We're always happy to answer questions you may have about your health insurance. Here's a selection of questions and answers that we've already helped our customers with.
Underwriting for health insurance is the process by which an insurer decides on what terms it will accept a person for cover based on the information they supply. If you get a Bupa By You health insurance quote online we use a method of underwriting called full medical underwriting. If you prefer, you can call us and have the option to choose Full medical underwriting or moratorium underwriting.
If you select full medical underwriting, we’ll consider your medical history. This won’t affect the cost of your policy, but we may not be able to cover you for conditions you already have. We’ll review your medical history and decide if we need to place any medical exclusions on your plan. New medical conditions arising after the start of your policy will be covered immediately subject to the policy terms and conditions.
If you select Moratorium underwriting you don’t need to provide your full medical history and accept that pre-existing conditions will not be covered unless you meet the moratorium criteria when you come to claim.
If you’re enrolling online you’ll need to complete our medical history form once you’ve purchased cover. The medical history form will ask you for any medical conditions or symptoms you or your dependants have had in the last seven years. We may write to your GP for more information – with your permission of course.
If you choose to call and buy, your medical history will be taken over the phone so you’ll need to be prepared to answer our questions. We may be able to let you know of any specific exclusions when you buy. If you can’t complete your medical history over the phone, we’ll send you the medical history form to complete and return to us.
Until you’ve completed your medical history form and returned it to us a broad exclusion will apply to your cover, and we won't be able to confirm exactly what your policy covers for you, meaning your claims might take longer to process and we might not be able to pay for treatment you need.
Every customer’s application for Bupa By You is fully considered on a case-by-case basis and may result in you being offered cover without any additional exclusions or with specific exclusions for a pre-existing condition. It’s very rare for an application to be declined completely but it can happen.
Moratorium underwriting is currently only available over the phone.
When you make a claim we’ll ask you questions about your (or your dependant’s) health and medical history. We may ask for a medical report (which we do not pay for).
If you or your dependant has any moratorium condition, that will not be covered.
A moratorium condition is any disease, illness or injury or related condition, whether diagnosed or not, which you or your dependant:
- received medication for
- asked for or received, medical advice or treatment for
- experienced symptoms of, or
- were to the best of your knowledge aware existed
in the five years before your start date stated in your membership certificate.
By a ‘related condition’ we mean any symptom, disease, illness or injury which reasonable medical opinion considers to be associated with another symptom, disease, illness or injury.
We’ll pay for treatment of a moratorium condition if after the relevant start date you or your dependant do not:
- receive any medication for
- ask for or receive any medical advice or treatment for, or
- experience symptoms of,
the condition for a continuous period of two years while you are covered under this policy.
You can call us to check that any proposed treatment is covered before you arrange it.
We won't cover you for any illnesses you're currently suffering from or have had before. These are known as pre-existing conditions.
A pre-existing condition is any disease, illness or injury for which in a period of time before your start date†:
- You've received medication, advice or treatment; or
- You've experienced symptoms
whether the condition was diagnosed or not.
†The time period is different depending on your choice of underwriting.
How do I tell you what my pre-existing conditions are? How do I tell you what my pre-existing conditions are?
When you buy health insurance online we’ll send you a medical history form to complete. If you prefer, you can download it and post it back to us. Medical conditions, and related conditions, that arose before the start of the policy won’t be covered so if you would like information on what you’ll be covered for before you buy, please call us on 0800 231 6173 ^.
If you choose to call and buy, your medical history will be taken over the phone so you’ll need to be prepared to answer our questions.
We’ll show any additional exclusions as special conditions on the membership certificate you receive from us when we have processed your medical history form. (The same process will also apply for any members of your family included in your application.) Until you complete the medical history form, we won't be able to confirm exactly what your policy covers you for, meaning your claims might take longer for us to process and we might not be able to pay for treatment you need.
You can ask us at renewal to re-assess any pre-existing condition to see if we can cover it in the future.
^ We may record or monitor our calls.
If you enrol online we’ll send you a medical history form to complete in your welcome pack. If you prefer, you can download it and post it back to us.
Our health insurance doesn’t cover chronic conditions.
A chronic condition is a disease, illness or injury which has at least one of the following characteristics:
- It needs ongoing or long-term monitoring through consultations, examinations, check-ups and/or tests.
