How does private health insurance work?

Private health insurance is similar to other types of insurance. You pay a monthly or yearly fee called a premium.


Getting Referred

If you have a health issue, see your GP and let them know about your private cover. They may refer you to a specialist, and you might choose private hospitals or specialists not offered by the NHS.


Informing Your Insurer

Tell your insurer you want to make a claim. They'll check if your policy covers the treatment you need. If it does, your claim gets approved.


Cost Coverage

Your GP will book your appointment, and your insurance covers the cost if your policy is active. You might pay an excess depending on your policy.

What Is WPA?

WPA (Western Provident Association) is a non-profit health insurer founded in 1901 and originated from the Reading Working People’s Hospital Contributory Fund. This initiative allowed workers to contribute a portion of their wages weekly to access healthcare services when needed. After merging with the Bristol Hospital Fund in 1939, it became known as the WPA in 1949.

Now, WPA specialises in private medical insurance and promotes healthy lifestyles through its comprehensive coverage options. It is headquartered in Taunton, Somerset.

Is WPA a good insurance company?

With over 120 years of experience in the industry, WPA Insurance has earned some recognition. It has been named Health Insurance Provider of the Year (Moneyfacts Consumer Awards), along with Best Specialist Health Insurance Company (Southern Enterprise Awards).

Based on 2,733 WPA health insurance reviews on TrustPilot , the company has a rating of 4.6 out of 5. Customers frequently commend WPA for its outstanding customer service, with many praising the prompt handling of claims. Notably, WPA mentions that 97% of claims are authorised, and the average call answering time is less than 3 minutes.

How does WPA complete health insurance work?

WPA’s complete health policy offers a flexible approach to building customised health insurance cover, and it starts with a core cover that provides a basic level to build upon. It covers pre-admission tests, consultations with private medical consultants, and eligible claims for treatments.

After finalising your policy details, the next interaction with WPA typically occurs during the claiming process. For example, if you visit your GP and require further consultations or treatment, you can choose a private hospital or facilities within an NHS hospital.

After leaving the hospital, you might need follow-up visits or outpatient care. If your treatment qualifies, you can start the claiming process online.

Just make sure to read the overview below and talk to WPA before more treatment to clarify what’s covered.

How much does WPA health insurance cost?

WPA will determine policy costs based on individual parameters. For instance, here are the health insurance quotes for a healthy 30-year-old in southeast England:


You can personalise your policy by adding optional perks, which will increase the price. For example:

Premier with extra outpatient cover£14.60/month
Premier with premium hospitals£2.80/month
Elite with cancer care£7.32/month
Elite with dental care£9.88/month
Elite with overseas medical treatment£1.01/month
Elite with premium hospitals£5.13/month

WPA provides a discount of up to 25% — members get 25% off in the first year, 15% in the second, and 5% in the third.

WPA health insurance cover

WPA health insurance plans are primarily divided into personal and business categories.

WPA Individual and Family Health Insurance

Here WPA’s health solutions have three levels of coverage:

  • Essentials is designed as an entry-level policy with a focus on surgery benefits. It gives access to private surgery, in-patient, and day patient benefits for elective surgeries, with an annual limit of £50,000.
  • Premier is a mid-range plan that builds on the standard cover offered by Essentials. It has no annual limit and is one of the most popular covers chosen by WPA members for its optional extras.
  • Elite is the most extensive coverage, which offers a wide range of benefits, including in-patient, day-patient, and outpatient benefits, along with cash benefits for dental care and optical treatment. Like Premier, there is no limit per year.

There is also a solution called Complete Health, which is a more flexible health plan for individuals and families.

Complete health

The Complete Health plan is a new addition to WPA’s product range. It offers core features that can be expanded by optional extras, which we’ll discuss in the next two sections.

Important note: There’s no maximum joining age, which ensures access to private treatment for all.
WPA complete health insurance core benefits explained

Here is what’s included in the complete health insurance plan by default:

Key benefitsDetails
Outpatient treatmentOutpatient benefits include a range of procedures and consultations with specialists. It includes complex diagnostic scans like MRI/CT/PET scans, as well as specialist referrals.
Hospital treatmentBoth in-patient and day patient treatment, which ensures financial support if you need to stay in the hospital for medical care.
Health & wellbeingA range of health and wellness benefits, like remote consultations with GPs and Health and Wellbeing Helpline counselling, including support for family members over the age of 16.
Additional benefitsHome nursing care for a maximum of four weeks, private ambulance transportation, lodging for parents and children during hospital admissions, coverage for incidental expenses, and a benefit for hospice donations.

