| In-patient and day-patient treatment |
| Nationwide network of hospitals | | - Nationwide network of hospitals
- Network hospitals are scaled into A, B, C, or Level Bands. These scales signify the category of accommodation and monetary level of certain benefits.
- Choose the hospital band or district area which is most appropriate for you and or your family to ensure you do not pay more than necessary
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| Hospital charges | Full refund | - Day-patient hospital accommodation charges
- In-patient hospital accommodation charges
- Operating theatre charges including surgical dressings and drugs
- Surgical appliances needed as a vital part of an operation
- Hospital fees up to a set limit if the hospital is not listed by your policy. (Out of band daily benefits for treatment received in a non listed hospital)
- Prostheses and appliances (artificial body parts - eg. hip replacement) when implanted as an integral part of a surgical procedure
- Intensive care, nursing care, drugs and surgical dressings
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| Medical or surgery fees | Full refund | - Surgeons and anaesthetists fees
- Nursing care
- Out of band benefit paid to members who use hospitals not on chosen list or receive treatment in a higher banded hospital
- Out of band benefit towards accommodation and treatment costs - Level A £315, Level B £240 and Level C £210. Payable for overnight stays only
- Out-patient prescriptions limited to 90% of costs and to a maximum of £300
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| Therapy fees e.g physiotherapy | Full refund | - In-patient pathology, physiotherapy and diagnostic procedures. Applies equally to day-patient treatment
- In-patient and day-patient physiotherapy, radiotherapy and chemotherapy
- Consultant oncologists fees in full including treatment when received in listed hospital
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| In patient cancer treatment e.g. radiotherapy and chemotherapy | Full refund | - In-patient and day-patient radiotherapy and chemotherapy charges in full
- Consultant oncologists fees in full including treatment when received in a listed or approved hospital
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| In patient psychiatric treatment | Annual limit: 28 days |
- In-patient and Day Care patient psychiatric treatment charges
- Treatment in respect of accommodation, nursing, drugs prescribed in a ward
- Specialist consultations and diagnostic procedures for psychiatric and mental conditions
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| Out-patient treatment |
| Consultation before a hospital stay | Full refund | - Expenses for specialist consultations and diagnostic procedures such as pathology and radiology
- Physicians' fees and specialist consultations available to both in-patient and day care treatment patients
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| Consultation after a hospital stay | Full refund | - Expenses for specialist consultations and diagnostic procedures such as pathology and radiology
- On referral by your specialist, consultations, investigations and treatment are fully covered
- Diagnostic procedures such as pathology and radiology
- Specific treatments such as radiotherapy, chemotherapy and physiotherapy related to treatment recieved is fully covered
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| Out patient physiotherapy | Full refund | - In-patient, day-patient physiotherapy fees in full
- Out-patient physiotherapy fees fully refunded when referred by a Specialist or GP unless otherwise stated herein
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| Out patient radiotherapy/ chemotherapy | Full refund | - In-/out-patient treatment including radiotherapy, chemotherapy, computerised tomography and MRI scans in full
- For specialist services and necessary drugs administered at the time of the treatment
- Consultant oncologists fees in full including treatment received
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| Out patient psychiatric treatment | Annual limit: £600 | - Specialist consultations and diagnostic procedures for psychiatric and mental conditions
- Treatment in respect of specialist consultations, ECT, diagnostic procedures including pathology and radiology
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| Additional benefits |
| Minor surgery by a GP | Annual limit: £600 | - Surgery undertaken at a specialists' consulting rooms or your local GP
- Refund up to 90% of GP minor surgery charges up to a maximum annual limit as shown
- Complementary therapist treatment includes alternative medicine, such as reflexology, chinese herbal medicine and most other similar treatments when referred by your GP
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| Parent accommodation if child needs an overnight stay | Full refund | - Accommodation for a parent accompanying a child under 12 years of age when medically necessary
- Maximum limit applies for up to 13 weeks
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| Private Ambulance | Full refund | - Private ambulance where medically necessary during the course of treatment
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| Post discharge home nursing | Annual limit: 13 weeks |
- If it immediately follows in-patient treatment covered by the policy
- If it is prescribed by a specialist for medical reasons (not domestic reasons)
- If it is under the direction of a specialist
- If it is performed by a qualified nurse
- Payable up to a maximum of 13 weeks in each policy year
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| Cash benefit if treated by the NHS | Annual limit: £150 a day | - Cash benefit when you are treated in a public ward under the NHS (and not as a private patient)
- Daily limit will be paid for up to a maximum period of 13 weeks. Maternity admissions are excluded
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| Maternity benefit | Per child: £700 | - Cash benefit for each birth when delivery and hospitalisation is provided under the NHS free of charge
- To qualify for complications of pregnancy and NHS child birth benefit membership must be over 10 months
- Payment up to 90% of total costs up to the maximum listed. Eligibility to benefits is available after a period of 18 months. Includes ante & post natal treatments
