Before buying, pin down ten things: the outpatient limit, the hospital list, the underwriting type, the excess structure, whether there's a six-week option, mental health cover, cancer cover depth, digital GP access, how renewal pricing works, and what the claims process looks like. Price only means something once those ten are like-for-like.
- ✓An outpatient limit is the single biggest hidden difference between similar-priced policies.
- ✓Underwriting type decides what's excluded; excess and hospital list decide what you pay.
- ✓Ask about renewal pricing before you buy — year-one discounts routinely unwind at year two.
Questions 1–3: what the policy actually covers
- What's the outpatient limit? Outpatient care — consultations, diagnostics and scans before you're admitted — is where most claims start. Policies range from no outpatient cover, through capped limits (£500–£1,500 a year is common), to full cover. A £500 cap can be exhausted by one consultation and an MRI, leaving you paying for the diagnostic stage of your own claim. This is the first number to compare, because it's the one insurers vary most to hit a price. See our outpatient limit guide.
- Which hospital list am I on? Every insurer tiers its hospitals. Budget lists cover regional private hospitals; premium lists add central London and specialist units. The wrong list means your nearest good hospital — or the one your consultant uses — isn't covered. Check the actual named hospitals near you, not the tier's marketing name. See hospital lists explained.
- How deep is the cancer cover? Cancer is where policies differ most consequentially. Look for: full cover for licensed cancer drugs (including ones the NHS hasn't adopted), no time or monetary caps on treatment, and cover for monitoring and recurrence. Some budget policies cover cancer only to NHS-equivalent standards — legal, but not what most buyers assume they're getting. See our cancer cover guide.
Questions 4–6: what you'll pay and what's excluded
- What underwriting type is this? Moratorium or full medical underwriting decides how pre-existing conditions are treated. A moratorium excludes conditions from the last five years until you've had two clear years; full underwriting fixes exclusions upfront based on a health questionnaire. If you're switching insurers, ask about CPME terms so conditions that arose while insured stay covered.
- How does the excess work? Not just the amount — the structure. Is it per policy year or per claim? Does it apply to outpatient claims, inpatient claims, or both? A £250 annual excess is very different from £250 per claim if you have a year with three separate conditions. Higher voluntary excesses cut premiums meaningfully, but only pick what you could comfortably pay. See excess explained.
- Is there a six-week option, and do I want it? The six-week option means the insurer only pays for private treatment if the NHS wait for it exceeds six weeks. It can cut premiums substantially — but with the median NHS wait at 12.4 weeks (May 2026), you'd still go private for most significant treatment, while losing fast access for the things the NHS turns around quickly.
Questions 7–8: the cover people forget to check
- What mental health cover is included? Mental health is often an optional extra, not core cover — and where included, it's frequently capped (a set number of therapy sessions, limited inpatient days). With mental health among the most-used benefits on modern policies, check: is outpatient therapy included, what's the session cap, is inpatient psychiatric care covered, and do you need a GP referral or can you self-refer? See mental health cover.
- What digital GP and everyday-health extras come with it? A 24/7 digital GP is now standard on most major policies and changes how much use you get from cover in an ordinary year — it's often the fastest route into a claim, too. Check appointment availability, whether prescriptions are included, and what else rides along: physio self-referral, health checks, discounted gym membership or rewards schemes. These extras differ sharply between, say, Vitality and WPA.
Get quotes with the ten answers filled in
Questions 9–10: what happens after you buy
- How will my premium move at renewal? Health insurance reprices every year with age, medical inflation and claims. Ask: is there a new-customer discount that unwinds at year two? Is there a no-claims discount, and how much does one claim cost me? What has this insurer's typical renewal increase been? Double-digit renewal rises are common, and knowing the shape in advance stops year two feeling like a bait-and-switch. See renewal increases.
- What does claiming actually involve? Ask the insurer to walk you through it: GP referral or digital GP, pre-authorisation by phone or app, how fast authorisation typically comes, and whether the policy is guided (insurer picks the consultant) or open choice. A policy that's painful to claim on isn't cheap at any price. See how to claim.
If a salesperson or website can't answer any of these ten crisply, that's information too.
