Standard Life Healthcare policyholders jargonbuster

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The Health & Well-being service

Individual planholders

Personal Health Information

Jargon buster

ABI
Acute condition
Alternative medicine and therapies
Annual renewal date
Check-up
Chronic condition
Cover start date
Data protection
Day-patient
Dental treatment
Diagnostic tests
Eligible treatment
Excess (per claim)
Excess (per plan year)
Exclusions
Financial Ombudsman Service
Full medical underwriting/full medical history assessment
Group Secretary
Guided Option
In-patient
Medical history disregarded
Medically underwritten/medical underwriting
Moratorium underwriting or no medical assessment
No-claims discount scale
Out-patient
PHI
PMI
Plan start date
Plan year
Planholder
Pre-authorisation
Pre-existing medical condition
Preventive treatment
Private Patient Unit (PPU)
Related condition
Self-pay
Switch terms/Continued Personal Exclusions (CPE)
Treatment
Underwriting terms
UK

ABI

Stands for the Association of British Insurers, of which Standard Life Healthcare is an active member.

Acute condition

A disease, illness or injury that is likely to respond quickly to treatment which aims to return the patient to the state of health they were in immediately before suffering the disease, illness or injury, or which leads to their full recovery.

Alternative medicine and therapies

Also known as 'complementary medicine', refers to different kinds of treatment that have traditionally not been available under the NHS but are becoming increasingly popular. They include acupuncture, homeopathy and chiropractic.

Annual renewal date

The date 12 months after the plan start date, and each anniversary after that date.

Check-up

A consultation with, or a visit to, any medical practitioner about any medical condition or any signs and symptoms of a medical condition.

Chronic condition

A disease, illness or injury that has one or more of the following characteristics:

it needs ongoing or long-term monitoring through consultations, examinations, check-ups and/or tests
it needs ongoing or long-term control or relief of symptoms
it requires the patient's rehabilitation or for them to be specially trained to cope with it
it continues indefinitely
it has no known cure
it comes back or is likely to come back

Cover start date

The date on which each insured person's cover starts under this plan.

Data protection

The Data Protection Act 1998 dictates how information about individuals can be stored and used.

Day-patient

A patient who is admitted to a hospital or day-patient unit because they need a period of medically supervised recovery but does not occupy a bed overnight.

Dental treatment

Dental procedures undertaken by a dental practitioner which are clinically necessary for the maintenance and/or restoration of oral health and are provided in accordance with accepted standards of dental practice.

Diagnostic tests

Investigations, such as x-rays or blood tests, to find or to help to find the cause of a patient's symptoms.

Eligible treatment

Refers to the treatment covered by a particular plan.

Excess (per claim)

The amount you will have to pay each time you or your insured dependants make a new claim for treament covered by the plan. If treatment for the same condition has gone on for more than a year, we will treat it as a new claim for any further treatment after the anniversary of the claim, and a further excess will be applied.

Excess (per plan year)

The first amount which must be paid by you before we make any payment under the plan for treatment covered by the plan. Only one excess is payable in each plan year for each insured person.

Exclusions

These are medical conditions or treatments which are not covered under the private medical insurance plan. There is a specific section in the plan documents which sets out these exclusions.

Financial Ombudsman Service

An independent body that investigates complaints - at no cost to you. Standard Life Healthcare is covered by this service and, in the unlikely event that you need to make a complaint, its decision will be binding on us.

Full medical underwriting/full medical history assessment

If you apply for cover on a full medical underwriting basis, this means that you will need to complete a health questionnaire to enable us to assess your medical history. Once we have all the information we need, we will decide whether to apply any personal exclusions. These will be clearly shown on your certificate of insurance included in the documents you receive when you take out your cover.

Group Secretary

The person within a company who is responsible for handling administration for a company or group health insurance plan.

Guided Option

Guided Option isn't a plan on its own, it's simply a different way to refer you for treatment, and is available on most of our plans. We have a special arrangement with leading hospital networks that means with Guided Option they'll choose your consultant and manage your treatment from beginning to end. By doing this they make better use of their resources and so can charge less. We then pass this saving on to you.

In-patient

A patient who is admitted to hospital and who occupies a bed overnight or longer, for medical reasons.

Medical history disregarded

If your underwriting terms state 'medical history disregarded', this means that there are no personal exclusions applied to your plan. This does not affect the remaining terms, conditions and exclusions of the plan, as detailed within the terms and conditions documents, which will continue to apply.

Medically underwritten/medical underwriting

The basis on which you apply for cover, and the process we use to decide the terms on which we will accept you and your insured dependants, based on the medical information we receive when you make your application.

Moratorium underwriting or no medical assessment

The moratorium clause enables you to join Standard Life without having to complete a health questionnaire. Instead a straightforward exclusion for any pre-existing condition is applied. However, provided you have no treatment, medication or advice for the condition or any related condition for two consecutive years after the plan starts, then the condition will become eligible for benefit - subject to the plan's normal terms and conditions. This two-year period is known as the moratorium.

No-claims discount scale

This is a scale of discounts on your premium. A no-claims discount scale is available on our personal healthcare plan. You move up or down the scale at each renewal depending on the number of claims you have made.

Out-patient

A patient who attends a hospital, consulting room or out-patient clinic and is not admitted as a day-patient or an in-patient.

PHI

Is the abbreviated reference for Permanent Health Insurance and not to be confused with PMI - see below.

PMI

Is the abbreviated term sometimes used in place of Private Medical Insurance.

Plan start date

The date on which the plan begins.

Plan year

A period of 12 months from the plan start date or from any annual renewal date.

Planholder

The person who has the contract with us as shown on the certificate of insurance.

Pre-authorisation

This is simply the process of getting a claim approved by us before you undergo any treatment. It provides you with the reassurance of knowing that your treatment will be covered so that you can concentrate on getting better. It also enables us to tell you if you are arranging treatment that will not be covered, for example if you are about to go into a hospital that is not on your list.

Pre-existing medical condition

This is a medical condition or related condition which, in the five years before the cover start date, you have either:

received medical treatment for
had symptoms of
asked advice on, or
were aware existed.

Preventive treatment

This is treatment undertaken - before any symptoms arise - which is designed to stop the patient from getting a disease or to catch it at its very earliest stages. Examples include inoculations against diseases, and mass screening programmes such as breast screening. Preventive treatment is not covered by private medical insurance.

Private Patient Unit (PPU)

Many NHS hospitals have set up PPUs to help supplement the funds they receive from the Government. PPUs may be a ward or wing within an NHS hospital set aside specifically for private patients. However, many now offer stand-alone purpose built units within the grounds of the hospital. They are dedicated to meeting the needs of private patients and offer similar 'hotel' facilities to those available with private hospitals.

Related condition

Any symptom, disease, illness or injury which reasonable medical opinion considers to be associated with another symptom, disease, illness or injury.

Self-pay

Patients buying private medical services direct from a hospital or specialist, as and when needed.

Switch terms/Continued Personal Exclusions (CPE)

If you currently have a private medical insurance plan with another insurer, you may be able to transfer to Standard Life on the same terms that you have with your current insurer. These switch terms are sometimes referrred to as Continued Personal Exclusions (CPE).

Treatment

Surgical or medical services (including diagnostic tests) that are needed to diagnose, relieve or cure a disease, illness or injury.

Underwriting terms

The different ways of applying and being accepted for private medical insurance cover. These include full medical underwriting, continued personal exclusions and medical history disregarded.

UK

Great Britain and Northern Ireland including the Channel Islands and the Isle of Man.