What can this policy cover?
Healthier Solutions is private health insurance that can help you get prompt, private medical treatment - so that you can concentrate on recovering and getting back to work. Core cover includes benefits to help pay for treatment, accommodation, meals, nursing care and drugs at the hospitals on our Key hospital list (PDF 2.03MB). Our friendly experts are happy to answer any questions you have about our health insurance and run through what you may or may not be able to claim for, depending on your medical history.
- Treatment and care included in Healthier Solutions core cover
The following benefits are covered as part of our core cover. You 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 private hospital on your list
- Specialists' fees - up to the limits in our specialist fee schedule
- Diagnostic tests - including X-rays, scans and ECGs
- Pre-admission tests carried out at hospital before your admission to check that you are fit to undergo surgery and anaesthesia
- Radiotherapy / chemotherapy treatment
- Extensive cancer cover supported by our cancer pledge
- NHS cash benefit - you're paid up to £100 for every night you spend having treatment in an NHS hospital, for a maximum of 30 nights per person per policy year
- Accommodation for one parent staying with a child of 15 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, although you have to have had the policy for 10 months
- £100 for each baby born to or adopted by a member, although you have to have had the policy for 10 months
- 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
- Specialist referred physiotherapy, osteopathy and chiropractic treatment
- Hospice donations of up to £70 for each day you are a resident, up to a maximum of 10 days
- A private ambulance for transportation to hospital for eligible treatment as a day-patient or in-patient (if medically necessary)
- Out-patient treatment of acute conditions, although specialist fees are subject to the limits in our specialist fee schedule
- Out-patient psychiatric treatment
- GP referred treatment by a speech therapist for children
- Options you can add to Healthier Solutions core cover
You may want to add these options to your core cover. They will increase your cover but also increase your premium.
- Complementary therapies referred by your GP. 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 £100 per procedure.
- 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 £300, accidental dental injury up to £600 and routine optical expenses up to £200. We apply a separate £50 excess to both the optical benefit and routine dental treatment, per person per policy year.
- Psychiatric treatment. Choosing this option means that you could claim for both in-patient and day-patient treatment if diagnosed with a psychiatric condition such as schizophrenia or clinical depression. Accommodation and nursing would be covered in full up to 28 days, and associated specialists' fees of up to £210 per week.
- Protected no claim discount. We think it's a good idea to be rewarded for not making a claim by receiving a discount when it's time to renew your policy. But by protecting your no claim discount, we won't penalise you even if you do make a claim. Full details of how our no claim discount works, and how you can protect it, are in our Healthier Solutions brochure (PDF 1,873KB), or you can read more in our general FAQs.
- Extended hospital list. If treatment in the Greater London area would be convenient for you, it's possible to upgrade your hospital list to include an additional range of hospitals and clinics.
- Options you could choose to reduce your costs
Choosing these options won't reduce the quality of fast, private care you'll receive with our core cover but it will reduce the benefit levels and also reduce your premium.
- Reduced out-patient cover. This option makes two significant changes to the out-patient cover usually included. We would still cover all the costs of any cancer treatment after you've been diagnosed, such as radiotherapy or chemotherapy. We would also cover in full the costs for CT, MRI and PET scans, but we'd remove cover for surgical procedures on teeth, emergency overseas cover and complications of pregnancy and childbirth.
You would also choose either a £0, £500 or £1,000 limit on costs per person per policy year for specialist consultations, diagnostic tests, specialist referred treatment by a physiotherapist, chiropractor or osteopath, and any psychiatric treatment as an out-patient.
- Policy excess. If you choose to apply an excess, it means that you will pay the agreed amount towards the cost of your claims. You can choose from £100, £200, £500, £1,000, £3,000 or £5,000, and the excess applies once per person, per policy year.
- Six week option. Choosing this option means that you won't be able to claim for in-patient or day-patient treatment, or NHS cash benefit, if the NHS can treat you within six weeks.
- Reduced hospital lists. 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 hospital list. However, you need to live within 30 miles of a hospital on the Trust list to choose the option.
What's not included in Healthier Solutions?
Like most private health insurance policies, Healthier 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. There are also some specific treatments and conditions that aren't covered:
- Healthier Solutions won't provide cover for
- Treatment undertaken by a specialist without your GP's referral
- Long term or chronic conditions (we do not apply this chronic condition exclusion to treatment for cancer)
- HIV/AIDS and related conditions
- Treatment for pregnancy or childbirth (although some complications may be covered if the mother has been on the policy for at least 10 months)
- Diagnostic tests and treatment for infertility
- Surgical or medical appliances such as neurostimulators (i.e. cochlear implants) and crutches
- Charges made by a GP, medical practitioner or specialist for completing a claim form
- Alcoholism, alcohol abuse, drug abuse, solvent abuse and other addictive conditions
- 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
- Sexual dysfunction
- Sleep disorders and sleep problems such as snoring or sleep apnoea
- Treatment for warts or verrucas
- Weight loss surgery
- Varicose veins of the leg unless they meet the criteria detailed in the terms and conditions booklet
Tell us how Healthier Solutions would fit you best
You can phone us direct on 0800 42 42 42, with reference SEL WEB.
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 a 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.