With the WPA health app, you can manage your Complete Health plan and add extra coverage options anytime, anywhere.

WPA complete health insurance optional extras explained

You have the option to add these additional benefits separately or include them all if you prefer:

Optional benefitsDetails
Cancer careYou’ll have full coverage for diagnosis and treatment without any financial limits. Plus, there’s unlimited follow-up care and personalised support from WPA’s team after you finish cancer treatment.
Enhanced outpatient options
  • Choose from various outpatient treatment consultations like physiotherapy and acupuncture with benefit limits ranging from £500 to unlimited.
  • Boost the core £250 benefit to £500, £1,000, or unlimited.
  • Get coverage for diagnostic tests like blood tests and x-rays with benefit options ranging from £500 to unlimited.
Mental health care
  • Brief therapy counselling (up to six sessions) based on clinical assessment
  • Hospital treatment for up to 28 days/nights
  • Outpatient therapy (£1,000/£2,500 coverage or extended therapy for complex conditions (up to 20 sessions)
Overseas emergency treatmentCoverage for up to 35 days per trip with a £250,000 limit or opt for up to 70 days with a £500,000 limit. Excludes the USA & its dependencies and winter sports resorts.
Winter sportsProvides a benefit for treatment on your return from a winter sports resort, using existing benefits.
Dental careFor dental emergencies, members receive £250 per treatment course in the UK or abroad, up to four courses. Dental injuries are covered up to £20,000.
Premium hospitalsOver 1,000 healthcare facilities across the UK, including Ramsay, Nuffield Health, BMI, Spire, and independent private hospitals and medical advisors.

NHS top-up personal

NHS top-up reimburses essential routine healthcare expenses for members and their families. Reimbursement for each invoice received can be 75% to 100%.

Here are the details:

BenefitDetailsCash limits
Level 1Level 2Level 3
GPPrivate visits to a doctor, including medical examination, vaccinations, and prescriptions£100£150£50
A&EUp to three visits to Accident & Emergency departments£20£40£60
Limited outpatient treatmentGetting a second opinion from a specialist£150£200£250
TherapiesUp to 4 sessions of various therapies like physiotherapy, acupuncture, etc.£200£300£400
Hospital stayCosts for accommodation in an NHS hospital for up to 20 nights£400£700£1000
OpticalCosts for services like eye exams, prescription eyeglasses, and contact lenses£65£100£150
New babySupport for the birth or adoption of a child£50£100£200

You’ll get help with NHS parking costs: up to £300 for cancer treatment or £50 for other hospital visits, with a total cap of £300 for cancer treatment.

What’s not covered on nhs top-up personal?

Exclusions from the NHS top-up plan:

  • Claims submitted over six months post-treatment
  • Long-term management of chronic conditions
  • Mental health issues (with a few exceptions)
  • Fertility, pregnancy, childbirth
  • Winter sports injuries


The Providental cash plan covers routine dental treatments to maintain oral health, acute dental issues requiring immediate attention, restorative dental treatments due to external blows to the teeth, face, or jaw, and more.

Here are more details:

General dental treatment100% of NHS costs, 75% of private costs up to £250Cover for common dental procedures like check-ups, fillings, and root canals, plus crowns, bridges, and dentures
Dental emergencies (UK or abroad)75% of treatment costs up to £500 (max 2 episodes) or up to £1,000 (max 4 episodes)Urgent dental problems like pain or swelling
Dental injuriesFrom £10,000 to £20,000, £250 for emergency appointments abroadScheduled care by a hospital specialist for injuries from external blows to teeth, face, or jaw
Restorative treatment£10,000Scheduled restorative care by a hospital specialist

What’s not covered on the providental plan?

The Providental plan doesn’t cover:

  • Claims not submitted within six months after receiving treatment
  • Existing conditions, except for general dental work
  • Dental items like mouthguards
  • Wisdom teeth treatment, unless done in a general surgery
  • Treatment due to hazardous sports or activities
  • Cosmetic treatments or those for appearance enhancement, unless specifically authorised

WPA business health insurance

Let’s continue this WPA health insurance review with business policies. WPA offers health insurance plans for both small and medium enterprises and larger companies with 150 or more employees. For SMEs, they provide customisable schemes, while larger companies can create tailored plans from scratch.

