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Frequently asked questions


We're always happy to answer questions you may have about your health insurance policy. Here you’ll find a selection of questions and answers that we've already helped our customers with.


To find out more or to get a quote call us

0808 256 9436 ^

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Most popular questions Expand all
  • Health insurance covers treatment for acute conditions that develop after your policy has started. An acute condition is a disease, illness or injury that is likely to respond quickly to treatment which aims to return you to the state of health you were in before suffering the condition, or which leads to your full recovery.

  • You can compare our different levels of cover by taking a look over our Comprehensive page and our Treatment and Care page.

    To help you decide which cover will be right for you, as a starting point, think about your lifestyle, budget and the areas of your life that concern you the most. Comprehensive covers medical costs from diagnosis to treatment.

    If you choose Comprehensive and full cancer cover, it includes diagnosis and eligible treatment. Alternatively if you choose NHS Cancer Cover Plus, cover is only available if the radiotherapy, chemotherapy or surgical operation you need to treat your cancer is not available under the NHS.

    Treatment and care covers eligible treatment and following this, any consultations, diagnostic tests and scans that are needed after you have received your treatment.

    With Bupa cancer cover there are no time limits and all your eligible treatment costs are paid in full for as long as you have a Bupa health insurance policy which includes cancer cover.

    If you’d like to speak to us about health insurance call 0808 271 4693^ and we can talk you through some suitable options. Alternatively you can get a quote online now.

    If you want to learn more about health insurance and how it works, take a look over our health insurance guide.

  • 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.

  • When you buy health insurance online we’ll send you a medical history form to complete and return. If you choose to call and buy, your medical history will be taken over the phone.

    Medical conditions, and related conditions, that arose before the start of the policy won’t be covered. If you’d like to know what you’ll be covered for before you buy, please call us on 0808 271 4693^.

    You can ask us at renewal to re-assess any pre-existing condition to see if we can cover it in the future.

    Watch our video to find out more.

  • Our private medical 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.

    Watch our video to find out more.

  • Please visit our members help and support area to find out more.

General questions about Bupa health insurance Expand all
Questions about medical underwriting Expand all
  • Underwriting for private medical 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.

Questions about medical history Expand all
Questions about health insurance subscriptions
  • Yes, when we calculate your renewal we apply a no claims discount based on the value of claims (if any) we have approved for payment during the 12 month 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.

    Download our No Claims Discount leaflet (PDF, 767KB) to find out more.

    Watch our video to find out more.

Questions about out-patient limits Expand all
  • Out-patient cover is for when you attend an appointment at a hospital or clinic but you’re not admitted and don’t stay overnight. As an out-patient you do not occupy a hospital bed.

    Out-patient cover could include the cost of appointments with consultants and therapists, diagnostic tests, MRI, CT and PET Scans. The above are all covered as part of eligible treatment.

  • Major diagnostic scans like MRI, CT and PET scans will be paid in full as part of eligible treatment; there are no annual limits are applied to major diagnostic scans.

    If you exceed your annual out-patient allowance, any subsequent bills would need to be funded by you.

    Excluded treatments include chronic conditions and chronic mental health conditions.

  • You can only change your limit at renewal and within the set limitations that we offer. You can choose from a range of yearly limits or unlimited cover.

  • When you take out a Bupa health insurance policy you will be able to choose an annual outpatient benefit limit from a number of set options. A lower limit will reduce the cost of your cover and a higher limit will increase the cost.

    Here's an example of how it works:

    David has a £1,000 annual limit on his outpatient cover. His GP recommends he sees a consultant so he visits a hospital for some treatment and tests. The cost for his blood tests and ultrasound treatment is £1100 and there are further costs of £200 for consultation fees. The total cost for his outpatient treatment is £1,300.

    As David is on a Bupa By You policy, Bupa will pay the £1,000 up to the benefit limit of his policy. David has agreed to pay an excess of £200 plus the remaining £100.

    Watch our video to find out more.

Questions about Cancer Cover Expand all
Questions about excess Expand all
    • 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.

    Watch our video to find out more.

Questions about hospital networks Expand all
  • 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)

What's next?

^ 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: 1 Angel Court, London, EC2R 7HJ.

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