WPA
WPA are a not-for-profit organisation with headquarters in Taunton, Somerset. Specialising only in private health insurance, WPA partner with individuals and companies to offer personal and business health insurance policies in the UK.
WPA traces its origins back to 1901 where it was set up as the Reading Working Peoples’ Hospital Contributory Fund. Nearly half a century before the creation of the NHS, the Fund provided workers the option to pay a portion of their wage into the Fund each week. They could then access this Fund at times of ill health.
In 1939, the Reading Working Peoples’ Hospital Contributory Fund merged with the Bristol Hospital Fund, and in 1949 it was renamed the Western Provident Association (WPA).
WPA is still committed to its founding principle to make healthcare affordable for hundreds and thousands of people, through its family policies and corporate schemes.
The World Health Organisation has recognised WPA as leading the way for coinsurance and shared responsibility policies. Shared responsibility is an innovative method of co-payment allowing the member to take control of the cost of their health insurance premium.
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WPA’s main private medical insurance product is called Flexible Health.
The policy covers a wide range of conditions as an in-patient or day-patient on specialist referral, and there are three levels of cover to choose from: Essentials, Premier and Elite.
There are several additional options you can choose to enhance the cover such as extra out-patient cover, structured counselling, dental cover, and premium hospitals.
Unlike most insurers the core cover is different on each of the three plan options, as are the additional benefits you can add to enhance your cover.
Flexible Health Essentials is an entry level surgery-only policy, with a maximum annual benefit limit of £50,000. There is limited out-patient cover for up to £150 for specialist consultations and diagnostics, and this is only eligible within a six-week period prior to surgery. There is only one additional option you can add to the Essentials policy which is the advanced cancer drugs benefit. This benefit provides £50,000, for the life of the policy, towards advanced anti-cancer treatment (targeted cancer therapies) when given with curative intent and where not readily available on the NHS.
Flexible Health essentials policies do not include the shared responsibility co-payment.
Flexible Health Premier is a mid-range policy offering enhanced cover as standard. The policy includes £350 towards out-patient consultations, therapies, and GP-referred diagnostic tests.
Specialist referred complex diagnostic tests are unlimited but only one MRI or CT scan is covered if it is GP-referred.
There are many additional options you can choose from to add to the Flexible Health Premier policy: extra out-patient cover (£1000 or £1500), cancer care, dental cover, mental health, structured counselling, and overseas emergency treatment.
Over 61%* of WPA members choose the Premier policy due to its range of optional extras. Multiple shared responsibility (co-payment) levels are available and there is no maximum annual benefit limit.
* Based on the number of policies sold across the Flexible Health product range between the 1st of September 2020 and the 31st of August 2021.
Flexible Health Elite is the most comprehensive policy available; it includes unlimited out-patient consultations and specialist referred diagnostic tests (up to £1000 when GP referred). Cancer care, dental care and emergency overseas treatment are included as standard. There are three optional extras you can add to the Elite policy: mental health, structured counselling, and premium hospitals.
Multiple shared responsibility (co-payment) levels are available and there is no maximum annual benefit limit.
WPA key benefits
WPA Health app – easy access to your secure account, make a claim 24/7, send and receive messages, view membership literature, and access the remote GP services benefit.
Clinical expertise – specialist in-house clinical teams provide dedicated and personal claims management to support those members with complex clinical needs.
Health and Wellbeing Helpline – telephone support covering a variety of different areas, many of which are provided by experts in their field.
Extensive hospital list – access to over 600 hospitals as standard.
Shared responsibility – an innovative method of co-payment allowing you to take control of the cost of your health insurance premium.
2021
Health Insurance Provider of the year 2020 & 2021
Outstanding Cashplan 2021
Best customer service delivery 2021
WPA core cover
Here is a summary of what is included in the core cover of the most popular plan, Flexible Health Premier:
| Benefit | Details |
| In-patient and day-patient treatment | Hospital treatment, critical care levels 2 and 3 (up to 28 days), drugs and dressings, specialist fees, diagnostic tests including MRI, CT and PET scans, in-patient and day-patient therapy, post operative consultations and tests (one follow-up within 90 days of surgery), protheses. |
| Out-patient treatment | A combined limit of £350 for specialist consultations and diagnostic tests, and GP referred diagnostic tests. Specialist and GP referred therapy, up to 10 sessions. Self-referred therapy, up to 4 sessions.
