Choosing the right private medical insurance in the UK can feel overwhelming. At WeCovr, our FCA-authorised experts help thousands of clients navigate this complex market. This guide cuts through the noise, comparing four of the UK's leading insurers—AXA, Aviva, Bupa, and WPA—to find the best value for you.
Comparing hospital access, claims handling and renewal pricing
When we talk about "value" in private medical insurance (PMI), it's about more than just the monthly premium. True value is a balance of three critical pillars: the quality of hospitals you can access, how smoothly your claims are handled in a time of need, and how fairly your policy is priced at renewal.
Getting this balance right is the secret to a policy that works for you, not just for the first year, but for the long term. This expert comparison will break down exactly how AXA, Aviva, Bupa, and WPA stack up across these key areas.
What 'Value' Really Means in Private Medical Insurance
The cheapest policy is rarely the best. A low initial premium can hide restrictive hospital lists, high excesses, or punitive renewal increases. Understanding the components of a policy is the first step to identifying genuine value.
Key Components of a PMI Policy:
- Core Cover: This is the foundation of every policy. It typically covers the costs of treatment when you are admitted to hospital as an in-patient (requiring an overnight bed) or a day-patient (admitted for a procedure but not staying overnight).
- Optional Extras: This is where you tailor the policy. Common options include:
- Out-patient Cover: For diagnostic tests, consultations, and scans before you are admitted to hospital. This is one of the most important and valuable additions.
- Therapies Cover: For physiotherapy, osteopathy, and other similar treatments.
- Mental Health Cover: Support for psychiatric care, therapy, and counselling.
- Hospital List: The network of private hospitals and facilities you are allowed to use. This is a major factor in determining your premium.
- Excess: The amount you agree to pay towards a claim each year. A higher excess lowers your premium.
- Underwriting: How the insurer assesses your medical history. The two main types are Moratorium and Full Medical Underwriting.
Crucial Clarification: Standard UK private medical insurance is designed for new, acute conditions that arise after you take out the policy. It does not cover pre-existing conditions or chronic conditions (long-term illnesses like diabetes, asthma, or high blood pressure that require ongoing management).
The Contenders: A Snapshot of AXA, Aviva, Bupa, and WPA
These four providers represent a significant portion of the UK's private health cover market. Each has distinct strengths and philosophies.
- AXA Health: A global insurance giant with a strong focus on digital health tools and comprehensive cover options. They are known for their structured hospital lists and broad range of benefits.
- Aviva: The UK's largest general insurer, Aviva offers highly flexible and often very competitive PMI policies. They are notable for their "Expert Select" guided hospital option, which can significantly reduce costs.
- Bupa: Perhaps the most famous name in UK health insurance, Bupa has a vast network and a reputation for comprehensive service. They operate their own facilities and have a strong heritage in healthcare.
- WPA (Western Provident Association): A not-for-profit organisation with a strong focus on customer service and ethical practices. They are known for their unique "Shared Responsibility" cost-sharing option and a commitment to their members.
Here is a high-level overview of the four insurers:
| Feature | AXA Health | Aviva | Bupa | WPA |
|---|
| Market Position | Global leader, technology-focused | UK's largest insurer, flexible & competitive | Iconic UK brand, extensive network | Not-for-profit, member-focused |
| Key Strength | Comprehensive options, digital GP | Cost-effective, "Expert Select" option | Brand trust, direct settlement network | Exceptional service, shared responsibility |
| Best For | Individuals seeking comprehensive cover and digital tools. | Price-conscious buyers happy with guided options. | Families and those wanting brand reassurance. | Those prioritising customer service and ethical approach. |
| Underwriting | Moratorium & Full Medical Underwriting | Moratorium & Full Medical Underwriting | Moratorium & Full Medical Underwriting | Moratorium & Full Medical Underwriting |
Deep Dive 1: Hospital Access and Lists
Where you can be treated is arguably one of the most important aspects of your policy. Insurers control costs by creating tiered hospital lists. Choosing a more restricted list lowers your premium, but it's vital to know what you're giving up.
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AXA's Approach (Health for You plan):
- Guided Option: Their most affordable list, directing you to a specific selection of quality-assessed hospitals.
- Standard List: A broad national network of private hospitals.
- Extended Cover: The most comprehensive list, including premium private hospitals in Central London (e.g., The London Clinic, The Lister).
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Aviva's Approach (Healthier Solutions plan):
- Expert Select (Guided): Aviva's "guided" option. You are given a choice of 3-4 specialists and hospitals from a specific network, significantly reducing premiums. This is a popular cost-saving choice.
