TL;DR
Choosing the right private medical insurance in the UK can feel overwhelming. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies of various kinds, we’re here to simplify your decision between the 'big three': AXA, Aviva, and Bupa. This guide gives you the expert insight you need.
Key takeaways
- AXA Health: Part of the global AXA Group, AXA Health (formerly AXA PPP Healthcare) has a long history in the UK. They are known for their comprehensive policies and a strong focus on clinical pathways and mental health support.
- Aviva: A household name in UK insurance, Aviva's "Healthier Solutions" policy is one of the most popular in the market. They are often seen as innovators, particularly with their integration of digital GP services and wellness rewards.
- Bupa: Perhaps the most famous name in UK private healthcare, Bupa is a provident association, meaning it has no shareholders and reinvests profits. It operates its own hospitals and clinics alongside its insurance arm, giving it a unique, integrated model.
- AXA: Typically linked to your out-patient limit.
- Aviva: An optional add-on. You choose a combined limit for consultations and therapies.
Choosing the right private medical insurance in the UK can feel overwhelming. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies of various kinds, we’re here to simplify your decision between the 'big three': AXA, Aviva, and Bupa. This guide gives you the expert insight you need.
A three-way comparison of the UK's biggest PMI brands on cost, cover, and service
When you’re considering private health cover, three names invariably come to the top of the list: AXA Health, Aviva, and Bupa. They are the titans of the UK Private Medical Insurance (PMI) market, collectively holding the majority of policies. But which one is genuinely the best fit for you, your family, or your business in 2025?
This in-depth comparison goes beyond the marketing brochures to give you the clear, unbiased information you need to make an informed choice. We'll break down their offerings on core cover, optional extras, cost, customer service, and those all-important value-added benefits.
At a Glance: AXA vs Aviva vs Bupa Executive Summary
For those short on time, here is a high-level overview of how the three giants stack up.
| Feature | AXA Health | Aviva | Bupa |
|---|---|---|---|
| Best For | Comprehensive cover & strong mental health options. | Digital health features & value-for-money flexibility. | Extensive network & brand recognition. |
| Market Position | A global insurance powerhouse with a focus on premium, comprehensive health plans. | A leading UK insurer known for innovation and its "Healthier Solutions" product. | The UK's most famous health insurance brand with a long-standing reputation. |
| Key Strengths | Strong cancer cover, excellent mental health pathways, extensive hospital list. | Aviva Digital GP, good value on mid-range plans, strong incentives program. | Bupa Direct Access, large network of Bupa-owned facilities, well-known brand. |
| Potential Downsides | Can be one of the more expensive options for top-tier cover. | Standard mental health cover is less comprehensive than others; requires upgrade. | Core product can be less flexible; some key benefits are paid-for add-ons. |
| Trustpilot Score (Jan 2025) | Typically rated 'Excellent'. | Typically rated 'Excellent'. | Typically rated 'Great'. |
Note: Trustpilot scores are dynamic and can change. This is an indicative guide.
Understanding the "Big Three": A Brief Introduction
Before we dive into the details, let's briefly introduce the contenders. Understanding their background helps contextualise their offerings.
- AXA Health: Part of the global AXA Group, AXA Health (formerly AXA PPP Healthcare) has a long history in the UK. They are known for their comprehensive policies and a strong focus on clinical pathways and mental health support.
- Aviva: A household name in UK insurance, Aviva's "Healthier Solutions" policy is one of the most popular in the market. They are often seen as innovators, particularly with their integration of digital GP services and wellness rewards.
- Bupa: Perhaps the most famous name in UK private healthcare, Bupa is a provident association, meaning it has no shareholders and reinvests profits. It operates its own hospitals and clinics alongside its insurance arm, giving it a unique, integrated model.
The Crucial Rule of UK Private Health Insurance: Acute vs Chronic Conditions
Before comparing any policy, it's vital to understand the fundamental principle of private medical insurance in the UK.
Standard UK PMI is 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. Think of things like joint replacements, cataract surgery, or treatment for an infection.
A chronic condition is an illness that cannot be cured but can be managed. Examples include diabetes, asthma, high blood pressure, and arthritis. PMI does not cover the routine management of chronic conditions. It may, however, cover an acute flare-up of a chronic condition.
