Private Medical Schemes Overview
Pearson offers two private medical schemes, Medical Insurance and Medical Insurance Plus, to give you the flexibility to choose how much coverage you need for you and your family. Each is administered by Aviva and regardless of which scheme you choose, each medical scheme includes Cancer Support, Fertility and Family Planning Services, Gender Affirmation Services, BacktoBetter Musculoskeletal Service, and Mental Health Pathway. Compare the plans below to help you choose the coverage that suits your unique needs.
Aviva 2025/26 Medical Insurance Cover Guide Summary (PDF, 107 KB)
Aviva 2025/26 Medical Insurance Member Guide (PDF, 2 MB)
Hospital
Guided Referral: with this option you work with a claims specialist who will guide you, based on your condition, to a hospital that offers the highest quality of care based on health clinical outcomes, patient safety, efficacy, proximity, and cost.
Excess
£50 excess, per person per scheme year. The Excess does not apply to Mental Health Pathway and the BacktoBetter services.
Outpatient Benefit Annual Limit
£2,000
Aviva 2025/26 Medical Insurance Plus Cover Guide Summary (PDF, 637 KB)
Aviva 2025/26 Medical Insurance Plus Member Guide (PDF, 2 MB)
Extended Hospital List: this option includes the same features as Guided Referral (from Medical Insurance) and may include these additional hospitals:
- The New Malden Diagnostic Centre
- Harley Street Clinic
- Cleveland Clinic London
- Lister Hospital
- London Bridge Hospital
- Nuffield Health St. Bartholomew’s Hospital
- Portland Hospital for Women and Children
- Princess Grace Hospital
- The Wellington Hospital
Excess
No excess
Outpatient Benefit Annual Limit
Full refund
Living with cancer isn’t a linear process. Every day is different, and you may experience a range of physical, emotional, and financial concerns, each requiring personalised assistance. The services offered through Aviva are designed to help you every step of the way.
- Aviva’s dedicated Cancer Claim Team will be by your side every step of your cancer journey. The clinical team is supported by trained GPs, nurses, and other medical professionals.
- Developed in partnership with Macmillan Cancer Support, the Cancer Care Guide makes it simple for you and your loved ones to find the information you need to help make living with cancer that little bit easier.
- Talking Through Cancer therapists are also on hand to offer you and your loved ones compassionate support and practical techniques to help you come to terms with the diagnosis and feel more in control of the situation.
For more information: Aviva: Support Following a Cancer Diagnosis (PDF, 105 KB)
This service supports the patient’s journey from pre-surgery assessment, counselling, and hormone assessment, up to and including gender confirmation surgery. Gender dysphoria support is available through Gender Identity Clinics and you don’t need to see a GP before making a claim for gender dysphoria, just contact Aviva before starting treatment. Counselling is available to members aged 12 and over. All other treatment (surgery, breast augmentation, etcetera) is only available to members aged 18 and over, except the wig benefit which has no minimum age requirements. Please contact Aviva on 0800 056 4458.
For more information: Aviva: Gender Identity Benefit – Enhanced (PDF, 87 KB)
This benefit reimburses members up to £20,000 per lifetime for medical services that include medication to stimulate ovulation, surgical intervention, and assisted reproduction. You must use clinics licensed by the Human Fertilisation and Embryology Authority to be eligible for reimbursement. Through Aviva’s partnership with Fertifa, you will have access to clinically led support through Fertifa’s app which includes access to remote consultations with a fertility nurse or doctor, family forming support (adoption, legal considerations of surrogacy, etcetera) and an educational hub comprised of guides, whitepapers, videos, and monthly webinars with Fertifa’s clinical team. Call the customer service helpline on 0800 056 4458 if you have any questions or would like to make a claim.
For more information: Aviva: Family Planning and Fertility Benefit (PDF, 200 KB)
This service should be your first point of contact if you experience muscle, joint, back, or neck pain. With BacktoBetter, you are paired with a case manager who will ensure that you get access to the most clinically appropriate support and treatment.
Note: The Excess does not apply to the BacktoBetter services if you are enrolled in the Medical Insurance Scheme.
For more information: Aviva: BacktoBetter (PDF, 197 KB)
The mental health pathway is a clinically driven approach to mental health support, providing a broad range of evidence-based treatment options including:
- Cognitive Behavioural Therapy (CBT), acceptance and commitment therapy, person-centred therapy, interpersonal psychotherapy EMDR (eye movement desensitisation and reprocessing therapy), and psychodynamic counselling
- Face-to-face treatment
- Psychiatrist/psychiatric specialist assessment and treatment, or
- In-patient care, where clinically necessary
To start the process for treatment, call Aviva at the customer service helpline on 0800 056 4458, where one of the advisers will put you in contact with the clinical team for a thorough assessment. After the assessment, a therapist will advise of the most appropriate course of treatment. The Excess does not apply to Mental Health Pathway services if you are enrolled in the Medical Insurance Scheme.
For more information: Aviva: Mental Health Pathway (299 KB, PDF)