Health Insurance Glossary 🔍

Acupuncturist

A healthcare professional specialising in acupuncture, registered under the relevant UK regulations or a member of the British Acupuncture Council (BAcC). Some PMI policies include acupuncture as a covered therapy.

Acute Condition

A medical condition that has a rapid onset, is expected to respond to treatment, and leads to a full recovery. Private health insurance is designed to cover acute conditions rather than chronic (long-term) conditions.

Annual Limit

The maximum amount your insurer will pay out for treatment in any one policy year. Limits vary by insurer and policy level — some policies offer unlimited cover for certain conditions such as cancer.

Annual Renewal Date

The yearly anniversary of when your private health insurance policy began. Your policy is reviewed at this date, and your premium may be adjusted to reflect factors such as age and medical inflation.

Assured (or Insured)

The person or persons covered by a health insurance policy.

Benefit

A specific type of treatment or service covered under your policy, such as outpatient consultations, physiotherapy, or mental health treatment.

Benefit Limit

The maximum amount payable for a specific benefit within a policy year. For example, a policy may cover up to £1,000 for physiotherapy per year.

Broker

An independent adviser who searches the market to help you find a private health insurance policy suited to your needs and budget. A whole-of-market broker, like Insured Health, can compare policies from all major insurers rather than being tied to a limited panel.

Cancer Cover

Cover for the diagnosis and treatment of cancer, including surgery, chemotherapy, radiotherapy, and follow-up care. Most comprehensive policies include full cancer cover, but the scope can vary — always check what is and is not included.

Cash Plan

A type of health plan (distinct from PMI) that pays a fixed cash amount towards everyday health costs such as dental, optical, and physiotherapy. Cash plans are generally lower cost but do not cover hospital treatment in the same way as PMI.

Co-Payment

A fixed contribution you make towards the cost of each claim, separate from your excess. Some policies include a co-payment option in exchange for a lower premium.

Consultant

A specialist doctor who provides diagnosis or treatment for a specific medical condition. Most private health insurance policies require a GP referral before you can see a consultant.

Certificate of Registration

A document issued by your insurer confirming the details of your private health insurance policy, including the policyholder, those covered, the start date, and the key terms of cover.

Chronic Condition

An ongoing health condition that requires long-term management and is unlikely to be cured, such as diabetes, asthma, or arthritis. Most private health insurance policies do not cover chronic conditions, though they may cover acute episodes arising from them.

Cooling-Off Period

A 14-day period after receiving your policy documents during which you can cancel your policy for a full refund, provided no claims have been made.

CT Scan

A computed tomography scan that uses X-rays to produce detailed cross-sectional images of the body. CT scans are used to diagnose a wide range of conditions and are covered by most PMI policies when referred by a consultant.

Curative Treatment

Treatment intended to completely eliminate a disease or condition, with a reasonable expectation of full recovery. Private health insurance is primarily designed to fund curative treatment of acute conditions.

Day Patient

Treatment that requires admission to hospital but does not involve an overnight stay. Day patient treatment sits between outpatient and inpatient care and is covered by most PMI policies.

Diagnostic Tests

Tests such as blood tests, X-rays, MRI scans, and CT scans used to identify or monitor a medical condition. Whether these are covered, and to what extent, varies by policy.

Excess

The amount you agree to contribute towards the cost of a claim before your insurer pays out. A higher excess typically results in a lower premium. Excesses may apply per claim or per policy year, depending on the policy.

Exclusion

A condition, treatment, or circumstance not covered by your policy. Common exclusions include pre-existing conditions, cosmetic treatment, and chronic long-term conditions.

FCA (Financial Conduct Authority)

The UK regulatory body that oversees financial services firms, including health insurance brokers and providers. Any firm selling private health insurance in the UK must be authorised and regulated by the FCA.

Full Medical Underwriting (FMU)

A method of underwriting where you disclose your full medical history upfront when taking out a policy. The insurer then clearly sets out what is and is not covered before the policy begins. FMU provides greater certainty about your cover compared to moratorium underwriting.

GP Referral

A recommendation from your GP (General Practitioner) to see a specialist or receive further treatment. Most private health insurance policies require a GP referral before covering private consultant appointments.

Group Health Insurance

A health insurance policy arranged by an employer to cover a group of employees. Also known as corporate health insurance or business health insurance.

Homeopath

A practitioner of homeopathy, typically registered with the Society of Homeopaths or a member of the Faculty of Homeopathy. A small number of PMI policies include homeopathy as an optional complementary therapy benefit.

Hospital List

A list of hospitals approved by your insurer for private treatment. Comprehensive policies typically allow access to a wider network of hospitals, while budget policies may restrict you to a shorter list. Choosing a restricted list can reduce your premium.

Inpatient Treatment

Treatment that requires you to be admitted to hospital overnight or for more than one day. Inpatient cover is a core component of most private health insurance policies.

Intermediary

A professional who acts between the client and the insurer, helping to find and arrange suitable health insurance cover. Brokers and independent financial advisers are types of intermediaries regulated by the FCA.

IPT (Insurance Premium Tax)

A UK government tax levied on most general insurance premiums, currently set at 12%. IPT is included in the premium quoted to you and is paid directly to HMRC by your insurer.

Loading

An additional charge added to your premium, usually as a result of a pre-existing condition or higher-than-average health risk. A loading means your premium is higher than the standard rate.

Mental Health Cover

Cover for the treatment of mental health conditions such as depression, anxiety, and stress. The extent of cover varies significantly between insurers and policy levels.