Critically, PMI also does not typically cover pre-existing conditions – any illness or injury you had symptoms of, or received advice or treatment for, in the years before your policy began (usually the last 5 years). How this is handled depends on your choice of underwriting.
Understanding this distinction is the single most important step to avoid disappointment at the point of claim.
Core Cover Comparison: What's Included as Standard?
All PMI policies are built around a core offering that covers the most expensive treatments: those requiring a hospital bed. This is known as in-patient and day-patient cover.
Here’s how the standard offerings from AXA, Aviva, and Bupa compare.
| Cover Element | AXA Health (Personal Health) | Aviva (Healthier Solutions) | Bupa (Bupa By You) |
|---|---|---|---|
| In-patient & Day-patient Fees | Covered in full. | Covered in full. | Covered in full. |
| Specialist & Surgeon Fees | Covered in full (with participating specialists). | Covered in full (with participating specialists). | Covered in full (with participating specialists). |
| Diagnostic Tests (In-patient) | Covered in full. | Covered in full. | Covered in full. |
| Cancer Cover (Core) | Comprehensive cancer cover as standard, including chemotherapy, radiotherapy, and surgery. | Extensive cancer cover as standard, including diagnostics, surgery and therapies. | Comprehensive cancer cover as standard for diagnosis and treatment. |
| NHS Cash Benefit | Yes, if you choose to use the NHS for in-patient treatment. | Yes, if you choose to use the NHS for in-patient treatment. | Yes, if you choose to use the NHS for in-patient treatment. |
| Private Ambulance | Included. | Included. | Included. |
Broker Insight: On core cover, the "big three" are remarkably similar. They all provide comprehensive cover for in-patient and day-patient treatment as standard. The real differences emerge when you start looking at optional extras, hospital lists, and value-added services.
Customising Your Policy: A Deep Dive into Optional Extras
This is where you tailor your policy to your needs and budget. The main options are Out-patient cover, Mental Health, Therapies, and Dental & Optical.
Out-patient Cover
This covers consultations and diagnostic tests that do not require a hospital bed. It's one of the most valuable, and most expensive, add-ons.
| Provider | Out-patient Options | Key Features & Broker Notes |
|---|---|---|
| AXA Health | - Full cover - £1,000 limit - £500 limit - No cover | AXA's standard guided option ("Expert Select") includes initial consultations even with no out-patient cover, which is a great value point. Their full cover option is genuinely comprehensive. |
| Aviva | - Full cover - £1,000 limit - £500 limit - No cover | Aviva's limits are straightforward. Choosing a limited out-patient option is a popular way to manage premiums. Be aware diagnostics can quickly use up a £500 limit. |
| Bupa | - Full cover - £1,000 limit - £750 limit - £500 limit - No cover | Bupa offers more granular limits, which can be useful for fine-tuning your premium. Their "Direct Access" service for certain conditions can bypass the need for a GP referral, speeding up access. |
Mental Health Cover
Awareness of mental health has grown, and insurers have responded. This is a key area of differentiation.
| Provider | Mental Health Options | Key Features & Broker Notes |
|---|---|---|
| AXA Health | Included as standard (but can be removed). | Best-in-class. AXA's standard cover is very strong, covering both in-patient and out-patient mental health treatment. Their "Stronger Minds" pathway provides rapid access without a GP referral for certain conditions. |
| Aviva | Standard (limited) or Enhanced add-on. | The standard mental health cover is more basic than AXA's. The "Enhanced" option is required for full psychiatric cover and is a highly recommended upgrade for those concerned about mental wellbeing. |
| Bupa | Included as standard (can be upgraded). | Bupa provides good standard mental health cover. Like Aviva, you may need to upgrade to their "Mental Health and Wellbeing" add-on for the most comprehensive benefits, including more extensive therapy sessions. |
Therapies Cover
This covers treatment from specialists like physiotherapists, osteopaths, and chiropractors.
- AXA: Typically linked to your out-patient limit.
- Aviva: An optional add-on. You choose a combined limit for consultations and therapies.
