Private Health Insurance

To keep the cost of your policy down further, you can choose to add an optional £100 excess to the outpatient benefit.

There is no excess to pay on the rest of the policy, and no option to add one.

If you choose the Outpatient benefit, you’ll be covered for up to £1000 of outpatient services in each 12 month period to pay for:

• Specialist consultations
• Diagnostic tests such as x-rays, blood tests and ultrasounds
• MRI, CT and PET scans

By choosing the Outpatient benefit, you’ll also benefit from post-operative physiotherapy, which would be in addition to any physiotherapy provided by the hospital as part of your surgery package. So if you’re referred for physiotherapy after your surgery or procedure, we’ll cover you for post-operative physiotherapy.

We’ll pay for up to 4 sessions if you’re referred by a GP and up to 10 sessions if you’re referred by a medical specialist.

The cost of these sessions doesn’t come from the £1000 Outpatient benefit pot. However if this is your first outpatient claim of the year, and you have an excess on your policy, the excess is applied. This means that you would have to pay for the first £100 of physiotherapy. This would be an unusual scenario though, as it’s likely that you would have made an outpatient claim before your surgery.

We don’t cover pre-existing conditions. To keep the cost of our policies down, we don’t cover heart or cancer related procedures, as these are areas the NHS prioritises. We will cover medical procedures when cancer is suspected but not confirmed e.g. biopsies.

We also don’t cover travel expenses to and from the hospital or treatment centre, or the cost of a private ambulance; Physiotherapy, psychiatry and specialist consultations relating to mental health; cosmetic surgery procedures; or procedures which solely involve needle injections.

Inclusions and exclusions vary between policy levels. For a full list, please read the plan guide of your chosen policy.

The claims process is slightly different depending on the cover level and benefits you choose. To start, you should always go to see your GP and at the point they refer you to a specialist just give our dedicated team a call to discuss your options. Detailed information on the claims process will be provided in your plan guide.

Pre-existing medical conditions are not covered until you’ve had no symptoms, treatment or advice for two consecutive years from the date your cover starts.

Yes, you have the right to cancel at any time. Your policy contains a 14-day cooling off period from the date we accept your application. If you change your mind during this time, providing that you have not made or intend to make a claim, we will refund your full premium. However, if you cancel after this period we will not refund any premiums paid, and if you have made a claim you will be required to pay the annual premium in full.

With each fixed-price treatment package, inclusions will differ depending on the procedure required.

What remains the same is our commitment to providing harder working health cover.

The package would typically include:

• The consultant surgeon/physician fees
• The anaesthetist fees
• The private hospital charges relating to
  • the operating theatre
  • accommodation either as an in-patient or day case
  • personal meals
  • drugs and dressings
  • in-patient tests
  • x-rays, pharmacy and occasionally physiotherapy
• The cost of treating any surgical complications relating to the treatment that occur during the operation whilst in hospital or within 30 days of your original surgical procedure. (Surgical complications that arise more than 30 days after your operation will only be covered if they qualify as a separate surgical procedure, and will be treated as a separate claim).
• The consultant surgeon/physician fees

We define these as:

• Medical procedures requiring a general anaesthetic
• Medical procedures requiring a regional or local anaesthetic in conjunction with an incision involving a surgical knife
• Endoscopic fibre optic procedures