Following a successful career as an Estate Agent, new NCF member Joshua Allen became a Healthcare Partner with WPA Healthcare two years ago. At a recent networking meeting, he took some time to tell us what attracted him to this new opportunity and shared some useful tips for anyone thinking about taking out private medical insurance (PMI).
Why I made the move
“I really enjoyed being an Estate Agent but was looking for an opportunity that offered me more flexibility and the opportunity to be my own boss,” Josh explained. “Becoming a franchisee with WPA ticked both those boxes!”
Based in Taunton in Somerset, WPA Healthcare have provided PMI for over 120 years and are one of the few genuinely not-for-profit providers in the UK. The WPA Foundation, for example, supports projects throughout the UK and is currently focused on supporting the purchase of healthy physical activity equipment in schools. Josh said, “It’s great to get thank you letters from pupils when I’ve been able to help their school buy some sports gear they’re loving!”
“I’m also finding that WPA seem to lead the way in terms of their cover, too. What we introduce as an additional benefit to members, other providers will offer in a year or so but probably make a charge for it as an add-on.” Being a WPA member has lots of other benefits, too. “As well as lots of High Street deals, available via our app, members have access to services like ‘My Skin Doctor’, which allows a professional to review photos of any skin conditions you may be worried about quickly. WPA’s ethos is one of early diagnosis; not only is this reassuring for our clients but it makes better business-sense: the earlier the diagnosis, generally the less expensive the treatment.”
My role as a Partner
“As a franchisee rather than a direct employee, I can make sure I really look after my customers. If what WPA offer isn’t right for them, I will say so,” Josh explains. For many people, Josh’s honesty is reassuring. “Having carefully explained to one potential client why they shouldn’t buy with me but with another provider, they went on to pass me three or four referrals to get in touch with their friends and family, who did go with me. It’s reassuring that honesty still pays off!”
As an Advisor I can provide advice not just information. This means that I am in a better position to review a policy or potential cover for a client to make sure it does what they need it to. Of course, this results in better value for them.
Some tips for anyone thinking about PMI
Whether you’re an individual, a family or a small business, private medical insurance means faster access to treatment, a greater choice of clinicians and reduced disruption to work and family life. But the cover on offer varies widely in cost, scope and flexibility so selecting the right policy requires some thought. Josh suggests taking into account the following will help you evaluate the options with confidence and avoid costly gaps.
1. Clarify what you actually need
Before you even look at PMI providers, define your own priorities. Many professionals choose PMI to bypass long waiting lists for diagnostics or consultant-led care. If that’s your main concern, look closely at outpatient benefits, including scans and specialist appointments, as these often determine how quickly you reach a diagnosis. Others might value predictable costs for planned treatments, making inpatient and day-patient cover more important. If you have dependants, assess whether family coverage is worthwhile; sometimes adding children is inexpensive relative to individual adult premiums. Be honest about your health history too; if you have a condition likely to require future treatment, the underwriting route you choose will affect what’s covered.
2. Factor in any pre-existing conditions
Underwriting is the process that all insurers go through to decide what cover they will offer you. For PMI, underwriting determines how insurers decide to treat any existing conditions. For example, it’s fairly common for health insurance not to cover conditions you’ve experienced in the last five years initially but they may become covered after a symptom-free period, usually two years. This is known as ‘moratorium underwriting.’ While this is a flexible approach and requires no medical questionnaire, it can leave grey areas around flare-ups. Full medical underwriting (FMU) is more predictable because exclusions are defined upfront, though it requires more disclosure and may reduce flexibility later. If you’re switching from an existing policy, “continued personal medical exclusions” (CPME) or “switch terms” may preserve current cover levels – valuable if you’ve had treatment in the past. If you have any pre-existing conditions, you will need to declare them but it’s worth thinking about how severe they may be in future.
3. Evaluate outpatient limits and optional add-ons
The cost of health insurance premiums vary most around outpatient benefits. Some policies cap outpatient diagnostics or consultations; others provide full cover. Lower limits can reduce cost but may leave you paying for key diagnostic steps. Check whether therapies (physio, osteopathy, mental health counselling) are included or require an add-on. Mental health provision differs sharply across insurers – some offer extensive outpatient support, while others restrict sessions. Dental, optical, travel, and health-screening benefits can be useful but are rarely cost-effective unless you know you’ll use them. (“As an example, I got about £720 cash back last year for my own medical, dental, optical and audio check-ups because these are covered on most WPA policies,” said Josh.)
4. Review hospital networks and added-value options
Insurers offer tiered hospital networks, with London and major city hospitals usually in the highest-cost tier. If you live or work near a major centre, confirm your preferred hospital is included. Also check consultant access; some policies allow any specialist who meets the insurer’s fee guidelines, others limit you to a list. Your experience and speed of care can vary significantly based on this.
Increasingly, the practical advantages of PMI are included things like virtual GP services, mental health helplines, legal and debt advice, and so on. These can shorten your path to diagnosis and reduce time away from work. Some insurers also offer wellbeing apps, discounts or preventive health programmes, which can add real utility for busy professionals. Think about what would actually be useful to you, now and in the future, in order to compare premiums and value before you buy.
5. Premium costs versus long-term sustainability
PMI premiums typically rise annually, some competitors as much as 16%, although most increase less if you haven’t needed to claim anything major. It’s important to assess whether you can sustain the cost over time, especially if switching becomes harder due to developing conditions. Like with many insurance policies, increasing the excess you’re prepared to pay can moderate your premium, but ensure the amount is realistic for you to pay.
Of course, if in doubt or in need of further advice, someone like Josh will gladly offer a free chat to help determine what you need. But, with the NHS under such strain, private medical insurance could provide you and your family with peace of mind. “A well-chosen policy should provide clarity, speed and confidence when your health matters most,” Josh concluded.