Saga Health Insurance The easy way to choose cover for you HealthPlan Super HealthPlan Secure HealthPlan Saver Plus HealthPlan Saver HealthPlan Support
Contents Why health insurance is the right choice Why health insurance is the right choice Why choose Saga? 4 Key benefits of Saga HealthPlans 5 Choosing from our range of health plans 7 Saga HealthPlan Super 8 As you grow older, looking after your health becomes increasingly important. At Saga we specialise in understanding the needs of people over 50, and we have more than 25 years of experience providing health insurance. So, whether you re choosing health insurance for the first time, or switching from an existing insurer, you can trust Saga to offer cover that s right for you. Saga HealthPlan Secure 9 Saga HealthPlan Saver Plus 10 Saga HealthPlan Saver 11 Saga HealthPlan Support 12 Personalising your policy 1 Choosing your underwriting method 15 Further information 16 We may use terms that you aren t familiar with, so we ve included explanations. As a newcomer to private health insurance, I was immensely impressed by the overall kindness, courtesy and efficiency of both Saga personnel and the hospital. Mrs Penney, Hertfordshire Peace of mind when you need it most The NHS does an admirable job providing a wide range of services, and remains second to none for emergency treatment. However, it is under increasing pressure when it comes to non-emergency treatment. Recent reports in the media have indicated that NHS waiting times are on the increase and, due to budgetary pressures, there is growing uncertainty about the level of service that will be provided in the future. Having health insurance gives you control of your own healthcare needs and the peace of mind that you ll have prompt access to the treatment you need, when and where you need it. Choice, convenience and comfort With health insurance you can expect a high standard of treatment, service and after-care. You get quick access to a specialist for a consultation and advice, and have the opportunity to choose both your consultant and the hospital in which you will receive treatment. If you need treatment, you will stay in a clean, quiet, private room usually with en suite facilities. You will have your own TV and phone, and a varied menu of high quality meals to choose from. Your friends and family can visit at any time and stay as long as you like, and car parking is generally free. All of this makes for the ideal environment to recuperate in peace. I never cease to According to our customer surveys conducted between March and July 2014, 90% of be impressed with the kind understanding and patience of Saga staff a jewel in the crown for customer service. customers saved money by Mr Magowan, Belfast switching to Saga Health Insurance. 2
Why choose Saga? Compare the key benefits of Saga HealthPlans With more than 25 years of experience in health insurance we understand what s important to our customers. That s why our health plans provide just the right type of cover. We also work hard to give you extra benefits that have real relevance and give you greater peace of mind. A comprehensive choice of cover options From top-of-the-range cover to a more basic plan that focuses on the essentials, we have an option to suit most needs and budgets. You can even choose to personalise your plan with a number of additional cover options (see page 1). Some of the most competitive premiums available 90% of customers who switched to us saved money, according to our customer surveys conducted between March and July 2014. Customer service you can rely on Our service doesn t end once you ve taken out cover. Our friendly, UK-based advisers are here when you need them, and you ll also have access to our 24-hour GP Telephone Consultation Service. Fast Track Appointments Our Fast Track Appointments service gives you the peace of mind that you ll be seen quickly if you fall ill. When you let us know your GP has referred you to a specialist, our team will find the most appropriate consultant with the expertise to help you. We ll even arrange an appointment at a time and place to suit you. It s quick and easy to join There is no upper age limit and you don t need to complete a medical when you take out Saga Health Insurance. If you re switching from another provider we could even cover you for conditions claimed under your existing policy (see page 15 for more details). If you d like to talk through your options with one of our UK-based specialist advisers, please call us on 0800 904 7409 Lines are open 8.0am-7pm weekdays, 9am-1pm Saturday and 10am-2pm Sunday. Saga HealthPlan Super Saga HealthPlan Secure Saga HealthPlan Saver Plus Saga HealthPlan Saver Saga HealthPlan Support Hospital charges for treatment in a hospital on the Saga Countrywide Hospital List 4 4 4 4 4 Consultant/specialist fees