choices Private Medical Insurance designed for today's world Arranged by UK
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1 choices Private Medical Insurance designed for today's world Arranged by UK
2 Quick access to private hospitals... If you were diagnosed with an illness, wouldn't you want quick access to diagnostic tests and advice from the best consultants? Private Medical Insurance puts you in control over when and where you receive your care.
3 National Assurance 'choices' Private Medical Insurance Plan 'choices' puts you in charge by offering a truly flexible and fresh approach to medical insurance. Through our menu of benefit and discount options, you'll be able to build a plan that suits your needs and budget. As a 'choices' policyholder you'll benefit from quick access to private hospitals, where you get treated by highly skilled consultants and nurses - all in a clean and safe environment. You'll also enjoy the comforts of a private room, with a friendly approach to visiting hours. No one likes to be admitted to hospital. With 'choices' every care is taken to make your stay as comfortable and stress-free as possible. Key benefits for you include: Access to hundreds of private hospitals throughout the UK, including Spire, BMI and Nuffield hospitals, including private wings in NHS hospitals. High quality patient care from the country's most experienced consultant surgeons and specialists. Cut waiting times - NO NHS waiting lists for you to deal with. Convenience - receive treatment at a time that suits you. On our plan you will benefit from.. Flexible cover - a variety of options allowing you to tailor your cover to suit your needs and budget. Peace of mind that a wide range of treatments, consultations and tests will be covered by your plan Important cancer cover - specialist drugs which prolong and save lives, such as Herceptin (breast cancer) and Avastin (bowel, kidney and colon cancer) are included. Many NHS trusts can't afford to prescribe these drugs. Our price promise - your premiums will NEVER increase just because of your personal claims history. Access to Best Doctors - a highly respected second opinion medical service. Gain access to quality healthcare at private hospitals throughout the UK 2
4 What is covered? 'choices' is all about putting you in control and allowing you to build your own private medical insurance plan. Your starting point is Foundation Cover. It provides a wide range of in-patient benefits, where you have to stay in hospital overnight. And day-patient benefits, covering treatments which require you to stay in hospital all day. You can then choose to add out-patient benefits, covering important consultations and tests... FOUNDATION COVER FOUNDATION & LIMITED OUTPATIENT COVER FOUNDATION & FULL OUTPATIENT COVER IN-PATIENT AND DAY-PATIENT BENEFITS Hospital accommodation and nursing care Prescribed drugs and dressings Operating theatre fees Radiotherapy and chemotherapy Maximum payable for consultations for each course of treatment is 360 Maximum payable for consultations for each course of treatment is 360 Maximum payable for consultations for each course of treatment is 360 Consultations, radiology, pathology Diagnostic tests including MRI/CT/PET scans Physiotherapy Surgeons, physicians and anaesthetists fees Oral surgery (non-dental) Parent accommodation (children under the age of 14) Prosthesis OTHER BENEFITS Private ambulance Home nursing 13 weeks per policy year 13 weeks per policy year 13 weeks per policy year OUT-PATIENT BENEFITS Specialist consultations, pathology, X-rays, diagnostic tests, MRI/CT/PET scans 2 consultations and full associated diagnostic tests per policy year 3 'Paid in Full' refers to all costs that are customary and reasonable. Please read the Policy Document for full terms and conditions.
