inspire Private Medical Insurance Plan Providing you with quality medical care at Spire Hospitals throughout the UK

Transcription

1 inspire Private Medical Insurance Plan Providing you with quality medical care at Spire Hospitals throughout the UK UK 'inspire' is provided by APRIL UK. In partnership with Spire Healthcare

2 Welcome to 'inspire'... APRIL UK have formed a partnership with Spire Healthcare to create inspire - an innovative private medical insurance plan that combines high quality healthcare with exceptional value for money.

3 Spire - a name you can trust your health to inspire allows you to receive a wide range of treatments at any Spire Hospital throughout the UK. Following a referral from your GP, you can now go to your local Spire Hospital with the peace of mind that all eligible consultations, surgical procedures, diagnostic tests and scans will be covered by your plan. Spire Healthcare is a leading provider of private healthcare, with 38 private hospitals throughout the UK. The company is built on a proud heritage of over 25 years experience of running successful private hospitals. What are the key benefits? Cut waiting times - NO NHS waiting lists, see a specialist or receive treatment when YOU need it Use award winning Spire hospitals - choice of 38 modern and clean hospitals with private rooms and facilities, located throughout the UK High quality patient care - Spire Healthcare work with over 3,000 of the country s most experienced consultant surgeons and specialists Wide range of treatments, consultations and tests covered with NO limits on day & inpatient benefits - peace of mind your costs will be covered in full Important cancer cover - specialist drugs such as Herceptin (breast cancer) and Avastin (bowel, kidney and colon cancer) which prolong and save lives are covered under inspire. Some NHS trusts do not provide these drugs Outstanding value for money - inspire provides access to Spire facilities only. This keeps our costs down which we pass on to YOU. You will be hard pressed to find another medical insurance policy which offers better value for money inspire is provided and administered by APRIL UK - an award winning protection and health insurance specialist With a Spire Hospital, you will have the peace of mind that you will receive exceptional care and commitment from a provider who has earned a reputation as a leader in the healthcare field 2

4 What is covered? COMPREHENSIVE HEALTH CARE IN-PATIENT & DAY-PATIENT BENEFITS Hospital Accommodation and Nursing Care Prescribed Drugs and Dressings Operating Theatre Fees It s important that your plan covers you whenever you need private healthcare. With inspire you can rest assure that if you are admitted into hospital, all in-patient and day-patient costs which are customary and reasonable will be paid in full. This includes costs for hospital accommodation, nursing care, specialist attention, tests and therapies and operating theatre fees. Radiotherapy & Chemotherapy Consultations, Radiology, Pathology Diagnostic Tests including MRI/CT/PET Scans Physiotherapy Surgeons, Physicians & Anaesthetists Fees Oral Surgery (non dental) Parent Accommodation Prosthesis OUT-PATIENT BENEFITS You will also receive comprehensive out-patient benefits, covering those all important consultations and diagnostic tests Specialist Consultations, Pathology, X-Rays, Diagnostic Tests, Physiotherapy MRI/CT/PET Scans OTHER BENEFITS Private Ambulance Home Nursing Physiotherapy limited to 500 per policy year 13 weeks per policy year NHS Cash Benefit 75 per night up to 30 nights per policy year Please note that there is an aggregate limit of 1m per person per policy year on total benefits payable under this plan. Benefits are payable during the policy period only. 3