If you’re interested, consider reaching out to a specialist who can provide you with more detailed insights and guidance.

Enterprise flexible benefits

The Enterprise plan offers health coverage for small groups of 2 to 14 employees. Here’s what it includes:

  • Hospital and day treatment — Hospitalisation, specialist and diagnostic tests, and specialist fees.
  • Cancer care — Meetings with specialists, along with treatments like chemotherapy, radiotherapy, and targeted therapies for cancer.
  • Outpatient treatment — Consultations with specialists, diagnostic tests, and outpatient procedures.
  • Help for mental health issues — Admissions, consultations, and psychological services.
  • Remote benefits — 24/7 access to a private GP helpline and phone support for employees with an Employee Assistance Programme, with up to six sessions of counselling.

Other benefits include receiving nursing care at home, access to private ambulance transport, coverage for accommodation expenses for parents and children during hospital stays, reimbursement for out-of-pocket expenses, and the option to make a hospice donation.

Members can enhance their Essential cover with these paid extras:

  • Therapy — A therapist recommended by your doctor or self-referred therapy from a chiropractor, osteopath, or physiotherapist, for up to four sessions.
  • Dental care cash benefits — Costs related to general dental treatment, emergencies, and injuries.
  • Structured counselling
  • GP services

What isn’t covered?

The following conditions are not covered by the business policy:

  • Long-term management or treatment of chronic conditions
  • Cosmetic surgery
  • Childbirth, pregnancy, and fertility issues, except for specific limited benefits related to childbirth if included
  • Neonatal treatment

Precision corporate healthcare

Precision Corporate Healthcare combines health insurance, cash benefits, and dental benefits into one package. Thus, it offers more flexibility and customisation to fit a company’s needs and budget.

The process follows typical steps:

  1. Choosing the base cover: health insurance, cash benefits, or a mix of both.
  2. Adding extras. You can add mental health treatment, outpatient benefits, extra Cash Plan perks, GP charges, and NHS car parking benefits.
  3. Adding Health & Wellbeing. Discounted spa visits, gym membership, opticians, screenings and assessments.
  4. Managing the premium. Employers can customise premiums with options like shared responsibility (co-payment), excess, and group deductible.

WPA’s Precision Corporate Healthcare is a hybrid product that lets employers choose benefit levels and options for each employee. This means you can create a unique benefit structure where every member has appropriate coverage that makes sense for them.

NHS top-up

The NHS corporate cash plan is a valuable tool for incentivising and rewarding employees, and it starts at just over £1 per employee per week. Regardless of the company size, this plan allows employees to feel appreciated while receiving reimbursements for routine healthcare expenses such as prescriptions, dental and optician appointments. Moreover, even when they’re not unwell, they can benefit from quicker access to therapeutic treatments.

The mycancerdrugs extra offers access to advanced cancer drugs unavailable through the NHS for those dealing with health challenges. Also, there is an assistance programme designed to support staff with stress management, counselling, and professional managerial assistance to stay engaged and focused.

Premiums & benefits

Depending on the percentage of costs WPA reimburses, the premium changes. Here it is for 75%:

Level 1Level 2Level 3
3-9 members£6.07£11.24£18.61
10+ members£5.60£8.51£13.78

Here are the monthly premiums for each member of the corporate cash plan with 100% reimbursement:

Level 1Level 2Level 3
3-9 members£8.14£15.47£24.28
10+ members£6.03£12.10£22.57

As for core benefits, these are the same as for NHS personal top-ups, but there are a few differences in the optional benefits. The full list includes:

  • Scans and screens — A health screen or reimbursement for an MRI/CT scan or ultrasound by a specialist every two years for £1.10/month.
  • Allergy testing — Tests done by a qualified allergist for £0.65/month.
  • Dental injuries — Treatment for injuries to the face, teeth, or jaw within 72 hours for £2.60/month.
  • mycancerdrugs — Targeted cancer therapies up to £50,000/lifetime for £4.50/month (£10.55 for smokers).
  • Cosmetic surgery — Reconstructive plastic surgery for upper body injuries after a 30-day wait for £3.10/month.
  • Essential European cover — Additional support beyond EHIC/GHIC coverage; up to £100,000 in the EEA and Switzerland for £1.10/month.
  • Structured counselling — Six sessions of confidential phone counselling for personal issues for £1.10/month.

