It's renewal time again. The private medical insurance (PMI) quote has landed, the premium has gone up, and your budget is exactly where it was last year. Sooner or later, someone asks whether it's time to look at who's eligible.
It's an understandable reaction. But reducing eligibility means some of your people lose access to healthcare support at a time when NHS waiting lists are long and many employees value that cover. Our advice: start with the policy itself.
PMI is often one of the biggest items in a health and wellbeing budget, so it makes sense to begin there. Every policy is made up of design choices, and several of them can reduce your private medical insurance premium while keeping the cover useful to your employees.
The trick is knowing which ones to look at.
WTW expects UK medical costs to rise by 10% in 2026, after a 10.6% increase in 2025. Employers are also dealing with ongoing pressure on the NHS and a higher National Insurance bill. Budgets are being squeezed on several fronts at once.
Reducing eligibility can look like the easy answer. There are other levers to try first.
The excess: Asking employees to contribute more towards a claim can bring the premium down.
Nobody's suggesting you cut a policy to the bone. The aim is to understand which choices drive the cost and which ones employees will notice.
When money is tight, many employers give richer cover to fewer people, but there's another route. Give more employees a focused level of cover and let individuals pay for extras if they want them.
The question then becomes how many of your people you can reach, rather than how much PMI the budget stretches to. Employees who want broader cover can upgrade at their own cost. Those happy with core cover stop paying for features they won't use. Eligibility conversations move away from seniority and towards the level of support everyone receives.
This won't suit every business. You'll need to check eligibility, underwriting and tax treatment, and the flex set-up has to be easy for employees to engage with. Still, it deserves a hearing before a cut to eligibility goes through by default.
Take a policy right back and you might be left with inpatient treatment and cancer care alone. Consultations, blood tests and scans can drop out of cover.
By the end of July, 6.21 million patients were waiting for NHS treatment, with around 111,000 of them waiting more than a year.
With waits like that, a policy that only helps once someone needs a hospital stay may miss the chance to investigate and treat problems earlier.
Ciphr asked 2,000 UK employees which of 48 benefits mattered to them. Paid sick leave topped the list at 68%. Private health insurance was valued by 37%, putting it joint tenth. Mental health and wellbeing support followed on 35%, with private GP access on 29%.
PMI is only one part of the picture. Core PMI combined with private GP access, mental health support and physiotherapy could meet more employee needs than spending the whole budget on premium cover.
Check for overlap too. Some employers pay separately for services that are already included in another part of their healthcare provision.
Don't forget prevention. Your healthcare package may already include health assessments, screening and digital tools. Employees can only use them if they know they're there.
Technology can make support easier to reach, but employees still need clear benefits communication to make use of it: what's on offer, why it's worth using, and when to turn to it.
REBA's Health and Wellbeing Research 2026 found that only 9% of employers have joined up their health benefits into one continuous journey. In many organisations, benefits and cover levels have been added bit by bit over the years. Renewal is a good time to review the whole lot, rather than just the quote on the table.
Questions to ask before your next renewal:
A premium policy has its place. But employees don't feel policy features. What they feel is getting advice, a diagnosis and treatment when they need it.
Healthcare cover doesn't need to be top tier to deliver value, but it does need to fit your workforce and be easy for employees to reach.
FlexGenius makes it easier to put this approach into practice.
You can offer core healthcare cover to everyone and let employees choose to upgrade or add extra healthcare benefits themselves, all through one platform. Employees who want more can buy it. Those who don't aren't paying for cover they'll never use.
Because all your benefits sit in one place, employees can see their full healthcare offer at a glance, from PMI to GP access, mental health support and health assessments. It also gives you a clearer view of what you're providing, which helps you spot duplication before renewal.
FlexGenius helps with communication too. You can send targeted messages to the right employees at the right moment, whether that's a reminder when enrolment opens or a prompt about support they may not know they have. Take-up data shows you which benefits people are actually using, so you go into your next renewal with evidence rather than guesswork.
Book a demo or download the brochure to find out how FlexGenius can help you get more from your healthcare budget.