Designed for Arranged and provided by Your life Your health Your benefits Aon Effective from 1 October 2015 bupa.co.uk This is page 1 of 8 which should be read together in full. These pages are for the summary of the Bupa Select for Aon from 1 October 2016. These pages only provide a brief
You re in safe hands with Bupa Welcome to your health insurance scheme, and to all the benefits and reassurance that we hope being with Bupa brings. you re in safe hands. It s this commitment to the quality of our service that s contributed to us being awarded Best Healthcare Provider at the Corporate Adviser Awards 2014. Illness can restrict your lifestyle, affect loved ones, and reduce your ability to work, so we know how important your health is to you it s important to us t. That s why you can rely on your cover should you need to make an eligible claim. From the moment you first speak to a member of staff in one of our UK-based call centres, you ll know Getting in touch For all claims or cover queries please call your Bupa helpline on: 0345 603 1205 We may record or monitor our calls. This is page 2 of 8 which should be read together in full. These pages are for the summary of the Bupa Select for Aon from 1 October 2016. These pages only provide a brief 2
Getting more from your Bupa membership Keep this bklet somewhere handy in it, you ll find a summary about the things you re covered for, the added benefits of being with Bupa, and what to do if you ever need to make a claim. And if there s anything else you d like to know about your membership, please call your Bupa helpline 0345 603 1205. If you have any speech or hearing difficulties and use a textphone, please call 0345 606 6863. bupa.co.uk If you like to research medical matters online, our website is always up-to-date and full of useful information. It s also one of the most popular health websites in the UK and has won awards for its presentation, clarity and use of plain English. When you visit, you will find a library of fact sheets, health tips and a selection of latest news stories relating to health and wellbeing. You will also find a number of health hubs on topics like cancer, bones and joints, and mental health conditions. These are an invaluable source of information if you want to know more about the prevention, diagnosis, treatment and management of these conditions. Visit us: bupa.co.uk Smart phone apps Health information can now be accessed straight from a smart phone. Our Health Finder app can help members manage their health with lots of useful health information. We have free versions for both iphone and Android. Scan the codes below or download them online. Bupa HealthLine If you want advice on everyday healthcare matters, our Bupa HealthLine is here to offer help and support whenever it s needed. You can call any time of the day or night and speak directly to one of our nurses in complete confidence and take as much time as you need. Nothing is t trivial and the call doesn t have to relate to illness or injury it could just as easily be about nutrition, fitness or lifestyle changes. The nurses can answer questions on anything from over-the-counter medication to managing a long-term condition like cancer or heart disease. So, whether you re a worried parent, a nervous traveller, or you just want to know the facts about a condition or treatment, they can be a great comfort. And, if they don t have the answer you re lking for, they will always try to point you in the right direction. You can call the Bupa HealthLine on: 0345 607 7777* or 0161 868 6415* *Calls may be recorded and to maintain the quality of our Bupa HealthLine service a nursing manager may monitor some calls always respecting the confidentiality of the call. We may record or monitor our calls. Android iphone This is page 3 of 8 which should be read together in full. These pages are for the summary of the Bupa Select for Aon from 1 October 2016. These pages only provide a brief 3
Your cover at a glance Recognised facility access is for partnership facilities. Your cover depends on you using certain Bupa recognised medical practitioners and treatment facilities. For more detailed information on what is and isn t covered by your scheme, call your Bupa helpline on 0345 603 1205. Benefits Maximum benefit available Notes Finding out what is wrong and being treated as an out-patient Out-patient consultations with a consultant Out-patient therapies and complementary medicine Facility charges for out-patient diagnostic tests on consultant referral Out-patient MRI, CT and PET scans on consultant referral Being treated in hospital with a scheme recognised consultant with a scheme recognised therapist or complementary medicine practitioner (acupuncture, chiropractic and osteopathy only) for the type of scan you need benefit limits apply for a facility that is not a scheme recognised facility Consultants fees with a Bupa recognised consultant and in a scheme recognised facility Parent accommodation one parent only, accompanying a child up to age 16 who is a