How to support employees with chronic conditions through PMI

Private medical insurance (PMI) is one of the UK’s most valued employee benefits, offering fast access to treatment and easing NHS pressure. Yet for your employees with chronic conditions, it often falls short and exclusions can leave those most in need without support.

As long-term physical and mental health conditions become more common, these exclusions risk undermining inclusive wellbeing strategies. So how can employers ensure all employees still receive meaningful health support?

Why is it so important for employers? 

Chronic illnesses is one of the biggest challenges facing both individuals and businesses. Around one in four UK adults is living with at least one long-term condition, and a figure that rises significantly with age, according to the Office for National Statistics. 

For employers, the impact is clear: 

• higher absence rates; 
• increased presenteeism; 
• reduced productivity;
• the potential to develop into a long-term disability if left unmanaged; and 
• recruitment pressures when staff are unable to work. 

There is also a cultural and reputational dimension. Employers are increasingly expected to demonstrate that their benefits are fair and inclusive. If PMI is seen as a “perk for the healthy,” it may conflict with wider diversity and wellbeing goals. Forward-thinking organisations are therefore looking for innovative ways to bridge the gap.

How to bridge the gap in health support 

Hybrid and supplementary cover

PMI works best when combined with other health benefits, such as cash plans, employee assistance programmes (EAPs), or specialist clinic access to help employees with chronic conditions receive day-to-day support, even if their PMI policy excludes treatment.

A cash plan, for instance, can cover the cost of routine therapies, diagnostic tests, or GP consultations. When combined with PMI, employees have a more rounded package.

Condition-specific pathways

Employers are increasingly adopting targeted support for commonly excluded conditions.

Examples include:

• Diabetes management programmes that include remote monitoring and lifestyle coaching.
• Musculoskeletal (MSK) pathways offering app-based physiotherapy backed by in-person clinical support.
• Mental health apps and talking therapies with no exclusion criteria.

These interventions help prevent conditions from escalating into acute, costly episodes.

Preventive and proactive health support

Exclusions often focus on long-term treatment, but employers can invest in prevention. Health screenings, wearable technology, lifestyle programmes, and proactive physiotherapy support can all reduce the long-term impact of chronic illness.

By helping employees understand and manage their health risks earlier, organisations can reduce the likelihood of chronic conditions deteriorating. Prevention also aligns closely with environmental, social and governance (ESG) and wellbeing strategies, demonstrating a genuine commitment to long-term employee health. 

Self-insured or trust-based solutions

Larger organisations may opt for healthcare trusts, giving them greater control over what is covered. With stop-loss insurance to manage risk, trusts allow employers to design more inclusive benefits that reflect their workforce’s needs.

Insurer innovation

The insurance market itself is gradually adapting. Some providers now offer moratorium underwriting that review exclusions over time, rather than applying blanket exclusions for life. Whereas others are piloting add-ons for specific conditions or building digital health solutions directly into PMI packages. These innovations suggest a more flexible future for PMI. 

A more inclusive approach to employee health

PMI remains a powerful cornerstone of employee benefits, but on its own it is rarely enough for a workforce increasingly affected by chronic conditions. By layering benefits, investing in prevention, and exploring innovative models, employers can ensure meaningful health support for all employees - not just the healthiest ones.
In doing so, they protect productivity, strengthen inclusion, and demonstrate a genuine commitment to long-term wellbeing.

Building inclusive health ecosystems

PMI exclusions may remain a feature of the market, but they should not define the limits of employee health support. Employers have both an opportunity and a responsibility to build wellbeing strategies that extend beyond the boundaries of traditional insurance.

By identifying gaps, layering benefits, and investing in prevention, organisations can create inclusive health ecosystems that support all employees, particularly those living with chronic conditions. To be effective, these strategies must also be measurable and adaptable - tracking engagement, monitoring outcomes, and evolving in response to workforce needs.