How does private health insurance work in the UK?

Many choose private health insurance for faster access to diagnosis, treatment and specialist care. Yet you're not alone in considering this option. The Financial Conduct Authority have calculated that 14% of the UK population (7.6 million) had private health insurance in 2024. ¹

What is private health insurance (PMI)?

Private health insurance, also known as private medical insurance or PMI, is a type of insurance policy that individuals can buy from an insurance company to help cover the cost of private healthcare. It works separately from the NHS and provides an optional additional layer of healthcare cover.

Many private medical insurance (PMI) policies include access to GP services (virtual, face-to-face, or both), physiotherapy and mental health support, alongside private hospital treatment and diagnostic tests such as MRI, CT and PET scans.  Many private medical insurance policies also include comprehensive cancer cover and access to specialist treatments, although cover levels and treatment options. The services available, eligibility criteria and level of cover vary by provider and policy.

Additional cover options often include optical, dental, hearing cover, travel insurance, and enhanced mental health support, though policies vary depending on the insurance provider and plan you choose.

One of the key benefits of having health insurance is usually speed and convenience. Many people choose to be seen privately because they can get appointments more quickly and at times that suit their schedule, while still having the safety net of NHS care when needed.

What is private health insurance and what does it cover? Learn what's typically covered, what's often excluded, and the key factors to consider before choosing a policy.

How does private health insurance work?

Setting up your policy

Step 1: Choose your cover

Most insurers offer a choice of cover levels, allowing you to tailor your policy based on the treatments, services and level of cover that matter most to you.

At Vitality, all our health insurance plans start with Core Cover, which includes:

• Virtual GP consultations
• In-patient and day-patient treatment (hospital fees, consultant fees and scans)
• Advanced Cancer Cover
• Talking therapies and mental health support
• Physiotherapy sessions
• Out-patient surgical procedures
• Plus, other benefits like NHS hospital cash benefit, childbirth cash benefit, home nursing, and private ambulance

Step 2: Customise your plan

Most private health insurance policies can be tailored to suit your needs and budget, allowing you to choose from different cover options, benefits and excess levels.

At Vitality, you can decide if you want to add any of the following Cover Options for an additional cost:

• Out-patient cover – gives you access to out-patient consultations, diagnostics- plus physiotherapy outside of our network
• Enhanced mental health cover – includes counselling and cognitive behavioural therapy (CBT), up to £1,500 towards eligible out-patient treatment, 28 days each of in-patient and day-patient treatment, plus access to guided digital mental health support.
• Therapies cover - includes chiropractic, osteopathy, acupuncture, podiatry, and two consultations with a dietician following a GP referral
• Optical, dental and hearing cover – contributes towards routine and emergency care
• Worldwide travel cover – pays for emergency medical expenses, travel disruptions, vaccinations, and more 

Step 3: Decide your hospital options

This allows you to choose your consultant or hospital from Vitality's network. 

At Vitality, you can choose from:

• London care – gives you access to all eligible private hospitals and NHS Private Patient Units in the UK that meet Vitality's quality requirements.
• Countrywide hospital list - gives you access to all the private hospitals in the UK's largest hospital groups 
• Consultant select - provides you with a choice of appropriate consultants from our network

Step 4: Choose your excess

An excess is an amount that you pay towards your medical treatment before your insurance picks up the rest of the cost. Choosing to pay higher excess will reduce the cost of your policy.

At Vitality, you can choose to pay an excess towards eligible treatment costs, helping to reduce the cost of your policy. Like home or car insurance, the higher the excess you choose, the lower your premium is likely to be.

You can choose an excess of £0, £100, £250, £500 or £1,000.

You can also choose how your excess is applied:

• Once per plan year (per person)
  If a claim is made, you'll pay your excess once per plan year for each person covered, regardless of how many eligible claims are made during that period.

• Each time you claim (per person, per claim)
  You'll pay an excess each time a new claim is made.
  
   

Read more: How excess works with Vitality health insurance

Step 5: Choose your underwriting type

Underwriting is the process insurers use to assess your medical history, and past claims before offering a health insurance quote. The type of underwriting you choose can affect what is covered and how much you pay for your policy.

Most insurers offer Full Medical Underwriting (FMU) or Moratorium Underwriting. If you're switching from another provider, you may also be able to choose Continued Personal Medical Exclusions (CPME), which carries over the underwriting terms from your existing policy.At Vitality we offer all three underwriting options: Full Medical Underwriting (FMU), Moratorium Underwriting, and Continued Personal Medical Exclusions (CPME, if switching from another health insurer).