- Hospital Options: A traditional list with tiers like "Key" (basic), "Extended" (adds more choice), and the "Trust" network which includes private wings of NHS hospitals.
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Bupa's Approach (Bupa By You plan):
- Essential Access: The most restricted list, focusing on a core network of hospitals.
- Extended Choice: A wider network including more facilities.
- Extended Choice with London: Their top-tier list, providing access to Central London's HCA hospitals. Bupa has a very strong relationship with the Cromwell Hospital.
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WPA's Approach (Flexible Health plan):
- WPA has a different philosophy. They offer lists that are generally more inclusive than competitors' entry-level options. Their premium hospital list is one of the most comprehensive on the market, but they also offer regional lists to manage costs. Their focus is on providing access to the best clinical care, not just the cheapest.
Insider Adviser Tip: Don't just tick the "national" box. Many standard "national" lists from major insurers exclude the top-tier, expensive hospitals in Central London. If you live or work in London and want access to these facilities, you must select a plan with an "Extended" or "London" upgrade. A broker like WeCovr can instantly check which hospitals are on which list for you.
Deep Dive 2: The Claims Experience - From First Call to Final Invoice
A smooth claims process is what you pay your premiums for. When you're unwell, the last thing you want is to be fighting with your insurer over paperwork.
| Insurer | Claims Process & Reputation | Digital Tools |
|---|
| AXA Health | Generally very efficient. Strong digital journey via their app and online portal. Fast pre-authorisation for common procedures. | Excellent app for claims submission, virtual GP access, and policy management. |
| Aviva | Solid and reliable. The 'Expert Select' process is well-managed, guiding you through the claim. Good telephone support. | Strong online portal ("MyAviva") that integrates health with other insurance products. |
| Bupa | Highly regarded. As Bupa runs some of its own facilities, they have "direct settlement" agreements with a vast network, meaning they often pay the hospital directly with no need for you to handle invoices. | The Bupa Touch app is comprehensive, offering claims tracking, pre-authorisation, and digital health services. |
| WPA | Consistently wins awards for customer service. As a not-for-profit, their focus is on the member experience. Claims are handled by UK-based teams who are known for being helpful and empathetic. | WPA has a simple and effective online portal and app for managing claims and benefits. |
Real-Life Scenario: A Member with Knee Pain
Let's imagine you develop persistent knee pain and your GP refers you to an orthopaedic specialist. Here’s how it might play out:
- Initial GP Visit: You see your NHS or a private GP. They write a referral letter.
- Contact Your Insurer: You call your PMI provider to open a claim.
- Authorisation: The insurer checks your policy details and confirms that diagnostics for knee pain are covered. They give you a pre-authorisation number.
- Choosing a Specialist (The Key Difference):
- With AXA, Bupa, or WPA's traditional lists, you'd typically be given a choice of specialists at any hospital on your chosen list.
- With Aviva's Expert Select, they would provide you with a shortlist of 3-4 approved specialists. You choose from that list. This is the trade-off for the lower premium.
- Treatment & Payment: You see the specialist, have an MRI, and are scheduled for keyhole surgery. The hospital and specialist invoice the insurer directly. You only pay your chosen excess.
Deep Dive 3: Renewal Pricing and No Claims Discounts (NCDs)
This is the number one reason clients contact a PMI broker. Your premium will increase each year due to two main factors:
- Age: You move into the next age bracket, which carries a higher risk.
- Medical Inflation: The cost of private treatment, drugs, and technology rises much faster than standard inflation, typically by 8-12% per year.
On top of this, any claims you make will likely affect your No Claims Discount (NCD).
| Insurer | No Claims Discount Structure | Renewal Pricing Reputation |
|---|
| AXA Health | A standard NCD ladder. Making a claim typically drops your discount level by 2-3 levels. Can offer a 10-year protected NCD for an extra premium. | Generally fair, but large claims will lead to significant increases, as with all insurers. |
| Aviva | Similar to AXA, with a scale typically going up to around 75%. Claims cause a drop down the ladder. | Their competitive entry-level pricing can sometimes mean steeper increases at renewal, especially after a claim. |
| Bupa | Has a "No Claim Discount" or a "Claim Rated" scheme. The NCD operates like car insurance. Large claims will see it drop. | Bupa's renewals are generally seen as stable but can be high if you are on an older, less flexible policy. |
| WPA | WPA's "Shared Responsibility" model is different. Instead of an NCD, you agree to pay 25% of every claim, up to a chosen annual limit. This can result in much more stable and predictable renewals, as the risk is shared. They also offer traditional NCD policies. | WPA is a not-for-profit, so any surplus is reinvested. This often leads to more sustainable and fairer long-term pricing for its members. |
Common Client Mistake: Sticking with the same insurer for years without reviewing the market. Loyalty rarely pays in the insurance world. After a few years, your initial "new customer" discount is gone, and you may be on an outdated plan. An independent review almost always finds better value.
