Purchasing private medical insurance is typically a straightforward process. However, if you are new to private health insurance and the private healthcare system in the UK, it’s unlikely that you would be familiar with common industry terminology.

In this guide, we go through the 10 most common health insurance terms and their definitions to help you throughout the process of purchasing your private medical insurance policy.

1. Premium

The premium is the amount of money you pay to your health insurance provider to keep your policy active. Premiums are typically paid monthly, however most providers also have the option for you to pay premiums quarterly or annually. The total premium you pay can depend on several factors, including the age of the individuals requiring cover, the number of members covered by the policy, the level of cover required, as well as the insurance provider you choose to go with. If you receive private health insurance through your occupation, then your employer will typically pay the premium in full for you.

2. Pre-existing conditions

A pre-existing condition can be any health condition, symptom, treatment, or diagnosis that someone has had before enrolling onto a health insurance policy. If you have a pre-existing condition, it does not rule you out of being able to purchase a policy, it could however result in the condition being excluded for a period after your policy starts, or your premium could be increased. Some examples of pre-existing conditions can include asthma, epilepsy, and diabetes.

3. Chronic conditions

A chronic condition can be any health condition, disease or injury that is considered long-term and requires ongoing monitoring and/or medication. The term ‘chronic’ describes a medical condition that is persistent and unlikely to be resolved. Many insurance companies exclude chronic conditions from cover as private medical insurance is generally designed for acute conditions that can be cured and arise unexpectedly after the start date of the policy.

4. Cover

The cover under a health insurance policy relates to the benefits included within the plan. Given the wide choice of benefits available through the various insurers, cover should be tailored around your personal circumstances, medical history, and budget. An independent health insurance broker will be able to help you find the best cover to suit your personal requirements.

5. Policy holder

A policy holder is the individual or group in whose name the policy is registered. The policy holder is the owner of the policy, and they get all the benefits the policy offers. When it comes to using the policy, the policy holder as well as any other members on the policy can make claims. 

6. Health insurance broker

A health insurance broker or brokerage is an independent person or company who specialises in recommending the right insurance for individuals, families, and businesses. They have access to the various policies available on the market and can compare different plans to find the most suitable for someone’s needs and budget. They can give expert advice and can help you choose and set up your health insurance policy. To speak to one today, get in touch with UK Health Insurance.

7. Medical underwriting

Insurers have different underwriting methods available, and the type of medical underwriting chosen determines which conditions are and are not covered. The underwriting method is chosen during your initial application to the insurer. This is when you will be required to complete a form or consent to a request for further medical information at the point of claim. The type of underwriting you choose is a fundamental step when applying for health insurance.

8. Excess

The excess is a pre-agreed amount of money that the policy holder pays upfront when making a claim. The customer can usually choose between different levels of excess when buying the policy, or when the policy is due for renewal. The higher the excess you choose to pay, the cheaper your premium becomes.

9. Claim

A claim is the process of claiming your health insurance policy benefits from the health insurance company you are insured with. Different providers have different methods of submitting a claim but generally, you first need to receive authorisation for your claim from the health insurance company before receiving any treatment.

10. Healthcare provider

The term healthcare provider can represent any medical professional or organisation that provides licensed healthcare services, including diagnostics, treatments, medication, surgery, or advice. Under health insurance, healthcare providers typically get paid for their services directly by the health insurance company. In some instances, however, the clients might need to pay for the service themselves, and then obtain reimbursement from the health insurance company; or, if the price of their treatment is more than what they can claim for, the client might be responsible for paying the shortfall directly to the hospital.


Understanding common health insurance terminology means that you can confidently purchase a plan to suit your budget and protection requirements. Should you require any further information visit our insurance hub or contact us for independent and free health insurance advice.

Are you looking to get private medical insurance?

Get a quick and easy quote below