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Individual health insurance, or private medical insurance (PMI), is cover for one adult to receive medical treatment privately rather than waiting for NHS appointments. It’s there to help you access care sooner, so you can focus on your recovery without long delays.
You’ll pay a monthly or annual premium, and your insurer typically covers your consultations, diagnosis and treatment at a private hospital or facility.
With the NHS waiting list in England alone, hitting 7.3million in June 2026, the appeal lies in the speed and flexibility of care. Whether you'll need quicker access to scans, cancer treatment or knee surgery, individual health insurance offers more control over how and when you receive medical support.
Every health insurance policy includes core cover, which forms the foundation of your plan. This typically pays for both inpatient treatment needing overnight stays, and outpatient consultations and diagnostic tests.
You’ll be covered for new conditions and injuries that develop after your policy starts, anything from a suspicious-looking mole that needs checking, to back pain that requires scans, or a hernia that needs surgery.
Some things aren’t covered, including A&E visits and some ongoing conditions like asthma and diabetes. But reassuringly, all the leading insurers include extensive cancer cover as standard.
You’ll usually be able to set an outpatient limit for your core cover. This sets the maximum cost the insurer will pay for consultations and tests outside of hospital stays. If you’re happy for the NHS to diagnose you before you go private for hospital treatment, setting a low outpatient limit can be a handy way to reduce your premiums.
As well as core cover, you also get to choose from some optional extras. This is a great way to shape your plan to match your budget and what’s most important to you. Depending on the insurer, examples include dental and optical cover, mental health support, and therapies including physio, acupuncture and chiropractic services. You may find your core cover already includes some level of these, with the option of adding extended cover.
You can also usually choose your hospital list, which is a list of places you can get treatment. Save money by opting for a standard list, or pay a bit extra for a wider choice of hospitals and Greater London area facilities.
These flexible options mean you can build a plan that gives you the level of cover you’re comfortable with, without paying for benefits you may not need.
We’ve worked hard to ensure the information on this page is accurate and up to date. However, insurers can change their terms, pricing and cover at any time. You should always check the full policy documents before choosing a plan to make sure the cover meets your needs.
Individual private health insurance offers greater control over how and when you receive medical care. Instead of facing lengthy waiting times for treatment, you can often access consultations, diagnostic tests and procedures far more quickly.
Whether you require a scan, surgery or an appointment with a specialist, private cover can help you receive high‑quality care at a time that suits you.
Some policies also include access to treatments that may not yet be widely available through the NHS. This can be particularly valuable for conditions such as cancer, where innovative therapies and advanced treatment options may play an important role in your recovery.
For anyone who values speed, convenience and choice in their healthcare, an individual health insurance plan can be a worthwhile investment. Depending on the level of cover you choose, you may also be able to add optional benefits such as dental treatment, mental health support or complementary therapies.
The cost of individual private health insurance can vary considerably depending on a range of personal and policy-related factors. These typically include your age, medical history, lifestyle, and the level of cover you select. As a general rule, premiums tend to increase with age, reflecting the higher likelihood of requiring medical treatment.
Given these variables, there is no single 'standard' price for cover. However, looking at typical pricing examples can help provide a useful point of reference. The following examples of quotes from a leading UK insurer, based on pricing from June 2025, can offer a general guide:
Non-smoker: £28.61 per month
Smoker: £35.61 per month
Non-smoker: £70.71 per month
Smoker: £75.33 per month
Non-smoker: £61.78
Smoker: £64.90
These examples highlight how factors such as age and smoking status can influence the cost of cover.
It's important to note that your own quotes may differ depending on your personal circumstances and the type of policy you choose. For this reason, it's worth reviewing your options regularly. At renewal, comparing providers or adjusting your level of cover could help you secure better value, and in some cases reduce your premiums.
You normally select an excess (the amount you agree to pay towards a claim) when applying for health insurance. However, some health insurance providers let you take out a policy without an excess.
Plans without an excess typically have higher premiums, but you’re less likely to face any unexpected charges when you make a claim. On the other hand, choosing a higher excess can reduce your monthly premiums, but it’s important to pick an excess level that you could comfortably pay if needed.
Policies handle excesses differently. Some charge it once per person each policy year, while others apply it every time you make a claim. Treatments spanning two policy years may mean paying the excess twice.
You can usually adjust your excess at renewal, either to lower your monthly cost with a higher excess or reduce the amount you pay upfront with a lower one. Always check the policy terms so you know exactly how it works before signing up.
If you are looking to reduce the cost of individual health insurance, there are several practical steps you can take without compromising access to quality care. By tailoring your policy to suit your needs and circumstances, it is often possible to strike a balance between affordability and comprehensive cover.