5 Freedom to pick and choose additional benefits Once you have chosen your standard medical insurance benefits, here are further options you can add to enhance your cover OPTION 1: PHYSIOTHERAPY AND COMPLEMENTARY MEDICINE This option provides you with access to physiotherapy and alternative therapies. These types of treatment are becoming more and more popular and will provide you with greater choice for your treatment. Physiotherapy Acupuncture Chiropractic care Osteopathy Homeopathy Combined limit of 500 per policy year FREE child cover on Health Cash If you choose joint cover, your partner and any number of dependants aged between 3 and 18 will be covered. On single parent cover, half the benefits will be payable to dependants. If you are aged 65 and over when the claim is made, half the benefits will be paid. OPTION 2: HEALTH CASH BENEFITS This option provides you with cash benefits when you need specific treatment or care, such as dental and optical attention. Dental treatment Optical care Hospital out-of-pocket cash Maternity cash Recuperative care cash Home help cash Serious accident lump sum Accidental death lump sum 150 per policy year 100 per policy year 25 per night 150 per child 350 per policy year 250 per policy year 10,000 lump sum 10,000 lump sum OPTION 3: PSYCHIATRIC BENEFITS This option provides you with access to psychiatric care, including consultations, medication and overnight stays in a psychiatric unit. In-patient, day-patient and out-patient cover 8,000 per policy year OPTION 4: EXTENDED HOSPITAL LIST Please note 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. As standard, the vast majority of private hospitals throughout the UK are covered. This option provides access to a handful of exclusive London hospitals. Please see our Hospital List for more details. Extended hospital list See Hospital List 4
6 5 Access high quality private healthcare at hundreds of private hospitals throughout the UK
7 Additional lifestyle benefit FREE! WHEN YOU TAKE OUT THIS PLAN Expert second opinion medical service As a National Assurance Private Medical Insurance policy holder you will receive Best Doctors, an expert medical consultation and secondary opinion service. 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 a medical condition. Best Doctors can ensure your diagnosis is accurate and identify the most appropriate treatment options available. They provide support and information to help people like you make the right medical choices. The Best Doctors service is provided independently by Best Doctors UK Ltd. It s valuable peace of mind to help you make the right medical decisions 6
8 Your cancer benefits explained... Comprehensive cancer cover Cancer is a real concern for many people. One in two people in the UK will be diagnosed with cancer at some point in their lives, new analysis suggests*. It's comforting to know 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 Consultations and specialist fees Diagnostic tests and scans - including bone/ct/mri/pet scans Cancer drugs and therapy - including hormone therapies, transplants, bisphosphonates Radiotherapy and Chemotherapy Biological therapies ('super drugs') Surgery and hospital charges Palliative treatment - including side effects and sickness drugs Maximum payable for consultations for each course of treatment is 360 Subject to pre-authorisation after 12 months Up to 10,000 during the lifetime of the plan 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. ADDITIONAL CANCER-RELATED BENEFITS Wigs External prostheses Up to 100 during the lifetime of the plan Up to 5,000 during the lifetime of the plan *Cancer Research UK, February
9 Helping you beat cancer... Every year thousands of people have their lives changed irrevocably by cancer. At National Assurance we understand the importance of providing effective cancer benefits. This is why, as a policyholder, you'll benefit from the following: Best Doctors is an expert second opinion medical service. They can: - identify world-leading cancer specialists to review your condition - provide reassurance your diagnosis is correct and you are receiving the appropriate treatment - help identify alternative specialists, facilities and treatment where required It's reassuring that you have the support and information to make the right medical decisions. Choice of specialist and hospital - freedom to choose from our extensive list of hospitals and facilities throughout the UK. Wide range of consultations, tests, treatments and drugs covered by your plan. 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 can't afford to prescribe these drugs. Please read the policy document for more information about our extensive range of cancerrelated benefits. 8
10 How to reduce your premiums What are the excess options? There is no mandatory excess on this plan, however you can choose from two excess options to reduce your premiums: Fixed excess option per person, per policy year Reducing excess option - Starting at 250 per person, per policy year Where you have chosen the 250 reducing excess option - for every year that all named policyholders remain claim free - you'll be rewarded with a reduction in your excess. Our excess options are a great way to reduce premiums, whilst providing generous medical benefits If a claim is made, there is no penalty in subsequent years. Instead, you will remain at the same excess level until the next claim free year, when you will be rewarded by a further reduction in your excess. Each policyholder will not have to pay more than once in any policy year - regardless of the number of claims. REDUCING EXCESS OPTION Starting point 250 For every claim free year you will be rewarded by a reduction in your excess Year 2 Year 3 Year 4 Year NIL The above example assumes no claims are made in the first five years of cover. 9
