Private health insurance

What can this policy cover?

Solutions helps your employees to avoid NHS waiting lists and get access to 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…

All policies will include the following cover plus access to our GP helpline and our Stress Counselling Helpline, free of charge, 24 hours a day.

• Hospital fees at a hospital on your hospital list
• We've enhanced our extensive cancer cover, see Our cancer pledge for further details and full terms and conditions
• 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
• No limit on targeted therapies for cancer
• NHS cash benefit 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 of 12 or under receiving eligible treatment
• Home nursing on specialist recommendation following treatment as an in-patient or day-patient
• Treatment for pregnancy and childbirth complications subject to a 10 month qualifying period
• £100 for each baby born to or adopted by a member, subject to a 10 month qualifying period
• 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 £100 per day, to a maximum of £10,000
• A private ambulance for transportation to hospital if medically necessary
• Out-patient treatments of acute conditions

Treatment, care and options you can add to Solutions core cover…

You may want to offer these options to your employees. If you choose these extra benefits, your premiums will increase.

• 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.
• 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 pathology. Specialists’ fees for consultations and tests for non-acute conditions would be covered, and your employees also have access to our award-winning Back-Up service.
• Extended hospital list. If care in the Greater London area would be convenient for you, it’s possible to upgrade your hospital list to include a choice of additional private hospitals and clinics.
• 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 reduce your costs…

Choosing 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 on the policy 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 employee, per policy year, irrespective 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 less essential extras. By taking this option, you would exclude cover for costs associated with 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. Or you could choose our Trust Care hospital list, which includes private patient units of NHS Trust and Partnership hospitals. To choose this list, your employees must live within 30 miles of a Trust Care hospital and have less than 50 employees covered by the scheme.
• Reducing out-patient cover. By choosing this option, your employees would still have full cover 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.

What’s not included in Solutions?

Like most private health insurance policies, Solutions won’t cover any pre-existing conditions unless we have expressly included treatment relating to them during full medical underwriting or under continued medical exclusions. Some occupations, and some specific 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 on 0800 158 5182.

Solutions won’t provide cover for these treatments…

• Long term or chronic conditions (except specialists' fees included under Option 2). This exclusion does not apply to treatment for cancer
• 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
• Experimental treatment. This exclusion does not apply to treatment for cancer
• Diagnostic tests and treatment for infertility
• 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
• 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.

Solutions; Value-for-money, flexible and effective

We know how important it is to find value-for-money for your business. Solutions is an affordable policy that can help keep your employees healthy, which also helps keeps the costs of absenteeism down. Find out more about Solutions. Call us on 0800 158 5182 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.

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