Private Medical Insurance | Your questions answered

Can you buy private health insurance at any time (and how soon can you claim)?

Record numbers of people are turning to private medical insurance (PMI) to complement NHS services or to bypass lengthy waiting lists. But is there ever a right time to buy health insurance, and if so, what are the rules about when you can claim?

Updated: 26.10.26

By Alex Mhandu

Can I get private health insurance at any time of year?

You can buy private health insurance at any time. Policies typically last for 12 months and can be renewed or cancelled at the end of the term (your provider will usually send you a reminder in advance of your renewal).

If you choose to renew your policy, your PMI provider may ask you if any of your circumstances have changed (for example, if you’ve given up smoking) and update your policy to reflect those changes. You’ll also be notified if your premium has changed.

How soon after taking out health insurance can you use it?

Generally, most PMI policies don’t have a waiting period, so provided the condition isn’t pre-existing, you can claim straight away.

However, if the condition is pre-existing, you will normally need to wait at least two years without any symptoms or seeking medical advice for that condition before your insurer will reinstate cover and you can make a claim.

What is the six-week exclusion period?

Some PMI providers offer the option to have a six-week exclusion period, which can help lower your overall premium. If you choose this feature, it means that if the NHS can treat you within six weeks, you must use the NHS rather than making a claim on your policy for private treatment. If the waiting list is longer, then you can choose to use your policy for private treatment instead.

Can I buy health insurance after a diagnosis or accident?

PMI policies don’t cover pre-existing conditions. This is defined by the Financial Ombudsman Service as an “illness or injury you had before your policy began or was renewed”. Usually, pre-existing conditions include anything you have notified a health practitioner of (for example, your GP) within the last five years. This includes anything you have sought advice for, or had symptoms of, whether you went on to receive treatment or not.

It means that while you can buy PMI at any point, you won’t be able to claim for specific conditions that you’ve already experienced or are currently suffering from.

How do insurers know when an illness started?

When you make a claim, your insurer can ask to see your medical records, which will show any conditions you’ve experienced along with any treatment you received.

Depending on the type of policy you take out, insurers may also carry out a process known as medical underwriting. This usually involves answering questions about your lifestyle, height, weight, and any pre-existing conditions. This helps insurers assess your risk profile and how likely you are to make a claim – the greater the risk, the higher the premium you can expect to pay.

There are different underwriting options for private medical insurance policies, and it’s important to understand the differences, as this will affect the claims process. When you look for policies, two common methods of underwriting are:

Full medical underwriting

Full medical underwriting is a comprehensive assessment of your medical history. You’ll be asked about previous and current conditions, how often you’ve experienced these, how severe they were and the treatments you’ve received. You’ll also be asked about your family’s medical history, any genetic or hereditary conditions you know about, and lifestyle habits (such as whether you drink or smoke).

Insurers may also ask for access to your medical records from your GP, and you could be asked to take part in a medical assessment in person.

Full medical underwriting can feel intrusive. It can also be a lengthy process if your medical history is complex. However, undergoing this process means that your premium is tailored to reflect your circumstances. It also means your policy will be clear about what is and isn’t covered right at the start, which can mean making a claim is more straightforward.

Moratorium underwriting

Moratorium underwriting is essentially the opposite of full medical underwriting. When you take out a policy, you won’t be asked for your medical history, and the insurer won’t ask to access your records. Instead, your insurer will request a copy of your medical records when you make a claim. If your insurer is happy that you meet the policy conditions, your treatment will be covered.

Moratorium policies also won’t cover any conditions you’ve had within the last five years. Although you may have the option to request that cover be reinstated if you experience no symptoms of these conditions for two consecutive years.

Moratorium underwriting policies have become increasingly popular as they can be purchased quickly and without the hassle of answering health questions, but claims often take longer to process. You also won’t know what conditions are excluded until you make a claim. If you’re unsure whether a specific injury or illness would be covered, speak to your broker or insurer before taking out the policy.

If insurance won't cover my current issue, what are my options?

If you can’t or don’t want to wait for NHS treatment, but you don’t have PMI or your policy doesn’t cover the treatment you require, you can self-pay instead. Private hospitals will usually offer packages that include diagnostic testing, treatment, and aftercare, and often have finance options so you can spread the cost.

If you’re not sure where to start, the Private Healthcare Information Network (PHIN) is a government-mandated organisation that provides information about private healthcare, including costs.

If you want to protect your future self, it’s well worth considering PMI while you’re otherwise fit and healthy with no known illnesses. Also, remember that pre-existing conditions don’t stop you from claiming for unrelated ailments, and after two consecutive years without symptoms or treatment, you may be able to get cover reinstated.

How to get private health insurance quickly

Private medical insurance can prove invaluable when you need it most, so it’s important that any policy you choose is set up appropriately and reflects your needs and circumstances. The quickest way to do that is to seek professional advice and support, and an insurance broker, such as Alan Boswell Group, can help you do that.

When you compare policies, bear in mind these considerations:

What pre-existing conditions you have (because these won’t be covered).

How the policy is underwritten (whether it’s full medical underwriting or moratorium).

Look at where private treatment will take place (PMI providers work with networks of hospitals, so check what choices you have in your area).

If there are any waiting periods, and how long they are.

FAQs

Can I change my private health insurance provider at any time?

Yes, you can, but if you want to change provider, it makes sense to do so at the end of the policy term. Changing before then may mean that you still have to pay for the duration of your existing cover or an admin fee to cancel the policy. You’re also unlikely to receive a refund on your policy if you’ve already made a claim in that policy year.

Before you change provider, be sure to consider any treatment you’re currently receiving and the type of medical underwriting you have. When you change provider, you’ll normally have to complete a ‘switch declaration’, which will include questions about pre-existing conditions, and you could lose access to cover for certain conditions for which you’re currently receiving treatment.

Can I cancel my private health insurance at any time?

Yes. If you’ve just taken out a policy, you’ll have a cooling-off period, usually between 14 and 30 days. Cancelling within this period means you should get a full refund minus any costs for the days the policy was active.

You can still cancel at any time after the cooling-off period, but you might not get a refund.

How long does it take for health insurance to pay a claim?

Most PMI providers will pay the hospital or consultant directly once your treatment has been completed, but you’ll need to have your treatment pre-authorised. This means you’ll need to speak to your PMI provider before seeking any treatment. In most cases, they’ll give you a list of consultants or practitioners you can choose to see, or they’ll decide for you depending on the type of policy you have. Your claim will likely be subject to an excess, which you normally pay to the healthcare provider.

Choosing the right private medical insurance for your needs

Private health insurance is designed to cover short-term, acute conditions where treatment should put you back on your feet. Most policies cover the majority of inpatient treatments and day care surgery, while some also cover outpatient treatment, such as appointments with specialists and consultants, as well as dental and optical treatment, and prescriptions.

Make an enquiry today

The increasing popularity of PMI and the number of options available can make choosing the right policy daunting, but that’s where we can help; speak to one of our PMI experts.

Speak to us: 01603 967955

Can you buy private health insurance at any time (and how soon can you claim)?

In this article

In this article

Can I get private health insurance at any time of year?