What does health insurance cover?

Health insurance aims to cover the cost of diagnosis and treating acute medical conditions in private health facilities. Every health insurance policy offers varying coverage depending on who’s being insured, the level of the policy and who the provider is. You may have the option to customise what cover is included in your terms.
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January 10, 2024
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List of cover options for health insurance

Here’s a snapshot of what may be covered when you compare health insurance policies. Some may only be available as an additional cover option, while others may be included as standard.

  1. Treatment in private medical facilities
  2. Private consultations and appointments
  3. Access to digital health services, such as virtual GPs
  4. Therapies, such as physiotherapy, osteopathy and acupuncture
  5. Outpatient care, such as scans, tests and x-rays
  6. Mental health support, treatments and therapies
  7. Inpatient care, such as surgery
  8. Dental, optical and hearing treatments
  9. Accommodation in medical facilities
  10. Telemedicine services, such as virtual GPs
  11. Scans, such as CT or MRI
  12. NHS cash benefits 
  13. Private ambulances
  14. Cancer treatments
  15. Digital health resources
  16. 24/7 medical helplines
  17. Private prescription charges
  18. Home nursing
  19. Specialist referrals
  20. Overseas coverage
  21. Hospital fees
  22. Consultant fees
  23. Rehabilitation services

Is everything included as standard?

Most health insurance policies will allow you to add or remove cover options, but it depends on the base policy you choose, the provider, your medical history and other factors. If there’s a specific cover option you’d like included, just let us know, and we’ll compare available policies on your behalf.

Who can be covered?

Many UK providers will offer cover for different circumstances, such as the following: 

  1. Individuals - A policy that covers a single individual under personal terms.
  2. Couples - Cover for two people under the same policy terms.
  3. Family - Cover for an entire family under the same policy terms.
  4. Employees - Cover for an employee or group of employees under the same policy terms.

What doesn’t health insurance cover?

Every health insurance policy will have exclusions. These are medical conditions, treatments or scenarios that you won’t be covered for in your policy. Cover exclusions will differ from provider to provider, and the medical history of the individual also plays a role in determining what isn’t covered. We recommend that you compare policies to understand the different cover exclusions fully, but we’ve created a list from various providers below to give you an example of what may not be covered:

  1. Chronic illnesses, such as HIV, including ongoing treatment for long-term or incurable conditions
  2. Pre-existing conditions that you had symptoms of or knew about before your policy.
  3. Routine pregnancy and childbirth-related treatments
  4. Fertility treatments, such as IVF
  5. Cosmetic treatments and surgery
  6. Drugs and treatments that are not established as being effective
  7. Allergic conditions
  8. Complications following overseas medical treatment
  9. Accident and emergency treatments
  10. Treatment required following alcohol, drug or substance abuse
  11. Organ transplants
  12. Self-inflicted injuries
  13. Sports injuries
  14. Hearing aids and lenses
  15. Sleep disorders
  16. Preventative treatments
  17. Treatments and services outside of your policy limit

Policy limits explained

Some policies may put in place limits on your coverage. This could be a financial limit, such as £500, or a number of times you can access certain services. If you reach your limit, you won’t be covered for subsequent claims. Most policy limits will apply for a year, and when you switch or renew your policy, your limits may reset. Here are some ways policy limits may be put in place:

To help you understand policy limits, we’ve pulled together some you may find across UK providers:

  1. Cash value policy limit - Your policy may have a limit, and when you access certain treatments and services, the cost will be deducted from your total limit.
  2. Cash value treatment limit - You may have a financial limit on medical services, such as up to £2,000 per year or £60 per claim.
  3. Number of treatments limit - You may have limits on specific treatments and services, such as ‘up to 28 days per year’.

