| Hospital charges & medical fees |
Therapy fees |
In patient cancer treat ment |
In patient psych iatric treat ment |
Consult ation before hospital stay |
Consult ation after hospital stay |
Out patient physio therapy |
Out patient cancer treat ment |
Out patient psych iatric treat ment |
Minor surgery by a GP |
Parent accomm odation |
Private ambul ance |
Home nursing |
NHS cash benefit |
Maternity benefit |
World wide emerg ency cover |
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| In-patient and day-patient treatment |
| Nationwide network of hospitals | | - Nationwide network of hospitals
- 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
- 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
- Surgical procedures performed on an in-patient or day care basis
- Nursing care
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| 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
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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
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| In patient psychiatric treatment | Annual limit: £250 a day | - In-patient and Day Care psychiatric treatment available for a maximum of 28 days per period of insurance
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| Out-patient treatment |
| Consultation before a hospital stay | Full refund | - 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
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| Out patient physiotherapy | Full refund | - In-patient, day-patient physiotherapy fees in full
- Out patient fees covered each year in conjunction with other therapy costs
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| Out patient radiotherapy/ chemotherapy | Full refund | - Out-patient radiotherapy and chemotherapy charges as part of a diagnosed treatment
- Diagnostic procedures which include pathology, radiology, CT and MRI scans
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| Out patient psychiatric treatment | Annual limit: £450 | - Benefits apply to each insured member per year and is the maximum cover under the scheme
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| Additional benefits |
| Parent accommodation if child needs an overnight stay | Full refund | - Accommodation for a parent accompanying a child under 10 years of age when medically advised
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| 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
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| Post discharge home nursing | Annual limit: 30 days |
- 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
- Limit quoted is the sum total amount payable for home nursing and applies to nursing which may include an overnight stay
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| Post discharge home nursing including home stay | Annual limit: 30 days |
- 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
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| Cash benefit if treated by the NHS | Annual limit: £2,000 | - These benefits are only paid for overnight stays
- First 2 nights spent in hospital excluded from claim
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| Maternity benefit | Full refund | - Complications of pregnancy - available after 24 months membership - Full cover
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| Cover available for existing conditions | | - After 2 years of continuous cover from the cover start date, all pre-existing conditions may become eligible for benefit
- Minimum of 2 years to elapse and no medical advice or treatment has been given or advised by a specialist
- Under no circumstances forego any medical treatment for the pre-existing condition as advised by a specialist
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| Specialist consultations and diagnostics such as pathology and radiology | Annual limit: £250 | - Hormone Replacement Therapy, available only as an out-patient and for a maximum of 3 years
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| Consultations for acupuncture, osteopathy, chiropractic and homeopathy | Annual limit: £500 | - Includes claims for other alternative or complementary treatments and includes, acupuncture, osteopathy, chiropractic and homeopathy
- Policy limit quoted applies as the sum total of benefit available to all alternative medicines listed and includes consultations and specialist services
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| Critical illness benefit | | - £7,500 per annum when unable to perform 2 out of 4 activities of daily living - (Moderate Disability)
- £15,000 per annum when unable to perform 3 out of 4 activities of daily living - (Severe Disability)
- Payment commences once you have been disabled for 6 months. Children under 6 years of age excluded from this particular benefit
- Assessment of mental impairment will also qualify for policy payments
- Payments continue for the rest of your life or until critical disability recovers
- The level of benefits for which you will be entitled to receive will be assesed on your ability to perform four Activities of Daily Living (ADLs) or your level of mental impairment. All payments made are Tax Free under current legislation
- The four Activities of Daily Living measured are Mobility, Personal Care, Dressing and Feeding
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| Dental expenses | Annual limit: £1,000 | - Dental expenses and benefits payable
- Higher limit of up to £5,000 cover for dental work as a result of an accident.
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| Acupuncture | Annual limit: £500 | - Policy limit quoted applies to all alternative medicines included within the policy
- Upon referral by a Specialist (not GP), out-patient treatment is fully covered
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| Homeopathy | Annual limit: £500 | - Policy limit quoted applies to all alternative medicines included within the policy
- Upon referral by a Specialist (not GP), out-patient treatment is fully covered
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| Osteopath | Annual limit: £500 | - Policy limit quoted applies as the sum total of benefit available to all alternative medicines listed and includes consultations and specialist services
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| Chiropractor | Annual limit: £500 | - Policy limit quoted is the sum total available for alternative treatments included within the policy
- Upon referral by a Specialist (not GP), out-patient treatment is fully covered
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| Children | | - Single premium of eldest child covers all other children
- 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
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| Overall Policy Limit | | - No overall limit to claims except where particular benefits have maximum levels applied
- Travellers Care (world wide travel insurance) - optional extra
- Premium values fixed each 2 year period. Upon each renewal a new 2 year fixed premium is available
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