TL;DR
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr provides expert analysis of the UK private medical insurance market. This guide compares comprehensive outpatient cover from two leading providers, AXA Health and Aviva, helping you make an informed choice for your health and peace of mind. WeCovr compares outpatient benefits from two top UK providers Choosing the right private medical insurance (PMI) can feel like navigating a maze of options, especially when it comes to outpatient cover.
Key takeaways
- Speedy Diagnosis: It pays for the initial consultations with specialists and the diagnostic tests (like MRI, CT scans, and blood tests) needed to find out what's wrong.
- Prompt Treatment: It covers treatments that don't require a hospital bed, such as physiotherapy, osteopathy, and sessions with a clinical psychologist.
- Avoiding NHS Queues: With NHS waiting lists in England reaching record levels, having outpatient cover means you can bypass these queues for diagnosis and get on the path to recovery much faster. According to recent NHS England data, millions are waiting for consultant-led elective care, with many waiting over 18 weeks.
- AXA Health: Part of the global AXA Group, AXA Health is a specialist health and wellbeing company. They are known for their focus on proactive health support and a wide range of policy options, including their flagship 'Personal Health' plan.
- Aviva: As the UK's largest general insurer, Aviva has a vast presence. Their 'Healthier Solutions' policy is a cornerstone of the private medical insurance UK market, prized for its clarity and comprehensive cancer cover.
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr provides expert analysis of the UK private medical insurance market. This guide compares comprehensive outpatient cover from two leading providers, AXA Health and Aviva, helping you make an informed choice for your health and peace of mind.
WeCovr compares outpatient benefits from two top UK providers
Choosing the right private medical insurance (PMI) can feel like navigating a maze of options, especially when it comes to outpatient cover. This single feature can be the difference between a policy that simply covers hospital stays and one that provides rapid access to diagnostics and treatment from the very first consultation.
In this comprehensive guide, we put two of the UK’s most respected PMI providers, AXA Health and Aviva, under the microscope. We’ll break down exactly what their outpatient options include, how they differ, and which might be the best fit for you and your family.
What is Outpatient Cover and Why Does It Matter?
Before we dive into the specifics, let's clarify what "outpatient" means in the context of health insurance.
An outpatient is someone who receives medical care—such as a consultation, test, or minor procedure—at a hospital or clinic but does not need to be admitted for an overnight stay. In contrast, an inpatient is formally admitted to a hospital bed.
Outpatient cover is arguably one of the most valuable components of a modern PMI policy. Why? Because it covers the crucial first steps of your medical journey:
- Speedy Diagnosis: It pays for the initial consultations with specialists and the diagnostic tests (like MRI, CT scans, and blood tests) needed to find out what's wrong.
- Prompt Treatment: It covers treatments that don't require a hospital bed, such as physiotherapy, osteopathy, and sessions with a clinical psychologist.
- Avoiding NHS Queues: With NHS waiting lists in England reaching record levels, having outpatient cover means you can bypass these queues for diagnosis and get on the path to recovery much faster. According to recent NHS England data, millions are waiting for consultant-led elective care, with many waiting over 18 weeks.
Without outpatient cover, you would rely on the NHS for your initial diagnosis and then potentially use your PMI only for the inpatient surgery itself. Comprehensive outpatient cover ensures your entire private healthcare journey is seamless and swift.
A Quick Look at AXA and Aviva: Two Titans of UK Insurance
AXA Health and Aviva are household names in the UK, both with a long-standing reputation for providing robust insurance products. They are titans of the industry, underwriting policies for millions of individuals and businesses.
- AXA Health: Part of the global AXA Group, AXA Health is a specialist health and wellbeing company. They are known for their focus on proactive health support and a wide range of policy options, including their flagship 'Personal Health' plan.
- Aviva: As the UK's largest general insurer, Aviva has a vast presence. Their 'Healthier Solutions' policy is a cornerstone of the private medical insurance UK market, prized for its clarity and comprehensive cancer cover.
Both providers offer excellent core products, but their approach to optional benefits like outpatient cover has key differences.
Core PMI Cover: What's Included as Standard Before Outpatient Add-ons?
All PMI policies start with a core module. This is the foundation of your cover and typically includes treatment received as an inpatient or day-patient.
