Private Health Insurance (PMI) in the UK: 2026/27 Guide
Private medical insurance UK 2026/27 - what PMI covers vs excludes, moratorium vs full underwriting, the tax angle, and PMI vs cash plans.
A buyer's guide to UK private medical insurance (PMI) for 2026/27. What PMI actually pays for - faster private treatment of new, acute conditions, with choice of consultant, hospital and private rooms - and, just as important, what it does not cover: chronic long-term conditions, pre-existing conditions, accident and emergency care, and routine GP services, all of which stay with the NHS. Plus how moratorium and full medical underwriting handle your history, the tax angle for individuals, employees and the self-employed, what drives the premium, and how PMI differs from a cheaper health cash plan. Sourced to MoneyHelper, the ABI and GOV.UK.
What private health insurance is (and what it is not)
Private medical insurance, also called private health insurance or PMI, is a policy that pays for private treatment of new medical conditions. Its core selling points are speed and choice - shorter waits for diagnosis and treatment, a choice of private hospital and consultant, and typically a private room. It is designed to complement the NHS, not replace it. You remain an NHS patient for anything PMI does not cover, and holding PMI does not remove your right to NHS care.
What PMI is not: it is not a substitute for the NHS, it is not emergency cover, and it is not a way to fund the long-term management of an existing or incurable condition. For a life-threatening emergency you still use NHS A&E or call 999. Everyday GP care remains with the NHS unless you buy a specific private GP add-on that sits alongside - not instead of - your NHS GP.
What PMI typically covers vs excludes
| Area | Typical position |
|---|---|
| Acute conditions | Covered. New illnesses or injuries that are likely to respond quickly to treatment and lead to recovery - the core of what PMI is for. |
| Chronic conditions | Generally excluded for ongoing management. A chronic condition needs long-term monitoring, control or relief of symptoms, or has no known cure or is likely to recur. Long-term care moves back to the NHS. |
| Pre-existing conditions | Normally excluded - anything you currently have or have already had. May be handled via a moratorium look-back or a full-underwriting exclusion. |
| A&E and emergencies | Provided by the NHS. Call 999 / attend A&E regardless of PMI. PMI is for planned private treatment, not emergency care. |
| Routine GP services | Stay with the NHS. Some policies offer a private GP add-on that sits alongside your NHS GP rather than replacing it. |
| Out-patient, diagnostics, therapies | Depends on the plan level. Basic policies may be in-patient only; comprehensive plans add out-patient consultations, scans, mental health and therapies. |
Insurers define "acute" and "chronic" in their own wording, so the exact boundary varies between policies - always read the definitions before you rely on cover for a particular condition.
Underwriting: moratorium vs full medical
Underwriting is how the insurer decides what your medical history means for your cover. There are two common bases, and the choice affects how pre-existing conditions are treated.
Moratorium underwriting
You do not declare your medical history when you apply, so buying is quicker. Any condition you had in a recent look-back period - usually the last five years - is automatically excluded. Those exclusions can fall away later: typically once you have gone a continuous period (often two years) without symptoms, treatment, medication or advice for that condition, it can become covered.
Full medical underwriting
You complete a detailed health questionnaire when you apply, and the insurer may contact your doctor. In return you get certainty up front - the insurer confirms exactly what is and is not covered, sometimes adding a specific exclusion or a higher premium for a named condition. The application takes longer than a moratorium policy.
Neither basis covers everything. Both are ways of managing pre-existing conditions rather than removing the general exclusion.
The tax angle: individual, employer-provided and self-employed
If you buy it yourself (individual)
Premiums are paid out of income you have already been taxed on, and there is no personal Income Tax relief on private medical insurance. There is nothing to claim back.
If your employer provides it (taxable benefit-in-kind)
Employer-provided PMI is a taxable benefit-in-kind. Because it is not one of the exempt medical benefits, the employer reports it on form P11D and you pay Income Tax on the value of the benefit - broadly the premium the employer pays for you - usually via an adjustment to your tax code. The employer pays Class 1A National Insurance on that benefit value at 15% for 2026/27; employees do not pay National Insurance on benefits-in-kind.
A short list of medical benefits are exempt from tax and NI when an employer provides them: one health screening or medical check per year, eye tests required by health-and-safety rules for screen use plus any special glasses needed for screen work, medical treatment for injuries or diseases caused by the work, and up to £500 of costs to help an employee return to work after at least 28 consecutive days off sick. Ordinary private medical insurance is not on that exempt list, per GOV.UK.