Cover is in full for complex diagnostic scans (one MRI or PET scan when GP referred), out-patient procedures and pre-admission tests. |
| Remote benefits (available 24/7) | Remote GP services includes access to a private GP helpline, video consultations, private prescriptions, and specialist referrals.
Health and Wellbeing helpline provides information, single-session telephone counselling, online computerised Cognitive Behaviour Therapy (cCBT) life skills course, debt and money information and support, legal information, manager support.
Up to six sessions of structured counselling is provided where clinically appropriate, following referral from the Health and Wellbeing Helpline. |
| NHS hospital cash benefit | Cash benefits for NHS in-patient (less than three nights) or NHS day-patient, up to £150 per night/day.
NHS in-patient (three nights or more) is up to £200 per night.
NHS out-patient complex diagnostic scans and NHS out-patient procedures (MRI, CT, and PET scans) up to £150 per day. |
| Further benefits | Additional benefits under the core cover include:
- Nursing at home for up to four weeks.
- Private ambulance transport.
- Parent and child hospital accommodation charges, up to 10 nights.
- Out of pocket expenses reimbursed at £10 per day.
- Hospice donation is £70 per day/night, up to £700.
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The main differences in the core cover between Premier and the other two plan options are summarised as:
Flexible Health Essentials is for elective surgery only, not non-surgical medical treatment. Out-patient consultations and diagnostics are limited to £150 in the six weeks prior to surgery. Complex diagnostic scans are not covered. The remote benefits do not include structured counselling and the further benefits are different and only include general dental treatment and optical treatment (75% up to £100).
Flexible Health Elite covers out-patient consultations and diagnostics in full, with no benefit limit. GP-referred diagnostics are covered up to £1000 and specialist referred therapy is unlimited. Cover for complex diagnostics, out-patient procedures and pre-admission tests are covered as they are on the Premier plan.
The Elite plan also includes cancer care, dental care, and overseas emergency treatment as standard under the core cover. In addition, there is £200 towards health screening and £200 towards optical treatment.
WPA benefit options
In addition to the WPA Flexible health core plans there are further options to choose from to enhance your cover, these are not available across all three plans, as indicated:
| Benefit | Details | Plan availability |
| Extra out-patient cover | Choose either £1000 or £1500 for:
Consultations with a specialist, diagnostic tests and GP referred diagnostic tests.
Specialist referred therapy and GP referred therapy; up to 10 sessions, self-referred therapy; up to 4 sessions of chiropractic therapy, osteopathy, and physiotherapy.
General dental treatment is covered up to £200.
Optical is covered up to £200.
Health screening is covered up to £200. | Essential: Not available
Premier: Can be selected
Elite: Not available *
*Some benefits included in core cover |
| Cancer care | Diagnosis cover is for consultations with a specialist including second opinions, diagnostic tests, scans, and biopsies.
Surgery, radiotherapy, and chemotherapy are covered in full.
Targeted cancer therapies for advanced anti-cancer treatment will be funded when given with curative intent, and where not readily available on the NHS.
NHS hospital cash benefit for cancer (overall combined maximum annual benefit limit of £6,000).
NHS in-patient or day-patient, up to £200 per night/day.
NHS out-patient complex diagnostic scans, out-patient cancer treatment and procedures, up to £150 per day. | Essential: Not available
Premier: Can be selected
Elite: Included in core cover |
| Advanced cancer drugs | Targeted cancer therapies up to £50,000 (lifetime benefit) towards advanced anti-cancer treatment when given with curative intent and where not available on the NHS.
This optional extra has a 14-day deferment period and is only available up to the renewal following your 66th birthday. | Essential: Available to select
Premier: Not available
Elite: Included in core cover |
| Dental care | General dental treatment up to £250 (£450 if you add both the extra out-patient and the dental care optional extras).
