TL;DR
Choosing the right private medical insurance in the UK can feel overwhelming. With so many options, how do you decide? At WeCovr, our FCA-authorised experts have helped arrange cover for thousands of clients, giving us unparalleled insight into the market.
Key takeaways
- Cover: What treatments are included as standard, what are the optional extras, and where are the hidden gaps?
- Cost: How do their prices stack up for different ages and cover levels?
- Service: What are their member benefits, digital tools, and claims processes really like?
- AXA: Offers a range of outpatient limits, from a basic £500 to a fully comprehensive "unlimited" option.
- Aviva (illustrative): Their "Expert Select" hospital option requires you to use their approved specialists, but in return, you get full outpatient cover. Otherwise, you can choose financial limits (e.g., £1,000).
Choosing the right private medical insurance in the UK can feel overwhelming. With so many options, how do you decide? At WeCovr, our FCA-authorised experts have helped arrange cover for thousands of clients, giving us unparalleled insight into the market. This guide cuts through the noise, offering a direct, expert comparison of the UK's three biggest PMI brands: AXA, Aviva, and Bupa.
A three-way comparison of the UK's biggest PMI brands on cost, cover, and service
When you're investing in your health, you need absolute clarity. This article is designed to be your definitive guide, directly comparing AXA, Aviva, and Bupa on the three pillars that matter most:
- Cover: What treatments are included as standard, what are the optional extras, and where are the hidden gaps?
- Cost: How do their prices stack up for different ages and cover levels?
- Service: What are their member benefits, digital tools, and claims processes really like?
We'll break down each provider's offering for 2026, helping you understand which brand best aligns with your personal needs and budget.
Who Are the Big Three? A Snapshot of AXA, Aviva, and Bupa
While they all offer private health cover, these three giants have distinct histories and philosophies.
AXA Health: Part of a global insurance powerhouse, AXA Health (formerly AXA PPP Healthcare) brings significant financial muscle and a focus on digital innovation to the UK market. They are known for their flexible "Personal Health" policy, which allows for a high degree of customisation.
Aviva: As the UK's largest general insurer, Aviva has a formidable presence and a long-standing reputation. Their "Healthier Solutions" policy is a popular choice, backed by a vast hospital network and a strong emphasis on member wellness and digital GP services.
Bupa: Unique among the three, Bupa is a provident organisation. This means it has no shareholders and reinvests its profits back into healthcare services. Bupa not only insures you but also runs its own network of hospitals, clinics, and dental centres, offering a more integrated healthcare journey.
| Provider | Established | UK Customer Base (est.) | Key Differentiator |
|---|---|---|---|
| AXA | 1940 (as PPP) | 2 million+ | Highly customisable policies & digital tools |
| Aviva | 1696 (legacy) | 1.1 million+ | Strong UK brand recognition & wellness focus |
| Bupa | 1947 | 3 million+ | No shareholders; owns its own clinics/hospitals |
Core Cover Comparison: What's Included as Standard?
Every private medical insurance policy starts with a "core" offering. This typically covers the most expensive treatments, primarily those requiring a hospital stay.
Crucially, all standard UK PMI policies are designed for acute conditions — illnesses or injuries that are new, curable, and arise after you take out the policy. They do not cover pre-existing conditions or chronic conditions (long-term illnesses like diabetes or asthma that require ongoing management).
Here’s how the core cover from AXA, Aviva, and Bupa generally compares.
| Feature | AXA (Personal Health) | Aviva (Healthier Solutions) | Bupa (Bupa By You) |
|---|---|---|---|
| Inpatient & Day-Patient Care | Covered in full for eligible treatment. | Covered in full for eligible treatment. | Covered in full for eligible treatment. |
| Cancer Cover (Core) | Comprehensive cancer cover as standard, including surgery, radiotherapy, and chemotherapy. | Extensive cancer cover as standard. Some advanced therapies may require an upgrade. | Comprehensive cancer cover as standard. Known for "Direct Access" to specialists. |
| NHS Cash Benefit | Yes. Pays a cash sum if you choose to receive eligible inpatient treatment on the NHS. | Yes. Provides a fixed cash benefit for each night spent in an NHS hospital for eligible care. | Yes. Offers an NHS cash benefit if you opt for NHS treatment instead of private. |
| Post-Treatment Care | Includes a set number of follow-up consultations and therapies after surgery. | Covers post-operative care, including consultations and physiotherapy sessions. | Covers follow-up care after an eligible inpatient or day-patient procedure. |
| Standard Mental Health | Typically covers short-term, inpatient psychiatric treatment. More comprehensive cover is optional. | Usually covers inpatient mental health care. Outpatient cover is a popular add-on. | Covers inpatient and day-patient mental health treatment. Fuller cover is an optional extra. |
| Virtual GP Access | Includes "Doctor at Hand" 24/7 virtual GP service. | Includes "Aviva Digital GP" provided by Square Health. | Includes "Digital GP" service for 24/7 phone or video consultations. |
Adviser Insight: While "comprehensive cancer cover" is a standard feature, the specifics matter. Bupa's 'Direct Access' pathway can speed up diagnosis for certain symptoms without a GP referral, which is a significant advantage. AXA and Aviva often have very high or unlimited financial limits for cancer drugs, but always check the specifics of the policy wording.