and 4 4 4 4 4 Treatment of psychiatric illness Up to a total of 28 days per year Surgical procedures 4 4 4 4 4 Consultations with a consultant/specialist and Practitioner and physiotherapy charges Therapist, homeopath and acupuncturist charges Up to 1,500 per year These benefits have a combined limit of 1,200 per year Additional 400 per year for post-operative therapist, physiotherapist, homeopath and acupuncturist charges These benefits have a combined limit of 500 per year These benefits have a combined limit of 500 per year and must be related to eligible in-patient or day-patient treatment Cancer treatment, including charges for radiotherapy and chemotherapy 4 4 4 4 CT, MRI and PET scans in a scanning centre on the Saga Countrywide Hospital List Treatment of psychiatric illness Additional benefits Up to 1,500 per year One scan, plus unlimited follow-up scans within 8 months of related eligible in-patient or day-patient treatment One scan before related eligible in-patient treatment, plus unlimited follow-up scans within 8 months of related eligible in-patient or day-patient treatment NHS cash benefit of 100 per night up to 2,000 per year 4 4 4 4 4 Nursing at home following in-patient treatment covered by the policy (on specialist recommendation) Up to 1 weeks per year Up to 1 weeks per year Up to 2 weeks per year Up to 2 weeks per year Recuperative care following in-patient treatment covered by the policy Up to 1,500 per year Up to 500 per year Private ambulance (on specialist recommendation) 4 4 Major dental cash benefit for specified dental procedures Up to 1,500 per year Treatment for accidental dental injury Up to 5,000 per year Overseas evacuation and repatriation service 4 Saga GP Telephone Consultation Service 4 4 4 4 4 Saga Health Information Line 4 4 4 4 4 Options and features Fast Track Appointments service 4 4 4 4 4 Optional Health Cash Benefits Cover 4 4 4 4 4 Optional Extended Cancer Cover 4 4 4 4 No Claim Discount (automatic introductory discount) 4 4 4 4 4 Optional No Claim Discount Protection 4 4 4 4 4 No upper age limit 4 4 4 4 4 Choice of optional excess ( 100, 250, 500, 750 and 1,000) 4 4 4 4 4 Optional cover for hypertension 4 4 4 4 4 Choice of hospitals (see the Saga Countrywide Hospital List for details) 4 4 4 4 4 4-week wait option 4 4 4 4 4 Please note: we pay charges up to the level within the published Schedule of Procedures and Fees. Full details of benefits available in the Membership Handbook. 4 5 6
Open here to compare our plans Choose from our range of health plans Saga HealthPlan Super Saga HealthPlan Secure Saga Health Insurance offers a choice of five health plans, each providing cover for hospital in-patient and day-patient treatment and care. The amount of out-patient cover and additional benefits varies between health plans, so have a look at our plan comparison table to help you choose the one best suited to your needs. The panels opposite summarise what each of the plans offer and you ll find full details on the following pages. Once you ve decided which plan is right for your needs you can personalise it to fit your own circumstances. These options are explained on page 1. HealthPlan Super Our top of the range plan gives the highest level of protection for eligible in-patient and day-patient treatment, and unlimited out-patient cover including consultations,, scans and physiotherapy. HealthPlan Secure This plan gives full cover for eligible in-patient and day-patient treatments. It provides 1,200 for eligible out-patient treatment, full cover for scans, plus an additional 400 per year for post-operative therapist, physiotherapist, acupuncturist and homeopath charges. HealthPlan Saver Plus This plan offers full cover for eligible in-patient and day-patient treatment, 500 for eligible out-patient treatment, plus one scan per year. It provides the main advantages of health insurance at a value-for-money price. HealthPlan Saver This plan is similar to HealthPlan Saver Plus but premiums are kept down by providing eligible out-patient treatment and scans only when they are related to in-patient hospital treatment. Saga HealthPlan Super is our top of the range plan, for those wanting the reassurance of comprehensive cover. It gives our best level of protection for eligible in-patient and day-patient cover and offers unlimited cover for eligible out-patient treatment including consultations, diagnostic tests, scans and physiotherapy. It also includes cover for complementary therapies such as homeopathy and osteopathy, treatment of psychiatric illness, the use of a private ambulance, home nursing, recuperative care and even assistance towards some major dental work. Consultations with a consultant/specialist, diagnostic tests, practitioner and physiotherapy charges CT, MRI and PET scans Therapist, homeopath and acupuncturist charges Up to 1,500 