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Pros and cons of private medical insurance

While most of us are rightfully proud of our National Health Service, it is increasingly under strain, leaving it difficult to get the care we need. Difficulties in getting GP appointments, a shortage of hospital beds, and long waiting times for tests and diagnostics are stressful.

8.08.25

By Alan Boswell Group

People talking about and checking the list of Pros and cons of private medical insurance

Given this backdrop, there’s little wonder that growing numbers of people in the UK are opting for private medical insurance (PMI).  

As with all types of insurance policies, taking out cover has pros and cons. Depending on your circumstances, the cost and level of cover available can vary significantly. In this article, we look at the advantages and disadvantages of private medical insurance to help you decide whether this cover is right for you.  

What are the advantages and disadvantages of private medical insurance?

When considering whether to take out PMI, it’s a good idea to consider its advantages and disadvantages.  

Pros of PMI

  • Shorter waiting times. You may face long waiting times if you rely on the NHS for certain types of care and treatment. In May 2025, the NHS waiting list stood at 7.36 million cases, comprising some 6.2 million individual patients. Around 2.87 million patients have been waiting more than 18 weeks, while the median waiting time was 13.6 weeks. If you have private medical insurance, you get prompt access to consultations, tests and scans, and faster treatment.  

  • Virtual GP service. Many insurance providers offer unlimited 24-hour access to GPs via video call or phone, meaning you get seen quickly when you have a problem. 

  • More choice. So long as they have been approved by the insurer, private medical insurance can allow you to select your preferred doctors, specialists, and hospitals. This ensures that you receive excellent care that aligns with your personal preferences. 

  • Access to cutting-edge treatments. Certain innovative treatments and medications that are unavailable through the NHS may be accessible through private medical insurance. 

  • Privacy and quality care. Private hospitals typically offer superior amenities, including your own room, quieter environments, and a better choice of food, all of which can significantly improve your overall healthcare experience. 

  • Better rehabilitation. Some private medical insurance plans will include physiotherapy or rehabilitation sessions, avoiding a potentially long NHS wait.  

Cons of PMI

  • Cost. The most obvious drawback to private medical insurance is the cost. Premiums depend on a variety of factors such as age, location, medical history, and level of cover. Depending on your circumstances, PMI can be prohibitively expensive. 

  • Limitations in cover. Not all conditions and treatments are covered under private medical insurance. Chronic illnesses, pre-existing conditions, and elective procedures could be excluded, meaning you may need to rely on NHS care for certain treatments. 

  • Emergencies and pregnancy are excluded. Routine pregnancy care and emergencies aren’t covered by PMI. However, some pregnancy complications may be covered. See our article on private medical insurance for pregnancy for more details. 

  • Danger of underinsurance. If you choose cheaper PMI, you may later discover that you are underinsured. This may mean that you must pay for any shortfall. For example, if you only have £1,000 cover for mental health issues, it may not stretch very far – a single hour’s consultation with a psychiatrist could cost you £350 or more. That said, using a broker specialising in PMI can ensure you’re not underinsured.  

Additional benefits of PMI

In addition to the advantages we’ve already looked at, private medical insurance offers a range of other benefits. These fall into two main categories: optional extras and additional services offered by your insurer.  

Optional extras you can choose

Optional cover depends on your insurer and type of policy, but common extras include the following: 

  • Dental and optical cover – for routine check-ups and some dental work.  

  • Travel cover – although in some cases, dedicated travel insurance is a better option. 

  • Mental health insurance – this may give you access to psychiatrists and psychologists or cover therapies such as Cognitive Behavioural Therapy. 

  • Therapies – you may be able to opt for complementary therapies such chiropractic or physiotherapy. 

Additional benefits offered by insurers

It’s in your insurer’s interest that you keep as healthy as possible. That’s why many insurers offer benefits like the following: 

  • Discounted gym memberships 

  • Discounted fitness products 

  • Discounted smart watches or fitness trackers (you may have to maintain certain levels of activity, which does determine the cost) 

  • Health magazines containing lifestyle, diet, and fitness tips 

  • Free gift-cards 

  • Optician vouchers 

  • Discounted fruit boxes 

  • Treats like free coffee or cinema tickets 

Should I have private medical insurance?

PMI is usually a sensible choice if you can afford it. If you become ill, you’ll generally get quicker and better-quality treatment, and a wider range of care options.  

It’s generally best to take out PMI when you are younger and in good health. This helps to keep premiums lower. If you leave it until you are older and have pre-existing conditions, the range of policies open to you will be much smaller, and premiums will be more expensive.  

Is private medical insurance worth it?

Ultimately, you need to decide whether PMI is worth it in your individual circumstances. If you can afford a good private medical insurance policy, it can relieve stress and worry if you become ill.  

The best approach is to talk to a specialist broker like Alan Boswell Group. We’ll be able to give you a range of options and talk you through how much certain types of cover cost. To get a broad idea of PMI costs, take a look at this article: private medical insurance UK cost per month. It’s also worth noting that, if you’re self-employed, a business private medical policy may be tax deductible.  

Need help with your insurance?

As we’ve seen, there are major benefits to having PMI. Certainly, if you can afford a good level of cover, it gives you peace of mind that you will have more treatment options and will be seen quickly if you become ill.  

Speak to us:  01603 967955

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