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Summary of exclusions

Like most private health insurance policies, Healthier Solutions won’t cover pre-existing conditions. The way we deal with previous conditions will depend on the type of underwriting that you choose. There are also some specific treatments and conditions that aren’t covered by our health insurance.

The following list is just a summary of the exclusions and you can find a more extensive list in the Healthier Solutions terms and conditions (PDF 0.5MB)

  • cosmetic treatment (except following an accident or surgery for cancer)
  • experimental treatment (limited benefit may be available - please contact us)
  • pre-existing conditions (unless we have expressly included treatment relating to them)
  • professional sports injuries
  • treatment undertaken by a specialist without GP referral
  • treatment for pregnancy or childbirth, although some complications are covered, as detailed in the terms and conditions, provided the mother has been on the policy for at least 10 months
  • treatment directly or indirectly related to birth control
  • diagnostic tests and treatment for infertility
  • treatment required as a result of war, terrorism, contamination by radioactivity, biological or chemical agents
  • AIDS/HIV and related conditions
  • alcoholism, alcohol abuse, drug abuse, solvent abuse and other addictive conditions
  • kidney dialysis
  • psycho-geriatric conditions
  • self-inflicted injury
  • sexual dysfunction
  • sleep disorders and sleep problems such as snoring and sleep apnoea
  • surgical or medical appliances such as neurostimulators (e.g: cochlear implants) and crutches
  • treatment for warts, verrucas or skin tags
  • weight loss surgery
  • charges by a GP, medical practitioner or specialist for completion of a claim form unless the claim is confirmed by us
  • long term or chronic conditions (this exclusion does not apply to treatment for cancer)
  • take-home drugs and dressings
  • varicose veins of the leg, unless they meet the criteria detailed in the terms and conditions
  • treatment outside a specified network

What is a network?

We’re developing a number of networks of facilities, specialists or other practitioners that we recognise to provide the treatment required for a specific condition or suspected condition.

By creating networks, Aviva has more control over the treatment pathway. This means we can drive better commercial deals, which helps us maintain affordable prices. What’s more, by controlling the treatment pathway we can give our customers greater assurance when it comes to clinical quality and treatment, and ensure that more treatment can be covered before benefits limits are reached.

Our networks are updated frequently as we work to ensure we get the best possible service for our customers. We regularly add or evolve networks, or in the event that a facility/specialist is no longer suitable for a network we may remove them. Please contact our claims team before arranging any treatment.

Contact our claims team on 0800 158 3333. Our lines are open from 8am-8pm Monday to Friday and 8am-1pm on Saturdays.

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Useful documents

A comprehensive private health insurance policy has a range of benefits and features that suit your needs as well as your budget. Find out more about Healthier Solutions in detail, with these documents.

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