- Bupa: Usually included, with sessions often approved via their telephone assessment service.
Client Scenario: Sarah, a 45-year-old marathon runner, was most concerned about quick access to physiotherapy. For her, a policy with strong, easily accessible therapies cover was more important than a high out-patient limit for consultations. We helped her compare plans that prioritised this need.
Cost Comparison: What Will You Actually Pay in 2025?
This is the million-dollar question. The cost of a private health insurance policy is highly personal and depends on several factors:
- Age: Premiums increase as you get older.
- Location: Treatment in Central London is more expensive, so premiums are higher.
- Excess (illustrative): The amount you agree to pay towards your first claim each year. A higher excess (£500 or £1,000) significantly reduces your premium.
- Hospital List: All insurers offer different tiers of hospitals. A list that excludes expensive Central London hospitals will be cheaper.
- Optional Extras: The more you add (like full out-patient cover), the higher the price.
- Underwriting: Your choice of underwriting method affects the price.
To give you an idea, here are some sample monthly premiums.
Sample Monthly Premiums (Mid-Range Cover, £250 Excess)
| Persona | AXA Health | Aviva | Bupa |
|---|---|---|---|
| 35-year-old, Manchester | £65 | £60 | £68 |
| 50-year-old, Bristol | £110 | £102 | £115 |
| 35-year-old, Central London | £85 | £80 | £90 |
| 50-year-old, Central London | £145 | £135 | £150 |
Disclaimer: These are illustrative estimates only as of late 2024 for a 2025 policy. They are not a formal quote. The only way to get an accurate price is to get a personalised quote.
Broker Insight: Aviva often comes out as the most competitive on price for mid-range, flexible policies. AXA can be pricier but often justifies it with more comprehensive standard features, especially for mental health. Bupa's pricing is typically in line with AXA's, reflecting its strong brand and network. Using an independent broker like WeCovr allows you to compare quotes from all these providers side-by-side in minutes, ensuring you don't overpay.
Underwriting Explained: Moratorium vs Full Medical Underwriting (FMU)
When you buy a policy, the insurer needs to know about your medical history to exclude pre-existing conditions. There are two main ways they do this.
| Underwriting Type | How it Works | Pros | Cons |
|---|---|---|---|
| Moratorium (Mori) | You don't declare your full medical history upfront. Instead, any condition you've had in the 5 years before the policy started is automatically excluded. This exclusion can be lifted if you go 2 full years on the policy without any symptoms, treatment, or advice for that condition. | Quicker to set up. Less intrusive paperwork. | Can lead to uncertainty. A claim may be delayed or rejected while the insurer investigates your medical history to see if it was pre-existing. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire, disclosing your full medical history. The insurer then tells you upfront exactly what is and isn't covered. | Certainty from day one. You know precisely where you stand. Claims process is often smoother. | Takes longer to apply. Can be more intrusive. Exclusions are often permanent. |
Common Client Mistake: Many clients choose moratorium underwriting for speed but don't fully understand the "2-year rule." They mistakenly believe that after 2 years, everything is covered. This is not the case. The condition must be completely dormant (no symptoms, treatment, or advice) for 2 continuous years while you are on the policy for the exclusion to be lifted.
Member Benefits & Value-Added Services: Beyond the Core Cover
In a competitive market, insurers add extra perks to stand out. These can provide significant day-to-day value.
-
AXA Health:
- Doctor at Hand: A digital GP service provided by Teladoc Health, available 24/7.
- Health and Wellbeing Hub: Online resources, articles, and support.
- Working Body: Support for musculoskeletal issues, often providing physio assessment over the phone.
-
Aviva:
- Aviva Digital GP: Powered by Square Health, this app-based service is highly rated and well-integrated.
- Get Active: Discounts on gym memberships and fitness trackers.
- Stress Counselling Helpline: Available to all members.
-
Bupa:
- Digital GP: Access to a 24/7 GP helpline.
- Bupa Direct Access: For some conditions (e.g., cancer, mental health), you can call Bupa directly without a GP referral, speeding up diagnosis and treatment.
- Member Offers: Discounts on Bupa services like health assessments, dental, and care homes.
