Aviva’s Health Insurance Plans: Coverage and Benefits

Understanding Aviva’s Health Insurance Portfolio: A Deep Dive into Coverage and Benefits

Aviva stands as a prominent provider in the UK’s health insurance landscape, offering a range of private medical insurance (PMI) products designed to provide individuals, families, and businesses with faster access to diagnosis, treatment, and specialist care. Their plans are structured to offer flexibility, allowing customers to tailor coverage to their specific needs and budget. The core of Aviva’s offering is built upon a modular system, typically starting with a fundamental plan—often the “Healthier Solutions” plan—to which various modules and options can be added.

Core Health Insurance Plans and Their Foundational Coverage

Aviva’s health insurance is not a one-size-fits-all product but a customizable suite. The entry point is usually a base plan that covers essential in-patient and day-patient treatment.

• In-Patient and Day-Patient Cover: This is the bedrock of all Aviva policies. It encompasses all medical treatment that requires a hospital bed, even if only for a day. This includes the cost of surgery, surgeon and anaesthetist fees, theatre charges, diagnostic tests (like MRIs and CT scans conducted in the hospital), and the hospital stay itself, including nursing care and meals. Coverage extends to NHS Private Patient Units and a wide network of private hospitals, ensuring treatment in comfortable, well-equipped facilities.
• Cancer Cover: Recognised as a critical area, Aviva includes comprehensive cancer care as a core component of its base plans. This is a significant differentiator, as some insurers offer this as an add-on. Coverage typically includes diagnostic tests, surgery, chemotherapy, radiotherapy, and other oncological treatments. Crucially, it also covers new, advanced cancer drugs not always readily available on the NHS and provides access to specialist cancer nurses and support services, offering both clinical and emotional support throughout the treatment journey.
• Mental Health Support: Modern health insurance must address mental well-being. Aviva’s base plans often include access to a Digital GP service, which can provide initial mental health advice and referrals. However, more substantial cover for treatment like cognitive behavioural therapy (CBT), counselling, and psychiatric in-patient care is frequently structured as an optional module, allowing customers to choose the level of mental health support they require.

Optional Modules for Enhanced, Tailored Protection

The true flexibility of Aviva’s health insurance lies in its optional modules. Customers can build a plan that precisely matches their concerns and lifestyle.

• Out-Patient Cover: This is one of the most common additions. While the base plan covers diagnostics and treatment as an in-patient, the out-patient module covers consultations with specialists, physiotherapy, and other therapies received without an overnight hospital stay. This module can often be selected with a financial limit (e.g., £1,000 per person per year) or on a full cover basis, directly impacting the premium. It is vital for covering the entire pathway of care, from the initial specialist consultation through to any follow-ups.
• Therapy and Wellbeing Benefits: This module expands cover for essential therapies like physiotherapy, chiropractic treatment, osteopathy, and acupuncture. It typically provides an annual allowance for these services, which can be accessed without a GP referral in many cases, promoting quicker recovery from musculoskeletal issues. Some plans may also include allowances for health screenings, eye tests, and dental check-ups, adopting a more holistic approach to health maintenance.
• Advanced Diagnostics and Quick Access: A key reason for choosing private healthcare is speed. Aviva offers options to enhance this further. This can include direct access to specialists for certain conditions (skipping the GP referral step) and guaranteed rapid access to diagnostic scans. This ensures that any worrying symptoms are investigated promptly, reducing anxiety and enabling faster treatment if needed.
• Travel Abroad Cover: For those who travel frequently, this module provides essential protection. It covers emergency medical treatment while outside the UK, ensuring access to quality healthcare facilities abroad. It often includes repatriation costs, which can be exorbitantly expensive if paid for out-of-pocket.

Detailed Breakdown of Key Benefits and Services

Beyond the core hospital treatment, Aviva policies are enriched with a suite of value-added services designed to support members’ health proactively.

• Digital GP Services: Policyholders have 24/7 access to remote GP consultations via phone or video call. This service provides quick medical advice, prescriptions, and referrals, often with appointment times available within hours, eliminating the wait for a NHS GP appointment for minor ailments.
• Aviva Digital Health App: This centralised platform allows members to manage their policy, access their digital health record, book GP appointments, and claim for eligible expenses like physiotherapy. It serves as a hub for all health-related information and services, streamlining the user experience.
• Second Medical Opinion Service: In cases of a serious or complex diagnosis, this service allows a policyholder to get an independent review of their diagnosis and treatment plan from a leading UK-based specialist. This can provide invaluable peace of mind and confidence in the proposed medical pathway.
• NHS Cash Benefit: Some plans include a daily cash payment if the member chooses to have eligible treatment as an NHS in-patient rather than privately. This money can be used to cover incidental expenses or loss of earnings, providing financial flexibility.
• Health and Wellness Resources: Aviva provides access to online health portals, fitness guides, nutritional advice, and mental wellbeing apps. These resources empower members to take a proactive role in maintaining their health, potentially preventing future illnesses.

Underwriting and Customisation: Understanding the Fine Print

The cost and terms of an Aviva health insurance plan are influenced by the type of underwriting.

• Moratorium Underwriting: This is a common, straightforward option. No medical questions are asked on application. Instead, pre-existing conditions (any condition for which advice, treatment, or medication was sought within a defined period, typically the last 5 years) are excluded from cover at the start of the policy. However, if after two continuous years of membership, the member remains symptom-free, without treatment, medication, or advice for that condition, it may become eligible for cover in the future.
• Full Medical Underwriting (FMU): With FMU, the applicant discloses their full medical history at the point of application. Aviva then provides specific terms, which may include exclusions for certain pre-existing conditions. This approach provides immediate clarity on what is and isn’t covered from day one, which some customers prefer.

Customers can further customise their plan by choosing an excess level. A higher voluntary excess (the amount the customer agrees to pay towards a claim) will result in a lower monthly premium. Options typically range from £0 to £500 or more.

Considerations for Families and Businesses

Aviva’s family policies allow children to be covered at a reduced rate, often with the option to include them for just the cost of the premium tax. Many family-focused benefits, such as coverage for maternity or child mental health services, may be available as optional extras. For businesses, Aviva offers corporate health insurance schemes. These are tailored group plans that can be designed to suit the size and needs of the company, often including additional services like employee assistance programmes (EAPs), which provide confidential counselling and support for a range of work-life issues. Corporate plans can be a powerful tool for attracting and retaining talent while promoting a healthy, productive workforce.

Navigating the Claims Process and Hospital Networks

Aviva operates using an extensive network of approved private hospitals and treatment centres across the UK. When treatment is needed, the process typically begins with a consultation with a GP (either NHS or through Aviva’s Digital GP service) to obtain a referral to a specialist. The member or their GP can then contact Aviva’s claims team for authorisation. Once a claim is pre-authorised, Aviva manages the payment of costs directly with the hospital and consultants (subject to plan limits), creating a cashless experience for the member. The extensive network ensures that treatment is received in high-quality facilities, often with reduced costs due to pre-negotiated rates, which helps keep premiums competitive. Members can use the Aviva app or online portal to find their nearest network hospital, check their cover, and initiate claims, making the entire process transparent and user-friendly. The efficiency of this system is a cornerstone of the value proposition, ensuring that the focus remains on recovery rather than administrative paperwork or financial worry.