Private Medical Insurance Calculator
Private medical insurance is priced around several genuinely distinct factors — your age above all, but also which hospitals you can actually access, how much excess you are willing to pay per claim, and your smoker status. This calculator estimates a monthly and annual premium based on your specific circumstances, alongside a realistic comparison of typical NHS and private waiting times for context.
Private Medical Insurance Calculator
Estimate your private medical insurance (PMI) premium based on your age, cover level and excess.
PMI premiums are indicative. Actual premiums depend on health declaration and insurer. Compare FCA-regulated providers.
The Network Tier That Decides Which Hospitals You Can Actually Use
The hospital access tier you choose is not simply a price lever — it genuinely determines which specific hospitals and consultants your policy will actually cover, which matters as much as the premium itself. A guided network, tied to a specific list of NHS-listed private facilities, sits at the most affordable end. Selected hospitals widen this somewhat, full UK access widens it further still, and full UK plus London access, the most comprehensive and most expensive tier, includes London’s specialist private hospitals specifically. Choosing a lower tier purely to save on premium is only a genuine saving if the hospitals it actually covers are ones you would realistically use — otherwise the policy may not deliver the access you were expecting when a real claim arises.
This is genuinely worth checking against your own real location and circumstances before choosing purely on price — a guided network policy that happens to include your genuinely nearest, most convenient hospitals can be a perfectly sensible, lower-cost choice, while the same guided tier could leave someone in a different area with a considerably less convenient list of covered facilities.
Why Your Premium Won’t Stay the Same Even If Nothing Changes
PMI premiums typically rise 5–10% at each annual renewal even with an entirely clean claims history, purely reflecting rising healthcare costs generally, and separately jump more sharply at specific age milestones as you move into a higher underlying age band. This compounding effect means a policy that feels affordable in your 30s can become a considerably larger expense by your 50s or 60s, even without ever making a claim, which is worth factoring into a long-term view of whether PMI remains affordable throughout the years you would most want it, not just at the point of taking it out.
This is worth genuinely planning for rather than being caught off guard by later — building an expectation of steadily rising premiums into a long-term household budget, rather than assuming today’s premium is a reliable guide to what the same cover will cost a decade from now, avoids the situation of PMI becoming unaffordable precisely at an age when it may matter most.
The Same Person, Three Decades Apart
The same base cover, non-smoker, mid-tier hospital access, costs roughly £58 a month at age 30, around £2,100 a year. By age 50, the identical cover level rises to roughly £175 a month, around £2,100 a year higher again. By age 65, it reaches roughly £430 a month, close to £5,160 a year — more than seven times the age-30 figure, for genuinely the same policy structure throughout. This is precisely why the compounding effect of both annual increases and age-band jumps matters more for PMI than it does for most other insurance types.
The Excess Trade-off in Real Pounds
Choosing a higher excess — the amount you pay yourself per claim before the policy contributes — meaningfully reduces the premium, since you are absorbing more of the smaller, more routine costs yourself while the policy still protects against the genuinely large ones. A £1,000 excess typically costs considerably less than a £0 excess for otherwise identical cover, and for someone who rarely claims, this can be a sensible way to reduce the ongoing premium without meaningfully reducing protection against the scenario PMI genuinely exists for — a serious diagnosis or major treatment, not routine, low-cost care. Our Critical Illness Calculator covers a related but genuinely distinct type of protection — a lump sum on diagnosis of a serious illness, rather than PMI’s ongoing access to private treatment itself.
What PMI Actually Buys You Over the NHS
The core, practical case for PMI is speed of access, not necessarily better clinical outcomes — average NHS waiting times for non-emergency surgery currently exceed 20 weeks, while the equivalent treatment through PMI is typically available within days to around two weeks for the same conditions. For some people, this speed genuinely matters considerably, particularly for a condition affecting daily life or work while waiting; for others, the NHS route remains entirely appropriate and PMI’s value proposition is more about choice and speed than an alternative standard of clinical care. Our Dental Insurance Calculator covers a related but separate gap PMI does not typically fill, since routine and private dental care sit outside most standard PMI policies.
Frequently Asked Questions
Does PMI cover pre-existing medical conditions?
Generally not automatically — most PMI policies exclude conditions you already had before the policy started, though some insurers offer “moratorium” underwriting, which can cover a pre-existing condition after a set claim-free period has passed.
Does PMI cover GP visits and routine care?
Standard PMI is primarily designed around specialist consultations, diagnostic tests and private hospital treatment, not routine GP care, which generally remains accessed through the NHS alongside a PMI policy rather than being replaced by it.
Can I add my family to an existing policy later?
Most insurers allow adding family members at any point, though this is typically treated as a new addition subject to its own underwriting, rather than automatically inheriting the terms of the original policy exactly as they were.
Is employer-provided PMI a taxable benefit?
Yes — PMI provided by an employer is generally treated as a taxable benefit-in-kind, meaning it adds to your taxable income for the year, which is worth factoring in when comparing an employer PMI benefit against arranging cover privately yourself.
Does switching PMI providers affect cover for existing conditions?
Potentially yes — a condition that developed or was diagnosed under a previous policy can be treated as pre-existing by a new insurer, so it is worth checking continuation terms carefully before switching provider purely to save on premium.
Important Information
This calculator provides an estimate for general information purposes only and does not constitute insurance advice. Actual premiums depend on full medical underwriting by the insurer. For an accurate quote, compare policies directly with insurers. See our Disclaimer for further information.