More than consultations — and on at least one policy, choosing a lower one silently removes cover you would never connect to it.

What the policy documents actually say

The out-patient allowance usually pays for specialist consultations, diagnostic tests and scans done without admission. WPA sets consultations with a specialist at £250 a year as standard, extendable by buying its Extra Out-patient Consultations option. The Exeter puts CT, MRI and PET scans, out-patient surgery and up to three sessions of post-operative physiotherapy in core cover, then sells broader out-patient consultation and diagnostic cover as an add-on.

Aviva's version carries the consequence people miss. Choosing a reduced out-patient limit of £500 or £1,000 does not only cap out-patient spending — it also removes in-patient, day-patient and out-patient cover for complications of pregnancy and childbirth, and for surgical procedures on the teeth performed in hospital. A limit selected to shave the premium changes cover in two areas that have nothing obviously to do with out-patient treatment.

AXA Health separates the pieces differently again: out-patient surgery carries no yearly limit, while scans are paid in full only at a centre in its Directory of Hospitals.

The practical problem is sequencing. Diagnosis usually happens out-patient, so a low out-patient limit can be exhausted before anyone has established what is wrong — leaving generous in-patient cover you cannot reach because you cannot afford to complete the investigation.

Ask what the limit covers rather than what it is. Two policies quoting £1,000 can differ on whether the initial consultation, the scan and the follow-up all draw on it.

Questions to put to the insurer or broker

  • Does the limit include diagnostics or only consultations?
  • Does choosing a lower limit remove any other cover?
  • What happens if the limit runs out mid-diagnosis?

Related questions

Sources

  • Source: Aviva — Healthier Solutions Terms and conditions (2025-04), read 4 September 2026.
  • Source: AXA Health — Personal Health membership handbook, October 2024, read 4 September 2026.
  • Source: The Exeter — Private Medical Insurance — Insurance Product Information Document (Health+) (2025-10), read 4 September 2026.
  • Source: WPA — Private Medical Insurance — Insurance Product Information Document (Complete Health) (2025-11), read 4 September 2026.

The limit behind every answer here

None of this reaches a condition you already have. Cover is written for problems that arise after it starts, so anything you have symptoms of when you apply is excluded — permanently under full medical underwriting, or until a symptom-free period has passed under a moratorium. Chronic conditions are excluded by every insurer whose wording we hold. Figures quoted come from current policy documents and change at renewal, so check the document you are actually offered.

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