What can I claim for under Hospital Benefit cover?

You can claim when:

• You are admitted as an in-patient to an NHS or private hospital/treatment centre or hospice and
• You submit your claim in accordance with our Terms and Conditions

Or on a day when:

• You are admitted to an NHS or private hospital/treatment centre as a day case patient and
• You are required to sign a consent form and are allocated a bed – the use of which is normally for a period of supervised recovery and
• You submit your claim in accordance with our Terms and Conditions

We will cover:

• You at the day/night rate for your plan level

For:

• A surgical procedure involving the use of theatre facilities when you’re admitted as a day patient, you sign a consent form and you have a local, regional or general anaesthetic. The surgical procedure is one that aims to treat disease, injury or abnormality by operating directly on or removing the affected body part, or removing a foreign body
• Overnight in-patient admissions for treatment, tests or investigations
• Maternity related in-patient admissions, from the 11th night that you have been an in-patient. You must give us evidence of the first 10 nights that you have spent in the hospital/treatment centre (these nights do not have to be consecutive)
• A dependent child required to remain in the hospital/treatment centre following its birth, from the date that the mother is discharged
• Claims submitted when the patient is discharged as an in-patient

We will not cover:

• Out-patient attendances, including procedures carried out in an out-patient setting
• Tests or investigations e.g. biopsies and endoscopies carried out for investigative purposes as a day patient
• Treatment and/or pain relief administered by injection as a day patient
• Cardioversion as a day patient
• Admissions for rehabilitation, domestic reasons or respite care
• Attendances at a GP or Dental surgery
• Maternity related admissions for the first 10 nights
• Any type of in-patient admission where the hospital/treatment centre could be regarded as your permanent residence
• If you had a day surgery procedure and are admitted as an in-patient on the same day this counts as one event not two so only one day/night can be claimed
• Exclusions (see section 6, General Terms and Conditions)