Support for mental health conditions

Transcription

1 Support for mental health conditions 1

2 Having a healthy mind is important for everyone That s why we re here to give you the support you need. Here s some information about our cover for mental health treatments and some of the terms we use. If there s anything we haven t included or if you have any questions, please give us a call we re happy to help. Mental Health Support Team Call * Our lines are open between 8am and 8pm, Monday to Friday and 8am and 4pm on Saturday. * We may record or monitor our calls, but all calls will be handled confidentially.

3 What cover do I have for mental health treatment? We can fund short to medium-term treatment for eligible mental health conditions. We don t cover longer term or chronic mental health conditions (we explain what this means on page 4). However, if your mental health condition becomes chronic while you have health insurance with us, we may be able to offer you support (see page 3 for what support is available). 2

4 How we can help you Knowing what treatment is available and deciding on the best option for you can be confusing. Whether you ve just been diagnosed with a mental health condition, are coming to the end of your treatment, or have already finished your treatment, we re here to help. Our qualified and specially trained nurses can give you information and support on: your treatment options managing your medication lifestyle choices such as diet, exercise or stopping smoking preparing for appointments with healthcare professionals and knowing what questions to ask advice about other support options. I have some questions, who can I call? If you have any questions, please call our Mental Health Support Team on * between 8am and 8pm, Monday to Friday and 8am and 4pm on Saturday. *We may record or monitor our calls, but all calls will be handled confidentially. 3

5 What is a chronic condition? The ABI definition of a chronic condition is one that has one or more of the following characteristics: it needs on-going or long-term monitoring through consultations, examinations, check-ups and/or tests it needs on-going or long-term control or relief of symptoms it requires rehabilitation or for you 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. We use this definition to help us assess if a condition is chronic. An example of a chronic condition is dementia, as this continues indefinitely and has no known cure. When we assess a claim for mental health treatment we look at these characteristics to see if we can cover you. If you ve claimed for a mental health condition in the past, we may need to ask you for some more information about your symptoms, possible causes and diagnosis to see whether or not your condition is chronic. We define a chronic mental health condition as a mental health condition which either meets the definition to the left or is a mental health condition for which you have claimed in three separate policy years. These need not be consecutive, or relate to the same policy. To find out if a condition you want to claim for is the same or related to any previous claims, we ll talk to you about your symptoms, possible causes and consider your diagnosis. We ll also talk to you about whether a condition may be related to a previous mental health condition you may have experienced, and might ask you for more medical information to confirm this. The Association of British Insurers. 4

6 Understanding your cover It s important to call us before you start any treatment. This is to confirm its eligibility, as in some instances your policy may not cover the cost of your treatment, even if we ve paid for this type of treatment before. How long can I claim for a mental health condition for? You can claim for a mental health condition over three separate policy years (see page six for an example of how this works). The condition doesn t have to be the same each time you claim and the years in which you claim don t have to be consecutive. What is a policy year? A policy year begins on the date that your policy starts and ends the day before your renewal date. For example, if you take out a policy on 3 April 2015, your policy year ends on 2 April What happens if I ve claimed for mental health treatment in three policy years? Your policy won t cover you for any mental health treatment once you ve claimed for the same or a related mental health condition in three separate policy years. However, we can still offer you support and advice, through our mental health support team. 5

7 An example of how your cover works Matthew has had Bupa cover for many years when he s diagnosed with depression^. Is Matthew covered? Matthew calls our Mental Health Support Team and we let him know that his policy covers treatment for his depression. He arranges to receive Cognitive Behavioural Therapy (CBT). What happens if Matthew needs more treatment? After his initial treatment, Matthew s CBT therapist suggests he would benefit from further sessions. He calls us, and once we ve received some information from his CBT therapist, we let him know that the extra sessions will be covered. Can Matthew continue to claim for his treatment if it returns? 18 months later, Matthew s depression returns. Because cover for short to medium-term treatment for depression is available under his policy in three separate policy years, he can continue to claim for the CBT he needs. Four years later Matthew s depression returns again and he needs more treatment. This is covered by his policy as he has only claimed in two previous policy years. What if Matthew wants more treatment in future policy years? If Matthew requires any further mental health treatment in a future policy year, whether it relates to a previously diagnosed mental health condition or not, it won t be covered under his policy because he s already claimed for mental health treatment in three separate policy years. However, our Mental Health Support Team can offer him information and support. What if Matthew is diagnosed with an unrelated mental health condition? If Matthew has received mental health treatment for the same or related condition in three separate policy years, treatment for the same or for an unrelated mental health condition will be covered under Matthew s policy if it takes place before the end of that third policy year. However Matthew s policy won t cover mental health treatment for any condition after the end of the third policy year, whether it is related to a mental health condition he has previously received treatment for or not. However, our Mental Health Support Team can help him with information and support. ^This is a fictional example. 6

8 Bupa health insurance is provided by Bupa Insurance Limited. Registered in England and Wales No Bupa Insurance limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Arranged and administered by Bupa Insurance Services Limited, which is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales No Registered office: Bupa House, Bloomsbury Way, London WC1A 2BA Bupa 2015 bupa.co.uk SEL/1150/OCT15 BHF 04796