Private Medical Insurance

For individuals and families

Introducing Healthier Solutions

Healthier Solutions is our individual private medical insurance (PMI) product designed with your clients in mind. With prompt access to eligible diagnostic tests and private medical treatment at a nationwide network of hospitals and clinics, it could help reduce waiting times and help them return to their normal routine sooner. 

Expert Select

We'll find the most suitable specialist and hospital for the customer's condition, giving them a range to choose from.

Enhanced cancer cover

We understand the importance of providing extensive cover and support at every stage of cancer treatment.

Wellbeing

Our range of wellbeing services can help your clients to make informed, balanced and positive lifestyle choices. 

Product details

Why Healthier Solutions?

Healthier Solutions is our modular PMI product for individual clients, helping them get prompt, private medical treatment through a nationwide network of UK hospitals. Among the benefits are:

  • Extensive cancer cover is standard on every policy
  • Flexible PMI, with options to help meet your clients’ needs and budgets
  • All levels of cover include some in-patient, day-patient and out-patient treatment costs
  • Selection of hospital options including Expert Select, our new, simple option which guides your client to the treatment they need in their local area
  • MyHealthCounts online wellbeing tool - rewarding clients for looking after and understanding their health
  • Access to Aviva Digital GP* - Get the support your clients need from an NHS-registered private GP via the app, with access to 5 video GP consultations per member over the age of 16, per policy year and repeat NHS prescriptions (NHS England exemptions accepted) with free delivery. Dependents under 16 can be added to adult member accounts. 
  • A No Claim Discount (NCD) of up to 75% and the option to include protected NCD which applies to each member, not just the policy
  • Each member can claim up to £250 per year, without affecting the NCD
*This is a non-contractual benefit that Aviva can change or withdraw at any time. Powered by Square Health.

Flexible, affordable PMI

Healthier Solutions has a wide range of options to choose from, so it’s easy for you to increase or decrease cover levels to create the PMI cover that helps to meet your clients’ budgets and needs.

Product benefits

There’s a lot to take on board about the cover available with Healthier Solutions. Our ‘Extra peace of mind’ sales aid can help you explain the modules to clients – but we’ve also broken down the information into 5 overview areas here:

Core cover

Options

Added value benefits included as standard

Networks

Explaining our hospital options

Why Aviva?

What makes our PMI different?

As one of the UK’s leading providers of PMI, we’ve developed cover that helps your clients get prompt access to treatment in quality facilities, as well as helping them to monitor and improve their daily health and fitness.

Depending on what's important to them, they can choose to increase or decrease their cover. Healthier Solutions is designed to be flexible to help meet your clients personal requirements. 

Why choose Healthier Solutions?

  • Fits around your clients’ needs

Not everyone wants the same levels of benefit or identical services. So clients can upgrade or reduce benefit levels according to preference and affordability.

  • Features that are really appreciated

Healthier Solutions does more than cater for illness and injury. It highlights health issues and incentivises improvements in health – from UK gym membership discounts to online programmes such as MyHealthCounts that can help reduce premiums at renewal.

  • Accessibility and choice

We work with specialists and hospital groups to create products that provide your clients with quality treatment, when they need it and where it’s convenient.

  • We deliver the service your clients are expecting

We treat our customers as individuals first, and count our numbers second. It’s why we place so much emphasis on in-house clinical expertise to support our claims teams and manage cases, one by one. 

  • We remove the stress from making a claim

If a client needs to claim, we help them focus on what’s important – making a recovery – rather than dealing with paperwork. That’s why we deal with most claims over the phone. Alternatively, they can make a claim on our MyAviva app - available to download from the App Store or Google Play.  Mobile data charges may apply.

  • We stay abreast of industry issues and evolve our products

We’re committed to making sure our cover and services are in line with the latest health developments and government legislation.

Claims

We’re here to help your clients when they need to make a claim. But it can be reassuring for them to understand how the process works when they’re considering taking out a policy.

Our approach to a very individual matter

If your clients need to claim, they become patients: people whose needs differ from case to case. We know they may not be feeling 100% when they call, and our claims teams will help them every step of the way. That need for individual attention is why we have a dedicated department looking after our PMI claims, with staff who have experience in the relevant fields and can familiarise themselves with the details of each claim they work on.

Specialist expertise and specialist claims support

Because some conditions are more complex than others, we have experienced advisers in dedicated condition-management teams. We also have specialist claims teams focusing on conditions such as oncology and mental health.

This means your clients will talk to experienced staff who can empathise and understand what they’re going through. And clinicians are on hand to give our staff detailed assistance, providing medical advice to make sure patients get the best possible treatment and support.