Optional Extras & Customisation: Tailoring Your Policy
The real difference between policies emerges when you start adding optional modules. This is where you can tailor the cover to your exact needs and budget.
1. Outpatient Cover This is the most important and impactful add-on. It covers diagnostic tests, specialist consultations, and scans that do not require a hospital bed. Without it, you would need to use the NHS for your initial diagnosis before you could be referred for private inpatient treatment.
- AXA: Offers a range of outpatient limits, from a basic £500 to a fully comprehensive "unlimited" option.
- Aviva (illustrative): Their "Expert Select" hospital option requires you to use their approved specialists, but in return, you get full outpatient cover. Otherwise, you can choose financial limits (e.g., £1,000).
- Bupa: Provides different levels of cover, allowing you to choose a set monetary limit for outpatient consultations and diagnostics.
2. Therapies Cover This add-on covers treatments like physiotherapy, osteopathy, and chiropractic care.
- All three providers offer this as an optional extra.
- The key difference is the number of sessions covered or the total financial limit.
- Often, a GP or specialist referral is required, but some policies allow self-referral for a limited number of sessions.
3. Mental Health Cover This is one of the most sought-after benefits in 2026. While core policies cover inpatient care, this add-on extends cover to outpatient psychiatric consultations and therapy sessions.
- AXA, Aviva, and Bupa all offer strong, comprehensive mental health upgrades.
- They provide access to networks of psychiatrists, psychologists, and therapists.
- Limits can vary, so it's vital to check how much outpatient therapy is covered per year.
4. Dental & Optical Cover This is usually a cash-back style benefit for routine check-ups, treatments, and new eyewear. It's less "insurance" and more a budgeting tool. All three offer it as an add-on, but it's important to weigh the annual premium for this benefit against your expected yearly spend.
| Optional Extra | Common Approach by AXA, Aviva, Bupa | Adviser Tip |
|---|---|---|
| Outpatient Cover | Tiered financial limits (£500, £1000, Unlimited) | This has the biggest impact on your premium. A mid-range limit of £1,000 is often the sweet spot for balancing cost and cover. |
| Therapies Cover | Limits on number of sessions or total cost. | If you have an active lifestyle or a history of musculoskeletal issues, this is a very valuable add-on. |
| Mental Health | Extends cover to outpatient therapy and psychiatric consultations. | In today's world, this is a must-consider option. Check the limits carefully as they can vary significantly. |
| Dental & Optical | Cash-back benefit for routine and major treatments. | Calculate your expected annual spend. If it's less than the premium increase, this add-on may not be cost-effective for you. |
Cost Comparison: How Much Does PMI with AXA, Aviva, or Bupa Cost in 2026?
This is the million-dollar question. The price of your private medical insurance UK policy is highly personal and depends on several factors:
- Age: Premiums increase as you get older.
- Location: Living in or near central London significantly increases costs due to higher hospital charges.
- Cover Level: The more optional extras you add (especially outpatient), the higher the price.
- Excess (illustrative): This is the amount you agree to pay towards a claim each year. A higher excess (£500 or £1,000) will lower your premium.
- Hospital List: Choosing a limited hospital network is cheaper than a full nationwide list.
- Underwriting: The method used to assess your medical history.
To give you a real-world idea, here are some illustrative monthly premiums for 2026.
Important: These are estimates only. For an accurate price, you must get a personalised quote.
| Scenario | AXA (est. monthly) | Aviva (est. monthly) | Bupa (est. monthly) |
|---|---|---|---|
| 35-year-old, Manchester £1,000 Outpatient, £250 Excess | £65 | £62 | £70 |
| 50-year-old couple, Bristol Full Outpatient, £500 Excess | £190 | £185 | £205 |
| Family (40, 38, 8, 5), Birmingham Core Cover Only, £1,000 Excess | £110 | £105 | £120 |
Client Mistake: A common mistake is focusing solely on the cheapest headline price. An ultra-low premium often means a very high excess, no outpatient cover, and a restricted hospital list. This can lead to disappointment at the point of claim. An expert PMI broker like WeCovr can help you find the true value, not just the lowest cost.
Underwriting Explained: Moratorium vs. Full Medical Underwriting
When you apply for PMI, the insurer needs to know about your medical history. They do this in one of two ways.
1. Moratorium Underwriting (Mori) This is the most common method. You don't have to declare your full medical history upfront. Instead, the insurer applies a general rule: they will not cover any condition you've had symptoms, treatment, or advice for in the five years before your policy started.