- It needs ongoing or long-term control or relief of symptoms.
- It requires your rehabilitation or for you to be specially trained to cope with it.
- It continues indefinitely.
- It has no known cure.
- It comes back or is likely to come back.
If any of the following statements are incorrect in relation to you (and your dependants), you must inform us immediately as it may affect the cover we are able to provide for you.
Living in the UK - You (and your dependants) have been resident in the UK for more than six months and you all reside at the address provided.
Registration with a UK GP - You (and your dependants) have been registered with a UK GP for more than six months.
Smoking status - If you’ve selected that you (or your dependants) do not smoke, this means that you or they have not smoked or chewed any tobacco products in the last two years.
Professional sports people - You (and your dependants) are not a professional sportsperson, or a semi-professional sports person who follows a sports occupation as your secondary means of livelihood.
Will my membership have a no claims discount applied to it? Will my membership have a no claims discount applied to it?
Yes, we calculate the cost of your Bupa By You policy, applying a no claims discount.
When we calculate your subscriptions each year we apply a no claims discount based on the value of claims (if any) we have approved for payment during the calculation period. We do not count any excess you are responsible for paying. Claims are considered for the main member and each dependant separately. (Please note: it may take several weeks from the date of your treatment for a claim to be approved for payment, depending on how quickly invoices are submitted to us).
The calculation period is the first 10 months of your first year and, for subsequent years, the first 10 months of the year just ending, plus months 11 and 12 of the previous year.
Which Bupa By You health insurance options include Cancer Cover? Which Bupa By You health insurance options include Cancer Cover?
With Bupa By You, full cancer cover comes as standard with Comprehensive 500, Comprehensive 750, Comprehensive 1000 and Comprehensive.
If you would like to reduce your costs, you can either:
- select our Treatment and care option, which means your cancer, as well as all other conditions will be diagnosed through the NHS, and any subsequent eligible treatment you need will be covered by Bupa.
- select our NHS Cancer Cover Plus option instead of Bupa Cancer Cover, which means you will be treated by the NHS if you develop cancer. However, if you need chemotherapy, radiotherapy or a surgical operation that is not available on your NHS, we will step in to cover these treatments for you.
If you’d like to remove cancer cover completely, please call us as this option isn't available online.
When we say full cancer cover it means you have no limit to how much you can claim for eligible treatment provided that you use a Bupa recognised consultant we have already agreed our fees with, within your chosen Bupa hospital network.
Which cancer drugs and treatments are funded by my Bupa cover? Which cancer drugs and treatments are funded by my Bupa cover?
Bupa membership gives you access to proven eligible cancer drugs and treatments, and the latest advances in medical technology, when there is good-quality clinical evidence to support it. If a specialist recommends a new drug for your cancer, we’ll pay for it as long as it’s licensed by the European Medicines Agency for your condition and included on our list of advanced therapies and specialist drugs, we’ll pay for it.
What about experimental cancer drugs and treatments? What about experimental cancer drugs and treatments?
We’ll always evaluate requests to fund new or experimental treatment. Bupa’s own clinical appraisal process takes an average of just 48 hours.
Do you provide cover for cancer drugs that haven’t yet been approved by NICE? Do you provide cover for cancer drugs that haven’t yet been approved by NICE?
As long as there is sound clinical evidence to prove benefit, we’ll fund it.
What if my cancer spreads once my treatment has started? What if my cancer spreads once my treatment has started?
While some insurers only provide treatment for the primary cancer (the cancer you are initially diagnosed with), Bupa will cover you even if your cancer spreads.
If you select full cancer cover, we’ll provide cover and support at every stage of your cancer, including palliative treatment, even if your cancer is incurable. If you select NHS Cancer Cover Plus, the NHS will provide palliative treatment but if your radiotherapy, chemotherapy or surgical operation recommended by your oncologist is not available on your NHS, we’ll cover your palliative treatment.
My family has a history of cancer. Will this affect the price of my Bupa cover? My family has a history of cancer. Will this affect the price of my Bupa cover?
No - Bupa doesn’t take family history of cancer into account when deciding whether or not to offer cover to a new customer and the price will not be any different to that of someone with no family history of cancer.
Bupa does not pay for unproven treatments. The only exception is when the treatment is part of a clinical trial, the protocols of which have been reviewed and approved by us. If you select NHS Cancer Cover Plus, we won’t cover treatments that are available to you on the NHS.