Dental emergencies up to £250 per course of treatment in the UK or abroad, maximum four episodes and £1000 per policy year (a 14-day qualifying period applies).
Dental injuries up to £20,000 (a 14-day deferment period applies).
Restorative treatment as a direct result of oral cancer, up to £10,000 or unlimited if the cancer care optional extra has been chosen (a 14-day deferment period applies). | Essential: Not available
Premier: Can be selected
Elite: Included in core cover |
| Overseas treatment | Not the USA and its dependencies, 70 days per trip, maximum 180 days and £500,000. | Essential: Not available
Premier: Can be selected
Elite: Included in core cover |
| Mental Health | In-patient and day-patient mental health treatment up to 28 days/nights.
Out-patient mental health treatment up to £1,000 for consultations with a psychiatrist, psychotherapy, psychology.
When recommended following an assessment, Eye movement Desensitisation and Reprocessing (EMDR) and Cognitive Behavioural Therapy (CBT).
Structured counselling (extended therapy) up to 20 sessions. | Essential: Not available
Premier: Can be selected
Elite: Can be selected |
| Structured counselling | Structured counselling (extended therapy) up to 20 sessions. | Essential: Not available
Premier: Can be selected
Elite: Can be selected |
| Premium hospitals | Extend your choice of over 600 hospitals by adding Premium Hospitals, primarily based in central London. | Essential: Not available
Premier: Can be selected
Elite: Can be selected |
NHS top up cash plan
WPA are unique to other health insurance providers as they offer a cash plan. The WPA NHS Top-Up Cash Plan contributes towards the cost of routine healthcare, which means you do not have to be ill to benefit. Benefits include reimbursement for specialist consultations, optical and dental costs, and a baby bonus on the birth of a child. It also provides access to remote GP services and the Health and Wellbeing helpline.
Shared responsibility
Most insurers offer the option to apply an excess to your policy to reduce your health insurance premium. WPA have a different approach, their policies include a Shared Responsibility co-payment.
WPA will pay 75% of all claims with the member paying the remaining 25% on each eligible claim, up to a capped limit you choose when you take out the policy. Once your contributions total the annual Shared Responsibility limit WPA will pay 100% of all future eligible claims until the next policy year starts.
Children under the age of 18 do not have their own Shared Responsibility, instead they will share it with the eldest member on the policy. If a child under 18 has cover alone they will have their own Shared Responsibility limit.
Shared Responsibility can only be reduced by one level at the renewal of the policy.
The Shared Responsibility limits you can choose from for Flexible Health Premier are: £250, £500, £750, £1000, £1500, £3000, and £5000.
The Shared Responsibility limits you can choose from for Flexible Health Elite are: £500, £750, £1000, £1500, £3000, and £5000.
Shared responsibility is not available on the Flexible Health Essentials plan.
Underwriting options
As with most health insurers WPA have three options you can choose from for how your policy is underwritten:
Moratorium underwriting
You do not need to disclose your medical history; a moratorium period of two years is in place for any condition for which you have experienced symptoms or received treatment for in the last five years.
Continued medical exclusions
You will need to answer a few questions regarding your medical history in the last five years and some questions on specific health conditions. The underwriting will transfer from your previous insurer rather than being re-underwritten. This option is only available to those with an existing health insurance policy with another insurer.
Full medical underwriting
You will disclose your full medical history which is submitted to WPA who will then apply underwriting terms accordingly.
You can read more in our guides section on underwriting. Our expert advisors can use their knowledge to assist you in choosing the right underwriting, considering your medical history and future medical needs.
Underwriting explained What is not covered
As with most leading health insurers, WPA policies are for cover for acute conditions and flare ups of chronic conditions. Chronic conditions, in terms of ongoing monitoring and maintenance are not covered by health insurance policies. Read more on chronic conditions.
Private medical insurance does not cover accident and emergency situations or rehabilitation and convalescence. Most leading health insurers do not cover treatment overseas. Self-inflicted injury and professional sports related injuries are also not covered on a health insurance policy.
