Private medical insurance BiK tax UK

UK private medical insurance (PMI) provided by your employer is a taxable Benefit in Kind. The annual premium — typically £600 (young single) to £2,500 (family + comprehensive) — is treated as additional income. For a higher-rate worker on a £1,200 premium, the annual tax bill is ~£480 (40% + implicit NI position). Even with the tax, PMI is usually worth having as a benefit — the untaxed value of avoided NHS wait times, quicker consultant access, and private treatment routinely exceeds the tax cost.

Verified against 4 official sources · Last reviewed 14 June 2026
On this page
  1. Tax mechanic
  2. Cost by band
  3. Salary sacrifice option
  4. When PMI worth it
  5. Family cover BiK
  6. In short

Tax mechanic

  • Employer pays the premium
  • Premium value becomes your taxable BiK
  • Reported on P11D annually
  • HMRC adjusts your tax code to collect the tax

Cost by band

At a £1,200/year premium:

Band Annual tax Monthly tax
Basic rate (20%) £240 £20
Higher rate (40%) £480 £40
Additional (45%) £540 £45

Salary sacrifice option

Some employers offer PMI via salary sacrifice: - Gross salary reduced by the premium - Employer pays PMI provider - You save Income Tax + NI on the sacrificed slice - No BiK charge (because you never received it as salary)

Net effect: your take-home reduces by only ~£580–£720 for £1,200 of PMI value.

Not all employers offer this. Ask HR.

When PMI worth it

  • Yes for: fast access to specialists, elective surgery routes, family coverage
  • Sometimes no: young single with excellent NHS access + low chronic-condition risk

Value depends on region — private access has bigger delta from NHS wait times in London + South East.

Family cover BiK

Spouse + kids adds to premium — usually £1,800–£3,000. Same BiK treatment. High-rate workers can end up paying £1,000–£1,500/year in tax on family PMI.

In short

UK PMI provided by employer is a BiK. Premium of £1,200 costs £480 tax/year for higher-rate. Salary sacrifice option (where available) makes it dramatically cheaper — often net positive.

Frequently asked questions

How is PMI reported to HMRC?

Employer reports on P11D annually. HMRC adjusts your tax code the following year to collect the tax.

Can I opt out of PMI to avoid tax?

Yes — most employer schemes are opt-in. Assess whether the untaxed value exceeds the tax cost.

Do I pay NI on PMI?

Employees no. Employers pay Class 1A NI at 13.8% on the premium.

What if I use PMI heavily one year?

No effect on BiK — you're taxed on the premium value regardless of usage.

What about excess/co-pay?

The excess/co-pay you personally pay is NOT taxable — only the employer-paid premium.

Glossary terms used on this page

Quick definitions for the key terms above.

  • Salary sacrifice — An arrangement where you give up part of your gross salary in exchange for a non-cash benefit (most commonly pension contributions), reducing your Income Tax and National Insurance.

Sources

All figures on this page are sourced from official UK government publications. We don't cite secondary commentary or other calculator sites.

  1. GOV.UK — Employer-provided benefits (Expenses and benefits)
  2. GOV.UK — P11D form
  3. GOV.UK — Income Tax rates
  4. MoneyHelper — Employee benefits

All tax figures on this page use the same configuration that powers our calculators — see our editorial standards for the review process.

Last reviewed: 14 June 2026. Next review due 14 December 2026.

Disclaimer: This page provides general information based on published HMRC and gov.scot figures. It is not personal tax or financial advice. For your specific situation, please consult a qualified accountant or contact HMRC directly.