WPA covers targeted cancer therapies only if they are administered with the intent to cure and are not available through the NHS.

What isn’t covered?

Similar to other plans, key exclusions of this plan include:

  • Claims not submitted within the right timeframe
  • Long-term management of chronic conditions
  • Mental health issues (except for the 24/7 helpline)
  • Pregnancy, childbirth, fertility issues
  • Injuries from winter sports

Other exclusions are detailed a few sections away.

How are WPA health insurance policies priced?

WPA health insurance policies are priced according to individual factors, such as age, health status, lifestyle, and location. Each plan has its unique pricing structure tailored to these variables.

WPA complete health insurance pricing

The premiums for WPA Complete Health policies depend on the selected core cover, optional benefits, and chosen level of excess or co-payment. The cost will vary based on these factors in addition to the usual ones like age and smoking habits.

WPA NHS top-up personal health cash plan pricing

WPA’s cash plans’ pricing depends on the core benefits you choose. Also, coverage includes up to five children under the age of 18 at no extra cost.

If you opt for extra benefits, the cost goes up, but it will also give you more coverage and benefits. For example:

  • Scans and screens: £200 annual limit for £1.85/month
  • Mycancerdrugs: Up to £50,000 coverage for £4.40/month (£10.55 for smokers)
  • Cosmetic surgery: Coverage up to £20,000 for £3.15/month
  • Essential European cover: £100,000 coverage for £1.05/month
  • Personal accident: £15,000 coverage for £0.55/month

WPA providental dental cash plan pricing

The dental-only Providental plan has different prices depending on the level of coverage you select. If you choose coverage of restorative dental treatment, for example, it will cost £2.60 more than routine coverage.

What is not covered on WPA health insurance?

WPA health insurance policies don’t insure for:

  • Chronic and pre-existing conditions (subject to underwriting type)
  • Dental issues, except for limited benefits with certain optional extras
  • Procedures for aesthetic purposes
  • Allergic reactions or conditions
  • Varicose veins (for the first two years)
  • Injuries sustained during dangerous activities
  • Costs for treating unborn babies or birth defects
  • Treatment outside the UK, unless specific optional extras are included

Overseas emergency treatment doesn’t cover travel to the USA and its dependencies, conditions that require current treatment in the UK or have been treated in the six months before travelling, and any treatment related to infectious diseases deemed epidemics or pandemics by the WHO.

In terms of cover restrictions, WPA reimburses medical treatment costs based on what it considers reasonable and customary, with limits on the maximum amount per person per year.

Can I get health insurance if I have an existing medical condition?

Yes, a person with a pre-existing condition can still obtain WPA health insurance coverage. However, treatment directly related to these existing conditions will be excluded. The insurance policy will be adapted to the individual’s medical history, and personal exclusions will be detailed based on past medical history declarations.

When does WPA health insurance reset?

WPA’s insurance resets annually, which coincides with the annual renewal of the policy. This means that benefits are reset and refreshed after a period of 12 months.

If you’re a member, you will be contacted about renewal terms approximately 21 days before the renewal date.

Can I switch my existing health insurance cover to WPA?

Yes, you can switch your existing cover to WPA without a break between policies for continuity. This transfer maintains the same medical underwriting terms as your previous insurer. The easiest way to switch to WPA is to contact WPA directly for a quote.

However, bear in mind that the terms of the new policy may differ from those of your previous insurer.

How to cancel WPA health insurance UK?

You can cancel WPA’s health insurance policy by notifying WPA directly or through your intermediary via:

  • Phone: 01823 625270
  • Email:

Alternatively, you can reach out by traditional mail: WPA, Enterprise Business Division, Rivergate House, Blackbrook Park, Taunton, Somerset, TA1 2PE.

Can you cancel WPA health insurance at any time?

Cancellation requires a 30-day notice period. If no claims have been made and the policy is cancelled after this period, WPA may issue a partial premium refund. However, if you have already made a claim, there will be no refund.

For premiums paid in full upfront, WPA calculates a pro-rata refund from the cancellation date to the end of the policy year. Monthly premium instalments are non-refundable.


Based on this WPA health insurance review, it’s evident that their detailed plans match and sometimes even surpass those of competitors. There are clear benefits to choosing one of their plans for yourself, your family, and/or your employees.

WPA is highly rated for its customer service and claims process, making it one of the best health insurers in the UK. If you’re looking to enter the private health insurance space for the first time or switch providers, it might be just what you need.