With regards to treatment of medical conditions you have had, or had symptoms of, before you join WPA, these will be excluded unless you have switched from another plan and have underwriting for continued medical exclusions.
In many cases pre-existing conditions can be covered, dependent on the status of the condition at the time of joining, and the time that has passed since you last received treatment or experienced symptoms. This is something our expert advisors can assist you with when selecting the best policy and underwriting for you.
WPA do apply some general exclusions and limitations as below:
- Long term chronic conditions
- End of life care
- Cosmetic treatment
- HIV/AIDS
- Fertility problems, pregnancy, and childbirth
- Injuries sustained through winter sports
- Mental health conditions
- Organ or tissue transplant
- Preventative treatment and screening tests
We compare health insurance policies for those who are new to health insurance or those who already have a policy in place.
Get a quote Summary of WPA Flexible Health policies
Having three distinctly different policy options under the Flexible Health plan, WPA offer health insurance to suit most budgets. The Essentials entry level plan is unlike any other insurer product and only provides cover for surgery, an expensive element of medical treatment. By removing the extras, it is an affordable way to have health insurance.
The Premier plan is the most popular of all WPA policies and does include good cover for diagnostics and treatment, although the limits are lower than most leading insurers. There are two options to increase out-patient cover, but these still combine both consultations and diagnostics under the limit. There is no option to have unlimited diagnostic tests, other than MRI, PET and CT scans. To have full diagnostics you would need to choose the Elite plan; however, the GP-referred diagnostics are limited to £1000.
Unlike most insurers WPA do not include comprehensive cancer cover as standard on all policies, it is an optional extra you can choose to add to the Premier plan and is not available to add on the Essentials plan. The WPA cancer cover does not include end of life care but does provide cover for targeted cancer therapies when given with curative intent, and where not readily available on the NHS.
WPA are behind most leading insurers when it comes to mental health; they do not cover it as standard. However, they have recently introduced structured counselling and do have plans to improve their mental health benefits further.
The WPA plans are competitively priced, and the Shared Responsibility co-payment does allow you to bring your premiums down by selecting from a wide range of Shared Responsibility limits.
WPA have a very good reputation for customer service and claims management, they are also popular with consultants and surgeons, and as a not-for profit provider they do re-invest profits into improving their products and service.
One very important benefit WPA members receive is that the policies are not based on a no claims discount system, their policies are ‘community rated’. This means that WPA will not increase your premium due to claims you have made. Premium increases are based on claims made within a wider pool of customers.
There is a 20% discount on health insurance for the self-employed, business owners and professionals under the age of 55. After the age of 55 the discount will reduce by 2% a year until you are 65. This makes the WPA plans extremely popular with members of professional institutions such as dentists, solicitors, teachers, surveyors, and accountants. There is however an age limit for joining WPA set at 65.
WPA provide an extensive choice of over 600 hospitals as standard, this does give the member excellent choice when it comes to access to consultants and where they want to be treated.
Unlike most other insurers WPA do not offer a ‘guided option’. The guided options are where the insurer provides a restricted list of consultants to choose from with the benefit being significantly reduced premiums. However, they are the only private medical insurer to offer a cash plan which can be used to top up your PMI policy.
WPA offers affordable health insurance with a long-term commitment to fair pricing, they are popular with consultants and surgeons and offer good discounts for many professions.
WPA hospital list
WPA provide an extensive choice of over 600 hospitals as standard, they include all BMI, Nuffield, Spire, Ramsay independent private hospitals and private wings of NHS hospitals.
You can extend your choice further by adding Premium Hospitals to the Flexible Health Premier and Elite policies, these are primarily based in central London.
Click on the link below to see the eligible hospitals in your location.
WPA hospitals Compare AVIVA Health with other leading providers
Click on the logo’s below to read about the other health insurers benefits and our independent review of their health insurance cover.
Health insurance guides
Below are our helpful guides that provide further information about how medical insurance works and the various options available. Should you prefer to speak to one of our expert advisors we are always available on the telephone to help.