Switching jobs can be exciting, but it often brings a tangle of questions about your private medical insurance (PMI). Will your new employer’s scheme pick up where the old one left off? Could a short gap leave you unprotected for pre-existing conditions? And what about tax—will you owe more, or less, under new payrolling rules? Here’s what you need to know to keep your cover on track and avoid unpleasant surprises.
Continuity of Cover: Avoiding Gaps and Exclusions
Most UK group PMI schemes—offered by providers like Bupa, AXA Health, Aviva, Vitality, and WPA—use either moratorium or full medical underwriting. The difference matters when you change jobs:
Moratorium underwriting: Pre-existing conditions are excluded for a set period (often two years) unless you’ve been symptom-free. If you move jobs and there’s even a short gap in cover, you may have to restart the clock on exclusions.
Full medical underwriting: You disclose your medical history upfront. Pre-existing conditions are usually excluded unless you can show continuous, unbroken cover. If there’s a break—even a weekend—your new insurer may refuse to cover a previous condition.
Continuity is key. Always request a continuity letter from your current insurer before you leave. This document confirms your cover dates and underwriting type, which your new employer’s scheme may require to maintain your protection for pre-existing conditions.
A Messy, Realistic Example
Imagine Sarah, who worked at Company A with group PMI from Bupa under moratorium underwriting. She accepted a new job at Company B, which uses AXA Health. Her last day was Friday, and her new job started the following Monday. She assumed the cover would transfer smoothly. Six months later, she needed treatment for a knee problem she’d had years ago. AXA refused the claim, saying her cover had lapsed over the weekend and the moratorium period restarted. Sarah had to appeal, providing her continuity letter and medical history, and spent weeks in limbo before her claim was finally reconsidered.
Practical Steps When Changing Jobs
Request a continuity letter from your current insurer before leaving.
Ask your new employer (HR or benefits team):
Which insurer do they use?
What type of underwriting is in place (moratorium or full medical)?
Will they accept your continuity letter to maintain cover for pre-existing conditions?
Are there any waiting periods or new exclusions?
Check for gaps between your old and new cover dates. Even a short break can affect your eligibility for cover on existing conditions.
Review your tax position. Employer-paid PMI is a taxable benefit unless an exemption applies. For the 2025/26 tax year, it is usually reported on your P11D. From April 2027, HMRC is phasing in mandatory payrolling of benefits in kind for certain benefits, including medical insurance. If your employer misreports or omits the benefit, you could face unexpected tax bills.
Keep evidence: Save all policy documents, emails, letters, and screenshots. If you need to dispute a claim or tax issue, this paperwork is essential.
What to Ask Your HR, Insurer, Broker, or Doctor
Can you confirm the exact date my old cover ends and my new cover begins?
Will my pre-existing conditions be covered without a new waiting period?
If I have ongoing treatment, will there be any interruption or need for new authorisation?
How will my PMI be reported for tax purposes (P11D or payrolling)?
What evidence do I need to provide to ensure continuity?
Underwriting Types and Transferability: At a Glance
Provider | Underwriting Type | Transferability |
|---|---|---|
Bupa | Moratorium & Full Medical | Usually transferable with continuity letter |
AXA Health | Moratorium | Strict on gaps; continuity letter required |
Aviva | Full Medical | Transferable with full disclosure and documentation |
Vitality | Moratorium | Requires documentation; check for waiting periods |
WPA | Moratorium | Less flexible; gaps may trigger exclusions |
Conversion Options If You’re Not Moving to Another Employer Scheme
If your new employer doesn’t offer PMI, you may be able to convert your group cover to an individual policy. This usually needs to be arranged within a set period (often 30 days) after leaving your old scheme. Conversion terms vary, so check with your insurer or broker as soon as possible if you’re considering this route.
Handling Disputes and Escalating Complaints
If you run into problems—like a claim being refused due to a gap in cover, or a dispute over pre-existing conditions—start by gathering all your evidence. Contact your insurer and ask for a written explanation. If you’re not satisfied, you can escalate to the Financial Ombudsman, who handles private medical and dental insurance complaints, including those about pre-existing conditions and policy exclusions.
How Caira by Unwildered Can Help
Changing jobs and navigating private health insurance can feel overwhelming, especially when paperwork and timelines get messy. Caira by Unwildered lets you upload your policy documents, letters, screenshots, emails, medical notes, and bills. Caira can compare policy wording, organise your evidence, draft questions or emails, and help you understand your next steps—day or night. No question is too basic, and having everything organised can make all the difference if you need to challenge a decision or clarify your position.
Useful Starting Points
This article is general information, not legal, tax, insurance, financial or medical advice.
