How does health insurance work?

Private health insurance allows you to access private treatment when you need it most. First, you can choose the insurance company and health insurance policy that meets your needs. Then, you can tailor your coverage to suit your circumstances and budget. You're covered as soon as you start paying the premium.

What will private health insurance cover?

Your private medical insurance will cover various treatments, depending on the policy options you choose. All health insurance policies include inpatient care if you need a hospital stay, cancer care and some mental health treatment. What's included will vary depending on your chosen health insurance policy.

Health insurance companies also offer a range of optional extras that you can add to your insurance. These typically include outpatient treatment, consultant appointments, diagnostic tests and outpatient physiotherapy.

What won't my private health insurance cover?

Health insurance is designed to treat acute conditions that can be cured with a course of treatment. This means that chronic conditions such as asthma, angina or diabetes aren't covered as they'll need to be monitored long-term by your GP.

Every health insurance policy also has exclusions. If you've seen your doctor or received treatment for a health issue in the five years before you take out the policy, it will be excluded from coverage for at least the first two years. However, if you stay symptom-free, it can be added later. Insurers each have a list of standard exclusions, typically things like a normal pregnancy, cosmetic surgery or treatment for addiction. A broker can help you to check the details to decide on the best policy.

Holding hands, caregiver and senior woman in wheelchair for support outdoor in retirement home.

What does a broker do?

You might think of a health insurance broker as an intermediary you don't need. However, health insurance brokers work to develop their knowledge of the health insurance market. They'll conduct a full market review on your behalf, comparing policies from many insurers and offering advice on the best policy for your needs.

If you decide to contact insurance companies yourself, you might decide to start with the biggest providers. However, a broker can help you to find coverage with a smaller provider that's a much better fit.

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The benefits of working with a health insurance broker

A health insurance broker compares different insurance policies from across the market to find you the right coverage. Here are a few benefits of working with a specialist health insurance broker.

1. You'll save time

Contacting insurance companies directly can involve making many phone calls or filling in your details online, which can be time-consuming. You may also have to chase insurers for a response or answer follow-up questions from each provider. When you work with an insurance broker, you'll provide your details once, and they'll do all the follow-up work for you.

2. Your broker is on your side

When you contact an insurance company for a quote, they'll tell you about the benefits of their policy to persuade you that they're the right choice. However, an independent broker isn't tied to any provider and can offer unbiased advice based on their knowledge of your circumstances. They'll also be able to offer advice on the optional extras that will help you get the best cover.

3. Help with comparing quotes

Health insurance quotes include many technical details and terms that can be tricky to understand. As a result, it can make it difficult to compare quotes and understand what's covered, excluded and what that means for you.

A broker will talk you through each quote so you understand the advantages and disadvantages of each policy and make an informed choice.

4. Support with renewals

The premiums on health insurance policies can change over time as your car insurance does. A health insurance broker can review your renewal quote and let you know whether it still offers the coverage you need or whether you might be better off switching.

5. Saving money

Health insurance brokers offer a free service because they're typically paid on commission by insurance providers. This means that working with them won't cost you anything extra, and they could save you money.

A good broker develops relationships with insurers, which means they often have access to the best deals. As a result, a broker can often get you a discount on your premium, better coverage, or both.

6. Knowledge of the health insurance market

If we asked you to name some health insurance providers, you'd probably come up with some big names easily. However, there are some smaller insurers that you may have yet to hear of offering excellent value health insurance. For example, some focus on family-friendly policies, while others offer discounts to professionals and self-employed people.

Health insurance brokers keep their knowledge current to provide expert advice on different insurance products.

7. Support when you make a claim

When you claim on your health insurance, you're looking for quick treatment without the NHS waiting list. Some claims are quick and easy. However, others are more complex, for example, if you have pre-existing medical conditions.

Our services include personal claims support. When you contact us for help with a claim, you'll usually be able to speak to the broker who advised you on your policy. That means that you won't have to spend time explaining your circumstances or the advice you received.

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What’s the process for working with a broker?

A good broker tailors their service to you to help you find a suitable policy. Of course, brokers work in different ways, but here are some steps you can expect from most brokers.

Having a chat

Most good brokers want to get to know you before providing advice. So they'll start the process with a chat to help them understand your needs before they obtain quotes.

Brokers also gather the information that insurance providers need to quote you. These can include:

Your age

Your age affects the potential cost of your premium. The older you are, the more expensive it could be.

Where you live

Health insurance brokers ask for your postcode as medical coverage is typically more expensive in London and major cities.

Your job

If your job carries certain health risks or you work in a high-risk industry, you'll pay more as you're more likely to claim.

Your hobbies

Your hobbies can increase your risk of injury. For example, your broker needs to know if you spend weekends deep sea diving or paragliding.

How much coverage you need

Your medical insurance includes core coverage and optional extras, and you can tailor your policy in other ways, such as having an excess. Brokers ensure that you understand what your choices are and help you to understand the benefits of different types of coverage.

Your medical history

Brokers sometimes take medical history details, although this depends on your underwriting type. This allows insurance companies to assess any exclusions before they provide coverage.

Who do you want to add to your policy?

If you'd like to include your partner or children in your policy, your brokers can guide you towards companies offering joint or family policies or that cover your children at no extra cost.


After that initial conversation, your brokers will assess your information and decide who will offer you the best coverage. They'll then contact them to ask for quotes.

If an insurer has any additional questions, they may contact you for details; otherwise, they'll deal with them for you. Of course, they'll also chase quotes if necessary.

Comparing quotes

When your broker has received a range of quotes, they'll contact you to discuss them. Medical insurance quotes typically include technical language, and brokers ensure you understand what's included and what isn't. They can also help you adjust your coverage to reduce your premium.

Setting up your policy

Once you've decided on a policy, your broker will contact the insurer to get everything set up before sending you a copy of the policy. They can also liaise with your insurance providers if you have any problems or questions.

Some providers offer an online portal or app to help you make claims or look for information. Brokers can provide backup support if you have any difficulties accessing these.

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Finding the right broker

A broker can give you expert guidance to help you find the right health cover, but you might wonder how to find a good broker, especially if you're a first-time buyer. Here are some questions to ask when you're looking for a broker.

Are they a specialist?

Independent brokers can offer advice on insurance products from across the market. However, your broker will have more in-depth knowledge if they specialise in health cover.

Are they regulated?

Look for brokers regulated by the Financial Conduct Authority (FCA), which means they're checked to ensure you're given fair and impartial advice.

Do they explain things clearly?

Insurance brokers understand insurance jargon, so you don't have to. When you contact a broker, you should feel they're listening to what you need and clearly explaining how the process works. That way, you can be sure that when they offer advice on quotes, it's based on your needs and presented in a way you can understand.

Also, ask yourself whether they're easy to contact in the first place. For example, do they pick up the phone when you call or promptly reply to your email?

Can you find reviews easily?

Reviews can tell you a lot about previous customers' experience of a broker's services. You can assess whether their approach will work for you and identify potential issues. It's also a good sign if reviews are easy to find instead of being hidden away.

Working Feedback collects reviews for us, and you can read them here.

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Get in touch

We're a specialist, independent insurance broker offering a personal service to help you find the right private medical insurance. Get in touch for a comparison quote.

Tobias Britton

Tobias Britton

With over 15 years of experience, Tobias leads the expert team at Globacare. A CII IF7 qualified adviser himself, with a Diploma of Insurance to his name too, he's our resident expert in health, life, income and business protection insurance.

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