Read more: The different types of medical underwriting explained

Step 6: Submit your application

Complete your application form and sign the declaration. Once your application is accepted, you'll receive your policy documents confirming your cover. If you've applied with Full Medical Underwriting, we'll also let you know if any health conditions are excluded from your cover.

As a Vitality member, you'll also be set up with access to the Care Hub—your digital hub for managing your health insurance. Use it to track claims, book GP appointments, and access your benefits with ease.

If you need to make a claim, the process typically involves:

1. An initial consultation with a GP.
2. A referral for specialist treatment.
3. Contacting your insurer for authorisation before treatment.

When you need treatment

Step 1: Initial Consultation with a GP

The first step is usually to see a doctor about your symptoms. This can be your NHS GP or a private GP. If you have insurance with us, you can use the Vitality UK app for a video consultation.

The GP will assess your condition and, if they believe you need to see a specialist, they will provide you with a referral letter. This is a crucial document for your insurance claim.

It's often recommended to ask for an "open referral." This means your GP refers you to a general specialist rather than a named one. This gives you more flexibility to choose from your insurer's list of approved specialists and hospitals.

For private physiotherapy and mental health treatments, you can usually refer yourself without needing to see a GP first.

Read more: How does a video GP appointment work?

Step 2: Contacting your insurer to start a claim

Once you have your referral letter, it's important to contact your insurer before booking any treatment—this process is called pre-authorisation. With Vitality, you can do this quickly via Care Hub, which shows what treatments are covered and which hospitals and consultants are available to you.

To get started, you'll need your policy number, a copy of your referral letter, and a brief description of your symptoms. Once approved, you'll receive an authorisation number—this confirms your claim and should be given to your consultant so they can bill Vitality directly.

Read more: How do health insurance claims work?

Step 3: Choosing a Hospital and Specialist

With your authorisation number, you can now choose a hospital and specialist from your insurer's approved network.

Most policies have a list of hospitals and clinics you can use. You might have a basic list, or you may have paid for a more extensive one that includes more expensive hospitals, such as those in central London.

The fees for consultants and specialists are often separate from hospital costs. Your insurer will confirm whether the consultant you want to see is within their fee guidelines.

Step 4: Receiving treatment

You can now book your initial outpatient consultation with the chosen specialist. During this appointment, the specialist may recommend further diagnostic tests (like an MRI or X-ray) or a course of treatment (such as physiotherapy or surgery).

If the specialist recommends any additional tests or treatment, you will need to contact your insurer again to get further pre-authorisation. It is vital to do this before you proceed to avoid having to pay for the costs yourself.

Payment

This is where the insurance steps in. When the insurer approves your treatment, they'll usually pay the consultant or the hospital directly.

If there's an excess on your policy, the insurance company will let you know how much to pay when you make your claim. Some insurance companies will ask you to pay it straightaway, others when they settle the bill for treatment.

If you use a hospital or consultant not covered by your plan, you may be responsible for a portion of the costs.

Can you still use the NHS if you have private health insurance?

Private health insurance works alongside the NHS rather than replacing it. If you already have cover in place, you can choose to use the NHS, private healthcare, or a combination of both for eligible acute conditions. Some people begin treatment through the NHS before moving to private care, while others use private healthcare initially and later return to the NHS. Having private treatment does not affect your entitlement to NHS care. Keep in mind that pre-existing medical conditions are not usually covered, so always check your policy terms and exclusions.

Many people with private health insurance continue to use their GP for routine care and treatment of chronic conditions, as well as emergency treatment through A&E. Private health insurance can provide faster access to certain treatments or private facilities, but it never replaces or excludes access to NHS care.

When choosing private treatment, just make sure your insurer agrees to the costs upfront. Remember that private health insurance won't cover chronic conditions (like diabetes or high blood pressure) and may not cover pre-existing conditions.

Read more: Pre-existing conditions, what does it actually mean?

How to choose the right private health insurance plan?

