TL;DR
Navigating the UK private medical insurance market can be complex, but understanding your options is the first step towards securing the right cover. At WeCovr, our experts have helped arrange thousands of policies, and this guide provides an in-depth look at WPA, a provider with a unique approach to health insurance. An overview of WPA private health insurance and WPA private medical insurance – cover style, service and flexibility Western Provident Association, or WPA, is a well-established and respected name in the UK private health insurance landscape.
Key takeaways
- What makes WPA different from other insurers.
- How their core policies work for individuals, families, and businesses.
- The unique features they offer, such as 'Shared Responsibility'.
- Who WPA is best suited for.
- How to get the most competitive quote for your needs.
Navigating the UK private medical insurance market can be complex, but understanding your options is the first step towards securing the right cover. At WeCovr, our experts have helped arrange thousands of policies, and this guide provides an in-depth look at WPA, a provider with a unique approach to health insurance.
An overview of WPA private health insurance and WPA private medical insurance – cover style, service and flexibility
Western Provident Association, or WPA, is a well-established and respected name in the UK private health insurance landscape. As a not-for-profit organisation, their focus is on providing excellent service and flexible cover for their members, rather than generating profits for shareholders.
This article offers a comprehensive overview of WPA's private medical insurance (PMI) policies. We will explore:
- What makes WPA different from other insurers.
- How their core policies work for individuals, families, and businesses.
- The unique features they offer, such as 'Shared Responsibility'.
- Who WPA is best suited for.
- How to get the most competitive quote for your needs.
Who are WPA and What Makes Them Different?
Founded in 1901, WPA has a long history of serving the health needs of its members. Their status as a provident association (a type of not-for-profit) is their most significant differentiator in a market dominated by large, shareholder-owned corporations.
Key Characteristics of WPA:
- Not-for-Profit Ethos: Any surplus is reinvested back into the organisation to improve services, develop new products, and keep premiums competitive. This customer-centric model is at the heart of their operations.
- Focus on Service: WPA consistently receives high praise for its UK-based customer service. Their teams are known for being accessible, knowledgeable, and empathetic, which is crucial when you need to make a claim.
- Flexibility and Choice: WPA policies are designed to be highly customisable. Members can tailor their cover by choosing different hospital lists, excess levels, and optional extras, allowing for greater control over their premium.
- Innovative Features: They are known for unique concepts like 'Shared Responsibility', a co-payment option designed to make comprehensive cover more affordable.
This structure often results in a strong sense of community and trust among their members, setting them apart from larger, more impersonal providers.
How Does WPA Private Medical Insurance Work?
Like all UK PMI, a WPA policy is designed to cover the costs of diagnosis and treatment 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.
It is crucial to understand that standard private medical insurance in the UK, including WPA's policies, does not cover pre-existing conditions or the ongoing management of chronic conditions (like diabetes, asthma, or high blood pressure).
The process typically follows these steps:
- See Your GP: If you develop a new symptom, your first port of call is your NHS GP.
- Get an Open Referral: Your GP will assess you. If they believe you need to see a specialist, they will provide you with an 'open referral' letter. This means they recommend a type of specialist (e.g., a cardiologist) rather than a specific named consultant.
- Contact WPA: You call WPA's claims team with your referral letter. They will verify your cover and authorise the consultation.
- Choose a Specialist: WPA will provide a list of recognised specialists from their approved network. This gives you a choice of consultants who meet their quality and fee guidelines.
- Diagnosis and Treatment: The specialist will diagnose your condition. If further tests (like an MRI) or treatment (like surgery) are needed, WPA must pre-authorise it before you proceed.
- Direct Settlement: WPA settles the bills directly with the hospital and specialists, minus any excess or co-payment you have on your policy.
This streamlined process ensures you get fast access to expert care while WPA manages the administration and costs.
WPA's Core Health Insurance Products Explained
WPA offers a range of policies tailored to different needs, from individuals and families to small businesses and large corporations.
