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020 7112 8842


93-95 Gloucester Place,

London W1U 6JQ, United Kingdom.

Unit 4 Arlington Court,

Business Park, Stevenage SG1 2FS

What is Private Medical Insurance (PMI)? A quick guide

While treatment on the NHS is free, there are usually waiting times associated with getting treatment, or even getting diagnosed in the first place.

Private Medical Insurance, or PMI, is health insurance that pays for private healthcare, which you may want to use for shorter waiting times and treatments which aren’t available on the NHS, as well as other benefits.

But do you need it?

Does Private Medical Insurance (PMI) cover everything?

In short, no.

If you are thinking about buying Private Medical Insurance, you need to read the fine print carefully to make sure you’ll be getting the level of cover you require.

Different policies have different levels of cover, so you might need to pay for a more expensive policy if more basic policies don’t provide the cover you need.

What does Private Medical Insurance (PMI) not cover?

Most Private Medical Insurance policies don’t cover private treatment for things like pre-existing medical conditions, organ transplants, injuries sustained while playing dangerous sports, most kinds of cosmetic surgery, chronic illnesses, and normal childbirth and pregnancy costs.

Are there any reasons to not buy Private Medical Insurance?

Health insurance has many benefits but it can be expensive, especially if you have a more advanced and premium policy.

If you have debts you need to pay, but you don’t have savings, it’s not a good idea to make your debts worse by buying Private Medical Insurance.

If you only expect to use private healthcare for a few individual treatments, paying for these with your savings could be cheaper than paying regular insurance payments.

If you are considering buying health insurance for your children, it’s worth noting that the NHS gives priority treatment to children.

Reasons to buy PMI (Pros)

While specific policies have different benefits, in general PMI has many positives.

  • You get a choice of specialists and surgeons, and a choice of hospitals to be treated in (within your policy’s hospital list).
  • You also get the option of being treated in a private wing of an NHS hospital if you prefer.
  • PMI also gives you more privacy because you get to be treated in a private room rather than on an open hospital ward.
  • Some specialist drugs are not available on the NHS because they are too expensive or not approved by NICE. These drugs might be available through private healthcare.
  • One of the biggest benefits of having PMI is getting access to treatment more quickly than if it was on the NHS.

Reasons to not buy PMI (Cons)

  • You might already get private healthcare included as a benefit to your job, in which case you probably wouldn’t need to pay for it yourself, unless you require a more advanced policy.
  • Most policies don’t cover treatment for chronic illnesses such as some types of cancer and diabetes.
  • A policy might not include an approved specialist or consultant who you want to see, or locations that are convenient for you.
  • It can be expensive, especially compared to getting treatment on the NHS, which is free.

Let Oracle Consultants help you

If you need advice on finding the Private Medical Insurance policy that’s right for you, check out our PMI section for more information, or get in touch to speak to one of our consultants.