Policy limits will vary from provider to provider, and different cover options with the same provider may have different limits. We’ve compared limits on three different cover options on specific policies to help show how limits may vary:

Mental health treatment (inpatient and day patient) NHS cancer cash benefit Private ambulance
Bupa - Bupa By You Up to 28 days per year £100 per night up to your total policy limit £60 per journey
Vitality - Core Cover Up to 28 days per year £100 per day or night up to £10,000 annual limit Paid in full
AXA Health - inSpire Health Plan Up to 30 days per year £100 per night up to a £2,000 annual limit Paid in full
The Exeter - Health+ Up to 28 days per year £150 per night up to 30 nights Paid in full
Aviva - Healthier solutions Up to 28 days per year £100 per night up to 30 nights Paid in full

How does cover change from provider to provider?

We’ve examined some of the most popular UK health insurance provider’s policies and summarised some of their key coverage. Please note that some options may only be available as an optional extra, have limits, or have additional terms and conditions. You may also find that each provider offers additional cover options not included in our lists.

Bupa health insurance cover

  • Ongoing mental health cover
  • Cover for addictions
  • Call Bupa directly for support
  • Access to breakthrough cancer drugs
  • Contact qualified nurses at any time
  • Emotional wellbeing and support (mental health cover)
  • Talk to a doctor 24/7
  • Digital GP services
  • Treatment in private hospitals
  • Private consultations
  • Therapies, such as physiotherapy
  • Outpatient care, such as scans, tests, x-rays and hospital appointments
  • Parent accommodation

Vitality health insurance cover

  • Video GP appointments
  • Mental health support
  • Cancer treatment
  • Private physiotherapy
  • Private hospital treatment
  • Inpatient and day patient diagnosis
  • Menopause support
  • Outpatient cover
  • Choose your own hospital list
  • Alternative therapies, such as acupuncture
  • Optical, dental and hearing
  • Cover while you’re abroad

AXA Health health insurance cover

  • Cancer, CT or MRI scans
  • Time in hospital on specialist referral
  • Inpatient
  • Outpatient
  • Heart cover
  • Cancer cover
  • Dental and optical
  • Therapies option (physiotherapists, acupuncturists, osteopaths and chiropractors)
  • Mental health support
  • Private GP consultations
  • Choice of hospitals
  • Overseas cover for planned treatment
  • Wide choice of specialists

The Exeter health insurance cover

  • Unlimited inpatient and day-patient treatment
  • Complete cancer cover
  • Outpatient surgery
  • Private ambulance
  • Home nursing
  • Parental accommodation
  • Post-operative physiotherapy
  • NHS cash benefit (If it’s easier for members to have free in-patient treatment under the NHS and the treatment would be covered under your policy, we’ll pay out £150 per night for up to 30 nights.)
  • Specialist fees and diagnostic tests
  • Mental health cover
  • Therapies cover

Aviva health insurance cover

  • Consultations and treatments with a specialist
  • Diagnostic tests
  • Hospital charges
  • Full cancer cover
  • Outpatient mental health treatment
  • Dental and optical cover
  • Additional treatments (osteopathy, physiotherapy, chiropractic)
  • Protected no-claims discount
  • Digital GP services
  • Health and wellbeing tools
  • Stress counselling helpline
  • Hospital lists (choice of hospitals)

WPA health insurance cover

  • Outpatient treatments
  • Hospital treatment (inpatient and day patient)
  • Health and wellbeing support
  • NHS hospital cash benefit
  • Cancer cover
  • Therapies
  • Mental health treatment
  • Overseas emergency treatment
  • Dental care
  • Premium hospital access

Freedom health insurance cover

  • Inpatient and day-patient treatment
  • Cancer treatment
  • Outpatient treatment
  • Mental health care
  • Alternative therapies
  • MRI, CT and PET scans
  • Fixed cash benefit towards pregnancy complications
  • Fixed cash benefit towards dental surgery procedures
  • Optical and dental cover

Compare health insurance cover options

We can help you understand more about your cover options and the policies currently available on the UK market. This is a free service, and we’ll aim to find you the best policy for your wants and needs. To get started, provide us with some basic contact information below.

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