Solutions, our private medical insurance for companies
Our private medical insurance can be adapted to your unique business needs. From flexible healthcare options to ongoing support, we're here to help your business and employees when it matters.
We'll find the most suitable specialist and hospital for your employee's condition, giving them a range to choose from.
Extensive cancer cover
We understand the importance of providing extensive cover and support at every stage of cancer treatment.
Mental Health Pathway
An end-to-end service based on clinical need, guided by clinical expertise, with a range of treatment options and no need for a GP referral.
Why choose us?
Solutions is our flexible PMI product for businesses. It gets members access to private medical treatment at a nationwide selection of hospitals and clinics, while its added value benefits can also help support your employees and your business.
Expert Select - our simple approach to accessing quality treatment
With Expert Select you don't need to decide which hospital list will best suit your employees. Instead when they make a claim we'll offer them a choice of on average between 4 and 5 quality assured medical facilities, including leading hospitals. What's more, as we recommend these facilities and specialists, there will be no extra charges or bills to pay, we'll settle it all directly.
We want to help you support your employees as they seek to live their best lives. That means encouraging them to consider their wellbeing in terms of everything they do - what they eat, how active they are, their mental health, how they sleep and how they save money.
5 Star rated by Defaqto
Defaqto is a leading financial information, ratings and fintech business that supports financial institutions, intermediaries and consumers to make smarter financial decisions.
Defaqto has given Solutions, Healthier Solutions and Optimum their highest rating, 5 Stars, meaning that these products have a comprehensive level of features and benefits and provide one of the highest quality offerings on the market.
What's covered with Solutions?
We offer an extensive range of cover to help your employees get back to feeling their best.
Your cover includes
- Acute conditions
Our Private Medical Insurance covers treatment for short-term illnesses or injuries that respond quickly to treatment and which leads to a full recovery.
- Extensive cancer cover
Extensive cover and support at every stage of cancer treatment.
As part of your core cover, you have full cover for in-patient and day-patient treatment at any hospital included under your hospital option. This includes all agreed treatment, the cost of drugs and nursing care. You’ll also be covered for diagnostic tests on referral from a specialist.
- Treatment for back, neck, muscle or joint pain (musculoskeletal conditions)
Solutions includes BacktoBetter, an independent musculoskeletal case management service for members, to help them get better and back to work quicker.
- Mental Health treatment
Solutions includes Mental Health Pathway providing your employees with quick access to quality talking therapy and counselling without needing a GP referral, simply call us and we will route them through to our clinical provider for assessment and treatment. Out-patient limits, if applicable, don't apply to Mental Health Pathway.
You're not covered for
This is a summary of some of the exclusions that apply to your policy, which may change depending on the options selected. Please see your terms and conditions for full details.
- Chronic conditions
We don't cover incurable or long- term illnesses or conditions, such as diabetes, epilepsy and asthma. But cancer treatment is covered as standard.
- Pre-existing conditions
We don't cover any previous health conditions your employees have prior to your cover starting, unless your underwriting allows it.
- Addictions and substance misuse
We don't cover treatment for addictions (such as alcohol addiction or drug addiction) or substance misuse (such as alcohol misuse or solvent abuse), or any related treatment.
- Pregnancy and childbirth
We don't cover treatment for pregnancy and childbirth but we do cover related conditions that can also be experienced outside of pregnancy and childbirth, and the specific complications listed in the terms and conditions.
- Cosmetic procedures
We will only cover cosmetic surgery that immediately follows an accident or treatment for cancer. See the policy document for full terms and details.
Adapt your cover
You can choose to increase your cover with additional benefits, which will increase your premium. Or, decrease your cover to suit your business needs and budget.
Increase your cover
Increase your cover with these options
- Dental and optical
Cover for routine dental treatment, treatment for accidental dental injuries and optical expenses, each up to a specific limit.
- Mental health upgrade
Cover for in-patient or day-patient mental health treatment through the Mental Health Pathway, up to a combined limit of either 28 or 45 days, if an employee is diagnosed with an acute mental health condition. This option cannot be selected if you select the £0 out-patient limit, or for members in Northern Ireland, the Channel Islands, Isle of Man or Isle of Wight.
- Routine and GP referred services
Includes consultations and diagnostic tests with a specialist for chronic conditions, GP referred radiology/pathology for non-musculoskeletal conditions and specified GP referred therapies for non-musculoskeletal conditions - up to 10 sessions, all benefits are subject to a combined limit of £1,000 for each member, every policy year.
- Hospital options
Expert Select, our guided hospital option is included as part of core cover. With Expert Select we will provide your employees with a choice of quality assured hospitals in their local area when they need to make a claim. If you would like your employees to be able to choose specific hospitals in their area to have treatment at, you can choose from one of our hospital lists. The Extended hospital list will give your employees an extensive number of hospitals to choose from.
Reduce your cover
Make your cover more affordable with these policy options
- Six week option
Reduce your premium by choosing to use the NHS for in-patient or day-patient treatment if it's available on the NHS within 6 weeks. Your employees will still be covered for private out-patient treatment, but private in-patient or day-patient treatment will only be covered if NHS treatment isn't available within 6 weeks.
- Policy excess
Reduce your premium by choosing a £50, £100, £150, £200, £250 or £500 member excess.
We apply the excess once, to each member, every policy year, regardless of the number of claims made during that policy year.
