Health insurance made simple
We’ve got everything you need to know about health insurance and how it works, whether you’re thinking of taking out a policy or you want to understand some of the terminology around health insurance. Watch our jargon busting videos, read important points about our cover (PDF 0.8MB) or have a look through our articles
Here’s a selection of questions and answers that we’ve already helped our customers with.
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.
It can be tricky to know what to look out for when you’re choosing health insurance. The level of care you need will depend on your lifestyle and the areas of your health you’re most concerned about. You’ll also need to consider your budget.
This is why comparing different health insurance policies can be useful; by getting quotes for different levels of cover you’ll be able to compare the costs against the benefits so you can make an informed decision.
When contemplating your options, you might want to look for a package with the following:
- Hospital treatment paid in full
- Outpatient therapies paid in full
- Eligible aftercare paid in full
- Post treatment tests and scans paid in full
It’s important you fully understand the health insurance policy you’re considering before joining. You’ll need to know what it includes and excludes to be absolutely certain that it meets your needs. Most health insurers also offer the option to set up couple and family policies too.
As a starting point, think about your lifestyle, budget and the areas of your health that concern you the most. Comprehensive covers medical costs from diagnosis to eligible treatment.
If you want us to cover you to diagnose a condition and provide private treatment following a diagnosis, then you could select our Comprehensive Policy.
However, if you are happy to be diagnosed by the NHS, but want to receive any required treatment privately, then you have the option to take out our Treatment and Care policy, which will be cheaper than our Comprehensive option.
We have 2 cancer cover options, that offer either full cancer cover (from private diagnosis to treatment to aftercare) or if you want to reduce your monthly premiums, our Cancer Cover Plus option, which means private treatment only kicks in if the NHS can't provide your care (terms and conditions apply).
You can get a quote online now. Alternatively if you would like speak to us about health insurance call 0808 115 3461^and we can talk you through some suitable options. If you want to learn more about health insurance and how it works, take a look over our health insurance guide.
The level of cover you’ll get will depend on the policy you take out.
For some policies, you’ll need to go through initial diagnosis and get a referral from the NHS before you’re able to claim any private treatment. Other more comprehensive policies include consultations and tests to help diagnose your condition.
Bupa By You covers you for new conditions that occur once your cover has started - so you won't be able to use it for medical conditions that were apparent before you took out cover. There are also certain conditions that, whichever plan you choose, will not be covered, for example chronic long-standing conditions or cosmetic surgery. Learn more about health insurance exclusions.
You'll be covered for eligible treatment from the moment you have agreed on the level of cover that's right for you and you've set up your monthly Direct Debit. Once your cover has started, you can cancel it within 21 days and as long as you haven't made any claims we'll refund all of your subscriptions for that month or year. You'll be sent all of the documentation that details what is and isn't covered and how you get in touch with us should you need to claim. You can also find this information in our policy benefits and terms (PDF, 229KB).
Each year before your renewal we'll send your renewal details including your new subscription price.
Yes, you can add your partner and/or your children (including newborn or adopted children) as dependants on your policy. 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^.
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 new Bupa By You customers who take out a family policy that covers at least one adult and one child. This is based on the saving that you make by taking out one family policy compared to individual policies for each family member. 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. Savings only apply to Bupa By You core insurance. We reserve the right to amend or withdraw our couples rate at renewal.
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. Each year at renewal you can change elements of your cover if your circumstances change.
If you’ve been part of a company health insurance scheme but you’re leaving it now, you can still have Bupa health insurance.
Anything that was excluded on your company scheme would remain excluded on Bupa By You. When joining Bupa By You as a company leaver, you will be required to meet our eligibility criteria.
Find out more about leaving your company scheme or call us today on 0808 271 4693^ to talk through your health insurance options.
There are several benefits of taking out health insurance. In the event that you develop a condition, you can relax in the knowledge that you have quick access† to the treatment you need to help you back on the road to recovery.
All of our policies cover eligible treatment costs in full, depending on the terms of the policy, providing you use a consultant who agrees to charge within Bupa limits (a fee-assured consultant) in a facility from your chosen hospital network.
