How does private health insurance work?

Private health insurance is similar to other types of insurance. You pay a monthly or yearly fee called a premium.


Getting Referred

If you have a health issue, see your GP and let them know that you have private insurance. They may refer you to a specialist, and you might choose to go to private hospitals or specialists not offered by the NHS.


Informing Your Insurer

Tell your insurer that you want to make a claim. They'll check if your policy covers the treatment you need. If it does, your claim will be approved.


Cost Coverage

Your GP will book your appointment, and your insurer will cover the cost as long as your policy is active. Depending on your policy, you may be required to pay an excess.

What is The Exeter?

The Exeter is a provider of private medical insurance, as well as Life and Income Protection products. The company was established in 2008 through the merger of The Exeter Friendly Society and The Pioneer Friendly Society. That said, its roots trace back to 1927.

The Exeter Health is one of the UK’s largest friendly societies, with over 100,000 members and over 100 staff. As a Mutual Society, it operates without shareholders or stock exchange listings. It prioritises member benefits over profits for third parties by reinvesting its profits back into the business.

The Exeter is fully regulated by the Prudential Regulation Authority and the Financial Conduct Authority.

Is The Exeter a good insurance company?

The Exeter has received positive recognition in the insurance industry. For instance, they won the Best Private Medical Insurance and Customer Service ’Above and Beyond’ awards at the Cover Customer Care Awards, and in previous years, they were highly commended for Best Individual Private Medical Insurance and Best Healthcare Service at other prestigious awards. More recently, The Exeter has been rewarded for the Best Care & Support Experience (HealthWise) and Best Health & Wellness Offering.

Also, this Exeter health insurance review wouldn’t be complete without customer reviews. The insurer has a 4.5 rating on Trustpilot based on 779 reviews, with 75% being 5-star reviews. Customers appreciate how nice and helpful the staff is and that they genuinely listen and assist in resolving any issues.

Common phrases found in many reviews of The Exeter include:

  • Affordable prices for the coverage provided
  • High-quality and attentive customer service
  • Professional and efficient handling of inquiries and claims
  • Easy and straightforward procedures

While all health insurance providers receive some negative feedback, the majority of reviews for The Exeter are positive.

How much does The Exeter health insurance cost?

The Exeter considers many factors when determining medical insurance premiums, some of which are:

  • Age — Older people pay more because they’re at higher risk for health issues.
  • Medical history — If you’ve had health problems before, your premiums will likely be higher.
  • Job — Riskier jobs can mean higher premiums.
  • Body weight — Higher weight can lead to higher premiums.
  • Smoking — Smokers pay more for insurance.
  • Location — For example, living in Central London means paying higher premiums because healthcare facilities there are pricier.
  • Plan type — The more extensive the coverage, the more members pay.

Here are sample health insurance quotes for a non-smoking 30-year-old man living in outer London:

Cover choiceGuidedGuidedTraditional
Outpatient cover£0£500£500
Hospital choiceStandardEssentialExtended
Mental healthNot includedIncludedIncluded

Bear in mind that there are many factors affecting premiums, so your situation will be assessed individually. You can use The Exeter’s online calculator for an estimate.

The Exeter health+ insurance cover options

New members choose from two treatment options from the beginning:


Traditional coverage offers more flexibility and options compared to other private health insurance plans. When you first enrol in the policy, you can choose from three different lists of hospitals. If you need to make a claim, your GP will refer you to any specialist listed within your selected hospital list.

Also, you can choose your own specialist if you prefer, either by following your GP’s recommendation or conducting your own research.


With the guided option, your GP provides an open referral, and The Exeter selects a shortlist of specialists tailored to your needs. This helps to lower premiums as they negotiate fees with their pool of specialists in advance.

You get expert recommendations based on your diagnosis and treatment needs, along with top-notch core cover and extra benefits.

Consider reading these claim instructions and downloading the policy document to understand the difference better.

