What to consider when choosing a health insurance plan?


If you’re thinking about getting covered with private medical insurance, there are a number of considerations and a great deal of reflection that must come first. After all, with so many different types of insurance on offer, you want to be sure that you’ve secured a plan that works best for you.

In the following blog, we’re going to take a look at some important considerations that you should make before opting for a health insurance plan; from exclusions and pricing to family plans vs individual plans, we’ve covered everything you need to know. Let’s take a look.

Family vs individual health insurance

One of the key factors to consider before opting for a health insurance plan is whether you’re looking for individual coverage or a family plan. Individual coverage is highly suited to young professionals and those living alone, as you’ll likely enjoy greater flexibility over the price of your coverage, as well as being able to personalise your plan with certain supplementary treatments.

A family health insurance plan is better suited to married couples, especially those with children. With a family-based insurance plan, each dependent member of your household will benefit from the same medical coverage (whether it be basic or comprehensive), and as you still pay just one (increased) monthly premium, you can end up spreading the cost of cover across your household more efficiently. This is especially the case for younger couples with children, as age is one of the most determinative factors when it comes to calculating the cost of your premium.

Do note that there are some terms and conditions that are specific to family plans: for example, adults cannot cover their parents or any other extended family members on their health insurance plan. Additionally, dependent children will usually be eligible to remain on their parents’ health insurance plan if they meet certain criteria: usually, they need to still live at the same address and be under a certain age, although some insurance providers will also include children on their plan if they’re in full-time education.

Exclusions and pre-existing conditions

It’s important to point out that health insurance plans don’t cover all medical conditions, in particular pre-existing conditions. If you have any pre-existing conditions (which can be categorised as a medical condition where you’ve either had treatment, symptoms of, or consulted for in the last 5 years) these won’t be covered by your health insurance policy. In some instances, pre-existing conditions may be covered if you opt for a moratorium underwriting, but you’ll need to be symptom-free for 2 years and meet any other criteria laid out by the provider.

You should also note that private health insurance doesn’t cover any incurable or untreatable conditions, including but not limited to:

  • Diabetes
  • Heart disease
  • Long-term mental conditions, such as bipolar disorder
  • Allergies and food intolerances
  • Cosmetic surgery (such as gender reassignment surgery or hormone replacement therapy, as well as any plastic surgery.)
  • Dialysis
  • Emergency care
  • Intensive care (excluding special circumstances)
  • Speech disorders
  • Learning disorders

Private health insurance also won’t cover prenatal or postnatal care during pregnancy, although some providers, may offer cover for some unexpected pregnancy complications. With these exclusions in mind, you’ll want to make sure to opt for a healthcare policy that works for your needs.

Basic vs. comprehensive coverage

Another important factor to take into consideration is the type of coverage that you’re opting for. When buying private health insurance in the UK, you’ll be able to pick between basic coverage, comprehensive coverage, or something in-between, depending on your chosen provider. Usually, basic coverage will offer in-patient care and some out-patient care, as well as digital GP consultations and cancer cover. This means that while you may be treated in a private hospital for a condition or illness, the diagnostic process will take place either via the NHS, or will be paid for by you in a private medical facility - it won’t be covered by your policy.

Comprehensive cover will usually be more all-encompassing, and the entire medical process (from the diagnostic period to treatment) will likely take place in private medical facilities. Comprehensive coverage may also include a wider range of treatments, which can include dental cover, mental health cover, optical cover and other alternative therapies. Do note that these are general guidelines, and the scope of comprehensive coverage will vary from provider to provider.


Just like with any other insurance policy, you’ll be required to pay an excess, and while some insurers may impose a mandatory excess, others may allow you to set your excess fee yourself - or you can even choose to have nil excess. Your excess is a fixed sum that you can pay towards any claims on your insurance, and depending on your chosen provider, this fee will either need to be paid annually, or any time you make a claim. 

Note that the higher your excess, the lower your premium will generally be, as your excess will contribute towards the cost of any treatment that you claim for. No matter what type of health insurance you opt for, always take the provider’s excess fee into account when shopping around.

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