📅 February 2026 ⏱️ 12 min read 📂 Health Insurance PPC How to Choose a Health Insurance PPC Agency in the UK (Without Wasting Thousands) 8 questions to ask, red flags to walk away from, and what good reporting actually looks like — from someone who’s spent 20 years on the agency side of insurance PPC. […]

How to Choose a Health Insurance PPC Agency in the UK (Without Wasting Thousands)

8 questions to ask, red flags to walk away from, and what good reporting actually looks like — from someone who's spent 20 years on the agency side of insurance PPC.

Andy — PPC Director, Hero SEO

PPC Director at Hero SEO with 20 years of PPC experience. Manages over £2 million in annual ad spend for insurance clients across multiple product lines. Google Ads certified. 1,100+ clients served.

Why Health Insurance PPC Needs a Specialist, Not a Generalist

There are over 1,600 Google Partner agencies in the UK. Most of them will happily take your money and run a Google Ads campaign for you. The problem is that health insurance PPC sits at the intersection of two of the most heavily regulated areas in digital advertising — financial services and healthcare — and most agencies have never navigated either.

A generalist agency running your health insurance ads will need to figure out FCA Financial Services Verification, Google's Healthcare and Medicines policy, ASA advertising standards, and the quirks of insurance keyword economics — all on your budget and your timeline. That learning curve costs real money when clicks are £3 to £15 each.

This isn't about agencies being bad at their job. Most are competent at running standard Google Ads campaigns. But health insurance PPC has specific compliance requirements that, if handled incorrectly, result in account suspension without warning. It has keyword economics where a single missing negative keyword can drain thousands per month. And it has conversion paths where the sale happens offline, requiring tracking setups most agencies have never built.

The right agency already knows all of this. They've made the mistakes on someone else's account years ago. They have the negative keyword lists already built, the compliance checklists already written, and the FCA verification process already documented. That's what you're paying for — not the clicks, the expertise that makes the clicks count.

8 Questions to Ask Before You Sign Anything

Print this section out. Take it into every agency meeting. The answers will tell you everything you need to know.

How many insurance PPC accounts do you currently manage?

You want a number, not a dodge. "We've worked across many industries" means they don't have insurance clients. An agency managing 5+ insurance accounts will have pre-built negative keyword lists, compliance templates, and benchmark data they can apply to your campaigns from day one.

"We currently manage insurance PPC accounts, including . Here's a case study."

"We've worked across many sectors including financial services." This is vague enough to mean anything — including zero insurance experience.

Can you walk me through the FCA Financial Services Verification process for Google Ads?

This is the litmus test. If they can't explain this clearly — including the September 2025 email domain requirement — they haven't set up a UK insurance account recently. You'll be their test case.

A clear, step-by-step explanation covering FCA authorisation requirements, the approved third-party vouch process, email domain matching, and typical timelines.

"We'll handle all the compliance stuff for you" without being able to explain what that actually involves. Or, worse: "What's FCA verification?"

What negative keyword strategy would you implement for health insurance?

This separates the experienced from the theoretical. Anyone who's run PPC for insurance in the UK knows about the "national insurance" problem, the NHS bleed, and the cross-product contamination from other insurance types. These issues are amplified in health insurance because of the overlap with NHS-related searches. If the agency can rattle off the key negative keyword categories without thinking, they've dealt with insurance accounts before.

Immediately mentions NHS, national insurance number, other insurance types (car, pet, life), job seekers, complaints/ombudsman, and US-specific terms (Medicare, ACA).

"We'll build a negative keyword list once we see the search terms data." This means they'll build it with your money — burning through budget on irrelevant clicks for the first few weeks while they learn what you should be excluding.

How do you handle Google's Healthcare & Medicines policy restrictions?

Health insurance ads face Google policy restrictions that don't apply to most other industries. A specialist will know about personalised advertising restrictions, prohibited health-condition targeting, and ad copy limitations. A generalist will discover these when your ads start getting disapproved.

