Up to 16mn people — a third of the working age population — say private medical insurance is essential, after NHS waiting lists for routine hospital treatment in England rose for the first time in seven months.
The number of appointments for patients waiting for NHS treatment in England jumped to 7.42mn in March, up from 7.4mn in February — the first uptick in waiting times since August 2024.
Despite the treatment backlog growing, millions are still holding back from buying private medical insurance (PMI), designed to cover the cost of private medical treatment, according to new analysis.
Only 8 per cent of a sample of 2,000 UK consumers aged between 18 and 70 had bought an individual PMI policy in the past two years, with a further 8 per cent having secured cover through their employer, according to a new nationally representative survey from health insurer The Exeter.
The analysis comes as demand for private healthcare is set to reach new records in 2025, according to the latest insurer-funded activity data from Healthcode.
“Private medical insurance is a highly desired product. Who doesn’t want access to prompt healthcare in a clean, calm environment?” said Brian Walters, managing director at specialist adviser Regency Health.
Advisers point to several reasons for the apparent gulf between those who believe private health cover is essential and the seeming hesitancy for some in purchasing cover.
The perceived cost of premiums is a key issue, say PMI experts.
Nearly three-quarters, or 74 per cent of people who took part in a recent survey by Benenden, a healthcare provider, said PMI was unaffordable.
Yet pricing research this year by myTribe, a PMI educational website, found that many could obtain cover for less than the price of a daily coffee.
“A 30-year-old pays on average £35.51 monthly for entry-level cover (treatment only, not diagnosis),” said Chris Steele, founder of the myTribe.
“Even comprehensive policies with outpatient diagnostics average just £53.51 monthly for a 30-year-old, less than many mobile phone contracts.”
Age and postcode can also influence the cost of health cover. Older people are more likely to suffer health problems, which may be reflected in premiums.
But postcodes can also play a big part in a PMI quote.
For example, a PMI policy with an address of Inverness, Scotland, will be cheaper than one with a Chelsea postcode, in London. This is because the cost of treatment is typically higher in bigger cities.
The rate of annual policy increases can also present affordability challenges, especially at renewal following a claim, where increases of 50 per cent are common.
In response to affordability concerns, most insurers, over the past few years, have introduced “guided” products, where the insurer guides the member to particular consultants or hospitals.
This has helped to reduce costs. But Walters of Regency Wealth says the products are not right for everyone.
“A lot of salespeople default to these plans to get a cheap price in front of the client, so buyer beware,” he says.
Affordability concerns aside, private medical insurance also suffers because of concerns from some that it will fail to pay out.
Chris Mooney, private medical insurance expert at LifeSearch, says health insurance is only designed to cover acute medical conditions or things a person is likely to recover from.
“Lots of people are looking into PMI when they already have a chronic condition, for example, diabetes,” said Mooney.
“The worry is all claims will be linked to an existing condition and therefore not paid.”
Specialist adviser LifeSearch says that when looking to buy a policy, an important choice is between moratorium, where pre-existing conditions from the past five years are excluded for a set period, and full medical underwriting, where lifestyle and medical history are disclosed.
It prefers the latter because “you get a list of conditions that aren’t covered from day one”.
With progress on NHS waiting lists likely to be slow, advisers say there are ways to keep premiums low for those considering going private.
Isaac Feiner, managing director of specialist advisers Lifepoint Healthcare, says the most effective “entry point” for private cover is typically a stripped-back policy that covers inpatient and day patient treatment, and possibly limited outpatient and outpatient diagnostics benefits and cancer cover.
“That gives people meaningful value while keeping premiums manageable,” says Feiner.
