Private health insurance

General FAQs

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If you're thinking about buying Solutions, you may have questions you'd like to ask. We're always happy to talk over the phone. If these FAQs don't show what you're looking for, then your financial adviser may be able to help. Alternatively, call us direct or ask us to call you back.

I work for a large company, but we don't want cover for everyone. Is that possible?

Thanks to the flexibility of Solutions, it can be the ideal policy for any business with between 2 and 249 employees. Whether you'd like a private health insurance policy that provides a wide range of benefits for a small number of senior staff alone, or provides a basic healthcare package to the whole workforce, right up to a fully comprehensive policy for all your employees. Solutions can help. Talk to your adviser, or ask us directly about ways in which Solutions could meet your needs.

Is there a maximum amount that our employees could claim on our policy?

No. The number of times your employees can claim per policy year is unlimited. There's no limit to the number of claims your employees can make for eligible treatment at a hospital from our networks or your chosen hospital list. But some benefits do have specific limits.

Is there a difference between 'Private Health Insurance' and 'Private Medical Insurance'?

We say 'private health insurance' most often, but your current provider may call it 'private medical insurance'. Both terms describe the same thing: a policy that helps employees get private treatment could be called private health insurance or private medical insurance.

Which kinds of underwriting do you use?

When it comes to underwriting, different insurers offer different options. We offer the following types:

  • Medical History Disregarded. This underwriting comes as standard for Solutions policies with over 100 members and can be chosen by smaller schemes, as long as at least 15 employees are covered. It means that we do not apply any medical exclusions to your employees. Standard policy exclusions will still apply.
  • Full Medical Underwriting. We ask your employees questions about their past health. Their pre-existing medical conditions and related conditions will be excluded unless we agree to accept them.
  • Moratorium.This replaces filling out a health questionnaire. An automatic exclusion applies to any disease, illness or injury (whether or not diagnosed) or any related condition if:
    • A member had symptoms of, medication for, diagnostic tests for, treatment for, or advice about such a disease, illness or injury within five years before joining Solutions and
    • There has not been a clear two-year period after joining during which the member has been free of medication for, diagnostic tests for, treatment for, and advice about such a disease, illness or related condition.
  • Continued Medical Exclusions. This option can be chosen if your company is transferring from an existing fully medically underwritten medical insurance plan. We'll apply the same personal medical exclusions that were applied to the previous plan. No new personal medical exclusions will be added.
  • Continued Moratorium. Your company can apply to transfer from an existing medical insurance plan which is underwritten on a moratorium basis. We apply our moratorium wording with effect from each member's original moratorium start date.

What are chronic conditions?

A chronic condition is a disease, illness or injury that has one or more of the following characteristics:

  • it needs ongoing or long-term monitoring through consultations, examinations, check-ups and/or tests
  • it needs ongoing or long-term control or relief of symptoms
  • it requires your 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.

Your Solutions policy will exclude claims for these conditions, however if you add option 2 'Routine & GP referred services' to your cover there will be some benefit available for chronic conditions.

What are musculoskeletal (MSK) conditions?

MSK conditions are any conditions relating to back, neck, muscle or joint pain, also commonly referred to as orthopaedic conditions. These are covered as standard through our market leading BacktoBetter service. For more information see our BacktoBetter FAQs page.

What information do I need to supply when I call for a quote?

It's up to you which type and level of cover you'd like for your staff. We'll need details about your employees, their dates of birth, and - if you are switching cover from another provider - you'll need to supply your renewal date, the type of underwriting on your current policy and details of any past claims.

Why don't you list your specialists and hospitals on the internet?

We do keep a copy of our Solutions hospital list online (PDF 1.70MB), but specialists may change the hospitals they work from. It would be almost impossible to keep a list of specialists up to date. Rather than give your employees incorrect information, we would rather let them know that we'll do our best to help you find a specialist or hospital covered under your policy, if they need to make a claim. Remember if we have a network for your employees' conditions or suspected conditions they’ll still need to use our network facility for their treatment rather than a hospital on your list.

Does Solutions include cover for international travel?

Solutions includes basic overseas cover for limited emergency treatment if your employees are temporarily abroad for a period of up to 90 days. But if you'd like to find peace of mind for a more extensive level of cover, then we can offer you International Solutions.

What is a network?

We’re developing a number of networks of facilities, specialists or other practitioners that we recognise to provide the treatment required for a specific condition or suspected condition.

By creating networks, Aviva has more control over the treatment pathway. This means we can drive better commercial deals, which helps us maintain affordable prices. What’s more, by controlling the treatment pathway we can give our customers greater assurance when it comes to clinical quality and treatment, and ensure that more treatment can be covered before benefits limits are reached.

Our networks are updated frequently as we work to ensure we get the best possible service for our customers. We regularly add or evolve networks, or in the event that a facility/specialist is no longer suitable for a network we may remove them. Please contact our claims team before arranging any treatment.

Contact our claims team on 0800 158 3344. Our lines are open from 8am-8pm Monday to Friday and 8am-1pm on Saturdays.


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