At WeCovr, we enhance this value further. All our private medical and life insurance clients receive complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, helping you stay on top of your health goals. We also offer discounts on other insurance products when you take out a PMI policy with us.
The WeCovr Verdict: Which Insurer is Right for You?
There is no single "best" provider for everyone. The optimal choice depends entirely on your priorities. Based on our extensive experience helping thousands of clients, here is our expert verdict:
-
Choose AXA Health if:
- Comprehensive cover is your top priority.
- You want the most robust mental health support available as standard.
- You are looking for a policy with very few hidden limits and a clear, high-quality service proposition.
-
Choose Aviva if:
- You are budget-conscious but still want a high-quality, flexible policy.
- You are tech-savvy and will make good use of a well-integrated digital GP service.
- You want the flexibility to build a policy that precisely matches your needs without paying for unnecessary extras.
-
Choose Bupa if:
- You value brand recognition and the reassurance of the UK's most established health insurer.
- You like the idea of their "Direct Access" pathways, which can speed up care.
- You live near Bupa-owned facilities and would prefer to use their integrated network.
The best way to make the final decision is to see personalised quotes and policy documents side-by-side. An independent broker like WeCovr is perfectly placed to provide this impartial advice, ensuring you find the ideal balance of cover and cost from across the market.
How to Get the Best Price on Your Private Medical Insurance UK
Navigating the options to secure the best deal can be simple if you follow a few expert tips:
- Use an FCA-Authorised Broker: A broker like WeCovr has access to the whole market and can compare policies and prices for you. This service is free for you, as the broker is paid by the insurer you choose. We often have access to preferential rates.
- Be Smart with Your Excess: Increasing your excess from £0 or £100 to £500 can reduce your premium by 30-40%. It's a trade-off between a lower monthly cost and a higher one-off payment if you claim.
- Review Your Hospital List: If you don't live in Central London, choosing a hospital list that excludes the most expensive city hospitals is an easy way to save money without compromising on the quality of care available to you.
- Compare Every Year: Don't just auto-renew. Insurers' prices and offerings change. A quick comparison each year ensures you always have the most competitive deal.
Does private health insurance cover pre-existing conditions?
Generally, no. Standard private medical insurance in the UK is designed to cover new, acute conditions that arise after your policy begins. Pre-existing conditions are typically excluded, either for a set period (with moratorium underwriting) or permanently (with full medical underwriting). Some specialist policies may offer cover for pre-existing conditions, but these are rare and more expensive.
Is it cheaper to buy PMI direct from an insurer or via a broker?
The price is usually the same, and can sometimes even be cheaper through a broker. An independent PMI broker like WeCovr can compare the entire market for you, not just one brand. We receive a commission from the insurer you choose, so our expert advice and comparison service is completely free for you. This ensures you get the right policy at the best possible price without the hard sell.
Can I switch my private medical insurance provider?
Yes, you can switch providers. It's important to do this carefully to maintain cover for conditions that have developed while you were insured. This can be done using 'Continued Medical Exclusions' (CME) underwriting, where your new insurer agrees to offer the same cover terms as your old one. A broker is invaluable in managing this process to ensure there are no gaps in your cover.
What is a '6-week option' on a PMI policy?
The '6-week option' is a popular cost-saving feature. If you add it to your policy, it means that for any in-patient treatment you need, if the NHS waiting list is less than six weeks, you would use the NHS. If the waiting list is longer than six weeks, your private medical insurance will kick in. As NHS waiting times for many procedures are currently much longer than this, it's a very effective way to lower your premium without significantly impacting your access to private care when you need it most.
Get Your Personalised Comparison Today
The choice between AXA, Aviva, and Bupa is nuanced, with no single right answer. The best private health insurance provider is the one that offers the right protection for your specific needs and budget.
Let us do the hard work for you. Contact a friendly WeCovr adviser today for a free, no-obligation quote and see how these leading brands compare for you.
Sources
- Office for National Statistics (ONS): Mortality, earnings, and household statistics.
- Financial Conduct Authority (FCA): Insurance and consumer protection guidance.
- Association of British Insurers (ABI): Life insurance and protection market publications.
- HMRC: Tax treatment guidance for relevant protection and benefits products.