However, if you go for two continuous years on the policy without needing any treatment, advice, or medication for that condition, it may become eligible for cover.
- Pros: Quick and easy application process.
- Cons: Lack of certainty. You may not know if a condition is covered until you make a claim.
2. Full Medical Underwriting (FMU) With FMU, you complete a detailed health questionnaire as part of your application. The insurer assesses your medical history and then offers you a policy with specific, named exclusions for any pre-existing conditions.
- Pros: Complete clarity from day one. You know exactly what is and isn't covered.
- Cons: Longer application process. Exclusions are often permanent.
Which is right for you? A WeCovr adviser can help you decide. Mori is often good for those with a clean bill of health, while FMU can provide valuable certainty for those with a more complex medical history.
Hospital Lists: Where Can You Get Treated?
Your choice of hospital list directly impacts your premium. All three providers offer a tiered selection.
- Tier 1 (Lowest Cost): A select list of local or partner hospitals. Good for saving money if you're happy with a more limited choice.
- Tier 2 (Standard Cost): A comprehensive nationwide list that includes most private hospitals outside of central London. This is the most popular option.
- Tier 3 (Highest Cost): The full nationwide list plus expensive private hospitals in central London (e.g., The Lister, The London Clinic).
Bupa's model is slightly different as they have their own Bupa Cromwell Hospital and a network of Bupa Health Centres, which can offer a more seamless experience for members using their facilities. AXA and Aviva partner with all major private hospital groups, including Nuffield Health, Spire Healthcare, and Circle Health Group, giving you extensive choice.
Member Benefits & Wellness Programmes: Beyond Insurance
In 2026, PMI is about more than just claims. Insurers compete to offer value-added services that help you stay healthy.
| Provider | Key Wellness Benefits |
|---|---|
| AXA | Doctor at Hand: 24/7 virtual GP. Strong mental health support pathway and access to dedicated nurses. Working Body service for musculoskeletal issues. |
| Aviva | Aviva Digital GP: 24/7 virtual GP with prescription service. Get Active scheme with gym discounts. Strong emphasis on preventative wellbeing tools within their app. |
| Bupa | Digital GP: 24/7 virtual GP. Direct Access: For cancer and mental health, allowing you to bypass a GP referral for certain symptoms. Family Mental HealthLine and access to Bupa's own health clinics. |
As a WeCovr client, you also get complimentary access to CalorieHero, our advanced AI-powered calorie and nutrition tracking app, helping you manage your health goals alongside the security of your PMI policy.
Claims & Customer Service: Who Delivers When It Matters?
A policy is only as good as the service you receive when you need it most.
- AXA is often praised for its digital-first approach. Their online portal and app make it easy to start a claim and track its progress.
- Aviva has invested heavily in its telephone support and clinical assessment teams, providing a guided experience through the claims journey.
- Bupa's integrated nature can be a major plus. If you are treated in a Bupa facility, the billing is often handled seamlessly in the background. Their telephone-based claims process is well-established and efficient.
All three providers have pre-authorisation processes, meaning you must get a claim approved before you undergo treatment. Failing to do so can result in your claim being denied.
Broker Advantage: If you ever face a problem with a claim, having a broker like WeCovr on your side is invaluable. We can act as your advocate, liaising with the insurer to ensure a fair and timely resolution.
AXA vs Aviva vs Bupa: The Final Verdict for 2026
There is no single "best" provider for everyone. The right choice depends entirely on your priorities.
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Choose AXA if: You want maximum flexibility and the ability to build a highly customised policy. Their digital tools are excellent, and they are often competitive on price for younger customers.
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Choose Aviva if: You value a strong, trusted UK brand and comprehensive wellness benefits. Their "Healthier Solutions" policy is a robust, well-regarded product, often appealing to families and those looking for good all-round cover.
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Choose Bupa if: You want a more integrated healthcare experience and the reassurance of a provider that runs its own facilities. Their "Direct Access" pathways for cancer and mental health are market-leading benefits.
The best way to find your ideal policy is to compare personalised quotes from all three.
How WeCovr Helps You Choose
Making this decision alone is tough. As independent, FCA-authorised brokers, our service is designed to give you confidence and clarity, at no extra cost to you.
- We Compare The Market: We'll get you quotes from AXA, Aviva, Bupa, and other leading insurers like The Exeter and Vitality, ensuring you see the whole picture.
- Expert, Unbiased Advice: Our specialists will explain the pros and cons of each policy in plain English, helping you find the perfect balance of cover and cost.
- It's Free: Our service is completely free for you to use. We are paid a commission by the insurer you choose, which doesn't affect the price you pay.
- Added Value: On top of finding you the best PMI deal, we offer discounts on other policies like life or income protection insurance.
Don't navigate the complex world of private health insurance alone. Let an expert guide you to the right decision.
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Can I switch my private health insurance provider easily?
What is a policy excess in health insurance?
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.












