
Choosing the right private medical insurance in the UK can feel overwhelming. With so many options, how do you know which provider is truly the best for you? At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we specialise in demystifying this complex market.
This definitive guide compares four of the UK's leading health insurers: AXA Health, Bupa, Vitality, and The Exeter. We'll cut through the marketing jargon to give you the expert insight needed to compare their underwriting, cover, and service, helping you make a truly informed decision.
When you compare private health cover, you're not just comparing price. You're comparing the fundamental promises an insurer makes about your future health. These promises are shaped by three key pillars:
Let's dive into how AXA, Bupa, Vitality, and The Exeter stack up across these crucial areas.
Each of these insurers has a distinct identity and market position. Understanding their core philosophy is the first step in finding your match.
Underwriting is the process an insurer uses to evaluate your health and medical history before offering you a policy. It determines what will be excluded from your cover. It is vital to understand that standard UK private medical insurance does not cover pre-existing or chronic conditions. Its purpose is to cover new, acute conditions that arise after your policy begins.
There are two main types of underwriting you'll encounter:
Full Medical Underwriting (FMU): You provide a full medical history declaration on your application. The insurer then assesses this and applies specific exclusions to your policy from day one.
Moratorium (Mori) Underwriting: You do not declare your full 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. This exclusion can be lifted if you go 2 continuous years on the policy without needing treatment, advice, or medication for that condition.
Here's how the four insurers approach underwriting:
| Underwriting Approach | AXA Health | Bupa | Vitality | The Exeter |
|---|---|---|---|---|
| Full Medical (FMU) | Yes. A standard option providing total clarity on exclusions. | Yes. The traditional route for those who want certainty from the outset. | Yes. Often recommended for a clear understanding of your cover. | Key Strength. Renowned for their flexible and human approach to FMU. |
| Moratorium (Mori) | Yes. Their most popular and quickest option for new customers. | Yes. A standard offering for those who prefer a simpler application. | Yes. A very common choice, aligning with their streamlined digital process. | Yes. A solid moratorium option is available. |
| Switching (CPME) | Yes. Seamless switching available for those with existing cover. | Yes. Allows you to switch from another insurer without losing cover. | Yes. Facilitates easy switching to their platform. | Yes. A straightforward process for those moving their PMI policy. |
| Adviser Insight | Standard and reliable underwriting. What you see is what you get. | A trusted and thorough process, but can be less flexible than others. | Efficient and modern, but the process is quite standardised. | Market Leader for Flexibility. Often able to offer terms where others may decline or apply broad exclusions. This makes them a top choice for those with past health issues. |
Broker Tip: Choosing the right underwriting is critical. A mistake here can lead to a rejected claim down the line. An expert broker at WeCovr can assess your medical history and advise whether FMU or Moratorium is the safer bet for your specific circumstances.
All PMI policies are built on a foundation of Core Cover. This typically covers the major costs associated with hospital treatment.
Beyond this, you can add Outpatient Cover. This pays for specialist consultations, diagnostic tests (like MRI and CT scans), and therapies that do not require a hospital admission. This is where policies differ significantly.
Here's a comparison of typical cover structures:
| Feature | AXA Health (Personal Health) | Bupa (Bupa By You) | Vitality (Personal Healthcare) | The Exeter (Health+) |
|---|---|---|---|---|
| Core In/Day-Patient | Full cover as standard. | Full cover as standard. | Full cover as standard. | Full cover as standard. |
| Cancer Cover | Comprehensive cancer cover is standard, with options to enhance it. | A core strength. Full, comprehensive cancer cover is a cornerstone of their plans. | Full cancer cover is a non-negotiable part of their core offering. | Comprehensive cancer cover included as standard on all policies. |
| Typical Outpatient Limits | Flexible. Options from £0 (no cover) up to £500, £1,000, or fully comprehensive. | Flexible. Tiered options from £0 up to £500, £750, £1,000, or fully comprehensive. | Flexible. Ranges from nil cover to fully comprehensive. Can be linked to reward status. | Simple & Clear. Options for £0, £500, or £1,000. |
| Mental Health Cover | Usually an add-on, but includes strong support via their Doctor at Hand service. | A strong focus. Good options for adding extensive mental health cover are available. | Integrated approach. Cover is included for certain conditions, with a focus on wellbeing. | Excellent. In-patient and day-patient mental health cover is included as standard. |
Client Mistake: A common error is choosing a policy with a low outpatient limit (£500, for example) to save money. A single MRI scan can cost over £500, and a specialist consultation £250, quickly using up your limit and leaving you with significant out-of-pocket expenses.
Your choice of insurer determines your choice of hospital. Insurers negotiate deals with hospital groups, creating "hospital lists" or "networks." A policy with a limited list will be cheaper but may not include the convenient private hospital down the road.
Adviser Tip: Never assume your local hospital is on the list. When getting a quote, always have your adviser at WeCovr cross-reference the hospital list with the facilities in your area that you would want to use.
The value of a modern health insurance policy often lies in the day-to-day benefits, not just the hospital cover.
| Feature | AXA Health | Bupa | Vitality | The Exeter |
|---|---|---|---|---|
| Wellness Programme | AXA ActivePlus: Offers gym discounts and other health-related perks. Good, but less central to the policy than Vitality. | Bupa Rewards: A catalogue of discounts and offers on various health and lifestyle brands. | Market Leader. The core of the proposition. Earn points for activity to get weekly coffees, cinema tickets, and significant discounts on Apple Watches, travel, and more. | Healthwise App: Provides access to remote GPs, prescription services, and mental health/physio support for all members. Focuses on utility over lifestyle rewards. |
| Therapies (Physio etc.) | Included with outpatient cover. Limits are usually financial (e.g., up to your £1,000 outpatient limit). | Included with outpatient cover. Limits can be financial or based on a number of sessions. | Usually covered under the outpatient limit. They have a network of preferred therapy partners. | Covered under the outpatient limit. A set financial amount to use as needed for recognised therapies. |
| Digital GP Service | Doctor at Hand: A well-regarded 24/7 service powered by an external provider. | Digital GP: Provided by Babylon, offering 24/7 video consultations and prescription services. | Vitality GP: An integrated app-based service for video consultations and onward referrals. | Healthwise App: In-built remote GP service, available to all members regardless of their cover level. |
When you're unwell, the last thing you want is a difficult claims process. While service can be subjective, market reputation and broker experience provide a clear picture.
The "best" PMI provider is different for everyone. Let's look at some common scenarios to see who might be the best fit.
The Young, Active Professional:
The Family Needing Comprehensive Cover:
The Older Applicant or Someone with a Health History:
The Person Seeking Straightforward, No-Fuss Cover:
Working with an expert adviser at WeCovr allows you to tailor these options precisely, ensuring you don't pay for benefits you won't use or miss out on cover that's vital for you.
There is no single "winner" in the UK private medical insurance market. Each of these four insurers offers a compelling proposition for different needs.
The most important takeaway is that the cheapest policy is rarely the best. The true value of private medical insurance is revealed when you make a claim. A policy that is poorly underwritten or has inadequate cover limits can be worse than no policy at all.
This is why using an independent, FCA-authorised broker like WeCovr is so crucial.
Ready to find the perfect health insurance policy that matches your unique needs and budget? Don't navigate the maze alone.
Speak to a WeCovr adviser today for a free, no-obligation comparison and quote. Let us do the hard work for you.






