One policy covers both parents and their children, with children often added free or at half rate, under a single excess and one renewal date.
How does family health insurance work in the UK?
Family PMI usually covers two adults and children on a single policy. Bupa and AXA cover children free up to age 20 in full-time education on some plans; others charge 25–50% of the adult rate. Family policies start at about £96/month.
Key numbers
- Typical family (2+2) starting price: from £96/mo
- Children free up to: 20 (Bupa, AXA on select plans)
- Child rate on other plans: 25–50% of adult
The child underwriting trap
Adding a child mid-policy triggers underwriting. Newborns added within 90 days of birth are usually accepted with no exclusions — after 90 days, any early diagnosis (jaundice, hip dysplasia) becomes a lifelong exclusion. Add newborns immediately.
How family cover is structured
One policy, one renewal date, one excess and one set of benefits covering two adults and their children. Children are normally covered to age 18, or to 21–24 while in full-time education depending on the insurer. Bupa and AXA cover children free on selected plans; most other insurers charge 25–50% of the adult rate per child, and several cap the charge after the second or third child so larger families are not penalised indefinitely.
What a family policy actually costs
A two-adult, two-child policy on a mid-tier hospital list with a £250 excess typically starts from around £96 a month. The main drivers are the ages of the adults, your postcode, the hospital list and whether outpatient cover is capped or unlimited. Children barely move the price on plans with free child cover, which is why the choice of insurer matters more for families than for single applicants.
The benefits families use most
In order of claim frequency across our family book: digital GP appointments, which remove the 8am scramble for a same-day slot; paediatric ENT, particularly grommets and tonsils, where NHS waits are long and the clinical case is time-sensitive; dermatology; orthopaedics and sports injuries in teenagers; and mental-health self-referral for adolescents, where NHS CAMHS waits are the longest of any pathway in the health service.
Excess structure — the detail that saves families money
Ask whether the excess is per policy year or per person per year. A per-policy excess means one payment covers every claim by every family member in that year; a per-person excess can multiply by four. On a family policy the per-policy structure is usually worth paying slightly more for, and it is the clause most people never read.
Cover levels can differ by member
Aviva and Vitality allow different cover levels for different family members, so the adults can hold comprehensive cover while the children sit on a lower-cost tier, or vice versa. Bupa applies one cover level to the whole policy. Where budget is tight and one family member has a clear need, per-member tiering is the most efficient way to spend the premium.
Maternity and what to expect
Routine pregnancy and childbirth are excluded on every mainstream UK plan. Some insurers pay a small cash birth grant, and complications of pregnancy such as an emergency caesarean may be covered on comprehensive cover. Genuine maternity benefit exists only on international plans and carries a 10–12 month waiting period, so it must be arranged well before conception to be of any use.
Child cover rules by insurer
| Insurer | Child cost | Covered to age | Per-member cover levels |
|---|---|---|---|
| Bupa | Free on selected plans | 20 in full-time education | No |
| AXA Health | Free on selected plans | 20 in full-time education | No |
| Aviva | 25–50% of adult rate | 21 (24 in education) | Yes |
| Vitality | 25–50% of adult rate | 21 | Yes |
| WPA | Reduced child rate | 21 | Partly |
| The Exeter | Reduced child rate | 21 | Partly |
Broker verdict
“Add a newborn inside ninety days. It is the single most valuable thing a new parent can do with a policy they already hold.” — , Head of Operations, PremierPMI
Related questions
Can we all be on different cover levels?
Sometimes — Aviva and Vitality allow per-member cover levels; Bupa doesn't.
How long are children covered for?
Usually to 18, extending to 21 or in some cases 24 while in full-time education. After that they need their own policy, which can normally be arranged on continued terms.
Is the excess charged per person or per policy?
It varies by insurer and plan. A per-policy excess is far better value for families because one payment covers every claim in the year.
Does family cover include maternity?
No. Routine pregnancy and childbirth are excluded on UK plans, though complications may be covered and some insurers pay a small cash birth grant.
PremierPMI is a UK private medical insurance broker specialising in whole-of-market placement across 10+ leading UK health insurers including Bupa, AXA Health, Aviva, Vitality, WPA, Freedom Health, The Exeter, General & Medical and National Friendly. FCA regulated (Tesha Family Ltd, FRN 1029667). Speak to a broker on 020 4525 0884, WhatsApp 020 8064 2273, or email contact@premierpmi.co.uk.
Ask a broker how your condition would be underwritten
PremierPMI's brokers are available Monday to Friday 9am to 5:30pm. Call 020 4525 0884, message us on WhatsApp 020 8064 2273, or email contact@premierpmi.co.uk. You can also request a callback or meet our team.