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Support and offers for individual members and customers

Questions about health insurance

What's the difference between Bupa Heartbeat and Bupa Cash Plan? Hide

Health insurance cover such as Bupa Heartbeat tends to focus on providing cover for conditions that are likely to require in-patient treatment and/or surgery at a hospital of choice. The purpose of Bupa Cash Plan is to provide help with the cost of everyday health care treatments and services, such as dental and optical fees, which aren’t generally covered under traditional health insurance policies.

I already have a Bupa Cash Plan. Is it worth me having Bupa Heartbeat health cover too? Hide

Yes. Bupa Heartbeat could complement your existing health cover plan because it provides cover for a wide range of eligible hospital treatments that might not be covered under your Bupa Cash Plan.

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General questions about Bupa Heartbeat health insurance

How do I decide which level of cover is suitable for me? Hide

As a starting point, think about your lifestyle and the conditions or illnesses which concern you the most. If you’d like to speak to a Bupa Health Adviser about health insurance, call 0800 600 500. It’s hassle-free and we should only take a few minutes to talk you through some suitable options.

If you are unsure about how to choose the right health insurance for you, the Association of British Insurers (ABI) has produced a guide to buying private health insurance.
 

Download the ABI guide “Are you buying private medical insurance?”

How much will it cost? Hide

Your subscription will reflect the level of cover you have chosen for you and, if applicable, your family. You can choose to reduce the cost of your health insurance cover by selecting a higher excess, and you can even opt for a fixed price option. See How does an excess work?

Will I need to have a medical? Hide

No. However, we will need to ask some questions about:

• your age, sex and medical history
• whether you smoke
• your current state of health
• your occupation

Is my cover renewed every year? Hide

We’ll write to you at least 28 days before your renewal date, and your annual cover will automatically be renewed unless you decide to end your cover.

Will my subscription increase if I make a claim? Hide

Your individual subscription costs aren’t influenced by the number of claims you make, but if you claim you will get a larger increase than a non-claimer.

Will my subscriptions increase next year? Hide

Subscription costs are primarily based on, and governed by the number of and cost of treatments Bupa pays for its insured members and medical treatment costs, which are rising all the time. For this reason, we hope you understand why subscription charges may need to increase from time to time. Should your subscription cost need to increase, we’ll provide 28 days’ written notice before any change takes place.

How does an excess work? Hide

Including an excess on your policy can help you to reduce the cost of your subscriptions. It means you have to pay for part of your eligible treatment costs, up to the amount of excess you have chosen – usually £100, £150, £200, £250, £500, £1,000 or £2,000. The excess starts at the beginning of each new membership year, even if treatment is ongoing. For each person that has excess under your policy, their excess amount will apply to them each membership year.

Do you provide cover for pre-existing conditions? Hide

If you’ve never had health insurance, we’ll need to base our decision on your past seven years’ medical history. So, if you have symptoms which you know could cause problems in the future, you’ll need to tell us straightaway. If you’re transferring an existing health insurance policy to Bupa, we’ll consider continuing your existing exclusions or treatment based on your claims history with your current insurer and the rules and benefits of your chosen Bupa scheme.

Can I add other members of my family to my membership? Hide

You can apply to add your partner and/or your children (including newborn children/adopted children) as dependants on your membership at any time. Give one of our Health Advisers a call so that they can update your policy.

How do I take out Bupa health insurance? Hide

Just call one of our Health Advisers on 0800 600 500. So that we can provide an accurate quote, please have the following information to hand for both yourself and any family members you’d like to include under the policy:

• personal details (date of birth, height, weight)
• medical history

Quotes are valid for 14 days.

When do I pay my subscription? Hide

You can pay your annual subscription in one go by debit or credit card or by monthly direct debit. Payment is due on the date the cover is to begin and, if paying by direct debit, each month after that.

What happens if I change my mind? Hide

You can change your mind within 21 days of the day your policy starts or, if later, the day when you receive your membership guide and your membership certificate. As long as you haven’t made any claims we’ll refund all your subscriptions.

After this time, if you decide for any reason that you don’t want your Bupa Heartbeat policy, we’ll refund any subscriptions you’ve paid which relate to a period after your cover ends.

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Questions about making a claim

How can I be sure what I'm covered for? Hide

Your membership guide and membership certificate will tell you everything you need to know about your cover. As soon as you receive this information you should read it and then put it in a safe place. If you need to make a claim and you’re not sure whether your treatment is covered, just call one of our advisers on 0845 60 68 000 and they’ll be able to confirm if your proposed treatment is covered by the benefits available to you.

