What if the treatment I need is not available at a hospital on my list?
In the rare circumstances where eligible treatment is unavailable in a hospital on the list we have issued you, please
contact us and we'll make arrangements for it to take place at another convenient and appropriate hospital.
I want to upgrade my hospital list
You can change your hospital list at your annual renewal only. However, if you're moving house and require access to hospitals in a different area, please
contact us for more information.
Will I have to pay the hospital bill and then claim it back?
Wherever possible we settle the bills direct with the hospital so that you don't have to worry about paying large amounts of money. Some hospitals may ask you to pay for out-patient treatment at the time of your consultation. If this happens, we have a simple procedure that means that you can reclaim these smaller amounts directly from us.
Can I be treated privately in an NHS hospital?
Yes. Your plan automatically covers you for eligible treatment at any NHS hospital anywhere in the UK, irrespective of whether it has been included on your hospital list. If you are admitted to an NHS hospital, but not as a private patient, then when admitted as either an in-patient or a day-patient, you will be entitled to receive a cash benefit. (These cash payments are not available if you have the NHS wait option where the NHS has provided treatment within the six-week wait period.)
If you prefer, you can arrange to be admitted to an NHS 'paybed' as a private patient, but availability is at the discretion of the NHS and you are not guaranteed a single room or facilities of a 'hotel' standard.
What if I have opted for the moratorium underwriting basis and am uncertain whether treatment I received before the start of my plan is related to the condition for which I now wish to claim?
Before undergoing any private treatment for which you wish to make a claim under your plan, you should
contact us to gain pre-authorisation for your claim. Wherever possible, we will assess your claim over the phone.
This way we will be able to establish the full facts about your condition and proposed course of treatment and will confirm our decision to you before you incur any costs.
What is a related condition?
A related condition is defined as 'any symptom, disease, illness or injury which medical opinion considers to be associated with another symptom, disease, illness or injury'. For example high blood pressure and heart disease are considered related, as are recurrent sore throats and tonsillitis.
What if my claim is urgent?
We try wherever possible to assess claims over the phone. If you need to see a specialist or be admitted to hospital urgently, please call us during normal office hours. We'll do everything possible to give you an immediate decision, explain what the next steps are and provide you with the help and advice you need.
Do I always have to write to you or complete a claim form?
No. We will initially assess your claim over the phone and advise you on whether your condition or treatment is covered. There are occasions where we will need further medical information from your GP or somebody treating you, in which case, you may be asked to complete a claim form.