Here’s what is generally included as standard with both AXA and Aviva's core plans:
| Feature | Description |
|---|---|
| Inpatient Treatment | Covers costs if you are admitted to a hospital bed for treatment, including surgery, accommodation, and nursing care. |
| Day-Patient Treatment | Covers scheduled surgery or treatment where you are admitted to a hospital or clinic but do not stay overnight. |
| Comprehensive Cancer Cover | Both providers offer extensive cancer cover as standard, including surgery, chemotherapy, and radiotherapy. |
| Hospital Fees & Specialist Charges | Pays for the costs associated with your hospital stay and the fees charged by surgeons and anaesthetists. |
Outpatient cover is an optional extra that you add to this core plan. You can choose different levels of cover, from full, unlimited cover to a capped amount per policy year.
Critical Reminder: Pre-existing and Chronic Conditions
This is one of the most important principles of private medical insurance in the UK. Standard PMI policies are designed to cover acute conditions that arise after you take out the policy.
- An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery (e.g., a cataract, joint replacement, hernia).
- A chronic condition is an illness that cannot be cured, only managed (e.g., diabetes, asthma, high blood pressure, arthritis).
- A pre-existing condition is any ailment for which you have experienced symptoms, received medication, or sought advice before your policy's start date.
Standard PMI policies from AXA, Aviva, and other UK providers do not cover the routine management of chronic conditions or treatment for pre-existing conditions. This is a fundamental rule of the market. The purpose of PMI is to get you diagnosed and treated for new, curable medical issues, quickly.
AXA Health's Outpatient Cover Options: A Deep Dive
AXA Health's 'Personal Health' plan is modular, allowing you to build a policy that suits your needs and budget. Their outpatient options are clear and flexible.
1. Full Outpatient Cover This is their most comprehensive option. If you choose this, AXA will pay in full for:
- Specialist Consultations: No limit on the number of sessions.
- Diagnostic Tests & Scans: MRI, CT, and PET scans are covered in full when referred by a specialist.
- Outpatient Therapies: Physiotherapy, osteopathy, and chiropractic treatment are covered if you add the 'Therapies' option.
2. Standard Outpatient Cover This option provides a good balance of cover and cost. It includes:
- Specialist Consultations & Diagnostic Tests: Covered in full.
- MRI, CT, and PET Scans: Covered in full.
- Important Note: This option does not cover outpatient therapies like physiotherapy unless you purchase the separate 'Therapies' add-on.
3. Limited Outpatient Cover (Financial Cap) A more budget-friendly choice where you set a financial limit on your outpatient claims per year. AXA typically offers caps such as £500, £1,000, or £1,500.
- This limit applies to all outpatient consultations, tests, and scans combined.
- Once you reach your annual limit, you would need to self-fund any further outpatient care or use the NHS.
4. The 'Therapies' Option For AXA, therapies are a separate add-on. If you want cover for physiotherapy, osteopathy, or chiropractic sessions, you must add this option. It covers a set number of sessions per year following a GP or specialist referral.
AXA's Outpatient Structure Summary
| Option | Specialist Consultations & Tests | Scans (MRI, CT, PET) | Therapies (Physio, etc.) |
|---|---|---|---|
| Full Outpatient | Covered in Full | Covered in Full | Requires 'Therapies' add-on |
| Standard Outpatient | Covered in Full | Covered in Full | Requires 'Therapies' add-on |
| Limited Outpatient | Covered up to annual limit | Covered up to annual limit | Requires 'Therapies' add-on |
Aviva's Outpatient Cover Options: A Detailed Analysis
Aviva’s 'Healthier Solutions' policy also offers different tiers of outpatient cover. Their approach integrates therapies more directly into their outpatient limits, which is a key point of difference from AXA.
1. Full Outpatient Cover Aviva’s top-tier option pays in full for eligible outpatient treatment, including:
- Consultations & Diagnostics: No yearly financial limit.
- Physiotherapy & Complementary Therapies: Covered in full when referred by a specialist.
2. Limited Outpatient Cover (Financial Cap) Aviva provides several financial limits to choose from, typically £500, £1,000, or £1,500 per policy year.
- This single financial pot covers specialist consultations, diagnostic tests, scans, and therapies (including physiotherapy).
