As an FCA-authorised broker that has helped arrange over 750,000 policies, WeCovr provides expert analysis of the UK private medical insurance market. This guide compares comprehensive outpatient cover from two leading providers, AXA Health and Aviva, helping you make an informed choice for your health and peace of mind.
Choosing the right private medical insurance (PMI) can feel like navigating a maze of options, especially when it comes to outpatient cover. This single feature can be the difference between a policy that simply covers hospital stays and one that provides rapid access to diagnostics and treatment from the very first consultation.
In this comprehensive guide, we put two of the UK’s most respected PMI providers, AXA Health and Aviva, under the microscope. We’ll break down exactly what their outpatient options include, how they differ, and which might be the best fit for you and your family.
Before we dive into the specifics, let's clarify what "outpatient" means in the context of health insurance.
An outpatient is someone who receives medical care—such as a consultation, test, or minor procedure—at a hospital or clinic but does not need to be admitted for an overnight stay. In contrast, an inpatient is formally admitted to a hospital bed.
Outpatient cover is arguably one of the most valuable components of a modern PMI policy. Why? Because it covers the crucial first steps of your medical journey:
Without outpatient cover, you would rely on the NHS for your initial diagnosis and then potentially use your PMI only for the inpatient surgery itself. Comprehensive outpatient cover ensures your entire private healthcare journey is seamless and swift.
AXA Health and Aviva are household names in the UK, both with a long-standing reputation for providing robust insurance products. They are titans of the industry, underwriting policies for millions of individuals and businesses.
Both providers offer excellent core products, but their approach to optional benefits like outpatient cover has key differences.
All PMI policies start with a core module. This is the foundation of your cover and typically includes treatment received as an inpatient or day-patient.
Here’s what is generally included as standard with both AXA and Aviva's core plans:
Feature | Description |
---|---|
Inpatient Treatment | Covers costs if you are admitted to a hospital bed for treatment, including surgery, accommodation, and nursing care. |
Day-Patient Treatment | Covers scheduled surgery or treatment where you are admitted to a hospital or clinic but do not stay overnight. |
Comprehensive Cancer Cover | Both providers offer extensive cancer cover as standard, including surgery, chemotherapy, and radiotherapy. |
Hospital Fees & Specialist Charges | Pays for the costs associated with your hospital stay and the fees charged by surgeons and anaesthetists. |
Outpatient cover is an optional extra that you add to this core plan. You can choose different levels of cover, from full, unlimited cover to a capped amount per policy year.
This is one of the most important principles of private medical insurance in the UK. Standard PMI policies are designed to cover acute conditions that arise after you take out the policy.
Standard PMI policies from AXA, Aviva, and other UK providers do not cover the routine management of chronic conditions or treatment for pre-existing conditions. This is a fundamental rule of the market. The purpose of PMI is to get you diagnosed and treated for new, curable medical issues, quickly.
AXA Health's 'Personal Health' plan is modular, allowing you to build a policy that suits your needs and budget. Their outpatient options are clear and flexible.
1. Full Outpatient Cover This is their most comprehensive option. If you choose this, AXA will pay in full for:
2. Standard Outpatient Cover This option provides a good balance of cover and cost. It includes:
3. Limited Outpatient Cover (Financial Cap) A more budget-friendly choice where you set a financial limit on your outpatient claims per year. AXA typically offers caps such as £500, £1,000, or £1,500.
4. The 'Therapies' Option For AXA, therapies are a separate add-on. If you want cover for physiotherapy, osteopathy, or chiropractic sessions, you must add this option. It covers a set number of sessions per year following a GP or specialist referral.
AXA's Outpatient Structure Summary
Option | Specialist Consultations & Tests | Scans (MRI, CT, PET) | Therapies (Physio, etc.) |
---|---|---|---|
Full Outpatient | Covered in Full | Covered in Full | Requires 'Therapies' add-on |
Standard Outpatient | Covered in Full | Covered in Full | Requires 'Therapies' add-on |
Limited Outpatient | Covered up to annual limit | Covered up to annual limit | Requires 'Therapies' add-on |
Aviva’s 'Healthier Solutions' policy also offers different tiers of outpatient cover. Their approach integrates therapies more directly into their outpatient limits, which is a key point of difference from AXA.
1. Full Outpatient Cover Aviva’s top-tier option pays in full for eligible outpatient treatment, including:
2. Limited Outpatient Cover (Financial Cap) Aviva provides several financial limits to choose from, typically £500, £1,000, or £1,500 per policy year.