Below are some key considerations when selecting your plan and level of cover:
Cost-saving option | How it works |
|---|---|
Six-week NHS wait option | This option allows you to use NHS services if treatment is available within six weeks. If not, you can proceed with private care. In many cases, you can still access private consultations and diagnostic tests, helping to lower premiums while retaining flexibility. |
Increase your excess | Choosing a higher excess means you contribute more towards the cost of a claim. In return, your monthly premium is typically reduced. |
Select only the extras you need | Some policies offer optional add-ons, such as wellness benefits or gym memberships. Limiting your cover to features you are likely to use can help avoid unnecessary costs. |
Maintain a healthy lifestyle | Certain insurers may offer lower premiums or incentives for healthy behaviours, such as not smoking or staying physically active. |
Individual health insurance policies are generally designed to cover one person. Although this may be sufficient for your current circumstances, you may later decide that you would like to include a partner or your children under the same plan. Most insurers do allow you to add additional members at a later stage, and doing so can often reduce the overall cost compared with taking out separate individual policies.
Many insurers apply discounted rates when more than one person is insured under a single policy. Some providers also offer particularly family friendly terms, such as charging for only one child regardless of how many children you choose to include.
There are practical advantages as well. Managing one policy is usually far simpler than keeping track of several separate ones. You will only need to complete one application, maintain one set of documents, and remember a single renewal date.
If you are considering expanding your cover in the future, you may find it helpful to review the options outlined on our family health insurance page, where you can explore how these policies work and what they typically include.
Your health insurance policy will usually begin on the date you choose when setting up your cover and direct debit. Once your policy is active, you’ll receive your full cover documents, which will confirm the exact start date. It’s important to review these documents, as each policy can have different terms and conditions.
You can usually make a claim as soon as your premiums are being paid, though this depends on the terms of the insurer you choose. However, some policies do include waiting periods for certain benefits.
For example, if your policy offers a ‘baby bonus’, then once you’ve held your policy for a set period of time – often 10 months – and kept up with all monthly payments, you can receive a cash payment when you have a baby. Some insurers also pay this bonus if you adopt a child up to one year old.
Always check your specific policy details to understand any waiting periods or conditions that apply before making a claim, so you know exactly when and how your cover will take effect.
Your level of protection will vary according to the insurer, the type of policy you select and any additional options you choose to include. To help illustrate what individual health insurance can offer, the following features are often provided as standard or made available as optional extras, depending on the insurer you choose:
Area of cover | What it typically includes |
|---|---|
Inpatient care | Covers the cost of hospital treatment requiring an overnight stay, including surgery, accommodation, and medical care in a private hospital, helping to reduce waiting times. |
Outpatient care | Includes diagnostic tests and consultations where hospital admission is not required, such as scans, X-rays and specialist appointments. |
Private consultations | Provides faster access to specialist consultations, supporting quicker diagnosis and treatment without lengthy delays. |
Digital healthcare access | Offers remote GP appointments via phone or video, along with 24/7 helplines from nurses or medical professionals for advice and support. |
Physiotherapy and musculoskeletal support | Covers treatment for muscle, bone and joint conditions, including physiotherapy and rehabilitation services. |
Cancer treatment | May include comprehensive cancer care, such as access to advanced treatments, care in a private hospital and, in some cases, home-based chemotherapy. |
Parent accommodation | If you add children to your policy, it often covers the cost of a parent or guardian staying overnight in hospital during inpatient treatment. |
Private ambulance transport | Covers medically necessary private ambulance journeys, usually subject to a limit per trip. |
Dental and optical cover (optional) | Cover can include check-ups, emergency treatment, or a combination of both. The extent of cover varies across providers, with some offering dental and/or optical care as standard, some as an extra add-on, and some not offering it at all. |
Mental health support | Provides access to counselling, talking therapies and potentially inpatient mental health treatment where required. |
While individual health insurance can provide valuable access to private medical care, it's important to understand that it does not cover all types of treatment or conditions. In particular, it's not designed to replace public healthcare services, but rather to complement them.
As a result, certain conditions – especially those requiring ongoing or long-term management – are typically excluded. Why? Including such cover would significantly increase premiums and excess costs for all policyholders, so this approach creates a more affordable route for those seeking cover.
The table below outlines exclusions commonly found in individual health insurance policies:
Exclusion | What is typically not covered |
|---|---|
Pre-existing conditions | Medical conditions you had before taking out the policy are generally excluded. In some cases, cover may be offered after a specified symptom-free period, depending on the insurer’s underwriting options. |
Chronic conditions | Long-term conditions such as asthma or diabetes, which require ongoing management rather than short-term treatment, are not usually covered. |
Emergency care | Immediate, life-threatening situations are typically handled by public healthcare services, meaning private health insurance does not usually cover emergency treatment. |
Allergies and intolerances | Conditions such as food allergies or intolerances are generally excluded, particularly where ongoing monitoring or management is required. |
Pregnancy and childbirth | Routine maternity care is not usually included, although some policies provide cover for complications arising during pregnancy. |
Cosmetic and elective procedures | Treatments carried out for aesthetic reasons, as well as procedures such as gender reassignment or injuries resulting from professional sports, are typically excluded. |
Some insurers reward everyday healthy habits. If you’re a non‑smoker and meet simple criteria like a healthy BMI with no diabetes or pre‑diabetes, you could see discounts of up to 15%. Read more about this on our ‘Health Insurance Premiums’ page.
Looking after more than just yourself? You could save up to 10% by choosing a couple or family plan. Not every insurer offers these savings, but our expert advisers know exactly where to look, helping you find the best deals and any extra perks available.