Assessing your needs

• Consider your medical history. Your medical history is an important consideration when deciding which provider to choose. Try to find an insurer who can offer you the treatments you think you may need in the future. If you already have a medical condition, it's unlikely to be covered by your private health insurance.
• Prioritise cover options. Different providers will offer different levels of cover. So, choosing the cover options that are right for you, and your family is important. Companies that offer comprehensive core cover can sometimes be more cost effective if you need to make multiple claims.
• Weigh up the costs. Most medical care is free in the UK, so you'll want to make sure you're getting private medical insurance that is worth the cost. Understand exactly what level of cover you're getting for your money. Also find out if there are any costs that you'll need to pay yourself, such as an excess.

Compare health insurance providers

• Don't focus solely on the cost. Some providers may appear more expensive but offer better cover in their core plan.
• Check hospital lists. Make sure you can access a hospital that's local to you and consultants who are specialists in their field.
• Understand underwriting. Underwriting affects what's covered. Providers may offer different underwriting options.
• Look at excess options. Some providers let you choose how often excess is applied.
• Review optional cover. Compare what extras are available.
• Consider wider benefits. For example, when you sign up with Vitality, you get access to Vitality Rewards.

Next steps: how to get private health insurance?

Step 1: Research providers

• Explore the major health insurance providers and compare what each one offers. Most insurers provide detailed information online, including downloadable brochures outlining their cover options.
• For tailored guidance, consider speaking to a specialist health insurance adviser who can help you compare health insurance plans across the market and find one that suits your needs.

Read more: How to compare health insurance plans?

Step 2: Get quotes

• When you have your list of preferred providers, get a quote from each of them. Be open and honest about all your medical history so you can make sure you're getting the right cover.

Step 3: Set up your plan

• When you've chosen your provider, set up your plan with your chosen cover options.
• You'll also need to agree the policy excess and type of underwriting.
• You can add your partner or family to the cover too.
• Make sure you're happy with your choices and understand what you're buying before you sign the policy terms.

Key takeaways

• Private health insurance provides access to private healthcare and can help cover the cost of eligible treatment. Benefits vary by insurer and policy, so always check what's included in your cover. Depending on your plan, this may include access to private GP services, physiotherapy, mental health support, private hospital treatment, specialist consultations, and certain drugs and treatments.
• It sits alongside the medical services provided by the NHS. If you have private health insurance, you can choose whether you want to access NHS treatment or private treatment.
• People take out private health insurance for many reasons. One of the main ones is reduced waiting times for non-emergency procedures.
• There are a wide range of cover options available. To make it easier to choose, most companies offer core cover which you can add to.

Why choose Vitality health insurance?

Thinking about taking out a health insurance policy or want to learn more about what Vitality offers?

Here's why 2 million people choose Vitality:

Comprehensive Core Cover

• Primary Care benefits including video consultations with a Vitality GP and access to our 24/7 Health Advice Line.
• Mental Health support, with up to 8 Talking Therapy sessions per year - including CBT and counselling.
• Private physiotherapy, with up to 6 sessions annually through our network of providers.
• In-patient and day-patient treatment with full cover for hospital fees, consultant fees, and diagnostic scans when admitted.
• Advanced Cancer Cover with full support for treatment, including drug therapies and personalised care.
• Vitality Menopause Support, delivered in partnership with Peppy.
• Plus, extras like NHS Hospital Cash Benefit, Childbirth Cash Benefit, and Home Nursing after hospital stays.

The Vitality Programme

We go beyond traditional health insurance by supporting you to live a healthier life—and rewarding you for it.

• Earn Vitality points by taking part in healthy activities such as exercising, completing health assessments, or attending health check-ups.
• Your points contribute to your Vitality status—Bronze, Silver, Gold or Platinum.
• The higher your status, the more you could save on your premium at renewal.
• You'll also unlock access to a wide range of discounts and rewards from partners like Apple Watch, Amazon Gift Card, Deliveroo Plus Gold, PureGym and many more.

Smart Digital Tools

Manage your health journey with ease through the Care Hub, available via Member Zone or the Vitality UK app:

• Book GP appointments
• Track and manage claims
• Self-refer for physiotherapy or Talking Therapies
• Access personalised support—all in one place

Ready to Get a Quote?

Getting a personalised health insurance online quote with Vitality is quick, simple, and hassle-free.

Just answer a few basic questions—like your age, location, and preferred level of cover—and we'll show you how much your plan could cost. Subject to eligibility, underwriting and the information you provide.

Need help with getting a quote? Our qualified experts are here to help. Request a free call back and get tailored advice.

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Sources: ¹ Financial Lives 2024 survey, FCA, May 2025.