AXA vs Aviva vs Bupa vs The Exeter Big Brands vs Specialist Cover
Choosing the right private medical insurance in the UK can feel like navigating a maze. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we make it simple. This definitive guide compares the UK’s health insurance giants—AXA, Aviva, and Bupa—against a leading specialist, The Exeter, to help you make an informed decision.
How mainstream insurers compare with a leading specialist provider
The UK private health insurance market is dominated by a few household names. AXA Health, Aviva, and Bupa are the "big three"—large, established corporations offering a wide array of policies to millions of individuals and businesses. They are known for comprehensive cover, extensive hospital networks, and strong brand recognition.
In contrast, specialist providers like The Exeter operate differently. As a Friendly Society, The Exeter is a mutual organisation, owned by its members rather than shareholders. This structural difference often leads to a distinct approach, focusing on specific customer needs, offering more flexible underwriting, and catering to demographics that mainstream insurers might find complex, such as the self-employed or those with pre-existing medical conditions.
This article will dissect the offerings of these four key players, helping you understand which approach—the scale of a corporate giant or the focused expertise of a specialist—is the right fit for your health and financial wellbeing.
Understanding the Core of UK Private Medical Insurance (PMI)
Before we compare providers, it’s essential to grasp what private medical insurance is designed for. Understanding these fundamentals is the first step to avoiding common misunderstandings and choosing the right policy.
PMI is for acute conditions that arise after you take out your policy. An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Think of conditions like cataracts needing surgery, joint pain requiring a replacement, or hernias needing repair.
Crucially, standard UK private medical insurance does not cover chronic conditions. A chronic condition is an illness that cannot be cured but can be managed, such as diabetes, asthma, or high blood pressure. The NHS remains the primary provider for managing these long-term conditions.
Likewise, PMI generally excludes pre-existing conditions—any ailment you had symptoms or treatment for in the years before your policy began.
Here are the key terms you’ll encounter:
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Underwriting: This is how insurers assess your health risk. The two main types are:
- Moratorium (MOR): The most common type. The insurer won't ask for your full medical history upfront. Instead, they will automatically exclude any condition you've had symptoms, advice, or treatment for in the 5 years before your policy starts. However, if you remain symptom-free and treatment-free for that condition for a continuous 2-year period after your policy begins, it may become eligible for cover.
- Full Medical Underwriting (FMU): You provide your full medical history via a detailed questionnaire. The insurer then states precisely what is and isn't covered from day one. This provides certainty but may lead to permanent exclusions.
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Excess: The amount you agree to pay towards a claim. For example, if you have a £250 excess and your treatment costs £3,000, you pay the first £250, and the insurer pays the remaining £2,750. A higher excess typically leads to a lower monthly premium.
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Hospital List: Insurers have tiered lists of private hospitals. A basic list includes a good network of hospitals but may exclude premium-priced central London facilities. Choosing a more restricted list can reduce your premium.
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Outpatient Cover: This covers consultations, diagnostic tests, and scans that don't require a hospital bed. Core PMI always covers inpatient treatment (when you're admitted to hospital), but outpatient cover is often an optional add-on that significantly impacts the price.
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No Claims Discount (NCD): Similar to car insurance, your premium can decrease each year you don't make a claim, up to a maximum discount (often 60-75%). Making a claim will typically reduce your NCD level.
The Mainstream Giants: A Closer Look at AXA, Aviva, and Bupa
These three providers represent the bedrock of the UK PMI market. They offer robust, feature-rich policies designed for a broad audience, from individuals and families to the largest corporate schemes.
AXA Health
As part of the global AXA Group, AXA Health brings significant financial strength and a worldwide reputation. Their UK policies are known for their clarity and modular approach, allowing customers to build a plan that suits them.
- Core Policy: Their 'Personal Health' plan provides comprehensive cancer cover and extensive inpatient treatment as standard.
- Digital Health: AXA is strong on digital integration, with its Doctor at Hand service providing 24/7 access to a virtual GP.
- Mental Health: They offer good mental health pathways, often including cover for talking therapies and psychiatric care as part of their standard or optional benefits.
- Flexibility: Customers can choose from various outpatient limits, hospital lists, and excess options to tailor their premium.
- Best For: Individuals and businesses looking for a reputable global brand with strong digital tools and flexible policy options.
Aviva
Aviva is one of the UK's largest and most recognisable financial services brands. Their 'Healthier Solutions' policy is a market staple, praised for its comprehensive cancer cover and 'BacktoBetter' physiotherapy service.
- Core Policy: Aviva’s standard cover is extensive, with a strong focus on diagnostics and treatment pathways.
- 'Expert Select' Hospital Option: This unique feature directs you to a curated list of high-performing consultants and hospitals, which can significantly reduce your premium.
- Cancer Cover: Their cancer promise is a key selling point, offering extensive cover for diagnostics, treatment, and aftercare.
- Digital Tools: The Aviva Digital GP app and other wellness resources are well-regarded.
- Best For: Those who value a trusted UK brand and are happy to use a guided hospital option in return for lower premiums.
