What can this policy cover?
With Solutions, your employees can avoid NHS waiting lists, and get prompt, private medical care. Our team is happy to answer any questions you have about Solutions, and full details of cover options are included in our Solutions brochure (PDF 1,678KB). All employees on the policy will have peace of mind knowing the costs of hospital accommodation, meals, nursing care and drugs are covered.
- Treatment and care included in Solutions core cover…
If your employees need to make a claim for the benefits below, we'll be happy to help. They can also access our GP helpline and our Stress Counselling Helpline (Over 16s only), free of charge, 24 hours a day.
- Hospital fees at a hospital on your hospital list
- Radiotherapy / chemotherapy treatment
- Specialists' fees - up to the limits in our specialist fee schedule
- Diagnostic tests - including X-rays, scans, blood tests and ECGs
- Out-patient CT, MRI and PET scans at a diagnostic centre that we recognise
- Specialist referred physiotherapy, osteopathy and chiropractic treatment as an out-patient
- Psychiatric treatment as an out-patient, up to £1,000 per person per policy year; on GP referral to a psychiatric therapist or specialist
- Cancer treatment, as explained in full on our Cancer Pledge page
- NHS cash benefits of up to £100 per night, for a maximum of 25 nights per person per policy year
- Accommodation for one parent staying with a child under 12 receiving eligible treatment
- Home nursing on specialist recommendation following treatment as an in-patient or day-patient
- Treatment for pregnancy and childbirth complications
- £100 for each baby born to or adopted by a member
- Limited overseas cover for emergency treatment when temporarily abroad for a period of up to 90 days
- Surgical procedures on the teeth performed in a hospital
- Hospice donations of up to £70 per day for a maximum of 10 days
- A private ambulance when medically necessary
- Treatment, care and options you can add to Solutions core cover…
Private health insurance is a very personal matter, but when it comes to cover for larger companies, some features can be of tangible benefit to your business. It's important to know that by choosing these benefits, your premiums will increase, but your financial adviser can tell you more - and we're always happy to talk about ways to make Solutions fit your particular business needs.
- Psychiatric treatment. Choosing this option means that your employees could claim for in-patient and day-patient treatment if diagnosed with a psychiatric condition, such as clinical depression. Your plan can provide a maximum of either 28 or 45 days' combined in-patient and day-patient treatment per person per policy year, as well as in patient treatment consisting of specialist's fees up to £210 per week.
- GP referred services. These include physiotherapy, chiropractic treatments, osteopathy and acupuncture. By adding this option, you can claim for up to 10 sessions in combined total. This option also covers minor surgery by your GP for up to £70 per procedure, and GP referred chiropody, podiatry, homeopathy, radiology and for non-acute conditions would also be covered.
- Extended hospital list. If care in the Greater London area would be convenient for your employees, it's possible to upgrade your hospital list to include a choice of additional private hospitals.
- Dental and optical cover. Eligible surgical procedures would be covered by your core cover, but by choosing this option you could claim for routine dental treatment up to £500, accidental dental injury up to £600 and routine optical expenses up to £300. We apply a separate £50 excess to both the optical benefit and routine dental treatment, per person per policy year.
- Options you could choose to contain your costs…
Choosing some of these options won't impact on the quality of prompt private care your employees can receive, but it could help you reduce the costs of cover. Choosing these options will reduce some of the benefits covered on your policy.
- Six week option. Choosing this option means that your employees won't be able to claim for in-patient or day-patient treatment, or NHS cash benefit, if the NHS can treat them within six weeks.
- Policy excess. You can add an excess of £50, £100, £150, or £200 to your policy. We'll apply it once per person, per policy year, irresepctive of the number of claims made.
- Reducing selected benefits. This option lets your employees claim for in-patient, day-patient and out-patient costs - but doesn't cover some of the extras. By taking this option, you would exclude cover for investigation into the causes of infertility, complications of pregnancy, oral surgical procedures and emergency overseas cover.
- Choosing an alternative hospital list. As an alternative to the list of hospitals included in core cover, you could choose our Signature hospital list if you live in Scotland or Northern Ireland.
- Reducing out-patient cover. By choosing this option, your employees would still have cover in full for CT, MRI and PET scans at a diagnostic centre that we recognise, and also out-patient radiotherapy and chemotherapy treatment. All other out-patient treatment would be limited to £1,000 per person per policy year. However, the monetary limit for out-patient treatment will not apply to cancer treatment received after diagnosis.
- What's not included in Solutions?
Some treatments and conditions aren't covered by our medical insurance. But if you have any questions, we'll do our best to answer them. Call us to find out more.
- Long term or chronic conditions (except specialists' fees and diagnostic tests included under Option 2)
- HIV/AIDS and related conditions
- Alcoholism, alcohol abuse, drug abuse, solvent abuse and other addictive conditions
- Health hydros or similar facilities
- Treatment undertaken by a specialist without referral by your employee's GP
- Treatment for pregnancy or childbirth (other than the complications as detailed in the terms and conditions booklet)
- Surgical or medical appliances such as neurostimulators (eg cochlear implants) and crutches
- Charges made by a GP, medical practitioner or specialist for completing a claim form
- Psycho-geriatric conditions
- Kidney dialysis
- Cosmetic treatment (except following an accident or surgery for cancer)
- Take-home drugs and dressings
- Professional sports injuries
- Experimental treatment (limited benefit may be available - please contact us)
- Treatment required as a result of war, terrorism or contamination by radioactivity or chemicals
- Self inflicted injury
- Sleep disorders and sleep problems such as snoring or sleep apnoea
- Treatment for warts or verrucas
- Weight loss surgery
- Treatment for infertility
- Varicose veins of the leg unless they meet the criteria detailed in the terms and conditions booklet
Solutions; Value-for-money, flexible and effective
We know how important it is to find value for money. Whether you're covering the whole workforce, or putting a policy into place for just a few staff, Solutions is an affordable policy that can help keep your employees healthy. And as you know, that can also help keep the costs of absenteeism down. Find out more about Solutions. Talk to your financial adviser, call us or ask us to call you back.
Full details of cover are in our terms and conditions booklet, which you'll find in the Useful information box on this page. You'll need to complete an application form for us to work out the final terms of your policy if we accept your application and, depending on your circumstances, non-standard terms may apply.