- Selected benefit reduction
This option removes benefit for:
* treatment for complications of pregnancy and childbirth
* investigations into the causes of infertility, and
* surgical procedures on the teeth performed in a hospital.
- Reduce your out-patient cover
Reduce your premium by limiting out-patient cover to £0, £1,000 or £1,500 for each member every policy year. Even if you choose one of these options, there will still be full cover for CT, MRI and PET scans, surgical procedures, radiotherapy and chemotherapy, physiotherapy for musculoskeletal conditions through BacktoBetter and pre-admission tests. Plus the limit doesn't apply to cancer treatment received after being diagnosed with cancer. If you select a £1,000 or £1,500 out-patient limit, there is also full cover for out-patient mental health treatment through the Mental Health Pathway. If you choose the £0 limit, Mental Health Pathway is removed from cover, meaning there is no cover for mental health conditions.
- Hospital options
To reduce your premium you can choose one of our reduced hospital lists. The Signature hospital list includes hospitals in Scotland and Northern Ireland only, or you can choose the Trust hospital list of NHS Trust and Partnership private hospital units (only available for policies with 1-99 members), if you live within the catchment area.
Cover that matters
With Solutions your employees have access to extensive cancer cover and direct access to both mental health and musculoskeletal treatment through our managed pathways and support for their wellbeing including our Digital GP service*.
*Aviva Digital GP is a non-contractual benefit that can be changed or withdrawn at any time.
We understand the importance of providing extensive cover and support at every stage of cancer treatment. We'll cover the cancer treatment and palliative care your employees need, as recommended by their specialist.
We also want to make sure that things are as comfortable as possible for your employees following their cancer treatment. So we'll provide extensive cover for their aftercare, including consultations with a dietitian, as well as money towards an external prostheses and a wig.
Mental Health Pathway
Our Mental Health Pathway provides your employees with access to quality talking therapy and counselling without needing a GP referral, simply call us and we will route them through to our clinical provider for assessment and treatment. Outpatient limits do not apply to Mental Health Pathway.
We offer a wide range of specialists, through our network of professionals including clinical psychologists, talking therapists, psychiatrists and counselors. Anyone over the age of 11, covered on the policy, can use the Mental Health Pathway.
Musculoskeletal conditions affecting the back, neck, muscles or joints can worsen over time. That's where our BacktoBetter service can help. Your employees will be referred to one of our third party clinical providers who will guide them down the right treatment pathway.
We'll pay for a physiotherapist (as recommended) when they need it. There's no need for a GP referral – your employees can simply call the customer service helpline to access BacktoBetter.
We’re dedicated to helping people live their best lives. That means encouraging them to consider their wellbeing in terms of everything they do – the way they work, what they eat, how active they are, their mental health, how they sleep and how they spend and save money. By promoting healthier habits and incremental shifts in attitudes and actions we help people make informed, balanced and positive lifestyle choices. Wellbeing services are non-contractual benefits Aviva could change or withdraw at any time.
Group scheme leavers
When an employee leaves your company and is no longer covered by your private health insurance scheme, don't forget that they may still be able to continue their cover on an individual policy.
We may be able to give them continued medical cover on one of our individual private health insurance plans, if they seek a quote for the new plan within 45 days of their leaving date, which they must accept within 30 days of receipt. Benefits, exclusions, terms and conditions on an individual plan may differ from those of the company scheme they were previously covered by, and the cost will depend on the product and options they choose.
Employees leaving your company can call us on 0800 158 2147 to find out more.
Lines are open Monday to Friday, 9am-6pm. For our joint protection, telephone calls may be recorded and/or monitored. Calls to 0800 numbers from UK landlines and mobiles are free. Our opening hours may be different depending on which team you need to speak to.
Which policy could group scheme leavers transfer to?
Healthier Solutions is our individual private health insurance which offers a range of tailored cover to suit their needs. The terms, benefits and exclusions may differ from the company scheme they were previously covered by. They can find out more on our private health insurance pages, or call us on the number above.
Get a quote
Need cover for 1 to 99 employees?
Use reference: SME-NAT Monday to Friday: 9:00am to 5:00pm
For our joint protection, telephone calls may be recorded and/or monitored. Our opening hours may be different depending on which team you need to speak to.
Need cover for 100 employees or more?
How to make a claim
It's quick and easy to make a claim
See your GP
Your employee should visit their GP if they're feeling unwell. If their GP wants them to see a medical professional, they should tell them they have private health insurance cover. It's simpler for your employee to ask for an open referral, so we can help find the best medical facility and consultant for them covered by your policy. If you choose our Expert Select hospital option your employees will always need to ask for an open referral.
If they have a mental health or musculoskeletal condition, there's no need for a GP referral.
Call our claims team
Once your employee has been given a referral by their GP, they need to call us to set up their claim.
They should call the claims team on:
Monday to Friday: 8.00am to 6.30pm
Saturday: 9.00am to 1.00pm
Calls may be monitored and recorded.
We'll settle quickly
We'll usually settle all eligible bills directly with the provider of treatment, usually the hospital or specialist.
How to make a claim
Transcript for video How do you make a health insurance claim?
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 contact 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.
Here’s a quick recap of how to make a claim:
1. 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.
2. Start your claim and book your appointment at an agreed hospital.
3. Let us know if you’re referred for more treatment – and check for a procedure code.
4. 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.
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