For Individuals & Families: Flexible Health
This is WPA's flagship product for individuals and families. It is built around a modular system, allowing you to balance your level of cover with your budget. It comes in three main tiers.
| Feature | Flexible Health - Essentials | Flexible Health - Premier | Flexible Health - Elite |
|---|---|---|---|
| Ideal For | Those seeking core cover for major procedures at a lower cost. | A balanced option with good outpatient and therapy cover. | Comprehensive cover with high limits and extensive benefits. |
| In-patient & Day-patient | Covered in full. | Covered in full. | Covered in full. |
| Out-patient Consultations | Up to 2 consultations. Scans on GP/Specialist referral. | Up to £1,000 limit. | Covered in full. |
| Therapies | Up to £350 limit. | Up to £750 limit. | Covered in full. |
| Cancer Care | Advanced cancer drugs included. | Advanced cancer drugs included. | Advanced cancer drugs included. |
| Mental Health Cover | £500 cash benefit for eligible in-patient treatment. | Optional add-on available. | Up to 28 days in-patient/day-patient care. |
Adviser Insight: The 'Premier' plan is often the most popular choice, offering a strong balance between comprehensive cover and affordability. The 'Essentials' plan is an excellent entry-level option for those primarily concerned with covering the cost of surgery.
For Businesses: Company Health Insurance
WPA has a strong reputation in the business health insurance market, particularly among small and medium-sized enterprises (SMEs).
- Enterprise Flexible Benefits: Designed for businesses with 2-14 employees, this scheme is highly customisable. Employers can set a core level of cover and allow employees to self-fund upgrades, providing flexibility without increasing the company's costs.
- Precision Corporate Healthcare: For larger companies (15+ employees), this offers a bespoke solution. It can be tailored to the specific needs of the workforce, with options for dental cover, travel insurance, and advanced health screening programmes.
Offering PMI is a powerful tool for attracting and retaining top talent, reducing absenteeism, and demonstrating a company's commitment to employee wellbeing.
Understanding WPA's Unique Features and Benefits
WPA policies include several features that distinguish them from the competition.
'Shared Responsibility' – The Co-payment Model
This is arguably WPA's most innovative feature. Instead of a traditional excess (a fixed amount you pay per claim or per year), Shared Responsibility is a co-payment model.
How it works: You agree to pay 25% of the cost of every claim, up to a chosen annual limit. This limit is your 'Shared Responsibility Cap'. Once you've paid that amount in a policy year, WPA pays 100% of all subsequent eligible claims for the rest of that year.
Example Scenario:
- You have a WPA policy with a £1,000 Shared Responsibility Cap.
- You have a consultation and an MRI scan costing £1,200.
- You pay 25% of this bill, which is £300. WPA pays the remaining £900.
- Your remaining Shared Responsibility for the year is now £700 (£1,000 - £300).
- Later in the year, you need surgery costing £8,000.
- You only pay the remaining £700 of your cap. WPA pays the other £7,300.
- For any further treatment that year, you pay nothing more, as you have met your cap.
Why choose it? Opting for Shared Responsibility can significantly reduce your monthly premium. It is best suited for those who are happy to share a portion of the cost of smaller claims in exchange for a lower fixed premium, while still having robust protection against large medical bills.
NHS Cancer Cash Benefit
While WPA provides comprehensive cancer cover, some members may choose to use the NHS for their cancer treatment. If you have this benefit and opt for NHS treatment, WPA provides a cash payment for each day, night, or chemotherapy session you receive. This money is yours to use as you wish – for travel costs, household bills, or anything else.
Digital Health Services
All WPA members get access to a remote GP service. This allows you to have a phone or video consultation with an NHS-practising GP 24/7, often within hours. They can provide medical advice, issue private prescriptions, and make referrals for specialist treatment, helping to speed up the entire diagnostic journey.
WPA Underwriting: How Your Medical History is Assessed
When you apply for private medical insurance, the insurer needs to assess your medical history. This process is called underwriting. WPA offers two main options.