In-patient treatment of psychiatric illness Up to 28 days of psychiatric illness Up to 1,500 Saga HealthPlan Secure provides cover for prompt access to a private hospital when eligible in-patient or day-patient treatment is required, so avoiding the possibility of NHS waiting lists altogether. It also provides out-patient cover to ensure that you are seen, diagnosed and treated promptly, and includes cover for complementary therapies. Consultations with a consultant/specialist,, practitioner, therapist, physiotherapist, acupuncturist and homeopath charges CT, MRI and PET scans Additional post-operative out-patient physiotherapist, therapist, acupuncturist and homeopath charges Up to 1,200 Up to 400 HealthPlan Support This plan keeps premiums very low by focusing on eligible hospital in-patient and day-patient treatment only. It ensures prompt access to private hospital treatment for those on a restricted budget. Nursing at home Up to 1 weeks Private ambulance Major dental cash benefit Up to 1,500 Recuperative care Up to 1,500 Saga GP Telephone Consultation Service Saga Health Information Line Nursing at home Up to 1 weeks Private ambulance Recuperative care Up to 500 Saga GP Telephone Consultation Service Saga Health Information Line All Saga HealthPlans include the Saga GP Telephone Consultation Service. This 24/7 helpline gives you access to a GP who can provide advice, reassurance and maybe even diagnosis without you having to leave your home. Fast Track Appointments service Health Cash Benefits Cover + Extended Cancer Cover + Fast Track Appointments service Health Cash Benefits Cover + Extended Cancer Cover + 7 8 If you have any questions please call us on 0800 904 7409 If you have any questions please call us on 0800 904 7409 9
Saga HealthPlan Saver Plus Saga HealthPlan Saver Saga HealthPlan Saver Plus is our most recently introduced, more affordable plan that provides good all-round cover for private hospital care. Should you need in-patient or day-patient treatment, it will meet all your eligible costs. There s also cover for out-patient treatment including consultations, and scans, making this plan a popular choice. Saga HealthPlan Saver is a low cost plan offering all-round cover for eligible in-patient and day-patient treatment. By providing out-patient treatment and scans only when they are related to eligible in-patient treatment, we are able to keep our premiums down. When I needed treatment for breast cancer you were very good. I am glad I went with Saga Health Insurance. I also told family and friends to go with you. Mrs Payne, Kent Consultations with a consultant/specialist,, practitioner, therapist, physiotherapist, acupuncturist and homeopath charges CT, MRI or PET scan CT, MRI and PET scans within 8 months following eligible in-patient or day-patient treatment Up to 500 One scan Nursing at home Up to 2 weeks Saga GP Telephone Consultation Service Saga Health Information Line Fast Track Appointments service Health Cash Benefits Cover + Extended Cancer Cover + I can t praise Saga enough for the service they offer without doubt it s the best my wife and I have experienced. Mr Suthers, Dorset Consultations with a consultant/specialist, diagnostic tests, practitioner, therapist, physiotherapist, acupuncturist and homeopath charges CT, MRI or PET scan CT, MRI and PET scans within 8 months following related, eligible in-patient or day-patient treatment Up to 500 when related to eligible in-patient or day-patient treatment One scan when related to eligible in-patient treatment or prior to eligible related radiotherapy Nursing at home Up to 2 weeks Saga GP Telephone Consultation Service Saga Health Information Line Fast Track Appointments service Health Cash Benefits Cover + Extended Cancer Cover + 10 If you have any questions please call us on 0800 904 7409 If you have any questions please call us on 0800 904 7409 11
Saga HealthPlan Support Personalise your policy Saga HealthPlan Support keeps premiums as low as possible by focusing on eligible hospital in-patient and day-patient treatment only. To make it even more affordable, it covers only the surgical aspects of cancer treatment. All other aspects, including chemotherapy, would need to be treated on the NHS. I have been extremely satisfied with my Saga Health Insurance policy and have recommended you to many of my friends. Mrs Lockhart, Northants Once you ve decided which Saga HealthPlan is right for you, you might want to tailor your policy to your specific needs with the following options. Not only can they improve your cover, but they could save you money too. Extended Cancer Cover 4-week wait Saga HealthPlan Super, Secure, Saver Plus and Saver all offer cover for cancer, including the latest treatment options and access to therapies including drugs such as Herceptin and Avastin. But for those who require