What Does Aviva Health Insurance Cover? Add-Ons, Exclusions & Costs

Aviva’s private medical insurance, sold as Healthier Solutions, covers private hospital treatment, specialist consultations, diagnostic tests, and cancer care in the UK, with optional extras for dental, wider mental health treatment, physical therapies, and a broader hospital list. So what does Aviva health insurance cover in practice? A core set of acute, treatable conditions is included on every policy, and anything outside that core either needs to be added for extra premium or is excluded altogether.

What’s Included as Standard

Every Healthier Solutions policy starts with the same baseline, regardless of which optional modules a policyholder picks.

Inpatient and day-patient treatment: hospital accommodation, nursing, surgeon and anaesthetist fees, and any diagnostic tests carried out while admitted.¹
Outpatient care: specialist consultations and diagnostic tests such as blood work, X-rays, CT, MRI, and PET scans. CT, MRI, and PET scans must be carried out at a recognised diagnostic centre. Outpatient cover is unlimited by default, but can be capped at £500 or £1,000 a year to lower premiums.²³
Cancer cover: diagnosis, surgery, chemotherapy, radiotherapy, targeted therapies, and ongoing aftercare and monitoring, with no monetary cap on the individual policy. Aviva partners with Macmillan Cancer Support for clinical, emotional, and financial guidance during treatment.⁴
Heart conditions: heart surgery, bypass operations, stent procedures, pacemaker fittings, and a course of outpatient cardiac rehabilitation, provided symptoms appear after the policy starts.⁵
Outpatient mental health: up to £2,000 a year for therapy and counselling for conditions such as anxiety, depression, OCD, and eating disorders, with a GP referral required.⁶
Other standard benefits: an NHS hospital cash benefit of £100 per night up to 30 nights, home nursing, a private ambulance, a £100 baby bonus, and parental accommodation for children under 15.³

Policies also come with several wellbeing services at no extra charge: the Aviva Digital GP app (unlimited 24/7 video consultations provided by Square Health), a 24-hour stress counselling helpline, the MyHealthCounts digital wellness tool, and Get Active fitness discounts.¹ One caveat matters: the Digital GP service is a non-contractual benefit, so Aviva can change or withdraw it at any time and it is not part of the insurance contract.⁷

Add-Ons You Can Bolt On

Healthier Solutions is modular. Each of the following areas is extra, with its own additional premium.

Dental and optical: up to £250 for routine dental treatment, £600 for dental treatment after an accident, and £150 toward glasses or contact lenses. A £50 excess applies separately to the routine dental and optical portions per person each year.⁸
Mental health upgrade: adds up to 28 days of inpatient or day-patient psychiatric treatment, on top of the standard £2,000 outpatient allowance.⁸
Other treatments and therapies: up to 10 sessions per condition (combined total) with a physiotherapist, osteopath, chiropractor, or acupuncturist, plus minor surgery by a GP up to £100 per procedure. A GP referral is required.⁸
Extended hospital list: wider hospital access, particularly in Greater London.⁹
Protected No Claim Discount: stops the NCD dropping after a claim. Once the protection is used it falls away and normal NCD rules resume.⁸

What’s Not Covered

Healthier Solutions is built around acute conditions, meaning illnesses and injuries expected to respond to treatment within a reasonable time. Several categories sit outside the policy entirely.

Chronic conditions such as diabetes, arthritis, asthma, and epilepsy. Cancer is the exception and is covered as standard.¹
Standard pregnancy and childbirth. Certain complications (ectopic pregnancy, miscarriage, stillbirth, eclampsia, retained placenta, and some caesarean sections) may be covered, but only if outpatient benefit has not been reduced.²
Cosmetic procedures and overseas treatment.¹
GP consultations. NHS and private GP fees are not reimbursed. The Digital GP app offers free video calls but sits outside the insurance contract.⁷
Self-inflicted injury, drug and alcohol abuse treatment, sleep disorders, kidney dialysis, experimental treatment, weight-loss surgery, and HIV/AIDS.³

Mental health has its own quiet limit worth knowing about. If a policyholder claims for the same mental health condition in three separate policy years, Aviva reclassifies it as chronic and withdraws further cover for that condition.³

How Pre-Existing Conditions Are Handled

Aviva defines a pre-existing condition broadly: any disease, illness, or injury for which the applicant has had symptoms, medication, advice, treatment, or diagnostic tests before joining, whether or not a formal diagnosis was ever made.¹⁰

There are two assessment routes. Full medical underwriting means filling out a health questionnaire (and possibly sharing GP records) up front, so Aviva decides which conditions are excluded before the policy starts. Moratorium underwriting skips the questionnaire; instead, Aviva reviews medical history at the point of each claim, and any condition that existed within the five years before joining stays excluded until the policyholder has gone two continuous years without symptoms, treatment, advice, or medication for it.¹¹

Where You Can Be Treated

The hospital list a policyholder chooses shapes both the price and the choice of facility. Aviva offers five.

