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Understand how private health insurance works, what it may cover, how underwriting affects pre-existing conditions, and what to check before choosing or reviewing a policy.
These FAQs answer the questions customers most often ask before comparing private health insurance, using a broker or reviewing existing cover.
Private health insurance can feel complicated when you first compare policies. Terms such as excess, outpatient cover, moratorium underwriting, hospital lists and pre-authorisation can make it harder to understand what you are really choosing.
This FAQ page explains the main questions customers ask Tessa Alliance when comparing private medical insurance, using a broker, making a claim or reviewing an existing policy. It is designed to give clear, practical guidance before you request a quote or speak to an adviser.
Start here if you want to understand what private health insurance is, how it works, and how it relates to NHS care.
Private health insurance, often called private medical insurance or PMI, is designed to help cover the cost of eligible private healthcare. Depending on the policy selected, it may help with specialist consultations, diagnostic tests, scans, hospital treatment, surgery and cancer care.
It works alongside NHS services and gives you an additional route to eligible private diagnosis and treatment when your policy allows.
Yes. In the UK, the terms private health insurance, private medical insurance and PMI are often used to describe the same type of cover.
You can read more in our Private Medical Insurance guide.
No. Private health insurance works alongside the NHS. Many people still use the NHS for routine care and emergency treatment, while using private medical insurance for eligible consultations, tests and treatment where they want additional choice or faster access.
No. Private health insurance is optional in the UK. Some people choose it because they want additional healthcare options, faster access to eligible treatment, private hospital access or more flexibility when arranging specialist care.
Private health insurance may suit individuals, families, parents, older customers and businesses that want additional healthcare options alongside the NHS. Suitability depends on your healthcare priorities, budget, medical history and the level of cover you want.
You may also find our guides on Personal Health Insurance, Family Health Insurance, Child Health Insurance and Senior Health Insurance helpful.
Cover varies by insurer and policy level, so it is important to compare benefits, limits and exclusions carefully.
Cover varies by insurer and policy level, but private health insurance may include specialist consultations, diagnostic tests, MRI or CT scans, in-patient treatment, day-patient treatment, surgery, cancer treatment, physiotherapy, mental health support and digital GP services.
Outpatient cover relates to consultations, diagnostic tests and treatment that do not require you to be admitted to hospital.
Examples can include specialist consultations, MRI scans, CT scans, X-rays, blood tests, physiotherapy and follow-up appointments. Depending on the policy selected, outpatient cover may be fully covered, limited to a set monetary amount each year, or excluded altogether.
For many customers, outpatient cover is one of the most valuable parts of a policy because it can help speed up diagnosis and access to specialists.
The difference is based on whether you are admitted to hospital.
In-patient treatment means you are admitted to hospital and stay overnight or longer. Day-patient treatment means you are admitted for treatment but leave on the same day. Outpatient treatment means you receive consultations, tests or treatment without being admitted to hospital.
Most private medical insurance policies provide comprehensive cover for in-patient and day-patient treatment, while outpatient cover varies depending on the level of cover selected.
Private health insurance is generally not designed to replace emergency NHS services. If you experience a medical emergency, you should contact 999 or attend your nearest NHS Accident & Emergency department.
Most private health insurance policies do not cover emergency ambulance services, A&E treatment or immediate emergency care. Private medical insurance is usually designed for eligible planned treatment, specialist consultations, diagnostics and elective procedures after the emergency situation has been stabilised.
For example, if you attended A&E and later required follow-up surgery or specialist treatment, your private health insurance may be able to assist with ongoing treatment, subject to policy terms and insurer authorisation.
This depends on the policy you select. Some policies provide access to a broad hospital network and allow greater flexibility when choosing consultants, while others operate on guided or restricted hospital lists to help keep premiums lower.
Before arranging cover, it is important to consider whether access to specific hospitals or consultants is important to you.
Many private health insurance policies include cancer cover, but the level of support can vary significantly between providers. Cover may include consultations, diagnostic tests, surgery, chemotherapy, radiotherapy, targeted therapies and cancer drugs, depending on the policy.
Some policies include mental health support as standard, while others offer it as an optional benefit. Cover may include counselling, therapy, psychiatric consultations or in-patient mental health treatment, depending on the provider and policy level.
Dental and optical benefits are often optional extras rather than core private medical insurance benefits. Some providers may offer these as add-ons, but cover levels and limits can vary.
Underwriting affects how your medical history is treated and whether previous conditions may be excluded.
Private health insurance is generally designed to cover new medical conditions that arise after your policy starts.
Pre-existing conditions are often excluded, although the exact treatment of previous medical conditions depends on the underwriting method and insurer involved. If you have an existing medical condition, it is important to discuss this during the application process so you fully understand how it will be treated under the policy.
Moratorium underwriting is a common application method where you do not usually complete a full medical questionnaire at the start. Recent medical conditions are normally excluded initially, but they may become eligible for cover later if you meet the insurer’s criteria.
Full medical underwriting means the insurer reviews your medical history before the policy begins. The advantage is clarity, because any exclusions are usually confirmed upfront before you decide whether to proceed.
