6 myths about UK private medical insurance busted for 2026

As more people look beyond the NHS for treatment, private medical insurance is on the rise.

The number of people covered increased by 4% between 2023 and 2024, while claims rose by 10%, according to the latest Association of British Insurers (ABI) data. 

With more people taking out policies and making claims, understanding exactly what your cover includes matters.

Here, we break down six myths around health insurance and explain what you need to know if you have a policy, or before signing up. 

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Myth 1. All health insurance policies are the same

Policies may look similar on the surface, but the differences can be significant.

Most plans cover hospital treatment and surgery. Beyond that, they can vary in areas such as:

• outpatient consultations and diagnostic tests
• mental health cover
• cancer treatment limits 
• the hospitals or consultants you are allowed to use.

There are also differences in how insurers handle claims. In April 2025, we surveyed 641 policyholders who had claimed in the previous two years. Customer scores ranged from 53% to 76%. 

See how providers including Aviva, Axa Health, Bupa, Saga, Vitality and WPA compare in our guide to the best private health insurance.

Myth 2. You need insurance to go private

You don’t.

Private medical insurance is one way to pay for treatment, but some people choose to self-fund. Research by Howden Life and Health found that 27% of people paid out of pocket for private treatment in the past five years.

Paying directly may suit you if you only expect one-off treatment or have savings available. However, costs can be substantial. A hip replacement can cost more than £13,000, while cataract surgery may cost around £2,800 per eye.

Insurance spreads that risk through regular premiums, whether or not you claim.

• Find out more: Self-fund or insure: what’s the best way to pay for private healthcare?

Myth 3. It covers every condition 

Health insurance does not cover every type of medical problem.

Most policies are designed to pay for treatment where you are expected to recover, such as operations, hospital stays or diagnostic tests. However, many plans exclude or limit cover for:

• pre-existing conditions
• long-term chronic conditions that require ongoing care 
• pregnancy and childbirth 
• cosmetic procedures.

Many comprehensive policies include cancer treatment, but the level of cover and any limits can vary between insurers, so it is important to check the terms carefully.

• Find out more: critical illness cover and insurance explained

Myth 4. If you’ve been ill before, you won’t get cover 

A previous condition does not automatically rule you out.

Insurers usually ask about your medical history when you apply. Existing or recent conditions may be excluded, particularly if ongoing, but that is different from being refused a policy altogether.

Some insurers go through your medical history in detail when you apply, setting out clearly what’s excluded. Others automatically exclude conditions you’ve recently had symptoms or treatment for.

Either way, check the small print so you’re not caught out later.

• Find out more: what does private health insurance cost and is it worth it?

Myth 5: It’s expensive

It can be expensive, but costs vary widely.

Premiums depend on your age, where you live and the level of cover you choose. 

In our July 2025 analysis of six major insurers, annual quotes for comprehensive cover for a non-smoking couple in their 30s ranged from £1,586 to £2,435. For a couple in their 50s, the range was £2,144 to £4,296.

If cost is a concern, you may be able to reduce it by limiting outpatient cover, choosing a higher excess or selecting a more restricted hospital list.

• Find out more: 7 ways to save money on private medical insurance

Myth 6. Workplace cover is the same as buying your own policy

If your employer provides private health insurance, it may look similar to a policy you would arrange yourself – but there are important differences.

With workplace cover, your employer usually selects the insurer and sets the level of cover. That choice determines what treatments are included and which hospitals or consultants you can use.

When you buy a policy yourself, you typically have more control. You can choose the insurer and adjust elements such as hospital lists, outpatient cover or excess levels to match your needs and budget.

Employer cover also normally ends when your employment does. In some cases, you may be able to continue it privately, but the cost and terms can change.