Does Bupa provide any specialist support for cancer patients? Does Bupa provide any specialist support for cancer patients?
Our support team is able to give members and their carers or family, advice related to their specific situation and to discuss options for being treated at home (where your consultant feels this is clinically appropriate). Our informed decision making service helps members understand the options available to them and the information they need to be able to make informed decisions about their own care.
Will Bupa pay medical investigation and treatment including initial diagnosis Will Bupa pay medical investigation and treatment including initial diagnosis
If you’re treated by a Bupa fee assured consultant in a Bupa recognised facility that is within your chosen Bupa network, we’ll fund all of your eligible diagnostic tests and investigations and all eligible treatment for cancer provided you have selected our full cancer cover. If you select Treatment and Care, initial diagnosis will not be covered even if you select the full cancer cover option.
Can I choose to be treated at my local NHS hospital? Can I choose to be treated at my local NHS hospital?
If you have full cancer cover and you opt to receive your cancer treatment in an NHS hospital and the treatment is funded by the NHS, Bupa can offer an NHS cash benefit which allows members to claim £100 for every day/night or session† for eligible cancer treatment.
† For each day you receive treatment for IV-chemotherapy and for each three-weekly interval of oral chemotherapy.
Yes – if you have full cancer cover or you have NHS Cancer Cover Plus and treatment isn’t available on the NHS, Bupa gives you the option to receive your chemotherapy at home safely (where your consultant feels this is clinically appropriate) from a specialist nurse. Treatment at home means there is as little disruption to your life as possible. If you have NHS Cancer Cover Plus and treatment is available on the NHS, we won’t pay for you to have this at home. We’ll only pay if it is unavailable on the NHS.
Payments are usually made directly by Bupa when you use our fee assured consultants and your chosen Bupa hospital network. So there’s no need to pay any costs yourself (except where an excess payment is applicable).
Our online cancer health hub contains information which has been developed to provide our members and their friends and families with helpful information about how and why cancer develops and details of the range of cancer treatments available.
Once you’ve chosen your Bupa By You product, you have a few ways to reduce your monthly premium if you reduce your level of cover. You can choose to select NHS Cancer Cover Plus which provides reduced cover compared to our full cancer cover. There are also different excess levels and Bupa hospital network access options that you can choose from. Depending on which ones you select you may be able to lower your monthly premium.
- Having an excess means that you have to pay part of any eligible treatment costs that would otherwise be paid by us up to the amount of your excess. By eligible treatment costs we mean costs that would have been payable under your benefits if you had not had an excess.
- An excess for Bupa By You applies per person per policy year. So, your excess could apply twice to a single course of treatment if your treatment begins in one policy year and continues into the next policy year.
- We will write to the main policy holder to tell them who you should pay the excess to, for example, your consultant, therapist or recognised facility. The excess must be paid directly to them - not to Bupa.
We will also write to tell the main policy holder the amount of the excess that remains (if any). You should always make a claim for eligible treatment costs even if we will not pay the claim because of your excess. Otherwise the amount will not be counted towards your excess and you may lose out should you need to claim again.
Unless we say otherwise in your membership certificate:
- We apply the excess to your claims in the order in which we process those claims.
- When you pay your excess towards treatment where there is a benefit limit, the amount you pay won’t reduce the benefit amount available.
- The excess doesn’t apply to NHS cash benefit.
Most of us feel better if we’re treated in a hospital as close to home as possible or in a hospital recognised for its expertise in treating certain conditions. We give you a choice of up to three hospital networks, to help meet your needs and manage your budget. Some postcodes may be excluded from the Essential Access Network.
You have a choice of up to three hospital networks across the UK, depending on where you live:
Essential Access: Excludes Central London. This is the lowest cost option where you’ll gain access to a national hospital network, including a selection of private hospitals and clinics in your area.
Treatment is covered in hospitals outside of central London.
Extended Choice: This option offers more choice than Essential Access as you'll gain a longer list of hospitals and clinics available to you. Extended Choice also includes a limited selection of hospitals and clinics in central London.
Extended Choice with Central London: You can benefit from all the advantages of Extended Choice, plus a much larger selection hospitals and clinics in central London, with this option.
The hospital network you choose is a list of hospitals across the UK which you can use. Each network includes a different level of access to hospitals nationwide.
