| In-patient and day-patient treatment |
| Nationwide network of hospitals | | - Nationwide network of hospitals
|
| Hospital charges | Full refund | - Day-patient hospital accommodation charges
- In-patient hospital accommodation charges
- Operating theatre charges including surgical dressings and drugs
- All hospital fees if the hospital is listed by your policy (Refunds in accordance with reasonable and customary fees for treatment)
- 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
|
| Medical or surgery fees | Full refund | - Surgeons and anaesthetists fees
- Surgical procedures performed on an in-patient or day care basis
- Nursing care
- After a specialist advises a hospital stay for treatment, individuals have the choice to go private or receive treatment under the NHS and get money back (see NHS Cash payments)
|
| Therapy fees e.g physiotherapy | Full refund | - Diagnostic procedures which include pathology, radiology, CT and MRI scans
- In-patient and day-patient physiotherapy, radiotherapy and chemotherapy
|
| 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
|
| 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
|
| 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
- Specific treatments such as radiotherapy, chemotherapy and physiotherapy related to treatment recieved is fully covered
- Drugs and dressings used in out-patient appointments
|
| Out patient physiotherapy | Full refund | - In-patient, day-patient physiotherapy fees in full
- GP only, referral is limited to 10 sessions per annum for out-patient treatment only
- Upon referral by a specialist (not GP), out-patient treatment is fully covered
- Upon referral by a specialist (not GP), out-patient treatment is fully covered and includes acupuncture, chiropractic and osteopath treatments
|
| Out patient radiotherapy/ chemotherapy | Full refund | - Diagnostic procedures which include pathology, radiology, CT and MRI scans
- In-/out-patient treatment including radiotherapy, chemotherapy, computerised tomography and MRI scans in full
|
| Out patient psychiatric treatment | Annual limit: £750 | - Specialist consultations and diagnostic procedures for psychiatric and mental conditions
- Treatment in respect of specialist consultations, ECT, diagnostic procedures including pathology and radiology
|
| Additional benefits |
| Minor surgery by a GP | Full refund | - Minor surgery performed by your GP
- Up to a maximum of £70 for each procedure will be paid for minor surgery performed by your GP
|
| Hospice | Annual limit: £700 | - A daily contribution of £70 will be made to the hospice for care and for a maximum of 10 days
|
| Parent accommodation if child needs an overnight stay | Full refund | - The hospital's charges where it is medically necessary for a parent to accompany a child under 14 in hospital
|
| Private Ambulance | Full refund | - Private ambulance where medically necessary during the course of treatment
- Immediately prior to or after treatment for in-patient or day-patient when recommended by a specialist
|
| Post discharge home nursing | Full refund | - 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
|
| Post discharge home nursing including home stay | Full refund | - 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
|
| Cash benefit if treated by the NHS | Annual limit: £10,000 | - Cash benefit when you are treated in a public ward under the NHS (and not as a private patient)
- Policy gives you the choice between going private or receiving substantial money back payment for eligible treatment under the NHS
- Children under 18 years of age will receive money back payments for NHS treatment at half the adult daily entitlement
- Treatment elected under the NHS instead of Private will receive £250 for every night spent in hospital. Remuneration for day patients £250 for each treatment
|
| Maternity benefit | Per child: £100 | - Cash benefit for each birth when delivery and hospitalisation is provided under the NHS free of charge
- Complications of pregnancy cover only - available after 10 month membership
- To qualify for complications of pregnancy and NHS child birth benefit membership must be over 10 months
- Obstetric procedures listed in the policy booklet
|
| Free medical help line | Full refund | - A 24 hour advice and help line manned 365 days a year. Calls answered by qualified Doctors. Unlimited access
- Helpline offers guaranteed access to a GP who will answer questions and offer medical advice over the phone
|
| 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
|
| Consultations for acupuncture, osteopathy, chiropractic and homeopathy | Full refund | - Referal by a GP for out-patient treatment including osteopathy, chiropractic, and physiotherapy is limited to 10 sessions per year in total
- Upon referral by a specialist (not GP), out-patient treatment including osteopathy, chiropractic, acupuncture and homeopathy are fully covered
|
| Homeopathy | Annual limit: 10 sessions |
- Limit applies as an aggregate for GP referred treatments as shown here
- Upon referral by a GP out-patient treatment including osteopathy, chiropractic, and physiotherapy limited to 10 sessions per year in total
- Upon referral by a specialist (not GP), out-patient treatment is fully covered
|
| Osteopath | Annual limit: 10 sessions |
- Limit shown applies to all complementary medical treatments referred by your GP
- Upon referral by a specialist (not GP), out-patient treatment is fully covered
- Upon referral by a GP out-patient treatment including osteopathy, chiropractic, and physiotherapy limited to 10 sessions per year in total
|
| Chiropractor | Annual limit: 10 sessions |
- Limit shown applies to all complementary medicine and treatments referred by your GP
- Upon referral by a GP out-patient treatment including chiropractic, osteopathy and physiotherapy limited to 10 sessions per year in total
- Upon referral by a specialist (not GP), out-patient treatment is fully covered
|
| Children | | - Children are covered providing they remain un-married
- 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
- Further premiums savings if eldest under 18 years of age
- Single premium of eldest child under the age of 20 covers all younger children named on the policy
|
| Overall Policy Limit | | - No overall limit to claims except where particular benefits have maximum levels applied
- Annual travel insurance and overseas cover are available as an option to the policy
- Pre-authorisation for treatment by phone (ClaimCall). A detailed confirmation letter will be sent within 24 hours for your use in consultations with specialists
|
