How to compare private medical insurance (PMI)
Choosing private medical insurance can feel complicated. Policies can look similar at first, but they often work quite differently in practice.
This guide explains what to look for and how the main UK insurers compare.
What all PMI policies have in common
Most private health insurance policies in the UK follow a similar structure:
- You pay a monthly premium
- The insurer pays for approved private treatment
- Cover is mainly for new (acute) conditions, not long-term care
Typically, policies include:
- Hospital treatment and surgery (inpatient care)
- Specialist consultations and tests
- Access to private hospitals
However, most policies do not cover:
- Emergency care (which remains NHS-led)
- Long-term (chronic) conditions
- Some pre-existing conditions
The key things to compare
a. What is covered (and what isn’t)
This is the most important difference between policies.
Look at:
- Outpatient cover (consultations, scans, therapies)
- Mental health cover
- Cancer treatment (some policies are more comprehensive)
Core hospital treatment is usually covered, but outpatient care may be limited or capped depending on the policy or condition.
b. Excess and costs
The excess is the amount you pay towards treatment.
- Higher excess = lower monthly premium
- Lower excess = higher premium
Some policies charge excess:
- once per year
- or for each claim (less common, but can be more expensive overall)
c. Hospital choice
Policies differ in which hospitals you can use.
- Some allow access to a wide national network (including central London hospitals)
- Others restrict you to a smaller list to keep costs down
This can have an impact on where and how quickly you’re treated.
d. How your medical history is handled (underwriting)
This affects what conditions are covered.
Common approaches to underwriting are:
Moratorium underwriting:
- no detailed medical history upfront
- recent conditions are excluded for a period (often around 2 years)
Full medical underwriting (FMU):
- you disclose your history upfront
- exclusions are clearly listed from the start.
In general, pre-existing conditions are not covered. If you have ever had cancer, it is unlikely an insurer will cover you for any reoccurrence or new cancer in the future.
Some policies say that if you are diagnosed, or have symptoms, in the first 3 to 6 months after buying the policy, the insurer may treat it as a pre-existing condition if they think it started before the policy began.
e. Flexibility and ‘add-ons’
Most insurers offer modular policies where you can choose:
- Outpatient limits
- Mental health cover
- Dental
- Opticians
- Excess level
This means even two policies from the same insurer can look quite different in practice.
How the main UK insurers differ
The UK market is dominated by a small number of providers, each with a slightly different approach.
| Feature | Bupa | AXA Health | Aviva | Vitality |
|---|---|---|---|---|
| Overall approach | Established provider with integrated healthcare services | Flexible, modular policy design | Simplified plans focused on core cover | Policies linked to health and wellbeing programmes |
| Hospital access | Wide network, including Bupa-owned facilities | Choice of hospital lists depending on plan | Varies by selected plan | Varies by selected plan |
| Outpatient cover | Optional, often subject to limits | Can be tailored (levels of cover available) | Often included with set limits | Optional, depending on plan |
| Mental health cover | Available depending on policy | Available depending on policy | Included on many plans | Included, with extended options available |
| Cancer cover | Included in core cover (scope varies by policy) | Included in core cover (scope varies by policy) | Included in core cover | Included in core cover (scope varies by policy) |
| Digital / remote services | App-basedservices available | Virtual GP and digital tools available | Digital services available | Digital tools and remote services included |
| Additional features | Focus on clinical services and access to care | Digital pathways and configurable cover | Fewer add-ons, more standardised offering | Incentives linked to lifestyle and activity |
| Key point to consider | Access to Bupa facilities and networks | Flexibility in how cover is structured | Simpler structure and pricing | Links between behaviour and incentives |
Other PMIs are available.
How much does it cost?
Assuming you are a 55-year-old man who does not smoke, has no previous existing conditions and have never had private medical insurance before, typical monthly costs range from £80 to £110.
| Monthly payment | Additional info | |
|---|---|---|
| BUPA | £110.75 | Essential Access Cancer Cover |
| AXA Health | £81.78 | No cancer care as standard |
| Aviva | £100.03 | Expert Select hospitals Full Cancer Cover |
| Vitality | £83.58 | Consultant Select Advanced Cancer Cover |
Assumptions : Excess £500, Moratorium Underwriting (if asked), Mental Health and Dentistry excluded, Outpatients £500 excess. Minimum consultant/hospital access. Prices are indicative as of 27 May 2026. Please confirm your plan with your insurer or employer.
What matters most in practice
Two policies that look similar can behave differently when you actually need care.
Key differences often come down to:
- How quickly you can access treatment
- Which hospitals and consultants you can use
- What limits apply (especially outpatient care)
- How claims are handled in real situations.
A simple way to compare policies
When reviewing policies, it can help to ask:
- What does this policy definitely cover?
- What are the main limits or exclusions?
- What will I need to pay myself (excess, caps)?
- Which hospitals can I use?
- What happens if I need ongoing treatment? e.g. after 12 months.
What this means for you
There isn’t a single ‘best’ PMI provider that PHIN can recommend.
The right policy depends on what you prioritise for cost, flexibility, hospital choice, or additional benefits.
Find out more
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