If you are self-employed
Premiums for your own personal health insurance are generally not an allowable business expense. Under the "wholly and exclusively" test in HMRC's Business Income Manual (BIM45560), protecting your own health is treated as a private purpose, not a trade purpose, so it cannot be deducted from your trading profits. A business can, separately, deduct the cost of insuring its employees as a staff benefit - but those employees are then taxed on the benefit as above.
See the benefits-in-kind complete guide for how P11D benefits are valued and taxed, and use the P11D benefit-in-kind calculator to estimate the tax on employer-provided cover.
What drives the cost of PMI
Premiums are individually rated, so no single "typical" figure applies. The main factors are:
- Age - premiums rise as you get older, because older people are statistically more likely to claim.
- Health and medical history - underwriting decisions and any loadings for past conditions.
- Level of cover - basic in-patient-only cover is cheaper than comprehensive plans that add out-patient consultations, diagnostics, mental health and therapies.
- Excess - a higher voluntary excess (the amount you pay towards a claim) lowers the premium.
- Hospital list - a wider or central-London hospital network costs more than a restricted list.
- Add-ons - dental, optical or private GP extras increase the premium.
Common ways to cut the premium include choosing a higher excess, a narrower hospital list, or a "shared care" option that uses the NHS where it can treat you quickly. Because premiums are personalised and change each year, get quotes for your own circumstances rather than relying on averages.
PMI vs health cash plan vs self-funding
| Option | What it does | Best for |
|---|---|---|
| Private medical insurance (PMI) | Pays for private treatment of serious, acute conditions - operations, hospital stays, consultations, diagnostics. | Faster access and choice of hospital/consultant for major, new conditions. |
| Health cash plan | Reimburses everyday routine costs - dental, optical, physiotherapy - usually up to fixed annual limits. Pay, claim, get money back. | Predictable routine healthcare costs. Low monthly premiums; often no underwriting or GP referral needed. |
| Self-funding | You pay privately for treatment as and when you need it, or rely on the NHS. No premium. | Those comfortable using the NHS or paying one-off private costs rather than an ongoing premium. |
A cash plan is not a cheaper version of PMI - it does a different job. Cash plans target routine, everyday costs, while PMI targets serious-condition treatment. Some people hold both, or hold a cash plan and rely on the NHS for major care.
Related calculators and guides
- Benefits-in-kind complete guide - how employer-provided PMI and other P11D benefits are valued and taxed.
- P11D benefit-in-kind calculator - estimate the Income Tax and employer Class 1A NI on employer-provided cover.
- Self-employed business insurance guide - which insurances a sole trader or company can deduct, and which are personal.
Frequently asked questions
Is private health insurance worth it in the UK?
Private medical insurance (PMI) pays for private treatment of new, acute conditions - faster access, choice of consultant and hospital, and private rooms - but it does NOT replace the NHS. It generally excludes chronic (long-term) conditions, pre-existing conditions, accident and emergency care, and routine GP services, which stay with the NHS. Whether it is worth it depends on how much you value quicker access and choice versus the premium, which you pay from already-taxed income with no personal tax relief. If an employer provides PMI it is a taxable benefit-in-kind reported on your P11D, so you pay Income Tax on the premium value while the employer pays 15% Class 1A National Insurance.
Do you pay tax on private medical insurance from your employer?
Yes. Employer-provided private medical insurance is a taxable benefit-in-kind. Because it is not one of the exempt medical benefits, the employer reports it on form P11D and you (the employee) pay Income Tax on the value of the benefit - broadly the premium the employer pays for you. The tax is usually collected by an adjustment to your tax code. The employer, not the employee, pays Class 1A National Insurance on the benefit value at 15% for 2026/27. This follows the GOV.UK "Expenses and benefits: medical treatment" guidance. A short list of medical benefits ARE exempt - one health screening or medical check a year, eye tests required for screen use and any special corrective glasses for screen use, and up to £500 of costs to help an employee return to work after at least 28 consecutive days off sick - but ordinary private medical insurance is not on that exempt list.
Does private health insurance cover pre-existing conditions?
