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In-patient and day-patient treatment

Included as part of your Core Cover.

If you need treatment, you’ll get all the following benefits:

 

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In-patient and day-patient treatment

Hospital fees - Full cover

  • Includes overnight stays, nursing and any drugs you might need while in hospital. We also cover the costs of intensive care treatment and operating theatre charges.

Consultants’ fees - Full cover

  • As long as your consultant is registered with an accredited body and recognised by us, we pay your in-patient and day-patient consultant fees in full, including your surgeons’ and anaesthetists’ fees, physicians’ fees and other consultant appointments.

Diagnostic tests - Full cover

  • If you’re admitted to hospital as an in-patient or a day-patient, we pay for the diagnostic tests you need – things like blood tests and x-rays. We also pay for any MRI, CT and PET scans if required.

 

Out-patient treatment

Out-patient surgical procedures - Full cover

  • We pay for surgical procedures covered by your plan where you’re treated as an out-patient.

 

Other benefits

NHS Hospital Cash Benefit If you choose to be treated on the NHS, rather than privately through your plan, we give you a cash amount. £250 per night (up to a maximum of £2,000) for in-patient treatment and £125 per day (up to a maximum of £500) for day-patient treatment.
Home Nursing To help you get back on your feet after a stay in hospital. If your consultant recommends home nursing instead of more in-patient treatment, we pay for it. Full cover
Private ambulance The use of a private ambulance for transfer between hospitals, whether NHS or private, if a consultant says it’s medically necessary. Full cover
Mental Health Cognitive Behavioural Therapy (CBT) or counselling, undertaken as an out-patient and arranged through our Mental Health Panel. Up to 8 sessions per plan year
Oral Surgery The surgical removal of impacted or partially erupted teeth, complicated roots, surgical drainage of a facial swelling, removal of jaw cysts and apicectomy. If you have an accident, we can also cover some kinds of dental surgery. Full cover in specified circumstances
 Rehabilitation  Rehabilitation treatment following a stroke or serious brain injury.  Up to 21 days
Pregnancy Complications We cover in-patient and day-patient treatment if you suffer from ectopic pregnancy, miscarriage, missed abortion, stillbirth, post-partum haemorrhage, retained placental membrane and hydatidiform mole. Full cover for specified procedures
Parent Accommodation If you have a child under 14 on your plan and they need to stay overnight in hospital, we pay for hospital accommodation so that a parent can stay with them. Full cover
Childbirth Cash Benefit As long as you’ve had your plan for 10 months, we’ll give you a cash payment following the birth or adoption of a child. We pay once per child, even if both parents are covered by the plan. The 10-month waiting period doesn’t apply to adoption. £100 per child
Weight loss surgery If you have a BMI of 35 or greater (with co-morbidity) or BMI 40+ (with no co-morbidity), we cover gastric banding and a gastric bypass subject to clinical approval. You’ll need to pay a 25% contribution to the cost of consultations and package of treatment.
Corrective Surgeries Procedures covered Eligibility criteria You’ll need to pay a 25% contribution to the cost of consultations and package of treatment, and have been on cover with us for a minimum of one year.
Removal of port wine birthmarks on the face  Age under 5 years - maximum of 10 treatments
Ear reshaping (pinnaplasty) Age 5-14 years
Breast reduction BMI less than 27 and under 21 years of age
Gynaecomastia BMI less than 27 and under 21 years of age

Our Full Cover Promise

Unlike some other health insurance plans, that can leave you out of pocket when you claim, when we say ‘Full Cover’, that’s just what we mean. So, if we say ‘Full Cover’, we promise to pay all consultants and anaesthetists fees for in-patient and day-patient treatment, as long as the treatment is eligible on your plan and the consultant is recognised by us. And if it’s not in your plan – or it’s not covered in full by your plan – we’ll tell you upfront. That’s a promise, too.

Important information

All benefits are per insured member, per plan year, unless stated otherwise and subject to further terms and conditions. You must be treated at a hospital eligible under your plan.

Frequently asked questions

Here are a few of the questions we’ve answered for our members

What's the difference between in-patient, day-patient and out-patient treatment?

In-patient treatment and day-patient treatment are when you need to stay in hospital and occupy a bed either for a day or overnight.
Out-patient treatment is when you don’t need to occupy a hospital bed for the day, but go to hospital for a few hours for a consultation, test or minor procedure.
Although Core Cover includes all eligible in-patient and day-patient procedures, as well as out-patient surgical procedures, you can also get extra out-patient cover by adding other Cover Options to your plan.

Is there anything not covered by in-patient and day-patient treatment?

We won’t cover any personal spending such as travel expenses, newspapers, phone calls or extra meals. We also won’t cover medical aids or appliances such as neck collars, splints and foot supports; mobility aids such as wheelchairs and crutches, glasses, contact lenses, hearing aids or cochlear implants; the provision or fitting of any external prosthesis; or any drugs and dressings that you take home. The same exclusions apply to out-patient surgical procedures.

Can I choose where I'm treated?

Our expert medical partners Alliance Surgical - an independent doctor owned organisation - will choose the best consultant for you, based entirely on your medical needs. However if you want to be treated at a particular hospital, you can also select a hospital list to add to your plan. Whichever hospital list you choose, you should only go to a hospital on that list. If you use a hospital that’s not on your list, you’ll need to pay 40% of treatment costs, excluding consultant fees. To avoid this, pick another hospital on your list.

How does my consultant get chosen?

When you need a referral, we leave our expert medical partners Alliance Surgical - an independent doctor owned organisation - to choose the best consultant for you, based entirely on your medical needs. If you've selected a hospital list on your plan, you can also get a referral from your NHS GP and see the consultant they recommend, as long as they are recognised by us and practice at a hospital on your chosen hospital list. If your GP doesn’t refer you to a named consultant, let us know and we’ll help find one for you from our Consultant Panel.

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