Medical care in the UK can best be explained in numbers.
Almost 3.5 million people living on these islands has cancer and every 75 seconds another person joins them.
A further 5.8 million are estimated to have diabetes, with 3.5 million suffering from cataracts.
Yet there is only one NHS and in January 7.2 million people were in the queue for treatment and almost 40% of those had been waiting for more than 18 weeks.
More than 1.6 million people held an individual private medical insurance (PMI) policy in 2024, a figure that has been growing for several years, according to Health & Protection’s Individual Private Medical Insurance Report 2025.
While the focus has remained on the NHS and has continued the surge in demand for PMI, there are concerns from some that individuals could be paying too much for their cover to subsidise insurers’ group businesses.
Although growth has been slowing there is hope that the sharp premium increases of the last few years are easing.
NHS driving PMI demand
“It all boils down to frustration on waiting lists,” says Bryan O’Connor, associate director at CAM Insurance.
“The NHS is in a poor state,” he adds. “People want to be seen quicker, so they are turning to private medical insurance.”
Karen Woodley, head of healthcare distribution at The Exeter, says people are much more aware of the state of the NHS now than ever before.
“When there is media attention on NHS waiting lists or people have concerns over accessing a GP, demand [for PMI] tends to peak,” she adds.
A Healthwatch England survey found the number of people using private healthcare for non‑urgent treatment and diagnostics has almost doubled in the past two years.
It found that 39% of people who had used private treatment in the past year did so because NHS waiting times were too long.
Another 31% were enticed by the perception of better quality of care and 30% for convenience, while a fifth were not ineligible for their procedure on the NHS.
As a result, Andy McClure, chief commercial officer at Benenden Health, describes the individual PMI market as being in “robust health”.
“People want the NHS to work, but they are taking a more pragmatic view,” he adds.
Sales have tailed off
Mark Southern, sales and marketing director at WPA, describes the individual PMI market as “buoyant”, but acknowledges it has tailed off from the post-Covid high.
Indeed, as the most recent Health & Protection Individual PMI Report showed the market grew by 6.5% in 2024, but this was down from the 11.5%, 13% and 12.1% recorded in the previous three years.
Issues for consumers include affordability and understanding how private medical insurance works. For the insurers, attracting younger, lower-risk clients is another challenge tied to the same issue of moderating cost increases.
“Affordability is the starting point to every conversation,” CAM Insurance’s O’Connor says.
Medical costs are rising and, in turn, premiums are increasing across the market. Claims are also fuelling inflation.
A record 162,000 people used medical insurance to fund their private treatment during the third quarter of 2025 – 2,000 more than 12 months earlier.
O’Connor has seen a 12% increase on average for medical inflationary costs among his clients.
Encouragingly, WPA’s Southern believes the sharp rise in premium prices in 2023/24 is levelling off, and he is seeing “reasonable increases coming through at an industry level”.
This could be due to insurers working to lower costs – guided options where insurers take more control of care pathways and practitioner choices are one such way.
“We take the lead on who they see and where they see them, as opposed to the traditional route of them asking to see a particular specialist,” The Exeter’s Woodley says.
“That makes it more affordable for our clients.”
A flexible approach
PMI products are evolving further too.
Instead of one-size-fits-all policies, they are becoming more flexible, offering bolt-on options, such as mental health cover or radiography, which alters the price.
Only dealing with a select number of hospitals is another way insurers are controlling their costs.
Deductibles are also being used to cut prices, with the most common route being excess, while insurers are also offering basic policies where outpatient cover is reduced or capped.
“Insurers are trying to make things more affordable,” says James Bradley, director of My Health Pal, “especially for younger families”.
This includes free insurance for a second child, while some family plans include free cover for newborn babies, hospital stays for parents when children are undergoing treatment and support for speech therapy.
Then there are products that promote healthy living, which could reduce risk for insurers.
“It is not reducing the price of the policy but gaining back elsewhere,” Bradley says.
Primary care access
Dr Nikita Patel, head of propositions at Axa Health, adds that more customers are now seeking personalised cover and flexibility that suits their specific needs and can evolve as their circumstances change.
The desire for immediacy, especially by consumers in their mid-30s to mid-40s, has also been noticed.
As Dr Patel notes, digital access to care is also appealing to many who need their healthcare to fit around their lives.
David Middleton, executive chairman of the Association of Medical Insurers and Intermediaries (AMII), highlights that access to primary care is the biggest challenge in the PMI market.
“It is difficult to get an appointment with a GP, so virtual GPs as a bolt-on to PMI is one of the biggest and best things that has happened.
“Most insurers do it now. I don’t know of any who don’t do the virtual GPs,” he adds.
“It used to be a unique selling point, not now it is probably the norm. If they don’t do it, they are pushing themselves out.”
Knowledge is power
A lot of people in the UK find private medical insurance confusing, Bradley believes, based on the enquires My Health Pal receives.
“We have been brought up to rely on the NHS, that is the way healthcare works in the UK,” he adds.
“So private is alien to some people until it is a necessity.
“It is to cover future aliments, it is an insurance policy.
“For most people, the first time they have a discussion around the private sector is when they need to use it. We need to have those conversations earlier.”
WPA’s Southern agrees there is an onus on the industry to get through to more people.
“It is down to us, the providers and the brokers, to break this down and make it understandable for customers,” he says.
Get them young
One trend in the UK’s PMI sector is that most individuals who hold such a policy are over the age of 45, The Exeter’s Woodley says.
Not attracting enough younger members to bring the average down appears to be a question of not only affordability, but priorities.
When people are in their 20s and early 30s, they typically focus on buying a home and having children.
“Younger people have different priorities at that stage of their life, and health insurance might not appeal to them,” Woodley adds.
However, there are some indications that younger populations are gaining interest in PMI.
WPA is seeing “a number” of people in their mid-30s joining this market, as Southern notes, “this is down to where our pricing point is”.
“They will then look at the things in the background such as the benefits and service,” Southern adds.
In terms of future thinking, insurers need to assess what varying demographics of the population require and adopt their proposition accordingly.
“Different types of policies for different demographics might be a way forward,” Woodley says.
‘Broken’ market
However, there are also deeper concerns with the individual private medical insurance sector. One adviser describes it as “broken”.
“It is not delivering how it should, in my opinion,” says Chris Hughes, the founder of Health Well Solutions.
He points to premiums from the individual market being used to support the large group business that all insurers tend to have as a reason why.
“Individuals are paying above what they should because if you are part of a large corporate you are not paying enough,” he continues.
“[Insurers] are obsessed with large market volume, and the biggest market share is the corporate business.
“They defend that with low premiums and so individuals tend to suffer.”
Useful and valuable
Whether the market is supporting individual policyholders or not, insurers appear to be changing their products to win and keep new business.
Much of this evolving offering is being centred around smart phones in the hope of connecting with younger people by providing them convenience and immediacy when it comes to their health.
“The canny operators are beginning to reshape the product, partly to manage costs, but in truth to make it more useful and more valuable for a younger audience,” Benenden Health’s McClure says.
AMII’s Middleton concludes: “The market is listening to what consumers want, but you could always do more, couldn’t you.”