What if my GP refers me to a non-recognised Bupa consultant? Hide

The vast majority of consultants are either Bupa partnership consultants or Bupa recognised consultants. You will not be covered if you see a non-recognised Bupa consultant. Please also be aware that there are still some consultants who charge fees in excess of your scheme benefit limits, and while they may be Bupa recognised to carry out the treatment, their fees will only be reimbursed up to your scheme benefit limit. Partnership consultants do charge within the benefit limits. To be sure your treatment will be covered in full, please contact us and the Member Services Adviser will check whether your consultant will be paid in full.

How do I make a claim? Hide

Don’t worry, making a claim is very straightforward. There are some steps to follow but they’re there to quickly get you the treatment you need. Here’s a step-by-step guide to what will happen should you need to make a claim.

Step 1 – See your GP and if he/she refers you for a consultation or treatment, explain you are a Bupa member.

• If you need to see a consultant ask your GP to refer you to a Bupa recognised consultant who charges within Bupa benefit limits and who has admitting rights to a Bupa Heartbeat hospital (please call the helpline if you’re unsure what your benefits are or need some help understanding what we mean by a Bupa Heartbeat hospital).
• If you need to see a therapist or complementary medicine practitioner ask your GP to refer you to a Bupa recognised practitioner. Your membership guide explains why this is important but you could also call the helpline for a quick explanation.

Step 2 – Call the Bupa helpline on 0845 60 68 000 and we will confirm whether:

• your consultant, therapist or complementary medicine practitioner is recognised by Bupa
• your proposed treatment is covered by the benefits available to you
• you need to complete a claim form

Please remember to have your membership number handy when you call. Lines are open 8am to 8pm Monday to Friday and 8am to 6pm Saturday. Calls may be recorded and monitored.

You could also call the Bupa 24 hour nurses’ Healthline prior to you seeing your consultant. Our fully qualified nurses will be happy to talk to you about your condition to help you get the most out of your consultation.

Step 3 – When you see the consultant, therapist or complementary medicine practitioner:

• show them your membership certificate and your special condition supplement if you have one.

Step 4 – If your consultant recommends out-patient diagnostic tests or treatment:

 

• call the helpline and we will confirm whether the tests and/or treatment are covered under your membership and the benefits available to you

    - If your consultant recommends day-patient or in-patient treatment:

• call the helpline and we will confirm whether your treatment is covered, what benefits are available to you and help you choose a Bupa Heartbeat hospital in your area

Step 5 – When you go into hospital:

• take your membership certificate and if you have one, a special condition supplement with you.

Step 6 – When you leave hospital:

• settle any personal expenses such as newspapers, phone calls or guest meals
• we will settle the medical and hospital bills covered under your membership

Step 7 – If your consultant recommends home nursing or out-patient treatment after your hospital stay:

• Call the helpline and we will confirm your cover and the benefits available to you
• Calls may be recorded and monitored.

What if I'm not covered, and need to go back to NHS care? Hide

You should still be able to discuss the option of NHS treatment with your GP. If you do not wish to go to the NHS for treatment, then you will have the option to pay for private treatment.

What's not covered? Hide

Bupa Heartbeat doesn’t routinely cover the following conditions and treatments. Full details can be found in the membership guides.

• Ageing, menopause and puberty
• AIDS / HIV‡
• Allergies or allergic disorders
• Birth control, conception, sexual problems and sex changes‡
• Chronic conditions‡
• Complications from excluded or restricted conditions / treatment
• Convalescence, rehabilitation and general nursing care‡
• Cosmetic, reconstructive or weight loss treatment‡
• Deafness
• Dental / oral treatment (such as fillings, gum disease, jaw shrinkage etc)‡
• Dialysis‡
• Drugs and dressings for out-patient or take-home use‡
• Experimental drugs and treatment‡
• Eyesight‡
• HRT and bone densitometry‡
• Learning difficulties, behavioural and developmental problems
• Overseas treatment and repatriation
• Physical aids and devices‡
• Pre-existing or special conditions
• Pregnancy and childbirth‡
• Screening and preventative treatment
• Sleep problems and disorders
• Speech disorders‡
• Temporary relief of symptoms‡
• Unrecognised providers or facilities

Am I covered for cancer treatment? Hide

Yes, we give members cover and support at every stage of their eligible cancer condition. We offer the most extensive support of any UK insurance provider, where each person covered by your policy has access to specialist oncology nurses, treatment at our unique network of specialist cancer centres, new cancer drugs and the option of treatment in the comfort of their own home.

Am I covered for NHS and private hospital stays? Hide

We’ll provide cover for eligible treatment regardless of whether you choose to stay in an NHS or private hospital.

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