Moratorium Underwriting

A simpler form of underwriting where you do not need to disclose your full medical history when taking out a policy. Instead, any condition you have had symptoms of, received treatment for, or sought advice about in the five years before the policy starts is automatically excluded for the first two years. If you remain claim-free for that condition for two continuous years, cover may then be reinstated.

MRI Scan

A magnetic resonance imaging scan that uses magnetic fields and radio waves to produce detailed images of the body's internal structures. MRI scans are commonly used to diagnose conditions affecting the brain, spine, joints, and soft tissue, and are covered by most PMI policies when referred by a consultant.

NICE (National Institute for Health and Care Excellence)

A UK public body that provides evidence-based guidance and recommendations on health and social care practices. Some insurers use NICE guidance to determine which treatments and drugs they will fund.

No Claims Discount (NCD)

A discount on your premium that builds up over time if you do not make any claims. The discount can be significant after several consecutive claim-free years.

No Claims Discount Protection

An optional add-on that allows you to make one claim in a policy year without losing your accumulated no claims discount. This can be worthwhile if you have built up a substantial discount over several years.

Open Referral

A system where your insurer directs you to an available specialist rather than you choosing your own. Open referral can reduce costs and waiting times, and is offered by some insurers as an alternative to choosing your own consultant.

Outpatient Treatment

Treatment or consultations that do not require a hospital stay. This includes GP or specialist consultations, physiotherapy, and diagnostic tests. Outpatient cover is often an optional extra on basic policies.

Palliative Care

Care focused on relieving symptoms, pain, and stress rather than curing a condition. It aims to improve quality of life for patients with serious illnesses. Cover for palliative care varies between policies and insurers.

Personal Medical Exclusions (PMEs)

Specific conditions or treatments excluded from your policy based on your personal medical history, typically identified during full medical underwriting. PMEs are listed in your policy documents so you know exactly what is not covered before you need to make a claim.

Physiotherapist

A healthcare professional registered with the Health and Care Professions Council (HCPC) who specialises in physiotherapy. Physiotherapy is covered by many PMI policies, either as a core benefit or an optional add-on, usually subject to a referral and benefit limit.

PMI (Private Medical Insurance)

The formal term for private health insurance. PMI is designed to cover the cost of private medical treatment for acute conditions — that is, conditions that are expected to respond to treatment. It complements, rather than replaces, NHS care.

Policy

The contract between you and your insurer that sets out the terms, conditions, benefits, exclusions, and limits of your health insurance cover. Always read your policy documents carefully to understand exactly what is and is not included.

Practitioner

A licensed healthcare professional authorised to practise in their field in the UK, such as a GP, consultant, physiotherapist, or osteopath. Most PMI policies require treatment to be carried out by a recognised practitioner to be eligible for a claim.

Pre-Existing Condition

A medical condition you have had before the start of your policy. Pre-existing conditions are typically excluded from new PMI policies, although switching insurers may allow you to carry over cover for conditions already included on your existing policy.

Premium

The regular payment you make to maintain your health insurance policy, usually monthly or annually. Premiums are affected by factors including age, location, cover level, excess, and medical history.

Reduced Hospital Cover

A cost-saving option on some policies that limits access to a smaller list of approved private hospitals. Choosing reduced hospital cover can lower your premium while still giving you access to private treatment.

Remission

A period during which the symptoms of a disease, particularly cancer, are reduced or absent. Remission does not necessarily mean a condition is cured. Some policies provide cover for monitoring and follow-up care during remission.

Renewal

The point at which your policy comes up for review, usually annually. Premiums often increase at renewal due to age-related factors and medical inflation. It is worth reviewing your policy at renewal to ensure it still offers value.

Six-Week Option

A policy option that means your insurer will only cover private treatment if the NHS waiting time for the same treatment exceeds six weeks. This option can significantly reduce your premium.

Specialist

A doctor with advanced training and expertise in a specific area of medicine, such as cardiology, oncology, or orthopaedics. Most PMI policies require a GP referral before covering a consultation with a specialist.

Specified Condition

A specific medical condition that is explicitly named and described within your policy, often in relation to the terms under which it will or will not be covered.

Sum Insured

See Annual Limit.

Switch

Moving your private health insurance from one insurer to another, ideally without losing cover for conditions already included on your existing policy. A broker can help you switch while protecting your existing cover.

Therapies

Treatments such as physiotherapy, osteopathy, chiropody, and acupuncture. These are often offered as optional add-ons to core PMI policies.

Therapist

A registered medical professional who delivers a specific therapeutic treatment, such as an osteopath, chiropractor, or physiotherapist. For a claim to be valid, treatment must usually be carried out by a qualified and registered therapist recognised by your insurer.

Treatment

Any medical service or procedure necessary to diagnose, manage, or treat a health condition covered by your policy. This includes consultations, surgery, diagnostic tests, physiotherapy, and prescribed medication administered as part of an eligible claim.

Underwriting

The process by which an insurer assesses the risk of covering you and determines what will and will not be covered under your policy. The two main types used in UK private health insurance are moratorium underwriting and full medical underwriting (FMU).

Waiting Period

A period after the start of a policy during which certain conditions or treatments are not covered. Waiting periods are more common with cash plans than with PMI.

Whole of Market

A broker described as whole of market can advise on and arrange policies from any insurer in the market, rather than being restricted to a limited panel. Insured Health compares policies from the UK's leading private health insurers.