greater reassurance and choice, we also offer optional Extended Cancer Cover (not available on our Support plan). This provides the additional benefits of covering experimental or unproven With our unique 4-week wait option, if the NHS waiting time is more than four weeks you can be seen in a private hospital. However, if your specialist confirms that the NHS can provide the treatment you need locally within four weeks of the date you need it, you ll be treated by the NHS but you can claim 100 cash benefit for each night you re in hospital. surgery and experimental drug treatments as long as There are also nine common conditions for which we ll they are part of an ethically approved trial. There are provide immediate treatment, even if you choose the also no time limits for cancer drug treatments, including 4-week wait option. These are: medical treatment to help prevent the recurrence of cancer or maintain remission. - Cataract surgery - Correction of squint - Varicose veins surgery - Insertion of grommets Our Extended Cancer Cover also provides up to 5,000 - Removal of gall bladder - Tonsillectomy for prostheses, up to 150 for wigs, and 100 for hospital - Haemorrhoidectomy - Adenoidectomy expenses. - Removal of bunions Protecting your No Claim Discount When you take out a Saga HealthPlan you ll usually start with a 5% No Claim Discount, and this rises annually by Saga is unique in offering a 4-week wait. Whilst some other insurers offer a similar option, this is on a 6-week wait basis so it s more likely you ll be treated privately with Saga. Choosing this option will reduce your premium. Surgical procedures 5% to a maximum of 60% if no claims are made. If you make a claim you just move back two levels on the scale, but you ll never fall below level 0, no matter how many claims you make. Excess options As with other insurance, you can add an excess to your Saga HealthPlan to reduce the premium. The excess is the amount you agree to pay each year towards eligible Level 0 1 2 4 5 6 7 8 9 10 treatment, before any benefit becomes payable. Saga Saga GP Telephone Consultation Service Saga Health Information Line Fast Track Appointments service Health Cash Benefits + % Discount off basic premium rate 0 10 20 25 0 5 40 45 50 55 60 Available for an additional premium, Saga s No Claim Discount protection allows you to make one claim without it reducing your No Claim Discount. HealthPlans offer a choice of 100, 250, 500, 750 or 1,000 optional excesses. I was looking for something straightforward and Saga fitted the bill perfectly. Their policy was simply the best in terms of price and benefits. Mrs Tse, Leeds 12 If you have any questions please call us on 0800 904 7409 1
Cover for hypertension Hypertension, or persistently raised blood pressure, can lead to serious medical problems such as stroke or heart attack. That s why many insurers don t offer cover for the condition itself, or associated conditions, if you already have it when you join. However, for an additional premium we may be able to provide you with full cover. Choose a local hospital Take a look through the Saga Countrywide Hospital List, which includes the hospitals, daypatient units, scanning centres and other private healthcare facilities across the UK where you can have treatment under your Saga HealthPlan. These include leading hospital groups such as Spire, Nuffield and BMI. Saga Countrywide Hospital List November 2014 At the back of the document you ll find an extra section the Saga Countrywide London Upgrade list, which includes further hospitals in Central London. If you think you might want to use the hospitals on this list, you can add it to your policy for an additional premium. Health Cash Benefits Cover With our optional Health Cash Benefits Cover you can make appointments throughout the year without worrying about the cost. The great thing about this cover is that if you do make a claim, you will not have to pay an excess and your No Claim Discount won t be affected. With Health Cash Benefits Cover you can claim the following: Dental care up to 200 per person a year Optical care up to 150 per person a year Dental accident up to 200 per person a year Dental emergency up to 200 per person a year Health screening up to 150 per person a year Payment methods We offer a number of convenient payment methods. You can pay your premium either monthly by Direct Debit, or annually by cheque, credit card or Direct Debit. You can save 7.5% if you pay your premium annually. Choose your underwriting method You ve chosen your Saga HealthPlan, added any additional cover and personalised your policy to suit your needs, so what s next? Choose your underwriting method When you take out a Saga HealthPlan you can choose from three different underwriting methods, depending on whether you re taking out a policy for the first time, or