Inpatient, outpatient, therapies, mental health, dental, optical and cash plans — what each layer of UK health insurance actually pays for, and what it adds to your premium.
Health insurance cover types — what each module actually pays for
Every UK private medical insurance quote is built from modules. Understanding what each one does is the difference between a policy that carries a claim end-to-end and one that runs out halfway. This hub explains each cover layer, what it costs and when our brokers recommend it.
The core layers of a UK PMI policy
| Cover layer | What it pays for | Typical premium impact |
|---|---|---|
| Inpatient and day-patient | Surgery, hospital stays, anaesthetics, diagnostics while admitted | Core — included on every policy |
| Outpatient | Consultations, scans, tests before or without admission | Often 20–40% of the premium |
| Therapies | Physiotherapy, osteopathy, chiropractic, acupuncture | Small, usually worth it |
| Mental health | Therapy sessions and inpatient psychiatric care, usually capped | Moderate; caps vary widely |
| Cancer cover | Diagnosis through treatment, including some drugs not routinely NHS-funded | Core, but the level differs by insurer |
| Dental and optical | Routine and accidental treatment, reimbursement-based | Low — often better on a cash plan |
Where policies most often fall short
- A capped outpatient limit that runs out mid-diagnosis, leaving you to self-fund the rest.
- A restricted hospital list that excludes the consultant you were referred to.
- Mental-health caps that cover assessment but only a handful of therapy sessions.
- Chronic-condition wording that stops cover once a condition becomes long-term.
- Therapies bundled inside the outpatient limit rather than sitting on top of it.
How our brokers build a policy
We start from what you would actually claim for, not from the cheapest premium. That means fixing the hospital list and outpatient level first, then using the excess to bring the price back to budget — the reverse of how most online quotes are assembled.
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.
Talk through your cover with a specialist PMI broker
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.