Explains the specific restrictions: no health-condition targeting, no "your condition" language in ads, prescription drug term restrictions, and how they write compliant ad copy that still converts.

"Google policies change all the time, we stay on top of them." This means they'll Google it when something goes wrong.

Who specifically will manage my account, and how many accounts do they handle?

The person in the pitch meeting is rarely the person managing your account day-to-day. You want to know who that person is, what their experience level is, and whether they're spread across 10 accounts or 100. An account manager handling more than 30–40 accounts cannot give yours meaningful attention.

"Your account will be managed by , who handles accounts and has years of experience with insurance PPC specifically."

"You'll have a dedicated team working on your account." This often means a junior will do the work, a senior will review it occasionally, and nobody feels personally responsible.

How do you track conversions that happen offline?

Most health insurance policies are sold over the phone or via email, not through an online checkout. If the agency can't explain how they'll track which Google Ads clicks lead to actual policy sales — not just form fills — they can't optimise your campaigns properly.

Mentions call tracking with dynamic number insertion, offline conversion imports from your CRM, GCLID tracking, and how this data feeds back into Smart Bidding.

"We track form submissions and phone calls through Google Ads." Without dynamic number insertion and CRM integration, they're only tracking half the picture.

Do I own the Google Ads account, or do you?

This is non-negotiable. You must own your Google Ads account. If the agency creates the account under their MCC (Manager Account) and you part ways, you lose your entire campaign history, Quality Score data, conversion data, and audience lists. Rebuilding from scratch can set you back months.

"You own the account. We link it to our MCC for management access, but it's yours. If we part ways, you keep everything."

"We manage everything through our agency account for efficiency." This is a lock-in tactic. Walk away.

What does your reporting look like — and what metrics do you focus on?

The answer reveals whether the agency is focused on making you money or making themselves look busy. Reports stuffed with impressions, clicks, and CTR are designed to impress, not inform. What you need is cost per lead, cost per acquisition, lead-to-sale conversion rate, and return on ad spend.

"We report on CPL, CPA, lead quality, and ROAS. Here's a sample report." — and the sample report actually shows these metrics clearly.

"We provide comprehensive monthly reports with full campaign analytics." Comprehensive usually means 30 pages of data you'll never read, with the numbers that matter buried on page 22.

Red Flags That Should Make You Walk Away

Beyond the questions above, watch for these warning signs during the sales process. Every one of these comes from real situations I've seen across 20 years of managing insurance PPC — patterns that repeat regardless of the insurance product being advertised.

Nobody can guarantee a £5 CPC or 50 leads per month before they've seen your account, your market, and your competitors. Any agency that makes specific promises before doing an audit is either lying or has no idea what they're getting into. A good agency will give you realistic ranges based on benchmark data — which is exactly what our health insurance PPC cost guide is designed to help with.

Long lock-in contracts protect the agency, not you. If they're confident in their work, they shouldn't need to trap you. Look for agencies offering monthly rolling contracts or 3-month initial terms with monthly thereafter. You should be able to leave if the results aren't there.

If an agency is reluctant to give you full access to your Google Ads account, that's a major red flag. Transparency means you can see exactly what's being done, what's being spent, and what's working. Some agencies operate a "black box" model because they don't want you to see how little work is actually being done.

Agencies on percentage-of-spend pricing are incentivised to increase your spend regardless of performance. If the first recommendation in month two is "you need to spend more," before they've demonstrated that your current spend is converting efficiently, question their motives.

If the agency only talks about clicks and leads without asking how your sales team handles enquiries, how quickly you respond to leads, and what your lead-to-sale conversion rate is, they're not thinking about your business — they're thinking about their dashboard. PPC doesn't exist in isolation. The best leads in the world are worthless if they sit in an inbox for 48 hours.

Understanding Agency Pricing

PPC agency pricing in the UK varies wildly. Here's what the main models look like and what's fair for health insurance campaigns.

