AXA vs Aviva vs Vitality vs The Exeter Lifestyle Rewards vs Traditional PMI
Choosing the right private medical insurance in the UK for your family can feel overwhelming. With WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, you get expert guidance to navigate this complex market. This guide dissects the leading approaches to help you decide.
Which approach to private healthcare works best for UK families?
The UK's private medical insurance (PMI) landscape has evolved far beyond simple hospital cover. Today, families face a choice between three distinct philosophies:
- The Traditional Model (e.g., AXA, Aviva): Focused on providing comprehensive medical cover for acute conditions with an emphasis on extensive hospital lists and a straightforward claims process.
- The Wellness-Integrated Model (e.g., Vitality): A dynamic approach that rewards you for healthy living, directly linking your activity levels to your premium costs and offering a suite of lifestyle benefits.
- The Lifestyle Rewards Model (e.g., The Exeter): A hybrid approach offering valuable, everyday health services like remote GPs and physio before you need to claim, adding tangible value without the intense engagement of a points-based system.
Deciding between them isn't about which insurer is "best," but which philosophy best aligns with your family's lifestyle, budget, and health priorities. This article provides a definitive comparison to help you make an informed choice.
The Foundations: Understanding UK Private Medical Insurance
Before comparing providers, it's crucial to understand what all UK PMI policies are built upon. Getting these fundamentals right prevents costly mistakes later.
Acute vs. Chronic Conditions: The Golden Rule of PMI
This is the most important distinction in UK private health cover.
- Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include joint replacements, cataract surgery, or treatment for an infection. PMI is designed to cover acute conditions.
- Chronic Condition: A disease, illness, or injury that has one or more of the following characteristics: it needs long-term monitoring, has no known cure, requires ongoing management, or is likely to recur. Examples include diabetes, asthma, arthritis, and high blood pressure. Standard UK PMI does not cover the routine management of chronic conditions.
Insider Tip: While PMI won't cover the day-to-day management of a chronic condition like diabetes, it may cover an acute flare-up or a new, related acute condition, subject to your policy terms.
Pre-existing Conditions: What About Health Issues You Already Have?
No standard PMI policy will cover conditions you had before taking out the cover. Insurers manage this through two main types of underwriting:
- Moratorium Underwriting: This is the most common type. You don't declare your full medical history upfront. Instead, the insurer applies a blanket exclusion for any condition you've had symptoms, medication, or advice for in the last 5 years. If you then go a continuous 2-year period after your policy starts without any issues related to that condition, it may become eligible for cover. It's simpler to set up but can create uncertainty at the point of a claim.
- Full Medical Underwriting (FMU): You provide your family's full medical history when you apply. The insurer assesses it and states precisely what is and isn't covered from day one. This takes longer to set up but provides absolute clarity on your cover.
Core PMI Terminology in Plain English
| Term | What It Really Means for Your Family |
|---|---|
| Excess | The amount you agree to pay towards a claim. A higher excess (£500 or £1,000) will significantly lower your monthly premium. A family might choose a higher excess to make the policy more affordable, treating it as a "catastrophe cover" for major issues. |
| Hospital List | The list of private hospitals and facilities you can use. Cheaper policies may have a limited local list, while comprehensive ones offer a nationwide network, including premium London hospitals. |
| Outpatient Cover | Cover for diagnostics, consultations, and tests that don't require a hospital bed. This is often the most significant variable in a policy's cost. You can choose from full cover, a capped amount (e.g., £1,000), or no outpatient cover at all to manage your premium. |
| No-Claims Discount (NCD) | Similar to car insurance, your premium is discounted for every year you don't make a claim. This discount can be significant, often reaching 60-75% over time. |
The Traditional Titans: AXA and Aviva
The traditional approach to PMI is built on a simple promise: if you or a family member gets sick with a new, acute condition, we will provide access to high-quality private diagnosis and treatment, fast. AXA and Aviva are masters of this model.
Their philosophy centres on robust, reliable insurance. The focus is less on daily engagement and more on being there when you truly need them.
Key Strengths of the Traditional Model:
- Comprehensive Core Cover: Strong focus on cancer care, in-patient treatment, and surgical procedures.
- Vast Hospital Networks: Extensive lists of private hospitals across the UK, offering genuine choice.
- Simplicity and Reliability: The "set and forget" model. You pay your premium and know you are covered for eligible conditions. There's no need to track steps or log gym visits.
- Established Claims Process: Decades of experience mean their claims processes are typically smooth and efficient.
