AXA vs Aviva vs Bupa vs The Exeter vs WPA Big Brands vs Specialist Insurers
Choosing the right private medical insurance in the UK can feel like a monumental task. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we guide UK individuals and families through this complex market every day. This article cuts through the noise, comparing the giants like AXA, Aviva, and Bupa against specialist insurers like The Exeter and WPA.
A detailed look at mainstream and niche PMI providers in the UK
The UK private health insurance landscape is dominated by a few household names, but a closer look reveals a vibrant market with specialist providers offering unique advantages. Understanding the difference between a 'big brand' insurer and a 'specialist' is the first step to finding a policy that truly fits your needs and budget.
- The 'Big Three' (AXA, Aviva, Bupa): These providers have enormous brand recognition, extensive hospital networks, and a vast range of policy options. They are the go-to for many individuals and large corporations, offering comprehensive cover and sophisticated digital health tools.
- The Specialists (The Exeter, WPA): These insurers often focus on specific market segments or offer innovative policy structures. They might cater to those with pre-existing conditions (under specific underwriting), the self-employed, or those seeking more control over their costs. They pride themselves on personalised service and a different approach to insurance.
Deciding between them isn't about which is "best" overall, but which is best for you. Let's break down the contenders.
At a Glance: AXA vs Aviva vs Bupa vs The Exeter vs WPA
This table provides a high-level overview of the key strengths and target audiences for each provider.
| Provider | Best Known For | Typical Customer Profile | Key Differentiator |
|---|---|---|---|
| AXA Health | Comprehensive cover & digital tools | Individuals & businesses wanting extensive options and strong digital integration. | 'Doctor at Hand' virtual GP service and a wide, flexible hospital list. |
| Aviva | Value for money & mental health support | Cost-conscious buyers and those prioritising strong mental health pathways. | The 'Expert Select' hospital option and extensive mental health benefits as standard. |
| Bupa | Brand trust & direct cancer care | Those prioritising brand reputation, cancer care, and access to Bupa-owned facilities. | Direct access to cancer treatment without needing a GP referral (on eligible policies). |
| The Exeter | Member benefits & underwriting flexibility | Self-employed, older applicants, or those with some minor health history. | Friendly Society ethos; standard no-claims discount protection. |
| WPA | Shared responsibility & cost control | Individuals and families happy to co-pay for treatment in return for lower premiums. | Unique 'Shared Responsibility' model and not-for-profit status. |
The Big Three: A Closer Look at AXA, Aviva, and Bupa
These titans of the UK PMI market offer a reassuring breadth of cover, but their approaches and pricing differ significantly.
AXA Health: The Comprehensive Digital-First Choice
AXA Health has established itself as a forward-thinking provider, blending extensive medical cover with powerful digital health services.
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Core Strengths:
- Digital Health: Their 'Doctor at Hand' service, powered by Teladoc Health, is a standout feature, providing 24/7 access to GPs via phone or video. This is often included as a core benefit.
- Hospital Lists: AXA offers one of the most comprehensive and flexible hospital lists on the market, including premier London hospitals like The London Clinic and HCA facilities.
- Mental Health: Strong focus on mental health support, with pathways to treatment and access to therapists and counsellors often included.
- Guided Option: Their 'Guided' option can significantly reduce premiums by directing you to a curated list of specialists for your specific condition, a great choice for those happy with expert guidance.
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Insider Tip: While AXA's full hospital list is extensive, their 'Guided' and 'Directory' options are excellent ways to manage costs. A common mistake is paying for the most extensive list when a more guided approach would suffice and save you hundreds of pounds a year.
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Who is AXA Health for? Individuals and families who value digital convenience, want a wide choice of hospitals, and seek comprehensive, modern health cover.
Aviva: The Value-Driven Market Leader
Aviva consistently competes on price without skimping on essential cover, making it a highly popular choice for those seeking a balance of benefits and affordability.
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Core Strengths:
- Value for Money: Aviva's 'Healthier Solutions' policy is often one of the most competitively priced in the market, especially for younger applicants.
- 'Expert Select' Hospital Option: This innovative model is a key cost-saving feature. If you choose this, Aviva will recommend a hospital from their quality-approved list. If you opt for a hospital from a more extensive list, you may need to co-pay.
