How mental health cover works
Mental health cover in a UK health insurance policy usually has two parts:
- Outpatient care: consultations with a psychiatrist or psychologist and talking therapies such as CBT or counselling. This is normally capped, either by the number of sessions or by a cash limit each year.
- Inpatient and day-patient care: treatment in a psychiatric hospital or day unit. This is usually capped at a number of days, most often 28 to 45.
Some insurers include both as standard. Others include only limited therapy and sell fuller cover as an add-on. A few don't include it at all unless you choose it.
How the main insurers compare
This is what each insurer publishes about its mental health cover (checked October 2026). Limits can differ between plan levels, so always confirm against your quote.
| Insurer | Included? | Outpatient and therapy | Inpatient / day-patient | GP referral? |
|---|---|---|---|---|
| Bupa | Standard in Bupa By You | Talking therapy; supports long-term care of new chronic conditions such as depression and anxiety | 28, 45 or 90 days, depending on policy | No, direct access |
| AXA Health | Optional add-on | No yearly limit on psychiatric clinician fees | Covered with the add-on | Yes, for therapy |
| Aviva | Outpatient core; inpatient optional | Up to £2,000 a year | Up to 28 days (optional extra) | Yes |
| Vitality | Core, with Enhanced option | Core: up to 8 talking therapy sessions. Enhanced: unlimited therapy and £1,500 outpatient | Enhanced: up to 28 inpatient plus 28 day-patient days per episode | No, self-referral for therapy |
| Freedom | Optional on Elite | Up to £2,000 | Up to 45 days | Check policy |
| WPA | Optional extra | £1,000 or £2,500, plus up to 20 counselling sessions | Up to 28 days | Check policy |
| The Exeter | Optional add-on | Unlimited outpatient | Up to 28 days a year | Check policy |
| Saga | Varies by plan | £1,500 to £2,500 | Up to 28 days a year | Check policy |
| National Friendly | Limited (My PMI Level 1) | One psychiatric assessment and up to 10 counselling sessions | Not covered | Check policy |
What to look for
When you compare quotes, check:
- Whether mental health is included at all. On some policies it's an add-on you have to choose.
- The therapy limit. Eight sessions is enough for a short course of CBT. A cash limit of £1,000 to £2,500 may cover more or fewer sessions depending on the therapist's fees.
- Inpatient days. Most people never need inpatient care, but if you do, the difference between 28 and 90 days matters.
- How you access care. Direct access or self-referral saves the step of seeing a GP first.
- Long-term conditions. Most insurers stop paying once a condition is classed as chronic. Bupa's cover is broader here.
- Whether using therapy affects your no-claims discount. Bupa's "Members First" talking therapy has no excess and doesn't affect your no-claims discount.
What's usually excluded
- Pre-existing conditions. Anything you've had symptoms of or treatment for in recent years, under the normal underwriting rules. See our guide to pre-existing conditions.
- Addiction and substance misuse. Freedom, for example, excludes addiction.
- Dementia and learning, behavioural and developmental conditions (excluded by Bupa, and commonly elsewhere).
- Ongoing management of chronic conditions, on most policies.
Free and low-cost alternatives
Health insurance isn't the only route to support:
- NHS Talking Therapies. In England you can refer yourself without seeing a GP, from age 18 (16 in some areas). In Scotland, Wales and Northern Ireland you usually start with your GP.
- Employee assistance programmes. Many employers offer one. Mind says these should offer some free counselling sessions, and they're confidential.
- Your GP, who can refer you to NHS mental health services.
If you're struggling right now, you can call the Samaritans free at any time on 116 123, or call NHS 111 and choose the mental health option.
For a broader look at how mental health cover has developed, read our article on mental health cover in private health insurance. Our condition guides to depression, anxiety, OCD and PTSD explain NHS and private treatment options.
Sources
- Bupa: Mental health cover
- AXA Health: Mental health insurance
- Aviva: Is mental health care covered?
- Vitality: Mental health cover
- Freedom: Elite optional benefits and Health insurance with mental health cover
- WPA: Complete Health insurance product information document
- The Exeter: Health+ policy document
- Saga: Health insurance quote brochure
- National Friendly: My PMI policy summary
- NHS: NHS Talking Therapies
- Mind: How to find a therapist
Questions and answers
Does private health insurance cover mental health?
Most insurers offer mental health cover, but not always as standard. Bupa includes it in Bupa By You, Aviva includes up to £2,000 of outpatient therapy as a core benefit, and Vitality's core cover includes up to eight talking therapy sessions. AXA Health, WPA and The Exeter sell it as an optional extra. Always check what level is included in the quote you're given.
Is therapy covered by health insurance?
Usually, within limits. Policies typically cover talking therapies such as CBT and counselling as an outpatient, capped either by a number of sessions or a cash amount. For example, Vitality's core cover includes up to eight sessions a year and WPA's add-on includes up to 20 counselling sessions.
Do I need a GP referral for mental health treatment?
It depends on the insurer. Bupa lets you access mental health support directly without a GP referral, and Vitality allows self-referral for its talking therapy sessions. AXA Health and Aviva need a GP referral for therapy. Many policies include a virtual GP service, which can make getting a referral quicker.
Are pre-existing mental health conditions covered?
Usually not at first. A mental health condition you've had symptoms of, or treatment for, in the last few years will normally be excluded, either until you've gone a set period without symptoms or treatment (moratorium) or permanently (full medical underwriting). AXA, Aviva and WPA all state that pre-existing mental health conditions aren't covered.
Does health insurance cover inpatient mental health treatment?
Many policies do, with a limit on the number of days. Bupa covers 28, 45 or 90 days depending on the policy, Freedom's Elite option covers up to 45 days, and Aviva, Vitality's Enhanced option, WPA, The Exeter and Saga cover up to 28 days. National Friendly's My PMI doesn't include inpatient mental health care.
Are long-term conditions like depression covered?
Most policies exclude chronic conditions. Bupa is an exception: it says its cover supports long-term treatment of new chronic mental health conditions such as depression and anxiety. Check how any other insurer treats an ongoing condition.
What isn't covered?
Common exclusions include pre-existing conditions, addiction and substance misuse (Freedom excludes addiction, for example), dementia, and learning, behavioural and developmental conditions (excluded by Bupa). Read the exclusions list for any policy you're considering.
Are there free alternatives?
Yes. In England you can refer yourself to NHS Talking Therapies without seeing a GP (from age 18, or 16 in some areas). Elsewhere in the UK you usually start with your GP. Many employers also provide an employee assistance programme, which Mind says should offer some free counselling sessions.
Insurers worth comparing
Further reading
- Mental Health Cover in Private Health Insurance: What's Included in 2026
- Virtual GP Apps Explained: What You Actually Get With 24/7 GP Services
- Pre-Existing Conditions and Health Insurance: What's Covered, What Isn't