switching PMI. You complete a health declaration. The new insurer agrees to carry over the same exclusions from your old policy. Essentially, you maintain the same cover status. | People who have developed medical conditions while insured and want to keep them covered after switching. | Not all insurers offer CPME, and it's not available if you have a company policy. You must be switching from another PMI policy with no break in cover. |
Warning: If you switch on a 'Moratorium' basis and have recently had treatment for, say, knee pain, your new policy will not cover that knee for at least two years. If you had stayed with your original insurer, it would have remained covered.
This is where an expert PMI broker like WeCovr becomes invaluable. We can navigate the complexities of underwriting and advise you on the safest way to switch without losing important cover.
How to Conduct Your Annual PMI Review: A Step-by-Step Guide
Feeling overwhelmed? Don't be. Follow this simple process.
- Gather Your Documents (1-2 Weeks Before Renewal): Find your renewal letter, policy certificate, and the previous year's documents for comparison.
- Analyse the Premium: Note the percentage increase. Is it in line with the market average (age increase + medical inflation)? If it's over 20%, it's a red flag.
- Check Your Core Cover: Is your excess still affordable? Is your out-patient limit sufficient? A common way to reduce your premium is to increase your excess or slightly lower your out-patient cover.
- Scrutinise the Hospital List: Use the insurer's online tool to confirm your local facilities are still covered.
- Review Your Life Changes: Have your personal or financial circumstances changed? Does your policy still reflect your needs and budget?
- Explore Added-Value Benefits: Are you using the digital GP, wellness discounts, or mental health support lines? These have real monetary value.
- Contact an Independent Broker: This is the most crucial step. A specialist broker can do the heavy lifting for you.
The Role of a Specialist PMI Broker
Navigating the private medical insurance UK market alone can be a minefield. An independent broker works for you, not the insurance companies.
Why use a broker like WeCovr?
- Whole-of-Market Access: We compare policies and prices from all the leading UK insurers, including Aviva, Bupa, AXA Health, and Vitality, giving you a comprehensive view of your options.
- Expert Advice: We understand the nuances of underwriting, hospital lists, and policy wording. We can advise you on whether to stick or switch, and how to do it safely with CPME underwriting if needed.
- No Extra Cost: Our service is free to you. We are paid a commission by the insurer you choose, which is already built into the premium price, so you pay the same (or often less) than going direct.
- Hassle-Free Process: We handle the paperwork and applications, saving you time and effort. Our team can often find savings or better cover in a single phone call.
- High Customer Satisfaction: Our focus on clear, impartial advice has earned us high ratings on independent review websites.
As a WeCovr client, you also get complimentary access to our AI-powered nutrition app, CalorieHero, to help you manage your health goals. Furthermore, clients who purchase PMI or Life Insurance through us are eligible for exclusive discounts on other insurance products, such as home or travel cover.
Beyond the Core Policy: Wellness & Added-Value Benefits
In recent years, the best PMI providers have transformed their offerings from simple claims-paying services into holistic health and wellness partners. When reviewing your policy, don't overlook these valuable perks, which are often enhanced annually.
Common benefits to look for include:
- Digital GP: 24/7 access to a GP via phone or video call. This can save you weeks of waiting for an NHS appointment for minor queries or prescriptions.
- Mental Health Support: Most policies now include a set number of therapy sessions (e.g., CBT) or access to mental health helplines, often without needing a GP referral.
- Wellness Programmes: Providers like Vitality are famous for rewarding healthy behaviour. You can earn discounts on your premium, free cinema tickets, or coffee just for being active.
- Health and Fitness Discounts: Many insurers offer significant discounts on gym memberships, fitness trackers, and healthy food.
These benefits can add hundreds of pounds of real value to your policy each year. If your current policy is light on these extras, it might be another reason to consider switching to a more modern provider.
Frequently Asked Questions (FAQs)
Will my private health insurance premium always go up every year?
Can I switch my PMI policy if I have developed a medical condition?
What is the difference between an acute and a chronic condition?
Do I need to declare every single GP visit when applying for or switching PMI?
Take Control of Your Health Cover Today
An annual health insurance review is your best tool for keeping costs down and ensuring your cover remains relevant. Don't let your renewal roll over without a proper check.
The market is complex, but you don't have to navigate it alone. Let the experts at WeCovr conduct a free, no-obligation market review for you. We'll compare the top UK providers and find the best private medical insurance solution for your health and your budget.
[Get Your Free, No-Obligation PMI Quote from WeCovr Today]
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
By tapping the button below, you can book a free call with them in less than 30 seconds right now:
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Who Are WeCovr?
WeCovr is an insurance specialist for people valuing their peace of mind and a great service.👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.
Just a quick and simple form and an easy conversation with one of our experts and your valuable insurance policy is in place for that needed peace of mind!