Private health insurance can offer peace of mind, faster access to care, and a more personalised healthcare experience. But before you dive into a policy, it’s important to make sure it actually fits your needs – both financially and medically.
Choosing the right policy can feel overwhelming. With so many options, insurers, and small print, it helps to know the most important questions to ask. These five questions will not only guide you through the process but also help you avoid costly mistakes and misunderstandings down the line.
1. What exactly is covered - and what isn’t?
This is the most fundamental question. Not all health insurance policies are created equal. Almost all health insurance policies provide cover for inpatient care – treatment that requires an overnight hospital stay or surgery – as well as some other basics, but from there, it varies.
Outpatient care (e.g. diagnostic tests, consultant appointments, scans), mental health support, dental cover, optical benefits, and therapies like physiotherapy are typically optional extras. Some insurers include these in more comprehensive plans, while others charge for each module separately.
Before you purchase your policy, it’s a good idea to sit down and think about what’s important to you in a policy. Equally, think about if there’s anything you don’t mind skipping. Some of the options to think about are: mental health, physiotherapy, cancer cover, and dental and optical.
Ask your broker or provider:
- What does the base policy include by default?
- What options are available for additional cover?
- Are outpatient diagnostics and consultations included?
- Are any conditions excluded from the outset – particularly chronic or pre-existing conditions?
Understanding your policy’s scope upfront means you won’t be caught out when trying to make a claim. It also ensures you’re not paying for benefits you don’t need – or missing the ones you do.
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2. How Does Underwriting Work?
Underwriting is the process insurers use to determine what aspects of your medical history are covered.
There are three main types:
- Moratorium underwriting: This is the most common and often the most cost-effective option for individuals and small businesses. You don’t need to disclose your medical history up front, but any condition you’ve had in the past five years will be excluded initially. If you go two consecutive years without any symptoms, treatment, or advice for that condition, it may be covered again.
- Full medical underwriting (FMU): You provide your full medical history at the outset. The insurer may cover or permanently exclude conditions based on what you declare. This can offer more clarity from day one but requires more admin and transparency. It is slightly more expensive than moratorium underwriting but can offer greater certainty on what’s covered.
- Medical History Disregarded (MHD): Typically available for larger company schemes – usually a minimum of 15 employees covered, though some insurers may offer it for as few as 10. This option disregards all pre-existing conditions – meaning they’re covered as standard. It’s a strong benefit for group schemes but not usually available to individuals or small businesses. It’s also usually the most expensive option, but it offers the most comprehensive cover and is highly valued in employee benefits packages.
Why it matters: Your underwriting method can determine whether a claim is approved or rejected. It also influences the policy price and future flexibility if your needs change.
For more information on the different types of underwriting, check out this blog next!
3. Can I Choose Where And How I’m Treated?
One of the biggest advantages of private healthcare is choice – so it’s important to know how much flexibility your policy gives you.
Start with location: Some policies only cover treatment at a limited selection of hospitals. Others offer wider geographic access or let you upgrade to a national hospital list.
Then consider the format of care: Many insurers now include virtual GP services, which allow you to speak to a doctor within minutes. This can be especially useful for busy professionals or parents.
Ask:
- Can I access top-rated hospitals in my local area?
- Am I limited to a set hospital list or can I upgrade?
- Can I choose my consultant or specialist?
- Are digital or virtual services like video GPs included?
- Is there international cover if I travel or work abroad?
- Can I save money on hospital lists by opting out of certain areas (i.e. London)?
Having the ability to tailor your treatment to your preferences is one of the core benefits of going private – so make sure your policy enables that.
4. How Much Will It Cost Now - And In The Future?
Private medical insurance is an ongoing investment, so it’s vital to consider both short-term affordability and long-term sustainability.
Beyond the monthly premium, think about the excess (the amount you pay towards each claim), co-payments, limits on benefits, and how premiums increase over time. Age, claims history, and medical inflation can all drive up renewal prices.
Things to ask:
- What’s the monthly or annual premium?
- What is the excess and how does it work per claim/year?
- Are there any benefit caps or co-pays?
- How does the insurer structure premium increases over time?
- Is there a No Claims Discount or a guided option that lowers premiums?
You want a policy that’s not only good value today – but remains affordable and appropriate in years to come.
If you want to find out why health insurance premiums (sadly, inevitably) rise, check out this blog next:
Help of a Broker
A good, trustworthy broker can be extremely helpful in all of these sections, but especially with cost.
Insurance companies, like many people who want to make a sale, might skirt questions about what their annual increases typically look like. A broker sells health insurance across multiple insurance companies, so they have no specific affiliation to any particular one. They also deal with thousands of cases a year and can identify trends with cost increases across the years, giving you a more accurate representation.
A broker can also help you plan for this by reviewing your policy annually and possibly helping you switch insurers, if it’s beneficial to you.
5. Who Will Help Me If I Need To Claim Or Change My Cover?
Buying insurance is only the beginning. What really matters is the support you receive when it’s time to use it.
Insurers differ in how they manage claims – some have digital-first systems with quick pre-authorisation, others have dedicated teams for more complex or ongoing cases. Having a real person to speak to can make a huge difference during a stressful time.
Questions to ask:
- What’s the claims process like? Is it online, phone-based, or both?
- Will I have a dedicated point of contact if my case is complex?
- Can I get advice or guidance before I undergo treatment?
- What happens if I want to switch policies or providers later on?
This is also where a broker really shines. At Lifepoint Healthcare, for example, we stay with you throughout your policy—handling claims queries, liaising with insurers, and helping you make changes when needed.
Final Thoughts
Buying private health insurance can be one of the best decisions you make for your health and wellbeing – but only if the policy fits your needs.
By asking these five questions before you sign on the dotted line, you’ll be better equipped to choose a plan that works for your lifestyle, budget, and future. Whether you’re buying as an individual, for your family, or on behalf of your business, the right information leads to better outcomes.
Need help navigating your options?
Lifepoint Healthcare is an independent broker working with leading UK insurers like Bupa, AXA, Vitality, and Aviva. We’re here to help you compare policies, explain your cover, and support you throughout your journey.
Speak to one of our expert advisers today!
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