The checklist as a comparison table
When you have two or three quotes in front of you, score them against each other like this — and only then look at the premium line.
| Question | What 'good' looks like | Red flag |
|---|---|---|
| Outpatient limit | Full or £1,000+ | £0 or £500 cap unnoticed |
| Hospital list | Your local hospitals named | Tier name only, no list checked |
| Cancer cover | Full, no caps, drugs included | NHS-equivalent only |
| Underwriting | Matches your history; CPME if switching | Moratorium misunderstood as 'covered' |
| Excess | Per year, affordable amount | Per claim, or set to hit a price |
| Six-week option | Deliberate choice, priced both ways | Added silently to cut the quote |
| Mental health | Outpatient therapy included, clear caps | Optional extra you assumed was core |
| Digital GP | 24/7, prescriptions included | Not included |
| Renewal | Typical increase disclosed | Year-one discount, no year-two answer |
| Claims process | App pre-auth, clear referral route | Phone-only, vague on authorisation |
This is also exactly the worksheet a good broker runs through with you — with the advantage that they already know each insurer's answers. The average UK adult premium is around £80/month, but what that £80 buys varies more than almost any other insurance product; these ten questions are how you find out.
Frequently asked questions
What should I check before buying health insurance?
Ten things: the outpatient limit, hospital list, cancer cover depth, underwriting type, excess structure, whether a six-week option applies, mental health cover, digital GP access, how renewal pricing behaves, and the claims process. Get those ten answers on each quote first — premiums only become comparable once the cover is like-for-like.
What is the most important question to ask about a health insurance policy?
The outpatient limit, for most buyers. It governs consultations, diagnostics and scans — the stage nearly every claim starts at — and it's the lever insurers pull hardest to hit a price point. A £500 cap can be gone after one consultation and an MRI, while full outpatient cover handles the whole diagnostic journey.
Why does the hospital list matter when buying health insurance?
Because cover only works at hospitals on your policy's list, and insurers tier their lists sharply — budget tiers exclude central London and some specialist units. Before buying, check the actual named hospitals within reach of you, and whether the ones your preferred consultants use are included. The tier's name tells you almost nothing.
Should I ask about the six-week option before buying health insurance?
Yes — and make it a deliberate choice, priced both ways. The six-week option means the insurer only pays if the NHS wait exceeds six weeks, which cuts premiums substantially. With the median NHS wait at 12.4 weeks you'd still go private for most big treatment, but you lose speed on anything the NHS handles quickly.
What should I ask about cancer cover before buying a policy?
Three things: are licensed cancer drugs covered even where the NHS doesn't fund them; are there monetary or time caps on treatment; and is monitoring and recurrence covered after the initial episode. Cancer is where budget and comprehensive policies diverge most — some cheaper plans cover cancer only to NHS-equivalent levels.
What questions about the excess should I ask before buying?
Ask the structure, not just the amount: is it charged per policy year or per claim, and does it apply to outpatient as well as inpatient claims? A £250 annual excess and a £250 per-claim excess behave very differently in a bad year. Then choose the highest excess you could comfortably pay at short notice.
Should I ask how renewal pricing works before taking out a policy?
Absolutely — it's the question buyers most regret skipping. Ask whether the first-year price includes a new-customer discount, what the insurer's typical renewal increase has been, and how claims affect any no-claims discount. Double-digit year-two increases are common, and knowing the trajectory beats being surprised by it.
What should I ask about mental health cover before buying health insurance?
Whether it's core or an optional extra, how many therapy sessions are covered per year, whether inpatient psychiatric care is included, and whether you can self-refer or need a GP referral. Mental health is one of the most-used modern benefits and one of the most commonly capped — assumptions here get expensive.
Is it worth asking about the claims process before buying?
Yes — a policy that's hard to claim on isn't cheap at any price. Ask how pre-authorisation works (app or phone), how quickly authorisation is typically issued, whether referrals can come from the digital GP, and whether the policy is guided or open choice on consultants. The answers reveal a lot about the insurer.
Do these questions matter if I'm buying through a broker?
They're exactly what a good broker should answer unprompted — use the list to test them. A broker who can compare outpatient limits, hospital lists, underwriting and renewal behaviour across Bupa, AXA Health, Aviva, Vitality, WPA and The Exeter is earning their commission; one who leads only on price is not.