What Vitality health insurance includes depends on which part of the plan you look at: a set of hospital-based core benefits comes with every Personal Healthcare plan, out-patient, therapies, mental health, travel and an optical, dental and hearing package are extras the planholder chooses, and the Vitality Programme of points and partner offers runs alongside and feeds into the renewal price. If you are deciding which extras are worth their cost, an FCA-authorised broker can have the plan priced with each one on and off. Name the extras you are unsure about on this page's form; a call from the broker to go through them costs you nothing.
The plan terms quoted here are from Vitality's Membership Guide (Your Personal Healthcare plan terms and conditions), print code VHTCR0002 08/2024, dated August 2024, which we read on 10 October 2026 in a copy held on mytribeinsurance.co.uk, a broker's website; page numbers are those of that PDF. It is not the newest word on the plan. Vitality's own core-cover and cover-options pages, as captured by the Internet Archive on 1 August 2026, already describe some things differently, and those differences are flagged where they arise. Treat this page as a map of how the plan is built, and check every limit against the terms and certificate that come with your own quote.
Vitality health insurance: what's included and what you choose
The guide's "Your benefits at a glance" section (page 8) sorts every benefit into one of two groups. Core Cover benefits are "included automatically". Cover options apply only if the planholder chose to add them, and the membership certificate records which ones were added. The options table repeats the point and adds that the certificate also carries the limits (page 11).
That makes the certificate, rather than a brochure, the document that settles what a given member holds. Several limits in the guide are printed simply as "See membership certificate", so two people insured with Vitality can hold quite different plans under the same name. The guide covers the Personal Healthcare plan; Vitality's website also lists a separate Health Lite plan, which this page does not describe.
The Vitality Programme is the third strand, and it is not insurance cover. Members earn points towards a status, get "discounts with our health partners" and use health-monitoring tools (page 7). It has its own section further down because it reaches the premium.
Core cover, benefit by benefit
The core table (pages 9 and 10) is built around hospital treatment. These are the main entries, with the limit as printed:
| Core benefit | Limit as printed | Page |
|---|---|---|
| In-patient and day-patient hospital fees, including critical care, theatre charges and diagnostic tests | Full cover | 9 |
| Out-patient surgical procedures | Full cover | 9 |
| Consultant fees for in-patient and day-patient treatment | Full cover | 9 |
| NHS hospital cash benefit, in-patient | £250 per night up to a maximum of £2,000 per plan year | 9 |
| NHS hospital cash benefit, day-patient | £125 per day up to a maximum of £500 per plan year | 9 |
| Childbirth cash benefit | £100 per child | 9 |
| Talking therapies arranged through Vitality's mental health panel | See membership certificate | 10 |
| Out-patient physiotherapy within Vitality's network | See membership certificate | 10 |
| Rehabilitation after a stroke or serious brain injury | 21 days per condition | 10 |
| Home nursing after eligible in-patient treatment | Full cover | 10 |
| Weight loss surgery and corrective surgery in children and young adults, in specified circumstances | 75% of the costs | 10 |
Several rows carry conditions the table leaves out. The NHS cash benefit is paid when you choose to be a non-paying NHS patient for treatment the plan would have covered privately, and nothing is payable for any part of an emergency admission (page 15). For the childbirth payment, "you must have been covered on the plan for at least 10 months before the birth" (page 13), with no waiting period for adoption. Weight loss and corrective surgery come with age, body-mass and length-of-membership tests, and the member pays the other 25% (pages 13, 17 and 18). Vitality's August 2026 core-cover page puts the talking therapy allowance at up to eight sessions a plan year and the physiotherapy at up to six Priority Physio sessions; the guide leaves both numbers to the certificate.
The same table lists a private ambulance between hospitals, accommodation for a parent while an insured child under 14 is an in-patient, named pregnancy complications (not antenatal care or normal childbirth, page 16) and a closed list of hospital oral surgery procedures. Routine dentistry is not core; it sits in the option covered further down.
Cancer has a section of its own: "Our Advanced Cancer Cover is included in all Personal Healthcare plans" (page 19). Surgery, radiotherapy and chemotherapy appear as "Full Cover", with fixed sums for items such as wigs (£300 per condition) and external prostheses (£5,000 per condition) (page 20). If you have had cancer, or a condition you suspect is connected, ask the broker on your call-back how Vitality's acceptance terms would treat your history; there is no charge for talking it over.