The Exeter health+ insurance cover

An extensive core cover is the foundation of every Health+ policy, which provides the following:

Unlimited in-patient and day patient treatment

The Exeter’s basic cover ensures that members have access to both in-patient treatment and day patient treatment without any restrictions. You can receive treatment for as long as necessary at a participating hospital, depending on your chosen treatment option. Hospital charges (including take-home drugs and necessary medical aids) are covered under this core policy.

To assist with your in-patient treatments, you have access to our HealthWise app, which provides free medical advice directly from experts. This service is available worldwide through a smartphone or tablet and includes:

  • Remote GP appointments (unlimited) — Offer medical advice, prescribe medications if necessary, and suggest further treatment options.
  • Second medical opinions (2 consultations/year) — Allows another expert to review your diagnosis and provide a different treatment plan if needed or simply offer reassurance.
  • Mental health support (6 consultations/year) — Support for various mental health conditions like depression, anxiety, and substance abuse, along with emotional and behavioural assistance (through video calls on the app).
  • Physiotherapy (6 consultations/year) — Assessing, diagnosing, and treating musculoskeletal conditions.
  • Advice on lifestyle and nutrition (6 consultations/year) — Assist with stress management, enhancing sleep quality, and boosting motivation for exercise.
  • Consultations with registered dietitians (6 consultations/year) — Sessions with an HCPC-registered dietitian to assist with special dietary requirements related to health conditions like coeliac disease.

You can learn more about HealthWise here by downloading the product guide.

Complete cancer cover

All Health+ members receive coverage for every stage of cancer, including access to the latest medications and treatments available.

BenefitLevel of coverage
Cancer treatment and chemotherapy administered at home if neededFull
Radiotherapy, including pain relief treatmentFull
Specialist consultations, tests, and scans after diagnosisFull
Surgery, including tumour removal and reconstructive surgeryFull
Bone marrow and stem cell transplants, excluding experimental proceduresFull
Hormone therapy required during cancer treatmentFull
All types of drug therapy for cancerFull
Palliative care to control cancer symptoms or alleviate painFull
Follow-up reviews related to ongoing cancer care, including during remissionFull
End of lifeA £250 donation to a hospice, with full coverage for terminal cancer care while awaiting admission

Cancer cover has no specific time or financial limits, but it doesn’t include preventative screening, treatment, or vaccines.

Outpatient surgery

Outpatient surgical procedures must be conducted by a specialist at a qualifying hospital according to your chosen treatment option. There are no limits for such type of outpatient

Private ambulance

If a patient requires medical treatment while travelling to, between, or from the hospital, The Exeter offers a private road ambulance service. This is unlimited, too.

Home nursing

In certain cases, patients may still require nursing care after leaving the hospital. If needed, the insurer provides unlimited home nursing services for hospital stays and procedures following their treatment.

Parental accommodation

If your children need hospital treatment, you can stay with them (up to age 18) for as long as necessary. Core plan members receive unlimited accommodation.

Post-operative physiotherapy

After surgery, recovery may require more than just the procedure itself. Under The Exeter’s core cover, you can get up to three physiotherapy sessions after any type of surgery, whether it’s in the hospital, for a day, or as an outpatient.

NHS cash benefit

If you choose to receive free hospitalisation through the NHS and it’s included in your policy, The Exeter will provide NHS cash benefits for up to 30 nights, £150 per night.

Hospital choices

There are three hospital choices available, and you can find the full list on this page.


The Health Essentials plan applies to facilities from the largest hospital groups and NHS private patient units.


The Standard option broadens the range of healthcare facilities covered to include independent hospitals and clinics in addition to those already included in the Essential list.


The Extended list offers the most extensive coverage, including access to a larger selection of hospitals in London.

Underwriting options

Your policy certificate will detail the underwriting terms that apply to your policy and how they affect your coverage.

Moratorium underwriting

Benefits will not cover medical treatment for any condition if a member experienced symptoms, treatment, medication, or advice related to that condition within five years before the policy started.