Generally no. Private medical insurance normally excludes conditions you already have or have had. As the ABI explains, you will "normally not be covered for any illnesses you are currently suffering from, or have already had". How pre-existing conditions are handled depends on the underwriting basis. Under moratorium underwriting you do not declare your history upfront, but any condition you had in a recent look-back period - usually the last five years - is excluded, though it can become covered later if you go a set period symptom-free and treatment-free. Under full medical underwriting you disclose your full medical history when you apply and the insurer confirms in advance what is and is not covered, sometimes adding a permanent exclusion or a higher premium for a specific condition.
Is private health insurance tax deductible?
For an individual buying their own policy, no. You pay PMI premiums out of income that has already been taxed, and there is no personal Income Tax relief for private medical insurance. For a self-employed sole trader, premiums for your own personal health insurance are generally NOT an allowable business expense either, because the "wholly and exclusively" test in HMRC's Business Income Manual (BIM45560) treats protecting your own health as a private purpose rather than a trade purpose. The main situation where PMI attracts a specific tax treatment is employer-provided cover, and there the effect runs the other way - it is a taxable benefit-in-kind you pay tax on, not a deduction. Businesses can, however, deduct the cost of insuring their employees as a staff benefit, while the employees are taxed on that benefit.
Does private health insurance cover chronic conditions?
No, not for ongoing management. Private medical insurance is built around acute conditions - illnesses or injuries that are likely to respond quickly to treatment and lead to recovery. A chronic condition is one that needs long-term monitoring, control or relief of symptoms, or that has no known cure or is likely to recur; these are generally excluded from PMI. In practice PMI may pay to diagnose a condition and for the initial acute phase of treatment, but once a condition becomes chronic and needs continuing long-term management, that care moves back to the NHS. This is why PMI is described as complementing the NHS rather than replacing it. Always read the policy's definitions of acute and chronic, because insurers word these limits differently.
Does private health insurance cover A&E and emergencies?
No. Accident and emergency care in the UK is provided by the NHS, and for a life-threatening emergency you call 999 or go to A&E regardless of whether you hold private medical insurance. PMI is designed for planned private treatment of new acute conditions - typically starting with a private GP or specialist referral, diagnostics, and elective procedures - not for emergency or urgent care. Some policies do include limited extras such as a private ambulance or a fixed cash amount for an NHS emergency admission, but the core of emergency medicine stays with the NHS. Similarly, everyday NHS GP services are not something PMI replaces; a private GP add-on, where offered, sits alongside your NHS GP rather than replacing it.
What is the difference between moratorium and full medical underwriting?
They are two ways an insurer decides how your medical history affects cover. With full medical underwriting you complete a detailed health questionnaire when you apply - the insurer may contact your doctor - and it tells you in advance exactly what is covered, so there is more certainty up front but the application takes longer. With moratorium underwriting you do not declare your history at the outset, which makes buying quicker, but any condition you had in a recent look-back period (usually the last five years) is automatically excluded. Those moratorium exclusions can fall away later: typically once you have gone a continuous period - often two years - without symptoms, treatment, medication or advice for that condition, it can become covered. Neither basis covers everything, and both are ways of managing pre-existing conditions rather than removing the exclusion.
What affects the cost of private health insurance?
Premiums are individually rated and rise as you get older, because older people are statistically more likely to claim. Beyond age, the main drivers are your health and medical history, the level of cover you choose (a basic in-patient-only policy costs less than comprehensive cover that adds out-patient consultations, diagnostics, mental health and therapies), the size of any voluntary excess you agree to pay towards a claim, the hospital list you pick (a wider or more central London hospital network costs more than a restricted list), and any add-ons such as dental, optical or a private GP service. Choosing a higher excess, a narrower hospital list, or accepting a shared NHS-treatment discount where the NHS can treat you quickly are common ways to reduce the premium. Because premiums are personalised and change each year, no single "typical" figure applies - get quotes for your own circumstances.
What is the difference between private medical insurance and a health cash plan?
They solve different problems. Private medical insurance (PMI) pays for treatment of serious, acute conditions - operations, hospital stays, consultations and diagnostics - giving you faster private access and choice of hospital and consultant. A health cash plan instead reimburses everyday, routine healthcare costs such as dental check-ups, opticians and physiotherapy, usually up to fixed annual limits per category: you pay for the treatment, send in the receipt, and get some or all of it back. Cash plans generally have low monthly premiums and often need no medical underwriting and no GP referral, so they are cheaper and easier to buy, but they are not designed to fund major surgery or serious-condition treatment. Some people hold a cash plan for predictable routine costs and rely on the NHS for serious care, while others buy PMI for the serious side; the two can also be held together.