A Closer Look: AXA vs. Aviva
| Feature | AXA Health (Personal Health) | Aviva (Healthier Solutions) | Broker Insight |
|---|---|---|---|
| Core Philosophy | Comprehensive, modular cover you can build yourself. | A strong, all-around policy with a focus on pathway and mental health. | Both offer excellent core products. AXA's modularity can be good for precise budgeting. Aviva's "Expert Select" hospital option can offer significant savings. |
| Digital GP Service | Doctor at Hand: 24/7 access to a virtual GP, often with quick referrals. | Aviva Digital GP: Provided by Square Health, offering similar 24/7 access. | Both services are excellent and a key benefit, reducing reliance on NHS waiting lists for a GP appointment. |
| Mental Health | Strong mental health options, including cover for consultations and therapy. | Often praised for its comprehensive mental health pathway, included as standard. | Aviva's focus on mental health as a core part of its offering is a significant plus for many families in the current climate. |
| Cancer Care | Comprehensive cancer cover with options to add advanced drugs and therapies. | Extensive cancer cover, including the option for a six-week promise for treatment post-diagnosis. | Both are market leaders in cancer cover. The key is to check the specific details on drug lists and treatment pathways with a broker. |
| Best For Families Who... | Want to tailor a policy precisely to their needs and budget, and value a huge global brand. | Want a strong, well-regarded all-round policy with excellent mental health support from day one. | ...prioritise straightforward, comprehensive insurance over lifestyle rewards and don't want to engage with an app to justify their premium. |
The Wellness Revolution: Vitality's Active Rewards Model
Vitality turned the UK PMI market on its head by asking a simple question: why not reward people for staying healthy? Their model is proactive rather than reactive.
The core premise is that by encouraging and rewarding healthy behaviour, members will be healthier and claim less, creating a virtuous circle of lower claims costs and lower premiums.
How the Vitality Model Works:
- Engage: You track your daily activity (like steps), workouts, and health checks through the Vitality app.
- Earn Points: The more you do, the more Vitality Points you earn.
- Get Rewarded: Points unlock weekly rewards (e.g., free coffee, cinema tickets) and partner discounts (e.g., subsidised Apple Watch, gym memberships).
- Lower Your Premium: Your points total determines your Vitality Status (Bronze, Silver, Gold, Platinum). The higher your status, the larger the discount on your renewal premium for the following year.
Is Vitality Right for Your Family?
| Pros | Cons |
|---|---|
| Can Significantly Lower Premiums: An active family achieving Platinum status can see their premium reduced by up to 25% or more. | Requires Consistent Engagement: If you don't engage, your premium can be higher than an equivalent traditional policy. "The Vitality Treadmill" is real. |
| Motivates Healthy Habits: The gamification and rewards can be a powerful motivator for the whole family to be more active. | Complexity: The points system and partner offers can be confusing to navigate initially. |
| Excellent Value-Added Benefits: The Apple Watch benefit, cinema tickets, and gym discounts can provide hundreds of pounds in real value each year. | Benefits Can Change: Partner offers and the points structure are subject to change, which can affect the overall value proposition. |
Family Scenario: The Smith family has two active parents and two teenage children. They all enjoy walking the dog, playing sports, and are motivated by gadgets. For them, Vitality could be perfect. The subsidised Apple Watches help them track their activity, the weekly cinema tickets are a family treat, and the potential premium reduction makes the policy highly cost-effective.
The Balanced Approach: The Exeter's Lifestyle Rewards
The Exeter's Health+ policy carves out a compelling middle ground. It recognises that families want more than just crisis cover, but may not want the high-engagement, points-driven model of Vitality.
Their approach focuses on providing tangible, everyday health and wellbeing support through their Healthwise service, which is included with every policy. Crucially, using most of these services does not count as a claim and will not affect your no-claims discount.
Key Features of The Exeter's Healthwise:
- Remote GP Appointments: 24/7 access to a GP by phone or video call, providing reassurance and quick prescriptions for the whole family.
- Mental Health Support: Access to qualified counsellors and therapists for short-term support without needing a GP referral.
- Physiotherapy and MSK Support: Quick access to remote physiotherapy assessments and sessions, ideal for sporting injuries or back pain.
This "value-add" philosophy means you get immediate and ongoing benefits from your policy from day one, not just when someone gets seriously ill.
Who is this best for? A family who wants the peace of mind of traditional PMI but also values quick, easy access to everyday healthcare. They might see a remote GP consultation for a child's rash or a quick physio assessment for a parent's back strain as a huge benefit, saving them time and worry. It's for those who want utility without the homework.
Head-to-Head Comparison: Which Model Suits Your Family?
This table breaks down the core differences to help you identify the best fit for your family's unique circumstances.