3. Diagnostics Only Cover Aviva also offers a 'Limited Diagnostics' option. This does not cover consultations with a specialist but will cover the cost of diagnostic tests and scans if a specialist refers you on the NHS. It's a lower-cost way to speed up the diagnostic part of your journey.
Aviva's Outpatient Structure Summary
Option | Specialist Consultations | Scans & Diagnostics | Therapies (Physio, etc.) |
---|---|---|---|
Full Outpatient | Covered in Full | Covered in Full | Covered in Full |
Limited Outpatient (£500-£1500) | Covered up to annual limit | Covered up to annual limit | Covered up to annual limit |
Limited Diagnostics | Not Covered | Covered (on NHS referral) | Not Covered |
This table highlights the key differences in how AXA and Aviva structure their comprehensive outpatient cover.
Feature | AXA Health (Personal Health) | Aviva (Healthier Solutions) | WeCovr's Expert Take |
---|---|---|---|
'Full Cover' Philosophy | 'Full Outpatient' covers consultations and scans. Therapies are a separate add-on. | 'Full Outpatient' is truly comprehensive and includes consultations, scans, and therapies under one umbrella. | Aviva's 'Full' option is simpler and more all-inclusive. AXA's modular approach offers more granular control, which may suit some buyers. |
'Limited Cover' Structure | The financial cap applies only to consultations and diagnostics. Therapies are covered separately if added. | The financial cap is a single pot for consultations, diagnostics, and therapies combined. | Aviva's single pot is easier to understand but can be used up quickly. AXA's separation can protect your therapy cover from being eroded by expensive scans. |
Therapy Access | Requires the specific 'Therapies' add-on. Can be accessed via GP referral (on some plans). | Included within the main outpatient limits. Typically requires a specialist referral. | AXA's direct GP referral for physio can be faster. Aviva's inclusion is simpler if you opt for full cover. |
Diagnostics Only Option | Not typically offered as a standalone outpatient option. | Available as 'Limited Diagnostics', covering scans only. | This is a useful budget option from Aviva for those mainly concerned with the cost and wait times for scans like MRIs. |
Mental Health Pathway | Strong mental health cover, often with options for outpatient psychology sessions. | Also provides robust mental health cover, with access to therapists and psychologists. | Both are excellent in this area. The specifics of which conditions are covered can vary, making a detailed comparison by a PMI broker essential. |
Let's see how these differences play out with a common medical issue.
Scenario: Persistent Back Pain
Journey with Aviva 'Full Outpatient' Cover:
Journey with AXA 'Standard Outpatient' + 'Therapies' Add-on:
Journey with Aviva '£1,000 Outpatient Limit' Cover:
As you can see, the structure of the outpatient cover matters immensely. The WeCovr team can walk you through these scenarios to find the policy structure that best protects you against the health issues you're most concerned about.
The cost of private health cover is highly personal. It's influenced by:
Below are illustrative monthly premiums for a 40-year-old non-smoker living in Manchester. These are estimates only and will vary.
Provider & Cover Level | Excess | Estimated Monthly Premium |
---|---|---|
AXA Personal Health (Core + Full Outpatient + Therapies) | £250 | £95 |
AXA Personal Health (Core + £1,000 Outpatient + Therapies) | £250 | £70 |
Aviva Healthier Solutions (Core + Full Outpatient) | £250 | £90 |
Aviva Healthier Solutions (Core + £1,000 Outpatient) | £250 | £65 |
Key Takeaway: The pricing is often very competitive. Aviva's limited option may appear slightly cheaper because the £1,000 cap has to cover therapies as well, whereas the AXA example includes a separate therapy allowance. This is why a simple price comparison is not enough—you need to understand what you're getting for your money.
PMI is no longer just about claims. Both providers offer a suite of wellness benefits to help you stay healthy.
WeCovr's Added Value: At WeCovr, we believe in promoting proactive health. That's why when you take out a PMI or Life Insurance policy through us, we provide:
You could go directly to AXA or Aviva, but you would only see one side of the picture. An independent, FCA-authorised broker like WeCovr works for you, not the insurer.
Both AXA and Aviva offer outstanding private medical insurance with excellent comprehensive outpatient options. There is no single "best" provider—only the best provider for you.
Ultimately, the subtle but important differences in their policy structures, hospital lists, and pricing mean that the right choice requires a personalised comparison.
Take the guesswork out of choosing your private health cover. The expert team at WeCovr is here to provide clear, impartial advice tailored to your exact needs and budget.
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