- Mental Health Focus: Aviva was a pioneer in enhancing mental health cover, often providing more extensive benefits for therapy and psychiatric care than many rivals as part of their core offering.
- The Aviva A-Lister: Access to a network of acclaimed specialists and consultants.
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Insider Tip: The 'six-week option' is a popular way to reduce Aviva premiums. This means your private treatment is only covered if the NHS waiting list for that treatment is longer than six weeks. It's a calculated risk that pays off for many, but you must understand the limitation before choosing it.
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Who is Aviva for? Cost-conscious individuals and families who still want robust cover, particularly for mental health, and are comfortable with a more guided approach to hospital choice to keep premiums down.
Bupa: The Trusted Brand with Integrated Care
As arguably the most recognised name in UK health insurance, Bupa leverages its brand trust and unique network of Bupa-owned clinics and facilities.
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Core Strengths:
- Brand Recognition: For many, Bupa is private healthcare. This trust is a significant factor in their market position.
- Cancer Care: Bupa's cancer cover is exceptional. A key feature is 'Direct Access' – if you have cancer symptoms, you can often call them directly to start the diagnostic process without waiting for a GP referral. This can save critical time.
- Bupa-Owned Facilities: Bupa operates its own clinics, health centres, and even a hospital (the Bupa Cromwell Hospital in London), offering a potentially more seamless member experience.
- Breadth of Cover: Their 'Bupa By You' policy is highly customisable, allowing you to build a plan that precisely matches your needs.
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Insider Tip: Bupa premiums can be higher than competitors. Their strength lies in their cancer promise and integrated network. If comprehensive cancer cover is your absolute priority, the premium can be justified. However, comparing their core cover against AXA and Aviva is essential to ensure you're not overpaying.
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Who is Bupa for? Those who prioritise brand trust, want the most direct and comprehensive cancer care available, and see value in an insurer with its own network of facilities.
The Specialists: A Deep Dive into The Exeter and WPA
Specialist insurers thrive by doing things differently. They target specific needs and offer innovative models that can be a perfect fit for those who don't fit the standard mould.
The Exeter: The Member-First Friendly Society
As a Friendly Society, The Exeter is owned by its members, not shareholders. This mutual status shapes their entire approach, focusing on long-term member value and service.
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Core Strengths:
- Member-Owned: Profits are reinvested into the business to benefit members, for example through better products or stable pricing.
- Underwriting Flexibility: The Exeter is known for taking a more individual approach to underwriting. They may be more willing to offer terms to applicants with some pre-existing medical conditions (though major, chronic conditions are still excluded).
- Standard No-Claims Discount Protection: Unlike most insurers where it's a paid-for add-on, The Exeter includes protection for your no-claims discount as standard on many policies after your first year. This means your first claim won't automatically hike your renewal premium.
- Community and Support: They offer member benefits like a health and wellbeing support line, demonstrating their focus on holistic member care.
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Insider Tip: The Exeter can be a fantastic choice for the self-employed or those with a less-than-perfect medical history. Their willingness to consider individual circumstances makes them a go-to provider for brokers helping clients who have been declined or offered expensive terms elsewhere.
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Who is The Exeter for? The self-employed, older applicants, those with minor health issues, and anyone who values the customer-centric ethos of a mutual organisation.
WPA: The Pioneer of 'Shared Responsibility'
Western Provident Association (WPA) is a not-for-profit insurer with a unique and compelling model designed to keep costs down by sharing them with the policyholder.
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Core Strengths:
- Shared Responsibility / Co-payment: This is WPA's flagship feature. Instead of a traditional excess, you agree to pay a percentage of each claim (e.g., 25%) up to an annual limit. This direct involvement in the cost encourages cost-conscious choices and results in significantly lower premiums.
- Not-for-Profit: Like The Exeter, WPA's focus is on its members. They have a reputation for excellent, UK-based customer service.
- Uncapped Out-patient Cover: Many WPA policies offer uncapped consultations and diagnostics, which is a very generous benefit compared to the fixed limits offered by many competitors.
- Flexible Cancer Care: WPA offers options to cap cancer cover in return for a lower premium, giving customers more control over their policy's cost and benefits.
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Insider Tip: WPA's model is brilliant but requires understanding. You must be comfortable with the co-payment structure. For a £4,000 procedure with a 25% co-payment, you would pay £1,000. It's perfect for healthy individuals who want 'just in case' cover at a low monthly cost and are happy to share the cost if a claim arises.