The Underwriting Minefield: Moratorium vs. Full Medical Underwriting
This is a technical but vital choice. It determines how the insurer treats your past medical history.
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Full Medical Underwriting (FMU):
- How it works: You complete a detailed health questionnaire, disclosing your full medical history. The insurer assesses it and may place specific exclusions on your policy from the start (e.g., "no cover for any treatment related to the right knee").
- Pros: Certainty. You know exactly what is and isn't covered from day one.
- Cons: The application process is longer. Conditions you'd forgotten about might be permanently excluded.
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Moratorium (Mori) Underwriting:
- How it works: You don't declare your medical history upfront. Instead, the insurer automatically excludes any condition you've had symptoms, treatment, or advice for in the 5 years before the policy started.
- The "Rolling" Rule: A pre-existing condition may become eligible for cover, but only after you complete a continuous 2-year period on the policy without experiencing any symptoms, treatment, or advice for that condition.
- Pros: Quick and easy to set up.
- Cons: Lack of certainty. A claim can be delayed or rejected while the insurer investigates if the condition is new or pre-existing. People often misunderstand the 2-year rule.
Adviser Tip: For most healthy individuals with no recent medical issues, Moratorium is fast and convenient. However, if you have a complex medical history, FMU provides valuable clarity, even if it means some exclusions. Discussing this with a WeCovr adviser is crucial to avoid problems at the point of claim.
The WeCovr Verdict: How to Choose the Right Provider for You
There is no single "best" provider. The right choice depends entirely on your priorities: budget, location, family needs, and attitude to risk.
- Choose AXA if: You want a comprehensive, feature-rich policy from a global brand and value excellent digital tools.
- Choose Aviva if: Your top priority is managing cost. Their 'Expert Select' guided option offers fantastic value if you are happy to trade some choice for a lower premium.
- Choose Bupa if: You value the reassurance of the UK's most recognised healthcare brand and want a straightforward, comprehensive claims experience.
- Choose WPA if: Exceptional customer service, ethical practices, and fair renewal pricing are most important to you. Their member-focused, not-for-profit status sets them apart.
The smartest decision is not to choose one off the shelf, but to have them compared for you. An independent broker works for you, not the insurer.
At WeCovr, we provide a full market analysis based on your specific needs, at no cost to you. We can pinpoint the policy that offers the best combination of hospital access, service, and long-term value. Furthermore, our clients gain complimentary access to our AI-powered nutrition app, CalorieHero, and can benefit from discounts when taking out other policies like life insurance.
Ready to find the perfect private health cover? Let our experts do the hard work.
Frequently Asked Questions about UK Private Health Insurance
Does private medical insurance cover pre-existing conditions?
No, standard UK private medical insurance (PMI) is designed to cover new, acute medical conditions that arise after your policy begins. It does not cover pre-existing conditions (illnesses you knew about before joining) or chronic conditions (long-term illnesses requiring ongoing management, like asthma or diabetes). Some policies may cover a pre-existing condition after a set period (usually two years) without symptoms or treatment, but this is not guaranteed.
What is an excess and how does it work?
An excess is a fixed amount you agree to pay towards the cost of your treatment when you make a claim. For example, if you have a £250 excess and your treatment costs £3,000, you would pay the first £250 and your insurer would pay the remaining £2,750. You typically only pay the excess once per policy year, regardless of how many claims you make. Choosing a higher excess is a common way to lower your monthly premium.
Can I switch my private health insurance provider?
Yes, you can switch PMI providers, and it is often a good way to find better value, especially if your renewal premium has increased significantly. You can switch on what is known as "Continued Medical Exclusions" (CME) underwriting, which allows your new insurer to carry over the terms of your old policy. This means you can continue to be covered for conditions that arose while you were with your previous insurer. A broker can manage this process for you to ensure a seamless transition.
Is private medical insurance worth it in the UK?
Whether PMI is "worth it" is a personal decision. It offers significant benefits, such as faster access to specialist consultations, diagnostic tests, and treatment, often bypassing long NHS waiting lists. It also provides more choice over where and when you are treated, and access to a private room. For many, this peace of mind and control over their health is a valuable investment.