member of the scheme and receiving eligible in-patient treatment in a scheme recognised facility Facility charges for surgical operations carried out as out-patient treatment Facility charges for day-patient treatment and in-patient treatment Cancer treatment benefit limits apply for a facility that is not a scheme recognised facility Cancer cover - as for other treatment set out in this table except for: Out-patient consultations with a consultant with a scheme recognised consultant Out-patient therapies and complementary medicine on GP or consultant referral Facility charges for out-patient diagnostic tests on consultant referral Facility charges for eligible out-patient cancer drugs with a scheme recognised therapist or complementary medicine practitioner (acupuncture, chiropractic and osteopathy only) We may record or monitor our calls. This is page 4 of 8 which should be read together in full. These pages are for the summary of the Bupa Select for Aon from 1 October 2016. These pages only provide a brief 4
Benefits Maximum benefit available Notes Mental health treatment Mental health treatment up to a maximum of 28 days each year for day-patient treatment and in-patient treatment combined and not individually Consultants fees, mental health and wellbeing therapists fees and diagnostic tests for out-patient mental health treatment Consultants fees for day-patient and in-patient mental health treatment Facility charges for day-patient and in-patient mental health treatment Additional benefits up to and from within your available out-patient benefit limits above with a scheme recognised consultant or mental health and wellbeing therapist with a Bupa recognised consultant and in a scheme recognised facility Treatment at home discretionary benefit upon authorisation, with a scheme recognised treatment provider, we pay for the charges that we agree to pay on your behalf Home nursing up to 2,000 each year when immediately following private eligible in-patient treatment Private ambulance charges when medically necessary and related to private eligible day-patient or in-patient treatment Overseas emergency treatment Please note: you will need to settle all accounts direct with the medical providers in the country of treatment. On return to the UK submit the itemised and dated receipted invoices to us for assessment. Out-patient consultations, therapies, diagnostic tests and complementary medicine paid up to and from within your available out-patient limit above when temporarily travelling outside the UK Out-patient MRI, CT and PET scans up to 100 towards all the fees and charges when temporarily travelling outside the UK Consultants fees for out-patient surgical operations, day-patient and in-patient treatment Overseas facility charges for out-patient surgical operations Overseas facility charges for day-patient and in-patient treatment paid up to the Bupa UK monetary limits that apply for Bupa recognised consultants up to 100 towards all the facility charges and not each charge individually up to 200 each day towards all the facility charges and not each charge individually when temporarily travelling outside the UK when temporarily travelling outside the UK when temporarily travelling outside the UK Repatriation and evacuation assistance discretionary benefit Your repatriation/evacuation upon authorisation, when arranged by a Bupa recognised medical assistance company Accompanying partner/relative during your repatriation or evacuation Cash benefits upon authorisation, up to 750 towards all the costs when arranged by a Bupa recognised medical assistance company NHS cash benefit for NHS in-patient treatment 200 a night for up to 35 nights each year for NHS in-patient treatment that would otherwise be covered under the scheme Family cash benefit 150 for each child born or adopted during the year we pay Family cash benefit for a main member only NHS cash benefit for NHS in-patient stays that you receive radiotherapy, chemotherapy or a surgical operation that is for cancer treatment 100 each night for NHS in-patient treatment for cancer treatment that would otherwise be covered under the scheme NHS cash benefit for NHS out-patient or day-patient treatment or NHS home treatment for cancer Procedure Specific NHS cash benefits 100 for each day you receive radiotherapy in a hospital setting 100 for each day you receive IV-chemotherapy and for each three-weekly interval of oral chemotherapy or part thereof 100 on the day of your surgical operation for eligible NHS out-patient or day-patient treatment or NHS home treatment for cancer that would otherwise be covered under the scheme Other NHS cash benefits are available to you under the scheme. These depend on the type of treatment you need. We only pay if your treatment would otherwise have been eligible for private treatment under the scheme. For information on Procedure Specific NHS cash benefits please call the helpline or go to www.bupa.co.uk/pscb. These cash benefits may change from time to time. None of these Procedure Specific NHS cash benefits is payable at the same time as any other NHS cash benefit. This is page 5 of 8 which should be read together in full. These pages are for the summary of the Bupa Select for Aon from 1 October 2016. These pages only provide a brief 5
