Comparing UK private medical insurance is harder than it looks. The five major insurers — Aviva, Bupa, AXA Health, Vitality and WPA — each publish 80–200 page broker documents, and the differences that matter to a client are usually buried two or three pages deep. This guide is the checklist HealthCareCompare uses internally to compare PMI plans for broker clients.
Step 1: Anchor on the client's claim profile
Most placement mistakes happen because the broker quoted on premium before understanding what the client is most likely to claim for. Ask three questions:
- What conditions exist in the family history (cancer, MSK, mental health)?
- What's the client's age band and chronic-condition risk?
- Is the policy individual, family or SME — and how much engagement will members have?
The answers point to a different insurer almost every time. A 52-year-old with a family cancer history is a Bupa client. A 34-year-old desk worker with back pain is an AXA Working Body client. A 28-year-old health-engaged tech worker is a Vitality client.
Step 2: Map cover modules to clinical risk
Every UK PMI plan splits into core inpatient cover plus optional outpatient, mental health, therapies, dental and optical modules. The trap is that "comprehensive" means different things at each insurer:
- Aviva: mental health is an optional module, not default.
- Bupa: cancer cover is full including many unlicensed drugs.
- AXA: mental health is included as standard on most plans.
- Vitality: advanced cancer cover is a paid upgrade.
- WPA: every module is configurable, with shortfall protection on consultant fees.
If you're comparing two quotes, normalise the modules first. Two "£120/month" quotes with different module configurations are not the same product.
Step 3: Check underwriting basis
PMI is sold on three bases: moratorium, full medical underwriting (FMU), and continued personal medical exclusions (CPME) on switch. Each insurer prices these differently and applies different rules to pre-existing conditions. CPME is the most common basis for switch business — and the basis most likely to surface a claim dispute later if exclusions weren't transferred cleanly.
Step 4: Pick the hospital list
Hospital lists are the biggest premium lever after underwriting. Every major insurer offers a tiered network — typically a "core" list, an "extended" list and a "London teaching hospital" list. Moving a client off the London list often saves 25–35% of premium with no clinical downside outside central London.
Step 5: Read the schedule of benefits
The schedule is where annual maximums, session limits, and excess structures live. Common gotchas:
- Outpatient annual maximums of £500–£1,500 that cap diagnostic spend before treatment starts.
- Mental health session caps (typically 8–28 sessions/year for talking therapies).
- Chiropractic and osteopathy routed under "therapies" rather than MSK — and capped separately.
- Cancer drug limits that apply per condition, per year, or over the policy lifetime.
Step 6: Stress-test with a cited tool
This is where HealthCareCompare exists. Ask the same question across all five insurers and read the cited answer side-by-side — with the page reference back to the broker doc. Brokers using HealthCareCompare close placements 40% faster and renew with fewer "I didn't know that was excluded" calls.