Jargon-buster
Private health insurance glossary
Health-insurance jargon, explained in plain English. If a term you’re stuck on isn’t here, just ask us — that’s what we’re for.
- Private medical insurance (PMI)
- Insurance that pays for private diagnosis and treatment of new, curable (“acute”) conditions — giving you faster access and a choice of hospital and consultant, alongside the NHS. Learn more →
- Whole-of-market
- Advice that compares every major insurer in the market, rather than a single provider or a limited panel — so the recommendation is based on fit, not who pays the most.
- Excess
- The amount you agree to pay towards a claim before the insurer pays the rest. A higher excess usually means a lower premium.
- Outpatient
- Care that doesn’t need a hospital bed — specialist consultations, diagnostic tests and scans. Cheaper plans often cap outpatient cover at a set amount per year.
- Inpatient
- Treatment that requires you to be admitted to a hospital bed, typically overnight or longer.
- Day-patient
- Treatment that needs a hospital bed but not an overnight stay — you’re admitted and discharged the same day.
- Hospital list (network)
- The set of hospitals you’re allowed to use on your policy. Broader lists cost more; “guided” or trimmed lists lower the premium.
- Underwriting
- How an insurer decides what your policy will and won’t cover based on your medical history. The two main types are moratorium and full medical underwriting. Learn more →
- Moratorium underwriting
- A quick set-up with no medical form. Recent conditions (often in the last five years) are excluded, but many can become covered again after a set period — commonly two years — without symptoms, treatment or advice. Learn more →
- Full medical underwriting
- You disclose your medical history up front and the insurer tells you exactly what is and isn’t covered from day one. More certainty, more paperwork. Learn more →
- Pre-existing condition
- A condition, symptom or medical advice you had before the policy started. These are usually excluded at outset, though moratorium terms can bring some back into cover over time. Learn more →
- Acute condition
- A short-term condition that responds quickly to treatment and is likely to be cured — what private medical insurance is designed for.
- Chronic condition
- A long-term condition that needs ongoing management rather than a cure (for example diabetes or asthma). PMI generally doesn’t cover chronic conditions long-term — the NHS does.
- Renewal
- The point each year when your policy rolls over and the premium is recalculated. Renewal increases are common — and often negotiable or beatable by comparing. Learn more →
- Six-week option
- A money-saving feature: the insurer only pays for private treatment if the NHS waiting time for it is more than six weeks. If it’s quicker on the NHS, you use the NHS.
- Guided / open referral option
- You let the insurer suggest a suitable consultant or hospital from its network rather than choosing freely. It reduces the premium in exchange for a little less choice.
- No claims discount (NCD)
- A discount on your premium that builds up for each year you don’t claim, similar to car insurance. Claims can reduce it at renewal.
- Cash plan
- A low-cost alternative or add-on that pays fixed cash amounts towards everyday health costs — dental, optical, physiotherapy — rather than full private treatment.
- Group PMI
- Private medical insurance arranged by an employer to cover a team. Often uses simpler “medical history disregarded” underwriting and is a valued employee benefit. Learn more →
- Medical history disregarded (MHD)
- Group-scheme underwriting where employees are covered without declaring their medical history — usually available once a scheme reaches a certain size.
- Continued personal medical exclusions (CPME)
- When you switch insurer, your existing exclusions carry across but no new ones are added — letting you move without losing the cover you already had. Learn more →
- Waiting period
- A set time at the start of a policy before certain benefits can be claimed (for example some therapies or dental cover).
- Co-payment / co-insurance
- A share of each claim you pay as a percentage (rather than a fixed excess). Common on some plans to keep premiums down.
- Critical illness cover
- A protection policy that pays a tax-free lump sum if you’re diagnosed with a serious illness listed in the policy, such as cancer, a heart attack or a stroke. Learn more →
- Income protection
- A policy that replaces part of your income if you can’t work due to illness or injury, paying a regular amount until you recover or retire. Learn more →
- Key man insurance
- Business cover that pays out if a key person (an owner or vital employee) dies or becomes critically ill, protecting the company’s finances. Learn more →
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