GP appointments: what the core table promises, and what it leaves to the certificate
Primary care is printed in the core table (page 9), but only part of it at a fixed level. Video consultations with a Vitality GP are "Full Cover", and a Health Advice Line runs 24 hours. Face-to-face consultations with a private GP in Vitality's network are shown only as "See membership certificate", and medication prescribed by a Vitality GP or network GP for an acute condition is reimbursed up to £100 per plan year. The guide is plain about the cost of seeing a GP in person and about which GPs count:
"There will be a co-payment for each face-to-face GP consultation. Please check your membership certificate for details of any limits and co-payments that apply. There is no benefit available for the fees of a private GP that is not a Vitality GP, or a GP not in our private GP network." (page 17)
Prescriptions have their own exclusions, among them routine or repeat prescriptions and medicines sold over the counter; claiming prescriptions on Vitality goes through them. Vitality's August 2026 core-cover page describes the core GP service as "Online and phone appointments with Vitality GP", so whether in-person appointments come with a plan bought today, and at what co-payment, is something to see in writing on the quote.
Cover options: out-patient, therapies and mental health
The options table (page 11) is where two Vitality plans most often part company.
Out-patient Cover. This pays for consultant appointments following a GP referral and for diagnostic tests your consultant orders, such as pathology, X-rays, ultrasound and ECGs, each up to the limit on your certificate. MRI, CT and PET scans are covered in full whatever that limit is (page 16). Physiotherapy arranged through Vitality's panel is paid in full, outside the limit and with no GP referral needed; a therapist you find yourself is paid at a set amount per session, inside the limit, and you pay any shortfall. Without the option, the guide says "you are covered for six sessions of out-patient physiotherapy in each plan year", and adds: "You must contact us, or visit the Care Hub, in order to arrange your treatment to ensure you see a physiotherapist on our panel" (page 16). Vitality's August 2026 cover-options page shows a choice of out-patient limits or full cover; a lower limit usually brings a premium down, and the figure on the certificate is what tells you how far consultations and tests will go.
Therapies Cover. A separate option pays, on referral from a GP or consultant, for chiropractic, osteopathy, chiropody/podiatry, acupuncture, homeopathy and up to two dietician consultations a plan year (page 11). The treatment must be for an acute condition and the practitioner recognised by Vitality (page 17).
Mental Health Cover. This adds 28 days of in-patient and 28 days of day-patient treatment per episode and £1,500 per plan year for out-patient treatment such as consultant appointments and psychologist consultations (page 11), on top of the core talking therapy line. How the two layers fit together, and the three-month rule on talking therapy, are set out on Vitality mental health cover.
Worldwide Travel Cover is the remaining option, with a guide of its own (page 12). Seeing what each of these adds to the price is fastest with a quote where the options are turned on and off one at a time; an FCA-authorised broker can line those versions up for you during a free call.
Optical, dental and hearing cover in one option
Glasses, dental bills and hearing aids come only as a single package, Optical, Dental and Hearing Cover (page 12). In outline, the page 12 table pays dental check-ups and routine scaling and polishing up to £100 a plan year and dental procedures at 80% of the costs up to £400; eyecare up to £500 a year through Vitality's network optician or 80% up to £300 elsewhere, within one overall eyecare ceiling; and hearing tests and aids at 80% up to £300. The rules behind each line are on the Vitality dental page and the Vitality eye test page.
What matters for this page is how the option sits in the plan. Your acceptance terms do not apply to it, the plan excess is not charged, and instead you pay 20% of dental procedure and hearing costs, and 20% of optical costs if you go outside the network partner (page 25). Claims under it need no pre-authorisation (page 32). And it is one of the benefits whose claims are left out when your claims band is worked out at renewal (page 39), which links it to the next section.
Vitality rewards, status and the renewal price
Every member has a status of Bronze, Silver, Gold or Platinum. Everyone starts at Bronze and earns points through the programme year from activities ranging from exercise to health assessments and check-ups (page 7). The guide puts the thresholds like this: "For example, currently you need 800 Vitality points to reach Silver status and you would need to increase this to 1,600 points to achieve Gold status. When there is more than one adult on a plan the number of points required to reach each status is increased." Only members aged 18 or over can take part.