5 Your choice of hospitals Spire Healthcare is an award winning healthcare and hospital group, with an unrivalled reputation for providing some of the best patient care and facilities in the UK. As a patient, you can trust Spire Healthcare to deliver exceptional care and treatment. With inspire you will be able to receive treatment from any of their 38 hospitals in the UK. 1. Blackpool Spire Fylde Coast Hospital 2. Brentwood Spire Hartswood Hospital 3. Bristol Spire Bristol Hospital 4. Bushey Spire Bushey Hospital 5. Cambridge Spire Cambridge Lea Hospital 6. Cardiff Spire Cardiff Hospital 7. Chatham Spire Alexandra Hospital 8. Edinburgh Spire Murrayfield Hospital 9. Edinburgh Spire Shawfair Park Hospital 10.Elland Spire Elland Hospital 11. Farnham Spire Clare Park Hospital 12.Gatwick Spire Gatwick Park Hospital 13.Gerrards Cross Spire Thames Valley Hospital 14.Harpenden Spire Harpenden Hospital 15.Hasting Spire Sussex Hospital 16.Hull Spire Hull & East Riding Hospital 17.Hythe Spire St Saviour s Hospital 18.Leeds Spire Leeds Hospital 19.Leicester Spire Leicester Hospital 20. Liverpool Spire Liverpool Hospital 21. Macclesfield Spire Regency Hospital 22. Manchester Spire Manchester Hospital 23. Methley Spire Methley Park Hospital 24. Norwich Spire Norwich Hospital 25. Portsmouth Spire Portsmouth Hospital 26. Reading Spire Dunedin Hospital 27. Redbridge Spire Roding Hospital 28. Solihull Spire Parkway Hospital 29. Southampton Spire Southampton Hospital 30. Southend-on-Sea Spire Wellesley Hospital 31. Sutton Coldfield Spire Little Aston Hospital 32. Tunbridge Wells Spire Tunbridge Wells Hospital 33. Warrington Spire Cheshire Hospital 34. Washington Spire Washington Hospital 35. Wirral Spire Murrayfield Hospital 36. Worcester Spire South Bank Hospital 37. Wrexham Spire Yale Hospital 38. Brighton The Montefiore Hospital List of hospitals correct at April 2014 Please visit Spire Healthcare s website for the latest information on their hospitals: 4

6 Additional Lifestyle Benefits Expert second medical opinion service As an APRIL UK policy holder you will also receive Best Doctors, an expert medical consultation and secondary opinion service. If you were diagnosed with a serious illness, wouldn t you want to know whether the diagnosis is correct? Or whether you are on the right medication or chosen the right course of treatment? Best Doctors provides access to the world s best medical experts who can review your diagnosis and get you the right answers about your condition and treatment. Best Doctors has a database of over 50,000 world-leading specialists - rated by their peers as the best in their field of expertise - who can conduct an in-depth review of your medical condition. It s valuable peace of mind to help you make the right medical decisions The Best Doctors service is provided independently by Best Doctors UK Ltd. 5

7 The APRIL UK Discount Portal Discounts on everyday shopping & dining We ve teamed up with a leading discount specialist to provide you with discounts at over 20,000 sites and locations - both on the highstreet and online. Just some of the big brands included... Through the APRIL UK Discount Portal you will be able to access discounts on the following: Groceries, Clothes, Dining, Electronics, Gym membership, DIY and Travel. Providing that you do not opt out of this service, a company called Logbuy who provide this service, will you with further details once your APRIL UK plan has been set up. The APRIL UK Discount Portal is provided independently by LogBuy Ltd. Brands illustrated correct at February

8 Your cancer benefits explained... Cancer is a real concern for many people. inspire provides access to important cancer treatment at Spire Hospitals FULL in-patient and day-patient cancer cover inspire provides the peace of mind that all in-patient and day-patient cancer treatment costs which are customary and reasonable, will be paid in full. It s comforting to know that the plan will be there when you need it most for crucial cancer related scans, consultations and treatment. YOUR IN AND DAY-PATIENT CANCER BENEFITS Diagnostic Tests including MRI/CT/PET Scans Consultations, Radiology, Pathology Radiotherapy & Chemotherapy Hospital costs including: Accommodation, Nursing, Drugs and Dressing Surgeons, Physicians & Anaesthetists Fees It s comforting to know that the plan will be there when you need it most for life changing cancer related scans, consultations, drugs and treatment YOUR OUT-PATIENT CANCER BENEFITS Specialist Consultations Diagnostic tests, e.g. pathology and scans MRI/CT/PET Scan Specialist cancer drugs, e.g. Avastin, Herceptin For up to 5 years following diagnosis For up to 5 years following diagnosis For up to 5 years following diagnosis For up to 1 year following diagnosis Please note that there is an aggregate limit of 1m per person per policy year on total benefits payable under this plan. Benefits are payable during the policy period only. 7