switching from another insurer or employer s scheme. The panels opposite summarise the three methods and the Underwriting Methods and Chronic Conditions leaflet has more details. But put simply, you can choose as follows: New to health insurance? In line with other insurers, we ll cover the cost of eligible medical conditions that arise after the date you join and will exclude any pre-existing conditions or any specified conditions you may have. You can choose Full medical history underwriting or the Moratorium method. Switching from another insurer? Moratorium method No medical declaration is necessary we ll simply exclude treatment for any medical condition and certain specified conditions you or anyone on your policy has experienced in the last three years (many other insurers insist on a longer period of five years). If you remain free from any advice, medication or treatment for an excluded condition for a continuous period of two years after your policy starts, we may be able to offer cover for it then. Full medical history underwriting Complete a medical history declaration for you and any family members you wish to be covered. We ll speak to your doctor if necessary, take into account the history of any existing conditions and let you know whether we can cover you for them. Continued personal medical exclusions This option is available if you wish to switch from your current insurer and retain cover for your existing medical conditions. It depends on your recent medical and claims history and the terms and conditions of your new policy. The process was carried out most efficiently by your helpful adviser. Also the choice of plans made it so much easier to decide. Mr & Mrs Lonsdale, Berkshire If you choose Full medical history underwriting or the Moratorium method we ll treat you as though you re taking out insurance for the first time and exclude any pre-existing conditions. But, for an additional premium, it may still be possible to receive cover for a pre-existing condition, in which case you should choose Continued personal medical exclusions. Switching from an employer s group scheme? If you have health insurance through a company scheme, you may still be able to receive cover for pre-existing conditions if you choose Continued personal medical exclusions (your policy will be subject to an additional premium and a compulsory 250 excess). Otherwise simply choose Full medical history underwriting or the Moratorium method. 14 15
Further information What isn t covered You should be aware that there are a number of exclusions that are commonly applied to most health insurance policies. Common exclusions include the treatment of long-term illnesses (chronic conditions), routine dentistry (unless you select Health Cash Benefits Cover), cosmetic surgery and professional sport injuries. In addition, there are specific exclusions depending on the health plan you choose. Further details of these exclusions can be found in the Policy Summary and the ABI guide to buying private medical insurance. If you would like us to send you a Membership Handbook to read, just call us. The terms we use Chronic condition: A disease, illness or injury, which has one or more of the following characteristics: n It needs ongoing or long-term monitoring, through consultations, examinations, check-ups and/or tests n It needs ongoing or long-term control or relief of symptoms n It requires your rehabilitation or for you to be specially trained to cope with it n It continues indefinitely n It has no known cure n It comes back or is likely to come back. Day-patient treatment: Treatment, which for medical reasons, means you have to go into a hospital or day-patient unit because you need a period of supervised recovery but do not have to stay overnight. Excess: The amount of money you pay towards your claim before any benefit becomes available. In-patient treatment: Treatment, which for medical reasons, means you have to stay in hospital overnight or for longer. No Claim Discount: The discount awarded annually to a policyholder for not making a claim during the previous policy year. No Claim Discount Protection: This enables you to make one claim without affecting your No Claim Discount. : Treatment given at a hospital, consulting room or out-patient clinic where you do not go in for day-patient treatment or in-patient treatment. Physiotherapist - a medical practitioner who practises physiotherapy and who meets our recognition criteria for benefit purposes in their field of practice, and who we have told in writing that we currently recognise as a physiotherapist for benefit purposes. When such persons provide such services to you as part of your in-patient or day-patient treatment, those services will form part of the private hospital charges. Practitioner: A practising member of certain professions