Claiming Always call your Bupa helpline before arranging any consultations or treatment to check the benefits available to you under your scheme. Also, should you have any queries about your treatment, we can offer you the opportunity to speak to a nurse working in Bupa s care management team. For more details please call your Bupa helpline on 0345 603 1205 We may record or monitor our calls. This is page 6 of 8 which should be read together in full. These pages are for the summary of the Bupa Select for Aon from 1 October 2016. These pages only provide a brief summary of the cover and full details including general terms and conditions, exclusions and benefit limits are not set out on these pages. Further details are available from the helpline although you may need to contact Aon for full details of the cover under the agreement. 6
A step-by-step guide to making a claim STEP 1 VISIT YOUR GP Your GP will advise you if you need to see a consultant or healthcare professional for your health needs. There are some conditions where a GP referral is not required and details of these are available from us on request. For information on these conditions please call your Bupa helpline or go to bupa.co.uk/policyinformation These details may be updated from time to time. STEP 2 ASK YOUR GP FOR A REFERRAL TO A CONSULTANT OR HEALTHCARE PROFESSIONAL FOR YOUR CONSULTATIONS OR TREATMENTS If you need to see a consultant or healthcare professional, let your GP know that you have Bupa cover. Your GP will either refer you to a consultant or healthcare professional or suggest that you contact us if you want a choice of consultants or healthcare professionals. STEP 3 CALL YOUR BUPA HELPLINE BEFORE ARRANGING A CONSULTATION OR RECEIVING TREATMENT Once you know the name of the consultant or healthcare professional you are going to see, please call us so we can confirm that your consultant, healthcare professional or treatment facility is Bupa recognised, that your recommended treatment is covered and which benefits you are entitled to under your Bupa membership. We will let you know what you need to do next and send you any necessary claim or pre-treatment forms you may need to complete. To help us to make the claims process as simple and swift as possible, please have the following information close to hand when you call to make a claim: your Bupa membership number the condition you are suffering from details of the treatment that your GP has recommended date(s) on which you are to receive treatment the name of the consultant or other healthcare professional involved details of where your proposed treatment will take place your expected length of stay in hospital (if applicable) STEP 4 GET A PRE-AUTHORISATION NUMBER When we have confirmed that your treatment is covered, we will discuss your claim with you and give you a pre-authorisation number. You can then contact your consultant or healthcare professional to arrange an appointment. We recommend that you give your pre-authorisation number to the consultant or healthcare professional you see so that the invoice for any treatment costs can be sent to us directly. Please call us to authorise any further consultations or treatment to ensure that they are covered under your Bupa membership. If for any reason you are sent the invoice, simply send it on to: Claims Department, Bupa, Salford Quays, M50 3XL Once we have paid the invoice on your behalf, we will send you a summary of your claim and treatment details. Please note that payment may take a few weeks depending on how quickly invoices are submitted to us. This is page 7 of 8 which should be read together in full. These pages are for the summary of the Bupa Select for Aon from 1 October 2016. These pages only provide a brief 7
Bupa health insurance is provided by Bupa Insurance Limited. Registered in England and Wales No 3956433. Bupa Insurance Services Limited. Registered in England and Wales No 3829851. Bupa Insurance Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Bupa Insurance Services Limited is authorised and regulated by the Financial Conduct Authority. Registered Office: Bupa House, 15-19 Blmsbury Way, London WC1A 2BA. Bupa 2015 Care homes Cash plans Dental insurance Dental services Health assessments Health at work services Health coaching Health information Health insurance Home healthcare International health insurance Travel insurance bupa.co.uk Aon (Premier) CMC/7998/Oct15 91843 UNI This is page 8 of 8 which should be read together in full. These pages are for the summary of the Bupa Select for Aon from 1 October 2016. These pages only provide a brief summary of the cover and full details including general terms and conditions, exclusions and benefit limits are not set out on these pages. www.bupa.co.uk Further details are available from