Why Two People With the Same Health Pay Different Private Medical Insurance Premiums

It’s one of the most common questions people ask when exploring private medical insurance (PMI): “Why does my friend pay less than me when we’re the same age and both healthy?” On the surface, it feels unfair. However, private medical insurance premiums are influenced by far more than just your current state of health. Understanding these factors can help you make smarter choices and avoid paying more than you need to.

Health Is Only One Piece of the Puzzle

While insurers do consider your medical history, it’s rarely the deciding factor on its own. Two people can be the same age, live similar lifestyles, and have no pre-existing conditions, yet still receive very different quotes. That’s because insurers price risk in layers, and many of those layers are invisible to consumers buying cover on their own.

1. Where You Live Matters More Than You Think

Healthcare costs vary significantly across the UK. Insurers factor in local treatment costs, consultant fees, and hospital charges. For example, someone living in London or the South East will almost always pay more than someone in the North of England, even with identical cover. This isn’t about health; it’s about regional medical pricing. A broker can assess whether a national hospital list or a more targeted regional option would still meet your needs while reducing your premium.

2. The Insurer You Choose Can Change the Price Dramatically

Each insurer assesses risk differently. Some are more competitive for younger individuals, while others cater to families, professionals, or those seeking comprehensive outpatient cover. Buying directly often means you only see one insurer’s pricing. A broker compares the entire market to find the insurer whose pricing model best fits you—not a generic profile. This is one of the biggest reasons two healthy people end up paying very different premiums.

3. Policy Structure Has a Bigger Impact Than People Realise

Two policies may sound similar but be structured very differently. Key variables include:

• Excess level – A higher excess can significantly reduce premiums.

• Outpatient limits – Often one of the most expensive parts of a policy.

• Hospital list – Broad vs limited access.

• Cancer cover options – Full vs guided pathways.

• Mental health cover – Included or restricted.

  
  

Without guidance, many people unknowingly select features they’re unlikely to use and then wonder why their premium is high.

4. Underwriting Method Makes a Difference

There are two main underwriting styles:

• Full Medical Underwriting (FMU) – Excludes known conditions upfront.

• Moratorium – Covers conditions after a symptom-free period.

  
  

Even if two people are healthy, choosing different underwriting methods can lead to different prices. The “cheapest” option at the start isn’t always the best long-term choice—something a broker will explain clearly before you commit.

5. Payment Frequency and Indexation Choices

Monthly payments usually cost more overall than annual ones due to financing charges. Likewise, automatic benefit escalation can quietly increase premiums year after year if it’s not reviewed. These details are often buried in policy documents but can make a noticeable difference over time.

6. Buying Online vs Using a Broker

Comparison sites and direct insurers don’t tailor advice; they sell standardised products. At Assure-U, we take the time to understand:

• How you actually use healthcare.

• What level of access matters to you.

• Where flexibility can reduce costs.

• Which insurers suit your profile best.

  
  

Importantly, we don’t charge admin fees, and our commission is paid by the insurer—not added to your premium. In many cases, clients pay less than if they’d gone direct.

The Bottom Line

Two people with the same health can pay different premiums because private medical insurance isn’t just about health—it’s about structure, location, insurer pricing models, and expert policy design. The right advice can mean the difference between overpaying for years or having cover that genuinely works for you at the best possible price.

Understanding Your Options

When considering private medical insurance, it’s essential to understand your options. Many people overlook the importance of tailored advice. A broker can provide insights that help you navigate the complexities of different policies. This ensures you find the best fit for your needs.

Speak to a Private Medical Insurance Broker

If you’d like a clear, no-pressure comparison of the UK’s leading insurers—and reassurance that you’re not paying more than you should—Assure-U is here to help. 📞 03300 100 441 📧 sales@assure-u.com We’ll explain your options in plain English and make sure your policy fits you, not the other way around.

In conclusion, understanding the nuances of private medical insurance can save you money and provide peace of mind. By working with a broker, you can ensure that you are making informed decisions tailored to your unique situation.