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, so take a look at these FAQ’s and then call us on 0800 158 5182 quoting reference SME-NAT. Calls to and from Aviva may be monitored and/or recorded.

Is there a maximum amount that employees can claim on the policy?

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

Which kinds of underwriting do you use?

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

  • 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, diagnostic tests or 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 injury 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 start date.
  • Medical History Disregarded. This means that we do not apply any medical exclusions to your employees, but only for schemes covering 15 or more employees.

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 BacktoBetter, our clinical case management service. For more information see our BacktoBetter FAQs page.

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.

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

You have the choice over the type and level of cover you provide your staff. After you've decided 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 copies of our Solutions hospital lists online (PDF 1.70MB), but specialists may change the hospitals they work from. To help prevent any confusion, if your employees need to make a claim we’ll do our best to help them find a specialist or hospital covered by your policy. Remember if we have a network for your condition or suspected condition you’ll still need to use our network facility for your treatment rather than a hospital on your list.

Does Solutions include cover for international travel?

Solutions includes a limited emergency overseas cover if your employees are temporarily abroad for a period of up to 90 days per policy year. If you or any of your employees are going to be spending extended periods of time abroad (more than six months at a time), we can offer you a more extensive level of cover under 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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