- This is a crucial difference: with Aviva's capped options, your physiotherapy sessions will draw down from the same limit as your MRI scan and specialist consultations.
3. Diagnostics Only Cover Aviva also offers a 'Limited Diagnostics' option. This does not cover consultations with a specialist but will cover the cost of diagnostic tests and scans if a specialist refers you on the NHS. It's a lower-cost way to speed up the diagnostic part of your journey.
Aviva's Outpatient Structure Summary
| Option | Specialist Consultations | Scans & Diagnostics | Therapies (Physio, etc.) |
|---|---|---|---|
| Full Outpatient | Covered in Full | Covered in Full | Covered in Full |
| Limited Outpatient (£500-£1500) | Covered up to annual limit | Covered up to annual limit | Covered up to annual limit |
| Limited Diagnostics | Not Covered | Covered (on NHS referral) | Not Covered |
Side-by-Side Comparison: AXA vs Aviva Outpatient Benefits
This table highlights the key differences in how AXA and Aviva structure their comprehensive outpatient cover.
| Feature | AXA Health (Personal Health) | Aviva (Healthier Solutions) | WeCovr's Expert Take |
|---|---|---|---|
| 'Full Cover' Philosophy | 'Full Outpatient' covers consultations and scans. Therapies are a separate add-on. | 'Full Outpatient' is truly comprehensive and includes consultations, scans, and therapies under one umbrella. | Aviva's 'Full' option is simpler and more all-inclusive. AXA's modular approach offers more granular control, which may suit some buyers. |
| 'Limited Cover' Structure | The financial cap applies only to consultations and diagnostics. Therapies are covered separately if added. | The financial cap is a single pot for consultations, diagnostics, and therapies combined. | Aviva's single pot is easier to understand but can be used up quickly. AXA's separation can protect your therapy cover from being eroded by expensive scans. |
| Therapy Access | Requires the specific 'Therapies' add-on. Can be accessed via GP referral (on some plans). | Included within the main outpatient limits. Typically requires a specialist referral. | AXA's direct GP referral for physio can be faster. Aviva's inclusion is simpler if you opt for full cover. |
| Diagnostics Only Option | Not typically offered as a standalone outpatient option. | Available as 'Limited Diagnostics', covering scans only. | This is a useful budget option from Aviva for those mainly concerned with the cost and wait times for scans like MRIs. |
| Mental Health Pathway | Strong mental health cover, often with options for outpatient psychology sessions. | Also provides robust mental health cover, with access to therapists and psychologists. | Both are excellent in this area. The specifics of which conditions are covered can vary, making a detailed comparison by a PMI broker essential. |
Real-Life Scenarios: How Outpatient Cover Works in Practice
Let's see how these differences play out with a common medical issue.
Scenario: Persistent Back Pain
- Policyholder: David, a 42-year-old office worker with a new policy.
- Problem: Develops persistent lower back pain that isn't getting better.
Journey with Aviva 'Full Outpatient' Cover:
- David's GP refers him to an orthopaedic specialist.
- He sees the specialist privately within a week. (Consultation covered).
- The specialist recommends an MRI scan to rule out a disc issue. David has the scan two days later. (Scan covered).
- The scan reveals muscle strain, and the specialist refers him for six physiotherapy sessions. (Therapy covered).
- All costs are covered in full by his Aviva policy.
Journey with AXA 'Standard Outpatient' + 'Therapies' Add-on:
- David's GP refers him to an orthopaedic specialist.
- He sees the specialist privately. (Consultation covered).
- The specialist recommends an MRI scan. (Scan covered).
- The scan reveals muscle strain, and the specialist recommends physiotherapy. Because David wisely included the 'Therapies' add-on, his six sessions are covered.
- All costs are covered. If he hadn't chosen the 'Therapies' add-on, he would have had to pay for the physio himself or use the NHS.
Journey with Aviva '£1,000 Outpatient Limit' Cover:
- Specialist Consultation: £250
- MRI Scan: £450
- Remaining Limit: £1,000 - £250 - £450 = £300
- The specialist recommends six physiotherapy sessions at £60 each (£360 total).
- Aviva covers the first five sessions (£300). David must self-fund the final session (£60).
As you can see, the structure of the outpatient cover matters immensely. The WeCovr team can walk you through these scenarios to find the policy structure that best protects you against the health issues you're most concerned about.