For health insurance PPC specifically, I'd argue fixed retainer or setup + monthly models are fairest for both sides. Health insurance has high CPCs, which means percentage-of-spend fees can become disproportionate to the actual work involved. A £10,000/month ad spend at 15% means you're paying £1,500 in management fees — which might be reasonable, but it should reflect the actual effort, not just a percentage.

Hidden Costs to Watch For

• Landing page development — Some agencies quote management only, then charge separately for landing pages. Clarify this upfront.
• Call tracking — Essential for insurance PPC. Some agencies include it, others charge £50–£150/month extra.
• Reporting tools — If they use premium reporting platforms (Data Studio, Looker, etc.), check whether that cost is included.
• Ad copy writing — Most agencies include this, but some charge for "creative services" on top of management.

In-House vs Agency: An Honest Assessment

I run an agency, so you'd expect me to say "hire us." But the honest answer is that in-house management works for some companies. Here's when each option makes sense.

There's also a hybrid model that works well for larger insurance companies: an in-house marketing manager who owns the strategy and relationship, with an agency handling the day-to-day execution and technical optimisation. This gives you control without needing deep PPC specialisation in-house.

Want to See How We'd Handle Your Account?

We'll audit your current Google Ads setup (or build a proposal from scratch), walk you through our approach, and give you honest benchmark expectations — before you commit to anything. No contracts, no pressure.

Frequently Asked Questions

UK PPC agency management fees for health insurance typically range from £500 to £3,000 per month, depending on the pricing model and complexity of your campaigns. This is on top of your actual ad spend. Percentage-of-spend models charge 10–20% of your monthly budget. Fixed retainers offer more predictable costs. For a detailed breakdown of total campaign costs including ad spend, see our health insurance PPC cost guide.

Proven insurance PPC experience with named case studies. Knowledge of FCA Financial Services Verification and Google's Healthcare & Medicines policy. Transparent reporting focused on cost per lead and cost per acquisition (not just clicks). Account ownership staying with you. No long lock-in contracts. And a named account manager who you can actually speak to — not a generic "team" that passes you around.

Leads should start coming in within the first 1–2 weeks if the agency knows what they're doing. However, proper optimisation takes 4–8 weeks as data accumulates and the agency refines targeting, bids, and ad copy. Be wary of any agency that says they need 3–6 months before you'll see any results — that's often a sign they're still learning. Equally, be wary of agencies promising instant results, as FCA verification alone can take 1–3 weeks.

Always use your own Google Ads account. If you have an existing account with conversion history, that data is invaluable and should not be abandoned. If you're starting fresh, create the account under your own Google account and grant the agency management access via their MCC. This ensures you retain all campaign data, Quality Scores, and audience lists if you ever change agency.

A generalist PPC agency manages campaigns across many industries — retail, SaaS, hospitality, etc. They know Google Ads well but may not know the specific compliance requirements, keyword economics, or conversion dynamics of health insurance. A specialist agency (or one with deep insurance experience) brings pre-built frameworks for compliance, campaign structure, and keyword strategy that a generalist would need weeks or months to develop. For regulated, high-CPC industries like health insurance, the specialist typically delivers faster results at lower risk.

Check three things. First, do you know your cost per lead and cost per acquired customer? If not, your tracking isn't set up properly. Second, look at your search terms report — are you paying for irrelevant clicks (NHS searches, national insurance, job seekers)? If so, negative keywords are being neglected. Third, has performance improved over time? A good agency should be improving CPL and lead quality month on month as they optimise. If you're unsure, a free PPC audit from a second agency will quickly reveal whether your current setup is performing well or underperforming.

See What 20 Years of Insurance PPC Experience Looks Like

No hard sell. We'll review your current setup (or outline a plan from scratch), give you honest benchmarks, and explain exactly what we'd do differently. If we're not the right fit, we'll tell you.