As part of Health & Protection’s Guide to PMI for new entrants, Sean Kennedy, director of Usay Compare, explores the critical importance of understanding target customers.
Overall, a huge factor in clients choosing PMI is peace of mind, knowing their health is protected and that private healthcare services are there when they need it.
Individual and retail clients looking for health insurance typically have several key factors they may want cover for.
The most common include:
- Delays in NHS treatment – with the waiting list sitting at more than seven million, more people are feeling the need to protect their future health and be prepared if they need quick access to healthcare.
- Access to diagnostics – Clients may want faster access to diagnostics and tests such as CT scans, MRI scans, blood tests and X-rays to determine the cause of their symptoms.
- Choice of specialists and hospitals – Private healthcare can give clients more choice over where they’re treated and whom by. This can provide reassurance and confidence in their cover.
Download the Guide to PMI for new entrants here
Budget and affordability concerns
For an individual looking to obtain private medical insurance, budget and affordability can be a concern; it’s usually the first and most immediate consideration when discussing PMI.
A common challenge in providing health insurance advice is helping clients to understand the balance between price and cover. Customers may be conscious of the cost, but unaware of how the different policy features, such as excess, hospital lists and outpatient limits can affect premiums.
Advisers play a key role in explaining the options available and how the policy can be tailored to reduce premiums or shape it around a defined budget, while remaining protected by health insurance.
There is also a strong focus on value for money and long term affordability.
Many clients are concerned about paying for something they may not use or dealing with increasing premiums year on year.
Clear explanations around what drives the cost of PMI, how reviewing a policy at renewal stage works, and what options may help keep cover sustainable and accessible over time can be crucial in building confidence and setting realistic expectations.
Understanding what PMI is
Helping clients understand what PMI is can be another challenge.
For many, it can be a common misconception that it replaces the NHS, when it is designed to support and work alongside it.
By providing faster access to diagnosis and treatment for eligible conditions while the NHS continues to be the go-to for emergency care and long term or chronic conditions, PMI helps take the strain off the NHS.
There can also be misconceptions around cover limits, pre-existing conditions and ongoing care, which can
lead to unrealistic expectations if not clearly explained.
Advisers therefore play a crucial role in explaining the product clearly, clarifying common myths, and helping
clients understand how PMI complements NHS services rather than competing.
Additional factors affecting PMI decisions
Beyond budget and core cover, advisers should be mindful of wider personal factors affecting individual PMI decisions.
Lifestyle, age and family stage can all shape priorities. For example, younger clients may focus on affordability and flexibility, while families often value diagnostics, paediatric care and peace of mind.
Expectations can differ widely between clients who have had employer paid PMI and those new to it, with the former often underestimating personal costs or overestimating cover.
Understanding such factors help advisers tailor conversations, manage expectations, and provide relevant, personal and well informed advice