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Who is WPA for? Cost-conscious individuals and families who are happy to take on a level of co-payment in exchange for lower premiums and who value excellent customer service.
Key Concepts in UK Private Medical Insurance
To compare these providers effectively, you need to understand the language of PMI. Working with an expert broker like WeCovr can demystify these options at no extra cost to you, ensuring you get the right policy.
A Crucial Note: What UK PMI Does Not Cover
It is vital to understand this fundamental point: Standard UK private medical insurance is designed to cover acute conditions that arise after you take out your policy.
- Pre-existing Conditions: Any medical condition you have had symptoms, advice, or treatment for in the years before your policy starts is generally excluded.
- Chronic Conditions: Long-term conditions that cannot be cured, only managed (like diabetes, asthma, or high blood pressure), are not covered by PMI. Their routine management remains with the NHS.
PMI gives you choice and speed for eligible, acute conditions—like a knee replacement, hernia repair, or cancer treatment—not for day-to-day management of ongoing illnesses.
Understanding Underwriting: How Insurers Assess Your Health
Underwriting is the process an insurer uses to decide whether to offer you cover and on what terms.
- Moratorium Underwriting (Most Common): This is the "don't ask, just cover" approach. You don't declare your medical history upfront. The insurer automatically excludes any condition you've had in the 5 years before joining. However, if you go 2 continuous years on the policy without any symptoms, treatment, or advice for that condition, it may become eligible for cover.
- Full Medical Underwriting (FMU): You complete a detailed health questionnaire. The insurer assesses your history and explicitly lists any conditions that will be excluded from cover from day one. This provides certainty but can be more complex.
- Broker Insight: Moratorium is quicker and easier, but can lead to disappointment at the point of claim if a condition is deemed pre-existing. FMU provides black-and-white clarity from the start. We can help you decide which is better for your circumstances.
The Role of Excess and Hospital Lists
These are the two biggest levers you can pull to control your premium.
- Excess: This is a fixed amount you agree to pay towards your first claim each year (e.g., £0, £100, £250, £500). A higher excess means a lower monthly premium.
- Hospital List: Insurers have tiered hospital lists. A basic list might include local private hospitals, while a comprehensive list includes premium central London hospitals. Limiting your hospital choice can dramatically reduce your premium.
Making the Right Choice for You: Practical Scenarios
| Scenario | Primary Concern | Likely Best-Fit Providers | Why? |
|---|---|---|---|
| Young Family in Manchester | Affordability, digital GP access, good mental health cover. | Aviva, AXA | Aviva's value and mental health benefits are a strong match. AXA's 'Doctor at Hand' is invaluable for parents with young children. |
| Self-Employed Builder, 55 | Income protection, potential for minor past health issues. | The Exeter | As a Friendly Society, they are well-disposed to the self-employed and have more flexible underwriting for minor conditions. |
| Company Director in London | Fast access to top specialists and London hospitals, minimal fuss. | Bupa, AXA | Bupa's brand and direct access pathways appeal to busy executives. AXA's top-tier hospital list and guided options provide choice and quality. |
| Retired Couple, Budget-Conscious | Catastrophic cover for major issues, keeping monthly costs low. | WPA, Aviva | WPA's shared responsibility model keeps premiums down for those willing to co-pay. Aviva's six-week option is another great cost-control tool. |
As a WeCovr client, you not only get expert advice to navigate these choices but also receive complimentary access to our AI-powered nutrition app, CalorieHero, to support your health goals. Furthermore, customers who take out PMI or Life Insurance with us can often benefit from discounts on other types of cover.
Is it cheaper to go directly to an insurer or use a broker like WeCovr?
Can I switch my private health insurance provider?
Does private medical insurance cover dental and optical?
What is the 'six-week option' in PMI?
Your Next Step: Get a Personalised Comparison
Navigating the differences between AXA's digital prowess, Aviva's value, Bupa's brand trust, The Exeter's flexibility, and WPA's unique model is what we do best. The information here is a powerful starting point, but the best private health cover is one that is tailored to your specific health needs, location, and budget.
Let our team of experts do the hard work for you. We'll compare the UK's leading insurers and find the right cover at the right price, with the personal service and high customer satisfaction ratings we're known for.
Related guides
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
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