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Private Health (PMI) · vs paying yourself · 2026

Private health insurance vs paying for treatment yourself

If you want private treatment in the UK, you have two broad choices: pay a monthly premium so an insurer picks up the bill, or skip the premium and pay out of pocket when you actually need care. Which works out cheaper depends less on the sticker prices and more on what you end up needing — and when.

Compare the twoPrivate health hub
Typical private health insurance costs

Independent research — typical UK costs from ABI, Which? and MoneyHelper published data.

Quick answer

The short version

  • Self-pay is often cheaper if you rarely need treatment — you pay only when you use private care, with nothing to lose in premiums.
  • Insurance wins when you face a big or repeated bill you could not comfortably fund yourself — one hip replacement can run to £14,000 or more.
  • The catch: insurers exclude most pre-existing conditions and need to approve a claim first; self-pay has no exclusions but leaves the full cost on you.
  • Average individual PMI runs around £80 a month in 2026, so roughly £950–£1,000 a year — the sum you are weighing against an unknown future bill.
The numbers

What each route costs in 2026

TreatmentTypical self-pay priceCovered by PMI?
Specialist consultation£150 – £300Usually, once you have a GP referral
MRI scan (single area)£250 – £730Yes, if diagnostics are included
Cataract surgery (per eye)£2,000 – £4,000Usually, if not pre-existing
Knee replacement£11,500 – £15,000Usually, subject to underwriting
Hip replacement£11,000 – £17,000Usually, subject to underwriting
Individual PMI premium—Around £80/month on average (£32–£210 depending on age and cover)

Indicative UK ranges for orientation, drawn from published private-hospital and PMI pricing — not a quote. London prices often run 20–30% higher, and consultations are charged separately from any procedure.

Self-pay

When paying yourself makes sense

The appeal of self-pay is simple: you keep the money until you need it. No monthly premium, no rise in cost as you get older, and no medical questionnaire deciding what is and is not covered. If you are generally healthy and would only go private for the odd scan or a one-off procedure, paying as you go can easily cost less over a decade than steady premiums would.

It also puts you in charge. You choose the hospital, the consultant and the timing, and you can pay for a single MRI or consultation to jump an NHS diagnostic queue without committing to anything ongoing. Many private hospitals publish fixed self-pay package prices, so you know the bill before you book. The risk is obvious, though — if you need something major, or need it more than once, the full cost lands on you with no ceiling.

Insurance

When insurance earns its keep

Insurance is really about the bills you cannot predict. A single joint replacement at £14,000, or a course of treatment that needs repeated scans and follow-ups, is exactly the kind of cost a policy is designed to absorb. Pay £80 a month and one significant claim can return several years of premiums at once. That certainty — knowing a large bill will not land on you all at once — is the real product, not a guaranteed saving.

There is a trade-off. Most policies exclude conditions you already have (through moratorium or full medical underwriting), and treatment usually needs the insurer’s sign-off before you go ahead. Premiums also climb with age, just as your chance of claiming rises. If you want a feel for what drives the price, our guide to private health insurance cost breaks it down, and the private health hub explains underwriting and hospital lists.

Deciding

How to weigh it up for yourself

A useful way to think about it: could you comfortably write a cheque for £15,000 if you had to? If yes, and your health is stable, self-pay leaves you free of premiums and free to choose case by case. If a bill like that would hurt, the premium is buying you protection from exactly that shock. Age, family history and whether you already have an employer scheme all tilt the balance — and the two are not mutually exclusive. Plenty of people insure for the big unknowns and self-pay for small, planned things like a one-off scan.

One more point that catches people out: a policy taken out today will not cover a condition you already have. So if the specific treatment you are thinking about is for something existing, self-pay may be your only private route anyway. It is worth checking the exclusions before assuming insurance solves the problem — see how cover interacts with pre-existing conditions.

Common questions

Insurance vs self-pay: FAQs

It depends on how much treatment you end up needing. If you rarely go private, self-pay usually costs less because you avoid years of premiums. If you face a large or repeated bill — say a £14,000 hip replacement — insurance can cover it for a fraction of that cost. Insurance is buying certainty against an unknown bill, not a guaranteed saving.
In 2026, a private specialist consultation is roughly £150–£300 and a single-area MRI £250–£730. Larger procedures cost far more: cataract surgery around £2,000–£4,000 per eye, and hip or knee replacements commonly £11,000–£17,000. Prices vary by hospital and region, and London tends to run 20–30% higher. These are indicative ranges, not quotes.
Yes. Private hospitals accept self-paying patients for one-off consultations, scans and procedures, and many publish fixed package prices so you know the cost before booking. You do not need insurance to go private — you can pay for a single MRI or operation and nothing more.
Usually not. Most policies exclude pre-existing conditions, either through a moratorium (a set period with no symptoms) or full medical underwriting. If the treatment you want is for something you already have, self-pay is often the only private route open to you. Always check the exclusions before assuming a new policy will help.
The average individual premium in 2026 is around £80 a month, or roughly £950–£1,000 a year. It can be as little as £32 for a young person on a basic plan or well over £200 for an older person on comprehensive cover. A higher excess and a guided hospital list bring the price down.
Many people do. You might hold a policy for major, unpredictable costs and self-pay for small planned things like a one-off scan to avoid an NHS wait. Some also self-pay for treatment their policy excludes. The two approaches sit together comfortably.
No. Whether you self-pay or use insurance, you keep full access to the NHS and can move between the two. Emergency and urgent care stays with the NHS regardless, and many people go private only for specific planned treatment while relying on the NHS for everything else.

Information only — not financial advice. This page compares two ways of paying for private treatment to help you understand the trade-offs; it is not a recommendation to buy, avoid or self-fund any care. Figures are indicative UK ranges, not quotes. My Insurance Expert is not an FCA-authorised intermediary and does not arrange or sell policies. Last updated: 2026-09-13

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