† quick access is subject to availability.
Understanding pre-existing conditions
Health insurance is designed to cover you for future risks, so any previous conditions you have will not be covered. Watch this video to find out more.
When you take out a health insurance policy with us, we’ll usually exclude cover for any symptoms, conditions, illnesses or injuries you had before you joined.
Your insurance is designed to cover future risk and so any previous conditions are usually not covered.
So, for example, if you injure your leg before taking out your policy and you then need further physio treatment after your policy has begun, this treatment would not be covered.
Or if you have a medical condition, such as a heart problem, before your policy begins, any health issues related to this condition that arise after you take out your policy will not be covered.
In this case you would need to seek treatment from the NHS or alternatively pay for private treatment yourself.
When you join Bupa, you can choose to be underwritten in a number of different ways. Most customers choose full medical underwriting.
In this scenario, we'll ask you to tell us about any previous health issues you've had when you join. It's important you answer these questions honestly or it may delay or invalidate a future claim.
When you make a claim, we may also check with your GP that you haven’t had the condition before.
You’ll be able to see any conditions that are excluded from your cover on your membership certificate. These will be under the section called special conditions
The same process will also apply for any members of your family included on your policy.
New conditions which arise after you take out your policy would most likely be covered. Check your policy documents for details on what you are and arent covered for. Just give us a call before making a claim to check!
You can speak to us at renewal to apply to remove any pre-existing conditions from your policy. It depends on the condition and the length of time you have been symptom, treatment and advice free.
Some conditions, such as pregnancies, cosmetic surgery and the maintenance of chronic conditions aren’t usually covered under your health insurance. Check your membership guide for full details.
Many factors can affect the cost of your health insurance but these are the most significant.
Advances in medical technology, drugs and treatments help lead to improved quality of life and recovery rates for many people.
Funding these new treatments, plus increases in the prices consultants and doctors charge, typically increases costs each year.
We work closely with doctors and hospitals to make sure these costs are fair and provide you with value for money.
To be fair to everyone, age is one of the things we use to calculate the cost of your policy.
Healthcare costs are different around the country and they also change at different rates each year.
To make costs fairer to everyone, they're linked to where you live and to the likely cost of treatments there.
If you’ve claimed previously, your price may be higher than if you haven’t.
If you have a product with a low claims bonus, or a no claims discount, and haven't made any claims or only low value ones, this may help reduce any price increase.
Also , the amount of excess you choose to pay if you make a claim affects the price you pay. Typically, the more excess you choose to pay, the lower your price.
Unhealthy lifestyle choices, like smoking for example, can also affect the cost of your health insurance.
It's important that you tell us about these choices because if you don't it could affect a future claim.
Or if you stop smoking then tell us. If you can prove that you've been smoke-free for a number of years, this may reduce the cost of your health insurance.
At Bupa, we don't have shareholders to pay.
We continue to invest in improving the healthcare you get from us and we aim to set your price as fairly as we can.
For most medical treatment, you need to make an appointment with your GP to get a referral to see a specialist or consultant.
Your GP looks after your ongoing health requirements and they have access to your complete medical history.
They’ll let you know if you need to see a consultant or healthcare professional.
If you do need to see a consultant, your GP will provide you with a referral letter which will detail the type of specialist they would like you to see.
We recommend that you ask your GP for an ‘Open Referral letter’ which will detail the care your GP would like you to have, but will not be addressed to a specific consultant, hospital or healthcare professional.
Using our open referral process means we can offer you a choice of specialists who will charge within Bupa’s agreed limits. You’ll still need to pay any excess and any additional fees beyond your outpatient limit that you have agreed.
We’re working to make it as simple as possible for you to access quality healthcare as quickly as possible.That’s why if you have a muscle, bone or joint issue, a mental health issue, are experiencing symptoms of cancer
you can call us directly to speak to a specialist adviser who will either refer you directly for treatment, normally without having to see your GP, or advise you what you need to do next.
When you’re unwell, it’s important that you get the right treatment.