allied to medicine who, in all cases, meets our recognition criteria for benefit purposes in their field of practice and who we have told in writing that we currently recognise as a practitioner for benefit purposes. The professions concerned are dieticians, nurses, orthoptists, psychologists, psychotherapists and speech therapists. Pre-existing condition: A medical condition which you already have when your policy starts or have had in the recent past. Specialist: A medical practitioner with particular training in an area of medicine with full registration under the Medical Acts who is currently recognised as a specialist for benefit purposes in their field of practice. Specified condition: The medical conditions that are associated with the following pre-existing conditions: diabetes, raised blood pressure (hypertension) or undergoing monitoring as a result of Prostate Specific Antigen (PSA) test. Therapist: A medical practitioner with full registration under the Medical Acts, who is a practitioner in physiotherapy, osteopathy or chiropractic, is registered under the relevant Act and who, in all cases, meets our criteria for therapist recognition for benefit purposes in their field of practice, and who we have told in writing that we currently recognise as a therapist for benefit purposes in that field for the provision of out-patient treatment only. A full explanation of the criteria we use to decide these matters is available on request. Underwriting terms: Further information is contained in the Underwriting Methods and Chronic Conditions leaflet. When it comes to health insurance, this is as good as it gets. Caroline Tse, from Leeds, is an NHS staff nurse with first-hand experience of private healthcare. She switched to Saga Health Insurance from another well-known provider several years ago and now says it is the best money she has ever spent. Thanks to her Saga HealthPlan, Caroline s hip operation was carried out within three weeks of diagnosis. I was diagnosed with osteoarthritis of the knee a number of years ago, but had no idea that my hip was affected until my daughter remarked that I was limping badly, says Caroline. I went to see the GP and was referred to a specialist who diagnosed osteoarthritis of the hip and told me that I needed a hip replacement. Simply the best Caroline previously had insurance with another well-known health insurer but decided to look for something different. I was looking for something straightforward where I didn t have to pay money upfront and Saga fitted the bill perfectly. Their policy was simply the best all round in terms of price and benefits. When I called Saga after being diagnosed it was all incredibly simple. They sent the forms out the next day with a letter to say I could proceed. Privacy is very important to me Caroline stayed in hospital for six days and was very pleased with the care. The consultant I requested carried out the operation in a lovely private hospital just 500 yards from home. It was great having a private room so I could rest without interruption. The staff were lovely, the food was freshly cooked and well presented, and the free parking made it easy for people to visit me. Saga took all the worry away Caroline was especially impressed that Saga dealt with the hospital directly. I didn t have to do anything after I had set the ball rolling. You don t want to be worried by financial considerations when you are trying to recover from an operation. The bill came to 11,000 and there is no way I could have afforded it out of my own pocket. All in all, when it comes to health insurance, this is as good as it gets. 16 17
Get in touch today Taking out cover is a quick and simple process, whether you re new to health insurance or are switching from another provider. To get covered, simply call one of our UK-based advisers today. There are no press-button menus and we will be happy to answer any questions you may have. 0800 904 7409 Lines are open 8.0am-7pm weekdays, 9am-1pm Saturday and 10am-2pm Sunday. saga.co.uk/health-insurance I wish to say a big thank you to all the health insurance staff the best move I made was to be insured by Saga. Mrs Floyd, Clwyd Saga Services Limited is a wholly owned subsidiary of Saga plc and is registered in England and Wales (Company No. 72602). Registered Office: Enbrook Park, Sandgate, Folkestone, Kent CT20 SE. Authorised and regulated by the Financial Conduct Authority. Saga Services Limited has arranged for its health insurance to be underwritten by AXA PPP healthcare Limited, Phillips House, Crescent Road, Tunbridge Wells, Kent TN1 2PL. AXA PPP healthcare Limited. Registered Office: 5 Old Broad Street, London EC2N 1AD, United Kingdom. Registered in England No. 148119. AXA PPP healthcare Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. CSB-HE0925 November 2014 PM/BR/QT/A4/N14