Private medical insurance (PMI) pays for private medical treatment when you need it: whether that's a specialist consultation, diagnostic tests, or a surgical procedure. Rather than joining an NHS waiting list that could stretch to months or even years, you get seen quickly at a private hospital or clinic of your choice.

Most policies work on a diagnosis pathway: you see your GP first, get a referral, then your insurer takes over. Some insurers now offer direct-access services so you can book a specialist without a GP referral at all. Baker Hudson Health will explain exactly how each policy works so there are no surprises when you need to claim.

The following are illustrative examples only. They do not represent real clients or actual cases. Individual policy terms, eligibility and outcomes will vary.

Suspected cancer: weeks, not months

Sarah, 47, found a lump and was told the NHS urgent-referral wait was 6–8 weeks. With PMI, she had a consultant appointment within 4 days, a biopsy within a week, and a treatment plan in place within 14 days: giving her the earliest possible start to whatever treatment was needed.

Hip replacement: back at work in 6 weeks

James, 54, was facing a lengthy NHS wait for a hip replacement that was making daily work extremely difficult. PMI covered the procedure privately; he was operated on within 3 weeks and back at work within 6: significantly reducing the period he was unable to earn.

Mental health support: no referral queue

Emma, 34, needed counselling after a difficult year but faced a 4-month NHS IAPT waiting list. Her PMI policy covered up to 10 private therapy sessions which she accessed within a week. Many modern policies now include mental health as a core benefit, not an add-on.

Being clear about exclusions is as important as understanding the benefits. Standard PMI exclusions include pre-existing conditions at the time of application (though some insurers apply moratorium underwriting which can reinstate cover after a symptom-free period), GP appointments, A&E and emergency care, routine dental and optical, cosmetic procedures, and pregnancy or fertility treatment. Every policy differs: Baker Hudson Health will compare policies carefully and flag any exclusions that matter to your specific circumstances.

Premiums vary widely depending on your age, the level of cover, your hospital list, and whether you include an excess. A healthy 35-year-old can find good mid-level cover from around £60–80/month. A family of four might pay £200–400/month depending on cover depth. Adding a voluntary excess (say £250–£500 per claim) can reduce premiums significantly and is worth discussing.

Baker Hudson Health compares rates across Aviva, Bupa, AXA Health, Vitality, WPA, The Exeter and others to find the right balance of premium and cover for your needs. We review your policy at renewal too: loyalty rarely pays with PMI and switching can save hundreds of pounds a year.