Helping your clients make a claim

The information to start a claim is in the policy documents, and all claims can be made online via our MyAviva app. However, clients may still want to contact you first for advice.

Making a claim with Expert Select

If your client has chosen Expert Select, there are four, simple steps they'll need to take whenever they make a claim. 

Step 1 - Customers ask their GP for an open referral, specifying the type of specialist they need to see without naming one.

Step 2 - We'll give the customer a choice of local medical facilities and consultants who meet our quality requirements.

Step 3 - We can immediately transfer the customer to the booking team at their chosen facility.

Step 4 - We'll settle all eligible bills in full with the approved provider so your client doesn't have to worry about any unexpected fees.

 

For all other hospital options

If your client has a hospital list on their policy, they'll need to follow a slightly different but equally straightforward process: 

Step 1 – see the GP

Clients should visit their GP if they're feeling unwell. If their GP wants them to see a medical professional then it is simpler for them to ask for an open referral. This simply states their condition and what type of specialist they need and we'll then help them find the most appropriate one for them.

It's really important that they get in touch with us before attending any appointments so we can make sure their claim is covered under the terms and conditions of the policy before they incur any costs.

 

Step 2 – call us

It helps us if your clients have some details to hand when they call, but we always do everything we can to help.

We'll ask for their personal details, including the policy number, a description of the symptoms and condition, what the GP has said, the name of their specialist and where they practice. If your clients are given an open referral, we'll just need to know the type of specialist they’re being referred to. And if we need more information from a GP, we'll do our best to make this happen quickly.

Call the claims team: 0800 068 5821

Monday to Friday 8am to 6.30pm, Saturday 9am to 1pm

Calls to and from Aviva may be monitored and/or recorded

 

Step 3 – update us with treatment details

If the specialist recommends hospital treatment, your client must tell us what treatment has been recommended and the procedure code (CCSD). We’ll then confirm whether the treatment is covered and let them know if they can get it through our networks, at a hospital covered under their hospital option or at another facility recognised by us.

 

Step 4 – relax, we’ll settle the invoices

We can settle most eligible bills directly with the hospital. Most specialists send their bills straight to us. If your clients do get a bill at home, they can forward it to us at:

Bill Payment Team,
Aviva Health UK,
Chilworth House,
Templars Way,
Eastleigh
SO53 3RY 

 

If they choose to use our MyAviva app, they will be able to take advantage of its great benefits:   

  • Start a new claim or update an existing one
  • Check policy information, including cover and benefit details
  • View their claims summary, update us on the next stages of their treatment and track the bills paid against their claim
  • Keep track of their excess and outpatient benefits (if applicable)
  • Live Chat directly to one of our claims team without having to pick up the phone

MyAviva is available to download from the App Store or Google Play. Terms and conditions apply and can be read in-app before signing up. Mobile data charges may apply. 

Wellbeing

These features are included at no extra charge with every Healthier Solutions policy. We think they’re appreciated by clients who want to lead healthier lives and have access to useful services that help maintain their wellbeing. They can help you demonstrate the value of having an Aviva PMI policy in place.

  • Access to the Aviva Digital GP app* - Gives your clients swift and convenient access to 5 GP video consultations, per member over the age of 16, per policy year, and the ability to order repeat NHS prescriptions in-app with free UK delivery (all NHS England exemptions accepted). Dependents under 16 can be added to adult member accounts. Please note, Aviva Digital GP is available to residents of Great Britain, Northern Ireland, the Channel Islands and the Isle of Man at home or abroad. The terms and conditions and the privacy policy for Aviva Digital GP can be viewed in-app before they sign up. Mobile data charges may apply. Aviva Digital GP is powered by Square Health.*
  • Stress Counselling helpline - Stress can develop when people feel they are having difficulty with the demands and expectations they face. This is where the Stress Counselling helpline can be useful. Members can talk in confidence to trained counsellors about issues that they feel are causing stress. The service is available to members aged 16 or over.
  • Get Active* - Gives your clients access to discounts at a range of health and fitness clubs, online workouts and a variety of other products and services that can enhance a healthy lifestyle. Terms and conditions and the privacy policy can be viewed online before signing up.
  • Cancer Care with Get Active* - Your clients can benefit from savings on products and services that can help make a small difference if they or someone close to them is living with cancer. Cancer Care with Get Active provides them with access to discounted products and services that can help with the daily living adjustments a cancer diagnosis and treatment can bring, as well as offers on services and experiences that may enhance quality time spent with family and close friends.
  • MyHealthCounts - An online health questionnaire and programme which can help your clients understand more about their health and the lifestyle choices that might affect it.
  • Mental health support articles* - We can support your clients with mental health guidance. Aviva can help manage and improve mental health by providing helpful information and articles. 
*These services are non-contractual benefits that can be changed or withdrawn by Aviva at any time.

