Private Medical Insurance (PMI) can help you bypass long NHS waiting lists so you can access medical treatment as and when you need it. But is there a point where your age can prevent you from accessing coverage (as it can with life insurance)? To help you plan your health regardless of age, here’s what you need to consider.
What is the maximum age for private health insurance?
The upper age limits depend on the health institution. Some have strict criteria for acceptance after the 65th birthday, and others cover people of all ages.
In most cases, you will find that the limit is around 80 years for new private health insurance policies. Existing policyholders will usually be able to renew their cover, but there may be restrictions and this will be at the discretion of your provider.
You must usually be at least 18 years of age to purchase a policy. If you have children, you can add them to your policy, usually for an additional fee. Some health insurers will even offer incentives if you decide to add children to your policy. For example, if you add two or more children to your Aviva policy, you will only pay for your oldest child.
Can you get health insurance after age 75?
Yes, you can. The average age limit for new policies is 80, so at 75 you should still have a good choice of providers.
Can you get health insurance over the age of 80?
Yes, you can still find private health insurance if you’re 80 (or older). Note that many health insurance providers have an upper age limit of 80 years. If you are older than this and looking for a new policy, your choice of providers may be limited.
If you are renewing your policy with an existing health insurer, there should be no problem (subject to their terms and conditions).
Does age affect the price of private health insurance?
Yes, there is. In general, you can expect the cost of private health insurance to rise as you get older. This is simply because we are more likely to suffer from health problems as we age.
However, the impact of age on the total cost of your policy varies. If you have a basic or intermediate level policy, you may see a slight increase in premiums. If you have a more comprehensive package, you’re more likely to see a significant price increase, especially after age 50.
What other factors affect the price of private health insurance?
While age plays a role in helping health insurers calculate your premium, it’s not the only factor. Your health insurance provider will also consider:
Where do you live – if you live somewhere where hospital costs are high, you can expect to pay more.
Your lifestyle – smoking and regular alcohol consumption above the recommended limit can increase your premium because there is a higher probability of developing the disease.
The policy you choose – the more your policy covers, the higher your premium is likely to be.
Can I continue with the company’s private healthcare if I retire?
This depends on your health insurance provider. If you are part of a group health insurance plan, your existing provider may offer some continuity with an individual health insurance plan.
If this option is available to you, don’t assume that the new policy will cover everything that your previous scheme of work covered. Double check the terms and compare other policies to make sure you get the best package for your needs.
Do I need private health insurance?
There are multiple advantages of private health insurance. You can expect much faster access to treatment compared to the NHS. In addition, depending on your level of coverage, you will also be able to choose where and with whom you receive treatment.
However, private healthcare doesn’t cover everything, so you should weigh the pros and cons before committing to a plan.
What does private health insurance cover?
You will be able to choose your level of cover, so your own policy will depend on what you have chosen. Common rules include:
- Hospital treatment if you have to stay in the hospital overnight.
- Day treatment if you have to stay part of the day, but not overnight.
- Access to GP advice 24/7, usually via video or phone.
- Cancer treatment and care (the types of treatment you can access may vary depending on the package you choose).
If you’re looking for more information about private health insurance options, these guides can help:
Can I get insurance if I already have a medical condition?
Private health insurance usually excludes pre-existing medical conditions. This means that everything you have suffered from in the last five years or had symptoms will not be covered.
In most cases, insurers will reinstate coverage if you have been symptom-free for a certain period of time, usually two years. You can find out more in our guide to pre-existing medical conditions.
How to choose the right private health insurance plan?
Private health insurance should benefit you, so when comparing policies, consider the following:
- What you actually want to be covered for – do you just want faster access to care or is cancer treatment very important to you?
- What features do you want – for example, do you want to be able to choose your consultant and hospital or are you happy to work from a list provided by your insurance company.
- Whether you want additional therapies – a number of health insurers also offer physiotherapy and alternative or complementary treatments in addition to medical care.
- What other options are there? – if you can’t find a policy that gives you what you want, you can opt for self-insurance instead. Alternatively, a cash plan may be all you need if you’re just looking to reduce your day-to-day healthcare costs.
How can I reduce the cost of private health insurance?
Private health insurance may seem like an expensive option, but it doesn’t have to be. You can keep costs as low as possible by:
Buy only what you need
Basic policies usually cover the essentials, such as hospital and day care, as well as access to a virtual GP. If this is all you need, you’ll pay less than policies with extensive features.
Limiting the network of hospitals
Private health insurances cooperate with a network of hospitals so you can choose where you will be treated. The wider the network (for example, if it’s within the entire country), the more you can expect to pay. If you would prefer to be treated locally, you can reduce costs by limiting the network of hospitals to your region only.
Limiting your choice of consultants
Like your hospital network, health insurers also offer you a choice of advisers, either from an unlimited list or a restricted (managed) list.
Choosing an unlimited list means you can choose any consultant you think is best for your needs. As you might expect, this is a more expensive option.
Guided lists are where your insurer provides a list of consultants to choose from (all of whom will be experts in their relevant fields).
Choosing a guided list can help keep your PMI premium low because your insurer will have selected consultants who work within the available budget.
Increasing your surplus
Increasing your excess can reduce your total premium. However, remember that you must pay your excess if you want the claim to continue. With that in mind, it shouldn’t be so tall that it becomes too tall.
Stay active
Some insurers offer incentives and discounts if you are interested in maintaining your health. For example, Vitality health insurance policies offer points if you are active. These points can be exchanged for prizes such as cinema tickets and vouchers.
Using a specialized broker
Specialty brokers are experts in their field and can help you find health insurance that fits your needs and budget.
If you are interested in more information, please contact us. We can connect you with a regulated broker who can explain what’s available and your options.
Waiver: This information is general and what is best for you will depend on your personal circumstances. Talk to a financial advisor or do your own research before making a decision.