CPME stands for Continued Personal Medical Exclusions. It is commonly used when switching from one insurer to another. The new insurer may accept the exclusions already applied by your current insurer, helping maintain continuity of cover.
Private medical insurance is usually designed for acute conditions that are likely to respond to treatment. It does not usually cover the ongoing monitoring or long-term management of chronic conditions in the same way as the NHS.
The cost of private health insurance depends on personal circumstances, cover level and provider pricing.
There is no single cost because premiums can vary depending on age, postcode, medical history, cover level, hospital access, excess, optional extras and the insurer selected.
The best way to understand cost is to compare quotes based on your own circumstances.
An excess is the amount you agree to pay towards an eligible claim before the insurer contributes. Choosing a higher excess can often reduce the premium, but it should remain affordable if you need to claim.
Not always. A cheaper policy may have lower outpatient limits, a more restricted hospital list, fewer additional benefits or different underwriting terms. It is important to compare value, not just price.
Premiums can increase due to age, medical inflation, overall insurer claims experience, changes to the policy and general market conditions. Renewal pricing can vary between insurers.
Not necessarily. Unlike some forms of insurance, health insurance premiums do not usually increase solely because an individual has made a claim.
Premiums can increase for several reasons, including age, medical inflation, overall insurer claims experience, changes to the policy and general market conditions. Some insurers may take claims history into account in certain circumstances.
The purpose of health insurance is to use it when you need it, so customers should not avoid seeking treatment because they are worried about making a legitimate claim.
Good value depends on whether the policy suits your needs, not only whether it has the lowest price. At Tessa Alliance, we help compare cover, hospital access, excess, exclusions and provider differences so you can make a more informed decision.
These questions explain what usually happens when you claim, use, switch or review existing cover.
In many cases, yes. Most insurers require a referral from a GP before authorising specialist treatment.
Many providers now offer access to digital GP services as part of their policies, making it easier to obtain referrals and medical advice quickly.
The claims process depends on your insurer. In many cases, you will need a GP referral or access through an approved pathway, followed by pre-authorisation from your insurer before treatment begins.
Always follow your insurer’s claims process to avoid unexpected costs.
Pre-authorisation is approval from your insurer before treatment takes place. It helps confirm whether the proposed treatment is eligible under your policy and can reduce the risk of unexpected costs.
In most cases, cover starts from the policy commencement date shown on your schedule.
However, certain benefits or conditions may be subject to waiting periods depending on the insurer and underwriting method selected. Your policy documents will confirm exactly when your cover begins and any restrictions that apply.
Yes, you can review and switch providers, but it is important to check how switching may affect underwriting and existing exclusions. In some cases, CPME underwriting may help preserve your current underwriting position.
Staying with the same insurer is not necessarily a bad thing. In many cases, it can be the right decision.
However, health insurance products and pricing change over time. An insurer that offered the best value when you first took out cover may not always remain the most competitive option several years later.
Reviewing your options regularly can help ensure your cover continues to meet your needs, your hospital access remains suitable, your premium remains competitive and any newer features or benefits are considered.
Switching is not always about saving money. Sometimes a slightly higher premium can provide broader cover, better hospital access or improved claims support. If your existing policy remains the best fit, Tessa Alliance will tell you.
Tessa Alliance can help you review your existing policy and compare it with available options. We can look at cover level, price, hospital access, claims history and underwriting before discussing the most suitable course of action.
In many cases, policyholders can cancel their policy, but cancellation terms, notice periods and refund rules can vary. You should check the insurer’s policy terms or speak to your adviser before cancelling.
These answers explain how our comparison service works and what to expect when you request a quote.
Many people assume they will get a better deal by going directly to an insurer, but that is not always the case.
When you approach one insurer directly, you only see that insurer’s options. A broker can compare multiple providers side by side, helping you understand the differences in cover, hospital access, underwriting, claims support and overall value.
At Tessa Alliance, we work with a range of leading UK health insurers, so rather than spending hours obtaining and comparing multiple quotes yourself, we do the research for you. We also explain the small differences between policies that can make a big difference if you need to make a claim.
Our aim is not simply to find the cheapest premium, but to help you find suitable cover for your circumstances and budget.
We start by getting to know what is important to you. Some customers want the widest possible hospital access, while others are focused on keeping costs manageable. Some place a high value on outpatient cover, mental health support or digital GP services.
We may discuss your budget, existing cover, preferred hospitals, medical history, family circumstances, level of cover required and excess preferences.
Once we understand your priorities, we compare suitable options across the insurers we work with and explain the differences in clear, straightforward language. Rather than simply presenting a list of prices, we explain the pros and cons so you can make an informed decision with confidence.
No. There is no obligation or pressure to buy a policy after getting a quote from Tessa Alliance. The aim is to help you compare suitable options and make an informed decision.
Tessa Alliance helps customers compare leading UK health insurance providers, including Bupa, AXA Health, Aviva, Vitality, WPA and The Exeter.
Yes. Tessa Alliance Limited is authorised and regulated by the Financial Conduct Authority under reference number 992413.
The online quote form only takes a few minutes to complete. Once submitted, Tessa Alliance can review your details and help you compare suitable private health insurance options.
Speak to Tessa Alliance for clear, no-pressure guidance before comparing private health insurance options.