- Obstetric procedures listed in the policy booklet
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| Emergency medical cover world wide | Full refund | - Full monitoring of your condition whilst an in-patient abroad
- Transfer to an alternative hospital abroad if the treatment being given is medically unsatisfactory
- Repatriation to the UK following discharge from hospital if you cannot return by the means originally planned
- Settlement of eligible medical bills and other charges
- World wide travel insurance
- Cover includes personal accident, personal liability, medical expenses, repatriation, luggage and personal money, delayed and missed departures
- Any holiday or business trip up to 30 days
- 24 hour dedicated emergency assistance contact line with multilingual medical support
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| Optical cover | Annual limit: £200 | - Spectacles and contact lenses
- Payment up to 90% of total costs up to the maximum listed. Eligibility to benefits is available after a period of 6 months
- Dental treatment includes prosthesis and in addition certain benefit maxima applies
- Each member and eligible dependant who wears contact lenses will have their subscriptions increased by 10% when joining
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| Cover available for existing conditions | | - Cover for many stable pre-exisiting conditions may be available following medical underwriting and subject to additional subsciption payment
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| Specialist consultations and diagnostics such as pathology and radiology | Full refund | - Full cover in-patient and day-patient treatment
- Full cover for out-patient treatment when recommended by a specialist
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| Consultations for acupuncture, osteopathy, chiropractic and homeopathy | Full refund | - Includes claims for other alternative or complementary treatments and includes, acupuncture, osteopathy, chiropractic and homeopathy
- GP referral is not required but members are encouraged to consult a GP before obtaining treatment
- Consultations must be for the purpose of obtaining treatment for a specific treatable medical condition
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| Chiropody | Annual limit: £600 | - Policy Limit quoted is the sum total available for all alternative therapies other than acupuncture, osteopathy, chiropractic and homeopathy
- GP referral is not required but members are encouraged to consult a GP before obtaining treatment
- Consultations must be for the purpose of obtaining treatment for a specific treatable medical condition
- Payment up to 90% of total costs of treatment up to a maximum of £600
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| Premium waiver under certain circumstances | | - Redundancy or incapacity of member - subscription waived for 1 year. Benefit available after 6 months continuous unemployement
- Death of member - dependants subscriptions waived for 1 year
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| Dental expenses | Annual limit: £1,000 | - Dental expenses and benefits payable
- Payment up to 90% of total costs of treatment up to a maximum of £1,000.
- Eligibility to benefits available after 6 months for routine dental treatment and 12 months for treatment including a fixed or mobile prosthesis
- Benefit maxima apply within £1,000 limit
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| Acupuncture | Full refund | - Out-patient treatment is fully covered
- GP referral is not required but members are encouraged to consult a GP before obtaining treatment
- Consultations must be for the purpose of obtaining treatment for a specific treatable medical condition
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| Homeopathy | Full refund | - Out-patient treatment fully covered
- GP referral is not required but members are encouraged to consult a GP before obtaining treatment
- Consultations must be for the purpose of obtaining treatment for a specific treatable medical condition
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| Medical Herbalist | Annual limit: £600 | - Policy limit quoted is the sum total of benefit available for all alternative therapies other than acupuncture, osteopathy, chiropractic and homeopathy
- GP referral is not required but members are encouraged to consult a GP before obtaining treatment
- Consultations must be for the purpose of obtaining treatment for a specific treatable medical condition
- Payment up to 90% of total costs of treatment up to a maximum of £1,000.
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| Osteopath | Full refund | - GP referral is not required but members are encouraged to consult a GP before obtaining treatment
- Consultations must be for the purpose of obtaining treatment for a specific treatable medical condition
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| Podiatrist (Foot Surgeon) | Full refund | - GP referral is not required but members are encouraged to consult a GP before obtaining treatment
- Consultations must be for the purpose of obtaining treatment for a specific treatable medical condition
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| Chiropractor | Full refund | - GP referral is not required but members are encouraged to consult a GP before obtaining treatment
- Consultations must be for the purpose of obtaining treatment for a specific treatable medical condition
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| Children | | - Children are covered providing they remain un-married
- Children covered until age 21
- Newborn children included on policy free until next renewal date provided parent has been a member for at least 10 mths. Notification of newborn required within 3 months to qualify
- Children may remain on policy until they are 25 (if in full time education) and will remain covered until the next annual policy review date
- Unit price for 1st and 2nd child, all other children covered by 2nd child premium
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| Overall Policy Limit | | - No overall limit to claims except where particular benefits have maximum levels applied
- Maximum £2,000,000 for emergency medical expenses and treatment received abroad
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