Bupa
Bupa is arguably the most famous name in UK health insurance. Uniquely, they are a provident association, meaning they have no shareholders and reinvest profits back into healthcare services. They also own and run their own hospitals and clinics.
- Core Policy: The 'Bupa By You' policy is highly customisable. Bupa's key strength is its 'Direct Access' for cancer and mental health, allowing members to bypass a GP referral for certain symptoms, speeding up diagnosis.
- Integrated Network: Owning their own facilities gives them greater control over the patient journey, which can lead to a more seamless experience.
- Cancer Care: Bupa's cancer cover is exceptional. If a cancer treatment isn't available that they would normally fund, they may cover a licensed alternative even if it's not on their approved list.
- Global Reach: Bupa operates globally, offering strong international health insurance options.
- Best For: Customers seeking fast access to care (especially for cancer and mental health) and who value the reassurance of a provider that is also a direct healthcare provider.
The Specialist Challenger: An In-Depth Look at The Exeter
The Exeter stands apart from the big three. As a Friendly Society established in 1927, their entire business model is built around their members. This member-first ethos permeates their product design and underwriting philosophy.
- Mutual Status: With no shareholders to pay, profits are used to benefit members, potentially through better pricing, enhanced benefits, or more lenient claims decisions.
- Flexible Underwriting: This is The Exeter's superpower. They are renowned for their willingness to consider applications from individuals with pre-existing health conditions. While they still won't cover those specific conditions, they are often more likely to offer cover for everything else, whereas another insurer might decline the application altogether.
- Focus on Underserved Groups: They are a popular choice for the self-employed, older applicants (with no upper age limit on their policies), and those in riskier professions.
- 'Health+' Policy: Their flagship policy is straightforward. A key benefit is unlimited outpatient diagnostics, which are included as standard on most of their plans. This is a significant feature, as many mainstream policies have limits on this.
- Community-Rated Pricing: For members who join before a certain age and stay with them, The Exeter uses a form of community rating at renewal, which can smooth out age-related price hikes that are common elsewhere.
- Best For: Older applicants, the self-employed, and anyone with a complex medical history who has struggled to get cover elsewhere.
Head-to-Head Comparison: AXA vs Aviva vs Bupa vs The Exeter
This table provides a simplified overview of how the providers' typical individual policies compare. Remember, the exact details can vary based on the specific options you choose. An expert broker at WeCovr can help you navigate these nuances.
| Feature | AXA Health ('Personal Health') | Aviva ('Healthier Solutions') | Bupa ('Bupa By You') | The Exeter ('Health+') |
|---|---|---|---|---|
| Provider Type | Global Insurer | UK Composite Insurer | Provident Association | Friendly Society (Mutual) |
| Core Cover | Full Inpatient & Day-patient | Full Inpatient & Day-patient | Full Inpatient & Day-patient | Full Inpatient & Day-patient |
| Standard Cancer Cover | Comprehensive, including chemo, radio, surgery. Some advanced therapies. | Comprehensive, including chemo, radio, surgery. Strong aftercare. | Comprehensive, with 'Direct Access' for certain symptoms. | Comprehensive, including chemo, radio, surgery. |
| Outpatient Cover | Optional add-on with various limits (£0, £500, £1000, Unlimited). | Optional add-on with various limits (£0, £500, £1000, etc.). | Optional add-on with various limits. | Unlimited diagnostics as standard (consultations optional). |
| Mental Health | Strong cover, often included in core or as a high-value option. | Covered as an optional add-on. | Strong cover with 'Direct Access' for certain mental health issues. | Covered as an optional add-on. |
| Underwriting | Moratorium or Full Medical. | Moratorium or Full Medical. | Moratorium or Full Medical. | More flexible approach. Moratorium or Full Medical. |
| No Claims Discount | Yes, up to 15 levels. | Yes, a multi-level scale. | Yes, a multi-level scale. | No. They use a form of community-rated pricing to avoid large claims-related hikes. |
| Digital GP | Yes, 'Doctor at Hand'. | Yes, 'Aviva Digital GP'. | Yes, 'Digital GP'. | Yes, 'HealthWise' app. |
| Unique Selling Point | Highly modular policy, strong digital tools. | 'Expert Select' guided hospital option for lower premiums. | 'Direct Access' for cancer/mental health; owns own hospitals. | Flexible underwriting for health conditions; unlimited outpatient diagnostics. |
| Best For | Families, tech-savvy users, those wanting brand security. | Cost-conscious buyers happy with a guided network. | Those prioritising speed of access, especially for cancer. | Older applicants, self-employed, people with some health conditions. |
Real-Life Scenarios: Which Provider is Right for You?
Theory is one thing; practice is another. Let's apply this knowledge to some common scenarios.
Scenario 1: The 30-Year-Old Freelance Designer
- Needs: Affordable cover, quick access to a GP around a busy schedule, and protection against long NHS waits for diagnostics that could impact their ability to work.
- Considerations: As a freelancer, income protection is paramount. They need a policy that won't break the bank but will get them diagnosed and treated quickly.
