What PMI is designed to do
Private medical insurance generally funds eligible private diagnosis and treatment for new, acute conditions arising after cover begins. Depending on the plan, it may include specialist consultations, scans, surgery, hospital charges, cancer care, mental-health treatment, therapies and digital services.
- Check inpatient, day-patient and outpatient definitions
- Check hospital and consultant access
- Check benefit limits and pre-authorisation
- Check the excess and renewal basis
What it commonly does not do
PMI is not usually a substitute for NHS emergency care, routine maternity, long-term chronic-condition management or every aspect of primary care. Pre-existing conditions may be excluded or subject to moratorium or switch terms.
- Never assume a previous condition is covered
- Never cancel existing cover before replacement terms are confirmed
- Use 999 or NHS emergency services when clinically appropriate
Why buying before symptoms matters
Underwriting assesses health history according to the insurer’s method. Once symptoms, referrals or investigations exist, they may affect exclusions even before a final diagnosis. Insurance arranged after the event generally cannot cover the event as new.
- Answer insurer questions fully and accurately
- Read personal exclusions
- Disclose any uncertainty through the secure application process
Why an advised comparison can help
Price alone cannot show whether the hospital list, diagnostics, underwriting or claims pathway fits your priorities. A regulated recommendation should explain why an option is suitable, the relevant disadvantages and the scope of the adviser’s insurer panel.