Which is why your GP may refer you to a specialist consultant.
As medical consultants may have different charges for their services,
it’s important that you can choose to access those whose charges are within Bupa agreed limits.
If you don't, you may need to pay the difference yourself.
Bupa has over 16,000 consultants nationwide who agree to work within fee limits, set by Bupa in conjunction with independent medical professionals. We call these fee assured consultants.
Costs are guaranteed to be met full for any consultations and treatments.
In all cases, even when using a Bupa Fee Assured Consultant, you will still need to pay any excess, and any additional fees beyond your outpatient benefit limit that you have agreed within your personal policy.
All Bupa Fee Assured consultants are assessed to the same standard as any other medical practitioner and meet our high standards of care.
When you take out your health insurance with Bupa, you can select the amount of excess you’re willing to pay to help set the cost of your premium to a level you’re comfortable with.
Paying an excess will help to reduce your premiums in a similar way to how you would with your car insurance, for example
Having an excess means that you have to pay part of your treatment costs up to the amount of your excess.
You pay this on your first eligible claim per member, per membership year.
You will only ever need to pay the total amount of your excess once per membership year, even if you make more than one claim and for more than one condition.
For example, if your treatment costs £3000 and you have agreed an excess of £500 you will pay £500 and we’ll pay the remaining £2500.
Your excess re-starts at the beginning of each membership year even if your treatment is ongoing.
So, your excess could apply twice to a single claim if your treatment begins in one membership year and continues into the next membership year.You can amend the amount of excess you choose to pay at each annual renewal.
You pay any excess directly to the person treating you, not to Bupa.
We’ll write to the main member to let them know the amount payable and who it should be paid to.
You should always make a claim if you have any treatment so we can keep track of how much you've contributed towards your excess.
This will mean you're not out of pocket for any future claims.
A chronic condition is an illness or disease which has at least one of the following characteristics
Examples of Chronic Conditions include arthritis, asthma, diabetes and psoriasis among many others.
Here are some examples.Your GP refers you to a consultant who diagnoses you with a chronic condition.
You then need regular medication and annual consultations as part of the ongoing care for your chronic condition.
These regular consultations would take place under the NHS, or you have the option to pay privately for this treatment yourself.
After a couple of years, you need to see a specialist consultant as you have suffered a sudden and untypical flare up of symptoms relating to your chronic condition that your GP can’t manage.
As a result, you need treatment to get you back to the same state of health before the flare up.
It’s worth noting, if your flare up is sudden and severe, you should call 999 and go to A&E. Emergency treatment like this isn’t covered under your Bupa policy.
Once your flare up has died down, you can continue with on-going medication and annual consultations through the NHS.
For any treatment that you’re not covered for, you should go back to your GP and the NHS for treatment.
You'll find more information in our document 'Important points about your cover', as well as your membership guide and membership certificate.
Getting health insurance when you’re self-employed
If you’re self-employed you may be considering health insurance to give you peace of mind for your business.
Will I need an excess on my health insurance policy?
Health insurance policies often include an excess. This is fairly standard with most insurance policies, but it’s worth understanding the impact excess can have on your cover.
In-patient vs. out-patient cover
When you’re looking at health insurance policies you may come across terms like in-patient and out-patient cover and not fully understand what these include.
Private health insurance exclusions
Before you take out health insurance, it’s important that you have a thorough understanding of what is and isn’t covered.
Do I need private health insurance?
If you’re considering private health insurance, you may be weighing up if you need it or not. We’ve broken down the benefits so you can see if suits your personal needs.
Call us
01134950976^
^ Lines are open Monday to Friday 8am to 8pm and Saturday 9am to 12:30pm. We may record or monitor our calls.
You can find independent information about the quality and cost of private treatment available from doctors and hospitals from the Private Healthcare Information Network: www.phin.org.uk
^ We may record or monitor our calls. Lines are open Monday to Friday 8am to 8pm and Saturday 9am to 12.30pm.
Bupa Anytime HealthLine is not regulated by the Financial Conduct Authority and the Prudential Regulation Authority.
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.
