Private Medical Insurance Terminology: 15 Key Terms You Need to Know

Navigating the world of Private Medical Insurance (PMI) can be daunting, especially when you encounter a multitude of unfamiliar terms and jargon.
To help you make informed decisions about your healthcare coverage, we’ve compiled a comprehensive glossary of key PMI terms.

Private Medical Insurance Terms

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PMI Key Terms


Definition: The premium is the amount you pay to your insurance provider for your PMI policy. It can be paid monthly or annually, and the cost may vary depending on factors such as your age, health, and the extent of coverage.


Definition: Excess refers to the portion of the medical costs that you agree to pay out of your pocket before your insurance coverage kicks in. For example, if your policy has a £500 excess, you’ll need to pay the first £500 of your medical bills, and the insurer covers the rest up to any policy limitations you may have.

Inpatient Treatment

Definition: Inpatient treatment refers to medical care that requires a hospital stay. Many PMI policies typically cover the costs associated with inpatient treatment, including surgeries, hospital accommodation, and nursing care.

Outpatient Treatment

Definition: Outpatient treatment includes medical services that do not require a hospital stay. These services may encompass doctor’s appointments, diagnostic tests, and minor procedures. PMI policies can offer coverage for outpatient treatment, but the extent of coverage can vary.

Pre-existing Condition

Definition: A pre-existing condition is a medical condition or illness that you have before obtaining PMI coverage. Many policies will exclude coverage for pre-existing conditions.


Definition: A specialist is a medical practitioner with expertise in a particular area of healthcare, such as a cardiologist, dermatologist, or orthopaedic surgeon. PMI policies often cover consultations and treatments provided by specialists.

Waiting Period

Definition: A waiting period is the duration you must wait after purchasing a PMI policy before certain benefits become available. Policies can have waiting periods specific treatments.

Network Provider

Definition: A network provider is a healthcare facility, doctor, or specialist that has an agreement with your insurance company to provide medical services at negotiated rates.


Definition: Renewal is the process of extending your PMI policy for another term, typically a year. It’s essential to review your policy at renewal to ensure it still meets your healthcare needs.


Definition: A claim is a formal request you submit to your insurance company in the event you require, treatment, consultations or tests.


Definition: Exclusions are specific medical treatments, services, or conditions that your PMI policy does not cover. Review your policy documents to understand what is excluded.


Definition: Underwriting is the process that insurance companies use to assess your risk as a policyholder. It could involve evaluating your health, and medical history to determine your eligibility and premium costs.


Definition: A broker is an intermediary who assists individuals or businesses in finding and purchasing PMI policies. Brokers can provide expert guidance and help you navigate the complexities of insurance options.


Definition: A co-payment is a fixed amount that you must pay for specific medical services, such as doctor’s visits or prescription medications. It is separate from your policy’s excess.

Private Medical Insurance Terminology

Understanding these key PMI terms will empower you to make well-informed decisions about your healthcare coverage. If you have questions about your PMI policy, terminology, or need assistance in selecting the right coverage for your needs, our team at Howha PMI is here to help. Don’t hesitate to reach out to us for expert guidance and personalised solutions tailored to your healthcare requirements.

Disclaimer: This glossary is for informational purposes only and does not constitute insurance advice. Please consult with a qualified insurance advisor to discuss your specific needs and policy details.

Speak to us today for more information about PMI and to get a no-obligation quote

You can call us on 0117 450 6496 or book a time to speak with us here – Get A Quote