How Much Does Comprehensive Outpatient Cover from AXA and Aviva Cost?
The cost of private health cover is highly personal. It's influenced by:
- Age: Premiums increase as you get older.
- Location: Costs are higher in central London and other major cities due to higher hospital charges.
- Level of Cover: Full outpatient cover is the most expensive option.
- Excess: A higher excess (the amount you pay towards a claim) will lower your premium.
- Hospital List: Choosing a more restricted hospital list reduces the price.
- No Claims Discount (NCD): Your premium will be lower if you have a history of not claiming.
Below are illustrative monthly premiums for a 40-year-old non-smoker living in Manchester. These are estimates only and will vary.
| Provider & Cover Level | Excess | Estimated Monthly Premium |
|---|---|---|
| AXA Personal Health (Core + Full Outpatient + Therapies) | £250 | £95 |
| AXA Personal Health (Core + £1,000 Outpatient + Therapies) | £250 | £70 |
| Aviva Healthier Solutions (Core + Full Outpatient) | £250 | £90 |
| Aviva Healthier Solutions (Core + £1,000 Outpatient) | £250 | £65 |
Key Takeaway: The pricing is often very competitive. Aviva's limited option may appear slightly cheaper because the £1,000 cap has to cover therapies as well, whereas the AXA example includes a separate therapy allowance. This is why a simple price comparison is not enough—you need to understand what you're getting for your money.
Added Value Benefits: What Else Do AXA and Aviva Offer?
PMI is no longer just about claims. Both providers offer a suite of wellness benefits to help you stay healthy.
- Digital GP Services: Both AXA (Doctor at Hand) and Aviva (Aviva Digital GP) provide 24/7 access to a GP via phone or video call, often with prescription delivery services.
- Wellness Programmes: AXA's 'ActivePlus' and Aviva's wellbeing services offer discounts on gym memberships, fitness trackers, and health screenings.
- Mental Health Support: Both have dedicated phone lines and resources for mental health, separate from the main policy benefits.
- Member Discounts: Policyholders get access to exclusive offers on a range of products and services.
WeCovr's Added Value: At WeCovr, we believe in promoting proactive health. That's why when you take out a PMI or Life Insurance policy through us, we provide:
- Complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero.
- Exclusive discounts on other types of insurance, such as travel or home cover, helping you save money across the board.
Why Use a PMI Broker like WeCovr?
You could go directly to AXA or Aviva, but you would only see one side of the picture. An independent, FCA-authorised broker like WeCovr works for you, not the insurer.
- Whole-of-Market Advice: We compare policies from AXA, Aviva, Bupa, Vitality, and other leading UK providers to find the perfect match for your needs.
- Expert Guidance: We decipher the jargon and explain the crucial differences in policy wording (like the therapy cover example) that you might otherwise miss.
- No Extra Cost: Our service is completely free to you. We are paid a commission by the insurer you choose, which is already built into the premium. You don't pay a penny more for our expert advice.
- Hassle-Free Process: We handle the paperwork and application, ensuring it's all done correctly.
- High Customer Satisfaction: Our clients consistently rate our service highly for its clarity, friendliness, and effectiveness.
Frequently Asked Questions (FAQs) about AXA, Aviva, and Outpatient Cover
What's the main difference between AXA's and Aviva's limited outpatient cover?
Is full outpatient cover always worth the extra cost?
Does private health insurance cover pre-existing or chronic conditions?
The Verdict: AXA or Aviva for Comprehensive Outpatient Cover?
Both AXA and Aviva offer outstanding private medical insurance with excellent comprehensive outpatient options. There is no single "best" provider—only the best provider for you.
- Choose Aviva if you value an all-in-one, simple-to-understand 'Full Outpatient' benefit that bundles everything together.
- Choose AXA if you prefer a more modular approach, allowing you to protect your therapy allowance separately from your diagnostic cover, which can be advantageous on capped plans.
Ultimately, the subtle but important differences in their policy structures, hospital lists, and pricing mean that the right choice requires a personalised comparison.
Take the guesswork out of choosing your private health cover. The expert team at WeCovr is here to provide clear, impartial advice tailored to your exact needs and budget.