11 Transparency and clarity We do not believe in penalising you for using your insurance. This is why we promise that your premium will never increase because of your own claims history Our premiums are designed to provide you with pricing stability, so you can budget your costs and maintain cover over time. We look to create long-term 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 private medical insurance 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. Which is why we promise that your premium will never increase because of your personal claims history. Even if you were diagnosed with cancer - which could lead to thousands of pounds 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 three options... Moratorium (ages 16-64) This means any medical issues you have experienced or had symptoms of, at any time in the five years prior to the start of cover, will be covered by the plan once you remain two 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), psychiatric 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 your previous medical insurance certificate during the application. 11
13 Some frequently asked questions Can I apply for this plan? What isn t covered? What hospitals are covered? You must be aged between 16 and 74 inclusive and a 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. How do I make a claim? Simple no fuss claiming - once referred for treatment by your GP, all you have to do is call our claims helpline. We have dedicated professionals available to provide you with assistance and guidance. Our Private Medical Insurance Plan does not cover you for the following: Chronic conditions Pre-existing conditions which have occurred before joining the plan (unless agreed at time of joining) Routine GP visits 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, unless Health Cash Benefit option has been chosen Preventative treatment You have the freedom to choose any private or NHS hospital in the UK for your treatment (other than a small number of inner London hospitals). Please see our Hospital List for some of the most frequently used hospitals. If you choose the Extended Hospital option, you will also have access to additional inner London hospitals. Please read the policy document for full details and exclusions. 12
14 How do I make a claim? It's quick and simple to claim on your Private Medical Insurance plan. Request a claim form As soon as you feel you may want to claim, contact the APRIL UK Claims Team to request a claim form: apriluk@healthclaims.co.uk Complete claim form Complete the claim form as instructed on the first page. Your GP will also need to complete one of the sections. Return claim form Send the completed claim form back to the APRIL UK Claims Team. This can be done by post or Assessment THE APRIL UK Claims Team will assess your claim and notifiy you of the outcome. Go for treatment Your consultation or treatment can take place, subject to acceptance. The invoice goes directly from the hospital/consultant to the APRIL UK Claims Team. 13
15 Contact us... Customer services (National Assurance) Open Monday - Friday: 8.30am - 5pm (free from a UK landline, charges may apply from mobiles) Claims helpline Call the April UK Claims Team once you have been referred by your GP. Open Monday - Friday: 8am - 5pm (charged at local rate, may cost more from mobiles) 14
16 National Assurance is a professional insurance intermediary which designs, creates and distributes affordable health insurance products. We bring together leading specialists to help ensure your insurance all goes to plan. We are committed to delivering a first rate service at affordable premiums. UK The insurer that meets the financial obligations of your policy The policy administrator who will manage your day-to-day needs An expert consultation and second opinion medical service Cancellation rights If for any reason you are not satisfied with your 'choices' 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 (who is the insurer for this plan) is unable to meet its obligations under the 'choices' 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: Assured Futures Limited Registered Office: 2 Des Roches Square, Witney, OX28 4LE. APRIL UK Registered Office: April House, Almondsbury Business Centre, Bradley Stoke, Bristol BS32 4QH. Arch Insurance Company (Europe) Limited Registered Office: 6th Floor, Plantation Place South, 60 Great Tower Street, London, EC3R 5AZ. This policy is distributed by National Assurance, a trading name of Assured Futures Ltd (registered in England No ), who is authorised and regulated by the Financial Conduct Authority. This policy is arranged by APRIL UK, 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 This policy is underwritten by Arch Insurance Company (Europe) Limited who 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 NAPMIBR 02/15 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.
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