Private medical insurance
For an employee, a waiting list is an inconvenience. For a contractor, it is an unpaid one — every week you cannot work is a week you cannot invoice. Private medical insurance buys speed of treatment, which for the self-employed is really a way of shortening the period their income stops.
Why speed matters more when you are self-employed
PMI does not replace your income — that is what income protection is for. What it does is shorten the time you spend waiting, which for someone with no sick pay is the same thing viewed from the other end.
The arithmetic is straightforward and rarely spelled out. If a procedure would keep you off work for a fixed recovery period either way, the variable is how long you wait before it happens. Cutting a months-long wait to weeks removes months of lost invoicing — which for a day-rate contractor can dwarf the annual premium several times over. That is the honest case for the product, and it is a much better one than the general appeal of private rooms.
How underwriting works, and why it matters at the start
Two approaches dominate. Moratorium underwriting asks no medical questions at outset but excludes conditions you have had in a defined recent period — often becoming eligible again if you go a set time without symptoms or treatment. Full medical underwriting asks the questions up front, so you know exactly what is excluded before you buy.
Moratorium is quicker to arrange; full underwriting gives certainty. The wrong choice usually surfaces at claim, which is the worst moment to discover an exclusion. Either way, pre-existing conditions are generally excluded, and this is the point most people misunderstand: PMI is designed for things that go wrong after you take it out, not for problems you already have.
What it does not cover
Being clear about the limits matters more than listing the benefits. PMI generally does not cover chronic conditions — long-term illnesses requiring ongoing management rather than a curable episode. It generally does not cover emergency treatment, which remains an NHS function. Cosmetic work, and usually pregnancy, sit outside it too.
It is best understood as cover for acute, treatable conditions where speed of access changes the outcome. Read what the policy excludes before comparing prices, because the exclusions differ between insurers considerably more than the headline benefits do.
Personal or through the company?
A limited company can pay for medical cover for a director or employee. Where it does, the premium is generally treated as a taxable benefit in kind for the individual, reportable in the usual way — so it is not the straightforwardly efficient arrangement that relevant life cover can be.
Whether the company route is better than paying personally depends on your own position and is a question for your accountant rather than an insurer's comparison table. Ask it before setting the policy up, since changing the arrangement later means new underwriting and, potentially, new exclusions.
This page is general information, not personal advice. Cover levels, underwriting terms and exclusions vary considerably between insurers, and tax treatment depends on your circumstances — confirm company arrangements with your accountant.
Private medical, answered
Does private medical insurance replace income protection?+
No — they cover completely different things. PMI pays for treatment; income protection pays you a monthly income when illness or injury stops you working. If you can only hold one, income protection covers the broader financial risk, because it responds whether or not private treatment would have helped.
Will my pre-existing conditions be covered?+
Generally not. Both moratorium and full medical underwriting exclude conditions you already have, though moratorium policies may bring some back into cover after a defined symptom-free period. If a pre-existing condition is your main concern, be clear about that at the outset — it changes which policies are worth considering.
Can my limited company pay for it?+
Yes, a company can pay for medical cover for a director or employee. The premium is generally treated as a taxable benefit in kind for the individual, so the arrangement is less clear-cut than some other company-paid cover. Confirm the position with your accountant before setting it up.
Does PMI cover chronic conditions?+
Usually not. PMI is built around acute conditions — those that respond to treatment and resolve — rather than long-term conditions requiring ongoing management. Where a covered condition later becomes chronic, policies typically continue to fund acute flare-ups but not routine ongoing care. The wording varies, so read it.