However, The Exeter covers a pre-existing condition if there are no symptoms or treatment for it for two years after the policy starts.

Full medical underwriting

If your medical history mentions any existing health issues that might need treatment later, The Exeter will not cover those conditions. These exclusions are based on the info you provided during the application and help the insurer manage risk by excluding known or likely conditions.

Existing, continued or transferred underwriting

You can continue the waiting period from your previous insurance plan with The Exeter. You’ll need a certificate from your old insurer and answer questions about recent or planned medical issues. This option also has a two-year waiting period.

You can also carry continued personal medical exclusions across policies.

Health+ insurance exclusions

The Health+ policy covers private treatment for acute conditions, so certain treatments aren’t covered under this policy.

Policy exclusions

Here are some exclusions to be aware of:

  • Ongoing or long-term conditions, like diabetes or asthma, except for cancer
  • Experimental treatments or drug therapies not clinically approved by NICE
  • Pregnancy, childbirth, fertility treatments, and preventative screening procedures
  • Gender reassignment treatment
  • Alcohol, drug, or substance abuse treatment
  • Emergency treatment at A&E units or urgent care centres
  • Cosmetic, plastic, bariatric, and weight loss surgeries
  • Regular eye, ear, or dental care
  • Educational and developmental issues
  • Major organ transplants
  • Professional sports injuries
  • Self-elected treatments
  • Injuries caused intentionally
  • Treatments overseas

Cover restrictions

These are the factors that limit The Exeter’s private health services:

  • Your treatment options influence which hospitals or specialists you can use.
  • Your choices can restrict or exclude certain coverage options.
  • The Exeter has a predetermined fee schedule setting the maximum amounts they pay to specialists.
  • If your policy includes an excess, it will reduce the amount they pay for eligible treatment costs each year.

Excess options

With Health+, you can select from various excess amounts, including £0, £100, £250, £500, £1,000, £3,000, and £5,000. Opting for a lower excess amount results in a higher premium, while choosing a higher excess amount gets you a lower premium.

Outpatient cover

In Health+ coverage, you can choose to add extra outpatient benefits for diagnostic tests, such as X-rays, ECGs, and pathology tests, as well as specialist fees. The options for annual outpatient limits are £500, £1,000, or unlimited.

Additionally, coverage applies to various scans, as well as all treatments and consultations related to cancer.

Unlimited outpatient diagnostics

If you opt for an annual limit of £500 or £1,000 for outpatient cover, you can enhance this with unlimited outpatient diagnostics. With this upgrade, diagnostic tests like CT, MRI, and PET scans are fully covered, and only specialist consultation fees are deducted from your chosen limit.

Please note that if you already have unlimited outpatient coverage, this benefit is automatically included.

Mental health cover

By including a mental health option, you gain coverage for specialised treatments as an in-patient or day patient, which includes nursing and hospitalisation for up to 28 days in a psychiatric hospital. On top of that, outpatient consultations (psychiatric treatment, psychological treatment) and cognitive behavioural therapists are fully covered.

Therapies cover

With The Exeter’s extra therapies cover, you can get specialist-referred treatment. This includes physiotherapists, chiropractors, osteopaths, acupuncturists, podiatrists, speech therapists, pain clinics, or two sessions with a dietitian.

What is not covered on The Exeter health insurance?

The Exeter’s health insurance, like in most cases with any provider, excludes claims related to conditions you have before taking out the cover.

However, The Exeter has a shorter timeframe compared to some providers. While some insurers may reject claims for conditions with treatment or advice in the last five years, The Exeter does so for conditions with treatment or advice in the last two years.

Chronic condition treatment:

If The Exeter determines that a member’s condition is chronic, they’ll cover the initial tests to diagnose it and the treatment to stabilise it for up to three months. However, they won’t cover ongoing treatment once the condition is stable.

If the condition worsens and there’s an acute episode, like a severe asthma attack requiring hospitalisation, they’ll cover the treatment for that episode. So, while ongoing asthma management isn’t covered, treatment for acute episodes is.