The status matters because of how renewal is priced. The increase is the sum of three parts the guide labels A, B and C: your age, a base rate for the changing cost of healthcare, and an adjustment for the claims you have made and your status (page 39). On age, "Typically this will be around 3%, but can be higher or lower than this depending on your age." On status:
"Regardless of which claims band you fall into, increasing your Vitality status can reduce the increase to your premium. The higher your status, the larger the reduction is likely to be."
— Vitality, Membership Guide VHTCR0002 08/2024, page 39 (copy hosted by mytribeinsurance.co.uk).
The same page adds that a member with no claims at all could receive a discount before the age and base rate increases are applied. The status counted is the one held at the end of the tenth month of cover in each plan year, and points activity has to be notified before then. The table that applies to you is printed on your certificate; the guide's own example table is discussed on Vitality discounts and offers, where it is labelled an example, not a quote.
Partner rewards are a separate matter from the premium. The guide says they may be a pound amount, a percentage discount, cashback or a benefit with no retail value, and "We may also change our Vitality partners from time to time and the incentives we offer" (page 38).
Exclusions that no option removes
Whatever options are added, the general exclusions on pages 26 to 29 stay. The ones buyers most often miss:
- Long-term conditions. The plan is built for acute conditions, and Vitality will normally not pay for treatment of a chronic condition when its purpose is only to keep symptoms under control. When a chronic condition first appears, the guide says Vitality will pay for the consultant appointments and diagnostic tests needed to find the cause, "providing your plan covers these", and for initial treatment to stabilise it. Cancer is not treated as chronic (page 26).
- Emergencies. Treatment in A&E or an urgent care centre, and any admission scheduled less than 24 hours ahead, is excluded, with a narrow exception for surgery straight after a pre-booked consultant appointment that meets the guide's conditions (page 27).
- Named conditions and treatments. Among them: assessments and treatment for neurodevelopmental conditions such as ADHD and autism, sleep disorders, obesity outside the weight loss surgery benefit, symptoms of menopause or puberty, refractive error outside the optical option, cosmetic treatment and hormone replacement therapy, with the exceptions printed on pages 27 and 28.
- Hospital lists. Where a list such as Countrywide or London Care (page 24) has been added, "If you use a hospital that is not eligible on your plan, you will have to pay 40% of the costs of the treatment (excluding consultant's fees) yourself" (page 25). Without a list, treatment must still be authorised in advance or it is not paid.
- Your own history. Conditions from before you joined may be excluded, for a time or permanently, depending on how you were underwritten; full medical underwriting and moratorium with Vitality explains the two routes.
Any excess you choose is on the certificate, applied either per claim or per person per plan year (page 25). If you have a particular condition or procedure in mind, mention it when the broker rings after you send the form, and they can raise it with Vitality before you commit.
Reading a Vitality quote for its benefits
Because so much sits on the certificate, a quote is worth reading against a short list: which options are switched on, the out-patient figure, whether a hospital list is attached, the excess and how it applies, whether face-to-face GP visits are included and at what co-payment, and the claims and status table. How a quote is put together is on getting a Vitality quote, and what moves the price is on what a Vitality plan costs.
Other insurers draw the line between core and optional cover in different places and set different limits. What private health insurance includes lays out the common pattern across insurers, and Bupa against Vitality puts the two side by side. When you are ready to compare, a broker can walk through a Vitality quote with you and price the alternatives in the same call; it is free, and it starts with a few details left on this page.
Vitality benefits: questions that come up
What's included in Vitality health insurance as standard?
Hospital treatment and consultant fees, Advanced Cancer Cover, NHS and childbirth cash benefits, home nursing, rehabilitation, GP video consultations, panel talking therapy and panel physiotherapy, with session numbers on the certificate. Out-patient cover, therapies, the mental health upgrade, travel and the optical, dental and hearing package are extras.
Can I add just the eyecare part of the optical option?
The guide sets out optical, dental and hearing as one option (page 12), not three. A broker can ask Vitality, free of charge, whether it would quote for only part of it.
Does Vitality pay for a GP outside its network?
No. The guide pays only for a Vitality GP or a private GP in its network, and lists the services of any other GP among its exclusions (pages 17 and 27).