Expert Select: the default guided option. The policyholder provides an open referral from their GP, and Aviva picks hospitals and specialists (typically within 25 miles of home) that meet its quality standards.³
Key Hospital List: the standard list of private hospitals, roughly 20% more expensive than Expert Select.³
Extended Hospital List: adds further hospitals, especially in London, for about 18% more than the Key list.³
Trust Hospital List: the cheapest option, restricting treatment to private patient units within NHS Trust and partnership hospitals. Availability depends on catchment area.⁹
Signature Hospital List: open only to residents of Scotland and Northern Ireland, excluding hospitals in England and Wales to lower premiums.³

Speedy Diagnostics: A Cheaper, Narrower Policy

For people who mainly want to skip NHS waiting lists for scans and tests, Aviva sells Speedy Diagnostics as a standalone policy. It covers specialist consultations with no limit on the number, outpatient diagnostic tests including scans and X-rays, and inpatient diagnostic procedures such as endoscopies and biopsies. It does not cover treatment after a diagnosis has been made, nor routine screenings, infertility investigations, or sleep disorder tests.¹² Premiums run roughly 70% cheaper than Healthier Solutions core cover, according to one industry review.¹³ If the diagnostic process turns up something that needs treatment, the policyholder either uses the NHS or pays privately.

Benefits That Only Come With Corporate Schemes

Several benefit areas are available only through Aviva’s large corporate schemes (generally employers with 250 or more employees on the Optimum or Optimum Referral product), not on individual Healthier Solutions policies.

Family planning and fertility: up to £20,000 of fertility treatment costs, including surrogacy and adoption support, plus fertility preservation for employees whose treatment may affect future fertility. Members get access to the Fertifa reproductive health app.¹⁴
Neurodevelopmental pathway: screening, assessment, and diagnosis of ADHD, autism spectrum disorder, and Tourette’s syndrome for members aged seven and over, with post-diagnosis support such as adapted CBT and up to two years of medication monitoring for ADHD.¹⁴
Gender identity cover in two tiers. Core cover aligns with NHS Gender Identity Clinic assessments and hormone support. The enhanced tier covers surgical procedures (genital surgery, mastectomy, breast augmentation, facial feminisation and masculinisation surgery, voice surgery), voice therapy (up to 20 sessions), hair transplantation (up to £30,000), and hair removal (up to £20,000). The hormones themselves are not paid for by Aviva and are obtained through an NHS GP prescription.¹⁵

What It Costs

Aviva advertises that health insurance costs less than £48 per month on average, based on 25% of customers aged 35–50 with new medical underwriting between January and March 2026.¹ What an individual pays depends on age, location (London and the South East are the most expensive regions), smoking status, the level of cover chosen, and claims history. Children can be added at a discounted rate: Aviva charges for the eldest child only, and any additional children aged 19 or under are included at no extra premium.¹⁶

Several levers can bring premiums down. Capping outpatient benefit at £500 or £1,000 a year, or removing it entirely, lowers the price, though reducing outpatient cover also strips out cover for pregnancy complications and hospital-based dental surgery.¹⁷ The six-week option, under which the policyholder agrees to use the NHS when the wait for inpatient or day-patient treatment is six weeks or less, can cut premiums by as much as 20%.¹⁸ Excess options run from £100 to £5,000 per person per policy year, and a higher excess can reduce premiums by 20–30% or more.¹⁹ Policyholders who complete health risk assessments, sync a fitness app, and track progress through the MyHealthCounts platform can earn up to 15% off their renewal premium, with progress assessed at the end of month nine of the policy year.²⁰

Premiums are not fixed. Aviva notes that medical inflation and advances in treatment technology push costs upward, and renewal premiums typically rise by 8–15% a year according to industry observers.¹⁶ For new policies, Aviva offers a renewal price guarantee: the first renewal premium will not increase provided no claims are made that reduce the no claim discount level.¹

1
Aviva. Health Insurance
2
Aviva. Healthier Solutions Terms and Conditions
3
MyTribe Insurance. Aviva Health Insurance Review
4
Aviva. Cancer Cover
5
Aviva. Heart Disease and Health Insurance
6
Aviva. Mental Health Cover
7
Aviva. Health Insurance FAQs
8
Aviva. Health Options
9
Aviva. Enhance or Reduce Your Health Insurance
10
Aviva. Understanding Medical Underwriting Types
11
Aviva. Pre-Existing Conditions
12
Aviva B2B. Speedy Diagnostics
13
Protection Review. Aviva Speedy Diagnostics
14
Healthcare & Protection. Aviva Adds Quartet of PMI Benefits To Support Diversity
15
Pearson Benefits UK. Aviva Gender Identity Enhanced
16
Aviva. How Much Does Health Insurance Cost
17
GoingPrivateUK. Aviva Health Insurance Cover UK
18
IAMinsured. How Much Does Aviva Health Insurance Cost Monthly
19
WeCovr. Aviva Health Insurance
20
Aviva B2B. MyHealthCounts