| Feature | Traditional (AXA / Aviva) | Wellness-Integrated (Vitality) | Lifestyle Rewards (The Exeter) |
|---|---|---|---|
| Core Philosophy | Protection: Be there when you need us for serious medical issues. | Prevention & Reward: We'll help you stay healthy and reward you for it. | Support & Utility: Use our services anytime to manage your everyday health. |
| Premium Structure | Based on age, location, cover level. Reduced by NCD and higher excess. | Based on the same factors, but dynamically adjusted by your wellness activity. | Based on traditional factors, but the built-in benefits add day-one value. |
| Engagement Required | Low: Pay your premium and call when you need to claim. | High: Daily/weekly tracking of activity is essential to maximise value. | Low to Medium: Use the Healthwise services as and when you need them. No tracking required. |
| Key Strength | Simplicity, reliability, and comprehensive cover for major medical events. | Potential for significant premium savings and tangible lifestyle rewards. | Immediate access to GP, physio, and mental health support without impacting your NCD. |
| Potential Drawback | You only perceive value when you make a claim. | Can feel expensive if you don't engage with the wellness programme. | May have a more limited hospital list compared to the giant traditional players. |
| Ideal Family Persona | The Planners: "We want a safety net. If something goes wrong, we want the best care without fuss." | The Achievers: "We're an active family. We'd love to be rewarded for our healthy lifestyle." | The Pragmatists: "We want fast GP access for the kids and quick support for aches and pains, on top of major medical cover." |
An expert broker at WeCovr can provide detailed quotes for all these options, helping you see the real-world cost differences for your family.
Key Factors to Consider Before You Buy
Choosing a provider is only half the battle. You must also configure your policy correctly.
- Underwriting: For families with a clear and recent medical history, Full Medical Underwriting (FMU) provides certainty. For others, a Moratorium can be simpler, but you must understand its limitations.
- Hospital List: Don't pay for a premium London hospital list if you live in Manchester and would never travel for treatment. Equally, a limited list might exclude a specialist centre you'd want access to. A broker can help you find the right balance.
- Excess: A family of four could save over £50 a month by moving from a £0 excess to a £500 excess. Consider how much you could comfortably pay towards a claim to make your premium more manageable.
- Outpatient Cover: Full outpatient cover is expensive. Capping it at £1,000 or £1,500 is a very popular way to balance cost and cover, ensuring you're covered for initial diagnostics without paying top-tier prices.
- Switching: If you already have a policy, don't just cancel it. A specialist broker can help you switch on a 'Continuing Personal Medical Exclusions' (CPME) basis, ensuring that any conditions already covered by your old policy continue to be covered by the new one.
Why Use a Specialist PMI Broker Like WeCovr?
Navigating the nuances of AXA's modular plans, Vitality's points system, and The Exeter's value-add services is complex. A specialist broker doesn't just sell you a policy; they act as your expert guide.
- Whole-of-Market Advice: WeCovr compares policies and prices from across the market, not just the providers mentioned here. We find the policy that truly fits your family, not the one that fits a sales target.
- Expert Guidance at No Cost: Our service is completely free to you. We are paid a commission by the insurer you choose, but this does not affect the premium you pay.
- Tailored to Your Family: We take the time to understand your family's lifestyle, health, and budget to recommend the right approach—be it traditional, wellness, or lifestyle-focused.
- Claims Advocacy: If you need to make a claim, we are here to help and provide support, ensuring the process is as smooth as possible.
- Exclusive Benefits: When you arrange a policy through WeCovr, you also get complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, and may be eligible for discounts on other products like life insurance.
Does private health insurance cover pregnancy and childbirth?
Generally, standard UK private medical insurance does not cover routine, planned pregnancy and childbirth. However, many policies will offer cover for complications that arise during pregnancy or delivery, making it a valuable safeguard for unexpected issues. Some high-end policies may offer limited benefits for routine childbirth, but this is not standard.
Is private medical insurance worth it if I have the NHS?
Private medical insurance is designed to work alongside, not replace, the NHS. The NHS provides excellent emergency and chronic care. The primary benefits of PMI are speed of access and choice. For a family, this can mean getting a diagnosis for a worrying symptom in days rather than weeks, choosing your surgeon, and recovering in a private room. This reduces stress and helps parents get back to work and children back to school faster.
Can I add my children to my policy, and is it expensive?
Yes, all major insurers allow you to add children to your policy. It is generally more cost-effective to have one family policy than multiple individual ones. Some insurers, like Vitality, often have offers where they only charge for the first child, making cover for larger families more affordable. A broker can find these deals for you.
Is PMI a taxable benefit if my employer provides it?
Yes. If your employer pays for your private medical insurance, it is considered a 'benefit-in-kind' by HMRC. This means you will have to pay income tax on the value of the premium. The amount will be detailed on a P11D form from your employer.
Making the Right Choice for Your Family's Health
There has never been more choice in the UK private medical insurance market.
- If your family values simplicity, reliability, and comprehensive cover for the big things, the traditional model offered by AXA and Aviva is an outstanding choice.
- If your family is active, tech-savvy, and motivated by rewards, the dynamic, gamified approach of Vitality could be both fun and highly cost-effective.
- If you prize everyday convenience and quick access to GPs and mental health support without wanting to track your every move, the lifestyle-focused model from The Exeter offers exceptional day-one value.
The best approach is the one that aligns with your family's unique identity. The next step is to see how these models translate into real-world costs and benefits for you.
Contact a WeCovr adviser today for a free, no-obligation comparison. Let our experts do the hard work and build the perfect health insurance plan for your family's peace of mind.
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!
There is no need to wait until the renewal of your current policy.
We can look at a more suitable option mid-term!
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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