9 Helping you beat cancer Please read our separate guide Chronic conditions and cancer explained which contains more information about our extensive range of cancer related benefits. Every year thousands of people have their lives changed irrevocably by cancer, either through a relative, friend or directly themselves. At APRIL UK we understand the importance of providing effective cancer benefits. Spire: the experts in diagnosis - Spire Pathology Services has one of the UK's largest networks of independent pathology laboratories in the UK. They perform an extensive range of tests across all clinical and cellular pathology disciplines. You will have the reassurance that they provide accurate and reliable tests, which will be delivered to your treating consultant promptly. NO financial or time limit on many benefits - peace of mind that treatment costs will be covered in full. Access to specialist drugs - drugs such as Herceptin (breast cancer) and Avastin (bowel, kidney and colon cancer) which prolong and save lives are covered. Some NHS trusts do not provide these drugs. 8

10 Spire's quality pledge to you... At Spire Healthcare our reputation is built on our ability to provide the service you want and need, resulting in excellent medical treatment you can rely on and personal care you'll appreciate. Our patients can be confident that their rights will be recognised and respected by all staff involved in their care regardless of their age, disability, race, religion, gender or sexual orientation. Our promise to you From the moment you arrive at the hospital, our thoughtful and supportive staff will be devoted to your well-being. We promise to explain medical matters in a straightforward language, without using technical terms or jargon. And, in conjunction with your consultant, we'll give you all the facts and advice you need to help you prepare for your visit. We'll make sure you have everything you require and be ready to discuss any decisions affecting your treatment. There will always be friendly faces on hand to answer your questions and make sure you're at ease with what's happening. How we ensure patients receive high quality care Many of the surgeons and specialists in our hospitals are leaders in their field. Our nurses are chosen not just for their professional skills, but also for their commitment to giving a high standard of personal care to all our patients. We have extensive experience across a wide range of surgery, and offer facilities for all kinds of tests, including X-rays, scans, endoscopic procedures and blood tests. Throughout your stay there will be a full medical team available 24 hours a day, trained and equipped to deal with medical emergencies, and dedicated to restoring you to full health as fast as possible 9

11 Transparency & clarity We do not believe in penalising you for using your insurance. This is why we promise that your inspire premium will never increase because of your own claims history Our premiums are NOT related to your own claims, providing greater pricing stability. We look to create long term business relationships with all our customers by providing a high quality service and value for money, year after year. It s how we like to do business. Premiums for inspire can go up in-line with medical inflation and your age. This simply reflects the increasing costs of providing your cover. However, some healthcare providers use a claims related pricing method. This can often see your premiums increase substantially if claims are made on your plan. We do not believe in penalising you for using your insurance. This is why we promise that your inspire premium will never increase because of your own claims history. Even if you were diagnosed with cancer, which could lead to thousands being paid for your hospital treatment and cancer drugs - you would not be charged a higher premium just for this. We find this is a fair and transparent approach to private medical insurance and will help you budget your costs and protect against unexpected premium increases. 10

12 Your underwriting options explained... You have a choice of 3 options... inspire is designed to cover new medical conditions... Moratorium (ages 16-64) This means any medical issues you have experienced or had symptoms of, at any time in the 5 years prior to the start of cover, will be covered by the plan once you go 2 consecutive years from the start date completely clear of symptoms, tests or medication for the condition or anything relating to it. Full medical underwriting (ages optional, compulsory) You will complete a medical questionnaire regarding your medical history. Our underwriters will review it and confirm if there are any medical conditions that will not be covered by the plan. Unless stated, all other medical conditions would be covered. Continued Personal Medical Exclusions (ages 16-64) If you wish to transfer your existing plan over to us you can choose this option. We will continue to provide cover for all medical conditions that were covered under your previous policy. However any medical exclusions would also continue to apply. Under this underwriting option you must declare if you have ever suffered from, or are currently being investigated for any type of heart (including hypertension) or cancer condition. In addition, you must also declare whether you are currently undergoing or expected to undergo in-patient, day patient or out-patient treatment for any medical condition. We will require previous medical insurance certificates for each applicant during the application. 11