Your policy document will contain a comprehensive list of exclusions.

Optional no claims discount with The Exeter health+ health insurance

The no claims discount system consists of fifteen levels, ranging from level 0 to level 15. The premium discount associated with each level is as follows:

Level 00% discount
Level 19% discount
Level 218% discount
Level 325% discount
Level 432% discount
Level 539% discount
Level 645% discount
Level 750% discount
Level 854% discount
Level 959% discount
Level 1063% discount
Level 1166% discount
Level 1270% discount
Level 1372% discount
Level 1474% discount
Level 1575% discount

Each member signed for the policy has their own NCD. If one member makes a claim, it won’t impact the NCD of other members. It is reviewed annually by considering the total claims paid for each member during that period.

At renewal, the NCD won’t decrease by more than three levels. The NCD levels are adjusted based on the size of the claims made by each member, as shown here:

  • If the total amount paid towards claims is £0.00, your discount level moves up by one level.
  • Between £0.01 and £300 — your remains the same.
  • Between £300.01 and £1,000 — your level moves down by one level.
  • Between £1,000.01 and £2,000, your level moves down by two levels.
  • If claims are £2,000.01 or above, your level moves down by three levels.

Claims such as the NHS cash benefit, hospice donations, and those below your excess amount will not impact the assessment of your NCD.

If your policy has NCD protection, that means that if a member makes a claim that would typically lower their NCD level, they won’t drop down the scale. Instead, they’ll stay at their current level. This protection stays in place until the policy renewal date for that member and can be reinstated if needed in the future.

Can I get health insurance if i have an existing medical condition?

You can still get health insurance from The Exeter even if you have pre-existing conditions. The coverage for them varies depending on the type of underwriting you select during the application process.

When does The Exeter health insurance reset?

The insurance cover resets at the end of the policy year, which spans 12 calendar months from the policy start date, also known as the renewal date.

Can I switch my existing health insurance cover to The Exeter?

If you already have health cover with another provider and want to switch to The Exeter, you have two options:

  1. Continued moratorium — If you’re still within the waiting period of your current plan, you can continue with it under The Exeter. If you’ve already passed this waiting period, you’ll get immediate coverage.
  2. Continued personal medical exclusions — This option lets you switch insurers while keeping the same medical exclusions as your current plan. You’ll need to provide proof of these exclusions to The Exeter.

There are some key criteria to keep in mind if you want to switch:

  • You must reside in England, Wales, Scotland, or Northern Ireland.
  • You’re responsible for paying all premiums to maintain the coverage.
  • It’s crucial to answer all application questions truthfully.
  • You must inform The Exeter about any changes in personal details, like a name or address change.
  • When making a claim, you must pay any agreed-upon excesses outlined in your policy documents.
  • Ensure that The Exeter approves your claim before initiating any treatments, tests, or consultations.

How to cancel The Exeter health insurance in the UK?

You can cancel The Exeter’s health insurance policy if you decide you no longer need the coverage or want to switch to another provider. To cancel, just get in touch with them directly:

  • Phone: 0300 123 3201
  • Hours: Monday to Friday, 8:00 am to 6:00 pm.

Can you cancel The Exeter health insurance at any time?

Yes, you can cancel at any time.

If you cancel within the 30-day cooling-off period and haven’t made any claims, you’ll receive a full refund of any payments. After the initial 30 days, if you pay annually, you may be eligible for a partial refund if you haven’t made any claims.

The Exeter health insurance contact numbers

You can reach out to The Exeter by mail at Lakeside House, Emperor Way, Exeter, EX1 3FD

That wraps up our The Exeter health insurance review, with everything from basic coverage to additional options and what’s not included.

When you compare health insurance options, it’s natural to feel overwhelmed by all the details, especially with so many insurers out there. But remember, choosing health insurance is a big decision, so take your time. If you want a deeper dive into what’s best for you, including your medical history and future needs, consider talking to a representative or specialist.