- Potential Best Fit:
- The Exeter: Their policy with unlimited outpatient diagnostics as standard is a huge plus for a freelancer worried about lengthy waits for scans. Their flexible approach is also good for self-employed individuals.
- Aviva: With the 'Expert Select' hospital option, the premium could be very competitive. Their digital GP is also a great benefit for someone working unconventional hours.
Scenario 2: The Family of Four
- Needs: Comprehensive cover for two adults in their 40s and two children under 10. They want peace of mind, a wide choice of hospitals, and good mental health support.
- Considerations: Family policies often offer discounts. They need a provider with a strong reputation and a seamless claims process.
- Potential Best Fit:
- AXA Health: Their modular approach allows the family to build a policy that fits their exact needs, perhaps with full outpatient cover and mental health support.
- Bupa: The 'Direct Access' feature could be invaluable for a parent worried about a child's symptoms, and their brand provides immense peace of mind.
Scenario 3: The 65-Year-Old Retiree
- Needs: A policy that will accept them at their age and provide robust cover for conditions common in later life, like joint replacements or cataract surgery. They have a history of well-managed high blood pressure.
- Considerations: Many insurers have upper age limits for new policies or increase premiums steeply. Their pre-existing condition could be a hurdle.
- Potential Best Fit:
- The Exeter: This is their sweet spot. They have no upper age limit for joining, and their flexible underwriting means they are more likely to offer cover despite the managed high blood pressure (though the condition itself would be excluded). The absence of a traditional NCD also protects against a single claim causing a huge premium spike at renewal.
The Cost Factor: What Influences Your PMI Premium?
Private medical insurance UK costs are not fixed. They are highly personalised based on a range of factors. Understanding these levers is key to finding a policy that provides the cover you need at a price you can afford.
- Age: The single biggest factor. Premiums rise as you get older because the statistical risk of needing treatment increases.
- Location: Living in areas with higher-cost private hospitals, like Central London, will increase your premium.
- Level of Cover: A basic inpatient-only plan will be far cheaper than a comprehensive plan with unlimited outpatient cover, dental, and optical benefits.
- Excess: Choosing a higher excess (e.g., £500 vs £100) will directly reduce your monthly premium.
- Hospital List: Opting for a more limited hospital network that excludes the most expensive facilities is a very effective way to manage cost.
- Underwriting: Moratorium underwriting is typically the default. Full Medical Underwriting can sometimes be cheaper if you have a very clean bill of health.
Navigating these options can be complex. An expert adviser can model different scenarios for you, instantly showing you how changing your excess or hospital list impacts the cost across all major providers.
The WeCovr Advantage: Why Use an Expert Broker?
You could go to each insurer directly, but you would be missing the single most valuable tool in your search: independent, expert advice. An FCA-authorised broker like WeCovr works for you, not the insurance company.
Here’s how we help:
- Market-Wide Comparison: We compare policies from AXA, Aviva, Bupa, The Exeter, and other leading UK providers to find the best fit for your specific needs.
- Expert Guidance at No Cost: Our service is completely free to you. We are paid by the insurer you choose, so you get our expertise without it costing you a penny extra.
- Demystifying the Jargon: We explain everything in Plain English, ensuring you understand exactly what you are and are not covered for.
- Tailored to You: We listen to your needs, health concerns, and budget to recommend the right provider and policy structure, saving you from paying for benefits you don't need.
- Exclusive Benefits: When you arrange a policy through us, you get complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero. We can also offer discounts on other policies, such as life or income protection insurance.
- High Customer Satisfaction: Our clients consistently rate our service as excellent, valuing the clarity and peace of mind we provide.
Switching Your PMI Provider: Is It Worth It?
If you already have a policy, you might be wondering if you can get a better deal elsewhere. The answer is often yes, but it must be done correctly.
When you switch, you can usually do so on a "Continued Personal Medical Exclusions" (CPME) basis. This special type of underwriting allows you to carry over the cover from your old policy without new medical exclusions being added. This means any conditions that developed while you were covered by your previous insurer will continue to be covered by your new one.
It's a powerful tool for saving money or upgrading your cover, but the process can be complex. It is highly recommended to use a broker like WeCovr to manage the switch, ensuring there are no gaps in your cover.
Does private health insurance cover pre-existing conditions?
Is Bupa better than AXA or Aviva?
How much does private medical insurance cost in the UK?
What is the main benefit of a specialist insurer like The Exeter?
Find Your Perfect Health Cover Today
Whether the comprehensive scale of AXA, Aviva, or Bupa appeals, or the specialist, member-focused approach of The Exeter seems a better fit, the ultimate decision is personal. The best private medical insurance is the one that provides you with security, peace of mind, and fast access to high-quality care when you need it most.
Don't navigate the complex world of PMI alone.
Ready to compare the UK's leading health insurers and find the perfect cover for you? Speak to a WeCovr expert today for a free, no-obligation quote and let us find the right policy for your health and your budget.
Related guides
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
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