Health Insurance Buying Tips: A Broker’s Checklist

Start here, because underwriting decides what the policy will actually pay for in your specific case. Under moratorium underwriting, conditions from a recent look-back period are excluded, with cover potentially returning after a trouble-free spell on the policy. Under full medical underwriting, you declare your history and the insurer confirms exclusions in writing before you buy, which trades a longer application for certainty.

If you already hold cover and are switching, a third route matters: continued underwriting, sometimes called CPME. Where the new insurer accepts the switch on continued terms, much of your existing underwriting position can carry across rather than resetting. Acceptance is the new insurer’s decision, made case by case, so never cancel existing cover before the replacement terms are confirmed in writing.

Why the order matters: a cheap quote on terms that exclude the condition you care about is not a saving. Our guides to moratorium vs full medical underwriting and pre-existing conditions go deeper.

Outpatient cover funds the front end of most health problems: specialist consultations, diagnostic tests and scans before any hospital admission. Insurers structure it differently, from no outpatient cover, through capped allowances at various levels, up to full outpatient options, and some place diagnostics in different benefit pots from consultations.

Sizing it is a genuine decision. Too little and a single investigation involving two consultations and a scan can exhaust the allowance; more than you would use is premium spent on nothing. Think about how you would want a new symptom investigated, then check how the specific plan counts consultations, tests and scans against its limits. Our outpatient cover guide works through the sizing question properly.

Cancer cover is where policies differ most at the moment you least want surprises. Inspect the actual treatment wording: what is covered from diagnosis, how drug therapies are handled, whether follow-up and monitoring are included, and what limits or time conditions apply. Providers structure this differently enough that two policies with the same headline premium can behave very differently through a cancer claim.

Mental health cover deserves the same scrutiny. Check whether it is included at all or is an option, how inpatient and outpatient mental health are treated, and what session or day limits apply. Some insurers operate named assessment pathways for defined mental health concerns, but specialist treatment normally follows an appropriate referral pathway, so understand your insurer’s process rather than assuming. Our mental health insurance guide compares how the main insurers approach it.

Before buying, understand how a claim would actually run on the plan: the referral your insurer expects, authorisation before treatment, using an eligible consultant and hospital from your list, paying your excess, and how outpatient limits are drawn down. A policy you do not know how to use is worth less than it costs. Our claims guide walks the process step by step.

Then think beyond year one. Premiums change at renewal with age, medical inflation and each insurer’s own pricing approach, and insurers handle claims history differently, from no claims discounts to engagement-based models. A policy that is cheapest today is not automatically the policy that treats you best over ten years, which is why we tell clients to read our renewals guide before their first renewal letter arrives, not after.

If you are replacing existing cover, the switching rules are where money is genuinely lost. Do not cancel the old policy before the new terms are agreed in writing; your claims and medical history since taking out the old policy matter to the new insurer; and continued underwriting, where accepted, can preserve aspects of your existing position. The cheapest premium is a bad deal if your underwriting position worsens on the way to it. Our switching guide covers the safe sequence.

Finally, the least glamorous tip on the list: read the policy wording before you commit. Exclusions, benefit limits, outpatient caps, cancer and mental health terms, the hospital list, the excess and the referral rules all live there. Ten minutes with the document beats any summary, including ours.