-
Full Medical Underwriting (FMU): You provide a full declaration of your medical history on the application form. The underwriting team assesses this information and will explicitly state any conditions that will be excluded from cover. This provides absolute clarity from day one but can be a more involved process.
-
Moratorium Underwriting: This is the most common type of underwriting. You do not declare your medical history upfront. Instead, the policy automatically excludes any condition you have had symptoms, treatment, or advice for in the 5 years before the policy started. However, if you go 2 full years on the policy without any symptoms, treatment, or advice for that condition, it may become eligible for cover.
Switching from Another Insurer (CPME Underwriting): If you already have a policy with another UK insurer, you can often switch to WPA on a 'Continued Personal Medical Exclusions' (CPME) basis. This means WPA will carry over the same exclusions from your previous policy. The advantage is that you don't have to go through a new moratorium period, and any conditions that were already covered by your old policy will continue to be covered by WPA. This makes switching insurers seamless.
An expert broker like WeCovr can help you navigate the complexities of underwriting and ensure you choose the best option for your circumstances.
Who is WPA Private Health Insurance Best For?
WPA's flexible approach and service-led ethos make it a strong contender for a wide range of people.
- Individuals & Families Seeking Value and Control: Those who want high-quality cover but are also budget-conscious will find the 'Shared Responsibility' model and modular plans very appealing. It puts you in control of the trade-off between premium cost and potential claim contribution.
- Self-Employed Professionals & Directors: The ability to access fast diagnostics and treatment is vital when you run your own business. A WPA policy minimises downtime and provides peace of mind. Their plans for small businesses are particularly well-regarded.
- Companies Prioritising a Positive Culture: Businesses that want to offer a genuinely valuable employee benefit will appreciate WPA's excellent service reputation. A good claims experience reflects well on the employer.
- Those Who Value Customer Service: If you are tired of long call queues and impersonal service, WPA’s not-for-profit, member-focused approach is a refreshing alternative.
Comparing WPA with Other Major UK Insurers
It's helpful to see how WPA stacks up against the other big names in the private medical insurance UK market.
| Provider | Key Differentiator | Market Position | Best For |
|---|---|---|---|
| WPA | Not-for-profit, 'Shared Responsibility' co-payment, strong service focus. | Specialist provider with a loyal member base. | Flexibility, cost control, and personal service. |
| Bupa | Huge global brand, owns its own hospitals and clinics. | One of the largest and most well-known UK providers. | Brand recognition and integrated healthcare services. |
| Aviva | Part of a massive insurance group, often offers competitive premiums. | A major player with a very large customer base. | Bundling with other insurance products and competitive pricing. |
| AXA Health | Strong focus on digital health tools and mental health support pathways. | A leading global brand with a strong UK presence. | Comprehensive digital tools and wellbeing programmes. |
Brokerage Insight: While Bupa and Aviva compete heavily on scale and price, WPA competes on service, flexibility, and its unique non-profit structure. For many, the ability to speak to a helpful UK-based team and tailor a policy precisely to their needs outweighs the brand recognition of the larger players.
WPA and WeCovr: Your Expert Guide
Choosing the right private medical insurance is a significant decision. As independent, unbiased brokers, our role at WeCovr is to provide impartial, expert advice. We compare policies from across the market, including WPA, to find the cover that best fits your needs and budget – all at no cost to you.
When you arrange a policy through us, you also get:
- Complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app to support your health goals.
- Exclusive discounts on other insurance products, such as life or income protection insurance, helping you build a complete financial safety net.
We handle the paperwork, explain the fine print, and ensure you get the most value from your investment in your health.
Is WPA a good health insurance provider?
Does WPA cover pre-existing conditions?
What is WPA's 'Shared Responsibility' feature?
How do I make a claim with WPA?
Ready to explore how a WPA policy could work for you? Contact WeCovr today. Our expert advisers can provide a free, no-obligation quote and compare WPA against other leading providers to ensure you make the best choice for your health and your wallet.
