Quote

Advisers: For online quoting, log in to the Adviser's area.

To get your private health insurance quote, fill in your details below. Your quote will be valid for 30 days.


Required Cover start date


Main Applicant's Personal Details

Title First name(s) Surname
Full Title List
Gender
Male     Female    
Date of birth

Main Applicant's Contact Details

Telephone number
 
Email address
Postcode

Family members

Add an eligible family member

A few more questions

1 Does your client and all applicants to be covered currently have health insurance?
Yes    No   
2 In the event of a claim, which of our private hospital networks would you use?

Please note that Vitality GP Select is only available to plans incepting ON OR AFTER 1st July 2015. For plans incepting BEFORE 1st July customers are only able to choose from three hospital lists - Local, Countrywide or Countrywide Plus.


 

Please select a hospital list below:

    Find your nearest hospital   About our treatment paths  
3 How would you like your health insurance underwritten?
Do you need help with this question?
4 If your client would like to add an excess to their plan, would they prefer to pay the excess once per person per plan year or once per person per claim?
Do you need help with this question?
Per claim Per year


I confirm that my client agrees to the terms and conditions for this quote.
Please let us know the names of any applicants that are employed in the armed forces(including territorial army) work offshore in the extraction or refinery of natural or fossil fuels or professional or semi-professional sports. For details of what cover is available for these occupations please refer to your plan terms and conditions or the Guide to Personal Healthcare.