13 Some frequently asked questions Who can apply? Is there an excess to pay? What isn t covered? You must be between the ages of 16 and 74 inclusive and resident in the UK, Isle of Man or Channel Islands. Children between the ages of 0 and 21 (25 if in full time education) can be covered under a Single Parent or Family plan. As standard, you will not have to pay an excess when you claim. However, you can reduce your premiums by choosing to have a 100 excess on your plan. This is payable once per person per policy year. inspire does not cover you for the following: Pre-existing conditions which have occurred before joining the plan (unless agreed at time of joining) Routine GP visits How to make a claim What are my cancellation rights? Should you ever need to cancel your plan, you can do so at anytime without penalty. If you cancel within 30 days from the start date, we will refund any premiums which have been paid, provided no claims have been made. Chronic conditions Simple No Fuss Claiming once referred for treatment by your GP, just call our Claims Helpline where dedicated professionals are available to provide assistance and guidance and send you a Claim Form to start your claim. Normal pregnancy and childbirth Cosmetic surgery Alcoholism, drug abuse and other addictive conditions Regular renal dialysis Self inflicted injury Professional sports injuries HIV, AIDS and related conditions Some types of dental treatment Preventative treatment What hospitals can I use? You can choose to receive treatment at any Spire Healthcare hospital in the UK. There is a list of hospitals on page 4, but Spire are growing their network all the time so look out for new hospitals! Please read the Policy Document for full details and exclusions. 12

14 About APRIL UK... APRIL UK are an award winning protection and health insurance provider. Since 1997 we have been providing innovative insurance plans to individuals and businesses throughout the UK. With inspire we have worked in partnership with Spire Healthcare to create a health insurance plan that is both kind to your pocket and delivers high quality healthcare. When it comes to your health, why should you compromise? We like to think that we have a different approach to insurance, which makes us stand out amongst the rest. And that is our focus on putting customers first and delivering excellent customer service. From answering your calls within 3 ring tones, (by a human - not a machine!) to providing plans that offer relevant benefits and value for money, APRIL UK is at the forefront of the insurance industry. 13

15 Contact us... Customer Services (APRIL UK) All calls will be answered by a person within 3 rings. Open Monday - Friday, 9am - 5pm Claims Helpline (EMR) Call this number once you have been referred to your GP. Open Monday - Friday, 9am - 5pm UK 'inspire' is provided by APRIL UK. In partnership with Spire Healthcare

16 APRIL - changing the image of insurance APRIL UK is part of APRIL, a global insurance provider. They were formed in 1988 and set out to change the image of insurance by putting the customer at the heart of the organisation. Today, APRIL has a market value in excess of 538 million and operate in 37 countries, looking after some 6 million policyholders worldwide. They have consolidated revenues exceeding 657 million and paid out claims totalling 157 million in 2012*. This plan is underwritten by Arch Insurance Company (Europe) Limited. They are part of Arch Capital Group, a global insurance provider who is listed on the US stock exchange with a book value in excess of 3 billion and rated A+ (Strong) for their financial strength by Standard & Poor s. *All figures correct at Cancellation rights If for any reason you are not satisfied with your Private Medical Insurance Plan, you may cancel it within 30 days from its start date for a full refund, provided that you have not made a claim. Extra Protection - The Financial Services Compensation Scheme In the unlikely instance that Arch Insurance Company (Europe) Limited is unable to meet its obligations under the Private Medical Insurance Plan, you will be protected by the Financial Service Compensation Scheme (FSCS). More details about the FSCS can be found on their website: Contact your advisor on: APRIL UK Registered Office: April House, Almondsbury Business Centre, Bradley Stoke, Bristol BS32 4QH - Tel: Fax: Arch Insurance Company (Europe) Limited Registered Office: 6th Floor, Plantation Place South, 60 Great Tower Street, London, EC3R 5AZ. APRIL UK is a trading name of APRIL UK (Insurance Services) Ltd (registered in England No ), who is authorised and regulated by the Financial Conduct Authority, registered number Arch Insurance Company (Europe) Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. The company is registered in England and Wales under registered No INSBR 05/14 APRIL UK All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior written permission of APRIL UK. UK 'inspire' is provided by APRIL UK. In partnership with Spire Healthcare