MyHealthCounts

How MyHealthCounts works

What’s involved in the 12-week programme?

How to make a claim

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Transcript 

How do you make a health insurance claim?

When you’re unwell and need to make a claim on your health insurance, we’ll do all we can to get you the healthcare you need, as soon as we can.

Here’s how you make a claim in four simple steps – and a few things to keep in mind along the way.

1. Ask your GP for a referral

First of all, see your GP, or use our digital GP app, and they’ll refer you for any investigations or treatment you need. Be sure to tell them you have private health cover with us.

There are two types of GP referral:

An open referral is where your GP says what kind of treatment you need, but doesn’t name a particular specialist or hospital.

A named referral is where your GP gives the name of a specific specialist, at a particular hospital. Though you’re not bound by this, and we can offer you other options, if needed. 

It’s a good idea to ask for an open referral, so there’s more flexibility with where you’re treated. If you have Expert Select or Optimum Referral, you’ll need an open referral.

If your cover includes BacktoBetter or our Mental Health Pathway, you don’t need a GP referral to make a claim for musculoskeletal or mental health symptoms – just call us direct through MyAviva - your secure online account, or by phone.

Remember! Get in touch with us before you have tests or treatment, so you know they’re eligible for cover. That way, you won’t have any unexpected costs.

2. Start your claim and we’ll get things moving

The easiest way to start your claim is through MyAviva. When you log in simply select your policy or scheme and you’ll see the option to start your claim. Alternatively, you can also start a claim over the phone.

Whichever way you choose, we’ll ask you about your symptoms and explain the best next steps, in line with your cover. We’ll also guide you through the process and answer any questions you have.

Sometimes, we ask for more information to get a better picture of your condition. Otherwise, we aim to make a decision on your claim straight away, explain which tests and treatments we can pre-approve and connect you with the hospital or clinic to book your appointment there and then.

Where will you get your treatment?

You’ll either see a specialist at a hospital on your list, or, if you have Expert Select or Optimum Referral, at a choice of hospitals we’ll help guide you towards. If it’s available, you could get treatment at a facility that has expertise in treating specific conditions, like cataracts or knee pain. 

The nationwide hospitals we use are based on ratings from independent regulators, like the Care Quality Commission – with most rated outstanding or good. We’ll also only recommend specialists who meet the standards of their relevant professional governing bodies, like the General Medical Council. So you know you’ll get the high standard of care you’d expect.

3. If you’re referred for more treatment

Hopefully by now you’ll be starting to feel better. But if your specialist refers you for more treatment we haven’t already approved, let us know, so we can check it’s covered. In MyAviva you can submit your update or start a Live Chat to speak to someone in the claims team there and then. You can also call us, if you’d feel more comfortable talking over the phone, or email us with any questions you may have.

Remember! For some treatments and tests, we’ll ask you for a procedure code. So check with your specialist, and have it handy when you get in touch.

4. And finally, we’ll settle the bills

Once you’ve had the care you need, we’ll settle bills we’ve authorised directly with your provider – so you don’t have to worry.

We’ll let you know through MyAviva if you need to pay any part of a bill, like if you have an excess or benefit limit.  If any bills are sent your way, just send us a copy and we’ll do the rest.

Key messages

Here’s a quick recap of how to make a claim:

Ask your GP for an open referral – and get in touch with us before you have any tests or treatment. For BacktoBetter or Mental Health Pathway, just contact us direct.

Start your claim and book your appointment at an agreed hospital.

Let us know if you’re referred for more treatment – and check for a procedure code.

We’ll settle authorised bills direct, so you don’t have to worry.

And that’s it! Four easy steps, and a friendly claims team on hand for guidance and support each step of the way.

So you can focus on your treatment, and getting back to health.

Helping you sell

We've shared some of our ideas that can help you identify clients, overcome objections, and make it easier to recommend Healthier Solutions.

Target market statement

Finding the right clients

Overcoming objections

Helping your clients to talk about their health

Answering clients’ technical questions

We’re here to help you

Quote and apply

Call us on 0800 158 3348, or email us at hcquote@aviva.com

Our Aviva Sales Consultants are on hand to guide you through the process

You can also use our Healthier Solutions premium illustrator as a guide, before getting a more detailed quote.

Lines are open Monday to Friday, 9am to 5pm.

Calls to and from Aviva may be monitored and/or recorded.

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