- All hospital networks will provide access to all types of possible tests, scans, treatment and aftercare.
- Some networks don’t have hospitals in some areas, please check the hospital availability in your area and that you’re happy with the distance you’ll have to travel to the hospital in your selected network. The hospital network lists can change from time to time.
- If you go for your treatment at a hospital that is within the network of facilities you have chosen as part of your cover your hospital charges will be covered in full†.
- If you go to a Bupa recognised hospital that‘s outside of your chosen network you’ll have to pay a proportion of your treatment costs. It is therefore important that you choose your network carefully.
- All of the local and national hospitals available in the Essential Access network are available in the other two networks, it’s just that Extended Choice and Extended Choice with Central London include more choices for you. Some of the networks may not have hospitals included in some geographical areas. You should check availability in your area. Hospitals and facilities included in the networks can change from time to time.
- All of our networks include treatment given by specific Bupa approved consultants specialising in the procedure.
†For eligible treatment on your core health insurance when you use a facility from your chosen Bupa network and a Bupa recognised consultant who agrees to charge within Bupa limits (a fee assured consultant)
Can I add other members of my family to my membership? Can I add other members of my family to my membership?
Yes, you can add your partner and/or your children (including newborn or adopted children) as dependants on your policy. Families save 10%* when adding a child to their policy and couples save 5%** when adding their partner to their policy.
*Terms and conditions apply. 10% saving applies to family cover which includes one adult or more and one or more children. The savings apply to family cover with children on their policy compared to the price of individual cover for each family member. All children covered must live at the same address as the main member. Savings only apply to Bupa By You core insurance. We reserve the right to amend or withdraw our family rate at renewal.
**Terms and conditions apply. A couple pay 5% less compared to the combined single premium price. The partner covered must live at the same address as the main member. Savings only apply to Bupa By You core insurance. We reserve the right to amend or withdraw our couples rate at renewal.
If you already have Bupa health insurance you can update your policy to add a partner and/or your children at any time, please call us on 0333 331 4195^.
Can I choose different levels of cover for each member of my family? Can I choose different levels of cover for each member of my family?
Yes - Bupa By You allows you to select the appropriate level of cover for each member of your family.
So if you feel that there are family members who would benefit from more Comprehensive cover, but others who might need access to Treatment and care, for example, that’s not a problem. Please call us in order to arrange different levels of cover, as this service is not available online.
Fast access to treatment
If you need a scan, we’ll aim to secure you an appointment within two working days and get your results back within two working days. If you need to see a specialist, you’ll have an extensive network of consultants to choose from, each with a minimum of seven years’ experience in their chosen field.
A simple, helpful claims process
Once you have a referral from GP, for most claims, a simple phone call can get you started. And for some issues, such as muscle, joint and bone conditions or mental health concerns, you can call us directly for advice.
Our cancer promise
We give cancer special consideration as we know it’s something you worry about. Rest assured if you are diagnosed with cancer, you’ll be in expert hands for as long as you have Bupa health insurance.
Access to drugs and treatments to cancer
We’ll pay for eligible breakthrough cancer drugs and treatments, often before they are available on the NHS or approved by NICE (National Institute for Health and Care Excellence) as long as they are evidence-based.
When you call, you want to speak to someone who really understands the complexities of your condition. That’s why we have specialist teams who are trained to support you in key area including cancer, heart, mental health and muscle, joint and bone conditions.
24/7 health advice
You can call our Anytime HealthLine around the clock for health information and advice from a nurse. If needed, we’ll aim to get one of our GPs to call you back within the hour for a consultation over the phone.
Treatment for the most commonly diagnosed cancers (breast, bowel and gynaecological) is provided through our unique network of specialist cancer centres, which guarantee you will be treated by an expert cancer specialist team. If you have NHS Cancer Cover Plus, you will have access to specialists through the NHS.
^ We may record or monitor our calls. Lines are open Monday to Friday 8am to 8pm and Saturday 9am to 12.30pm.
Bupa health insurance is provided by Bupa Insurance Limited. Registered in England and Wales No. 3956433. Bupa Insurance Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Arranged and administered by Bupa Insurance Services Limited, which is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales No. 3829851. Registered office: Bupa House, 15-19 Bloomsbury Way, London WC1A 2BA.