Understanding health insurance

Help understanding health insurance

Find answers to some common questions about our health insurance.

Questions about health insurance? Just ask


Who are you?

Hello, my name's Ed Reed. I've been at Bupa for 16 years.

Come and ask me about health insurance, what you're covered for,

and any other questions you might have.

What is health insurance?

Health insurance or private medical insurance,

often referred to as P M I is an insurance product that can cover

the cost of private treatment, anything from physiotherapy,

the smaller things to the larger things like cancer and everything in between.

And you can pay monthly or annually.

And health insurance is there for any new conditions that arise after the policy

has started.

How does health insurance work?

So health insurance works. It starts off if you have a problem, an ailment,

you would need a GP referral and you can either get a GP referral via your N H

S gp or you can use our digital GP app. Once you have a referral,

you would give us a call and speak to one of our friendly advisors who would

talk you through everything from your policy limits,

if you have an excess who and where to pay your excess.

And we can also help you find a consultant to see.

Once you have the consultant you need to see, you'd give them a call,

book your appointment. At the point that you've called us,

we'd give you an authorization number so we would pay bills directly.

Once you have seen the consultant,

you could then give us a call for any further treatment, but it's really,

really easy.

You just need to give us a call once you've got that referral and we will talk

you through everything to help you.

What's the difference between health insurance and the NHS?

Everybody has access to the N H s.

You would keep your N H Ss GP and in an accident and emergency situation,

again, you'd use the N H Ss.

Where it's really different is the access or speed of access to

consultations, your treatment, your diagnosis, and your care.

It's also convenient in the sense that you can pick your own appointments around

your schedule, and that's a really big factor.

What does health insurance cover and what cant it cover?

Health insurance covers any new conditions that started after the policy

starts. For any conditions that started before the policy starts,

they wouldn't be covered.

There are also general exclusions that apply to all of our policies,

and a few examples of the general exclusions are pregnancy, cosmetic surgery,

and chronic conditions.

And a chronic condition is a condition and that can't be cured,

and that would just be maintained. Two examples are asthma and diabetes.

You would typically use the N H S A full list of our general exclusions can be

found on our website.

How can I get a quote, does this take long?

You can get a quote online. That's the quickest way to get a quote.

If you know what it is you want,

you don't need to talk through any of the options. You've done your research.

Then you can get a quote online and you can actually buy online as well. If,

however, you do have questions and you want to run through your medical history,

and you've got questions maybe about some of the options that are available at

hospital lists and excesses, et cetera,

you're able to give our friendly team a call and they'll be able to talk you

through everything.

Will I have access to private GP's?

Yes, you will have access to private gps.

You can access the private GPS via our digital GP app.

You are able to speak to GPS over video or on the telephone.

You can access them night and day and 24 hours a day

and it's unlimited appointments.

If you do want to see a GP face-to-face, you're able

to use our pay as you go service.

This isn't included in your policy,

but full details can be found on our B website.

Can I use my cover straight away?

You can use your cover straight away.

You can speak to a nurse on the Anytime Healthline.

You can also speak to a GP on the digital GP app.

If you do need to make a claim straight away,

we may need a medical report from your gp.

And health insurance is designed to cover new conditions after the policy


Does health insurance cover A&E?

No health insurance doesn't cover a and e.

It's because there isn't facilities in private hospitals.

If you have an accident in emergency situation,

then you need to call 9 9 9 or use the one service.

If you following an accident in emergency situation,

there may be times that the private medical insurance will be able to help you

in a follow-up situation.

Can I cancel at any time and will I be charged to do so?

Yes, you can cancel at any time. If you are thinking about canceling,

please give us a call.

What does out-patient cover mean?

Outpatient cover is well means when you don't occupy a bed in a

hospital, so you're not a day case or an inpatient.

Outpatient can consist of consultations, physiotherapy,

or mental health therapies.

You have different outpatient limits that you able to choose from.

You can cap the outpatient limit. You can have full outpatient,

or you can exclude it altogether and use the N H Ss for your diagnosis.

When you call us up to pre authorize your claim,

we can talk you through the limits that are available because if you are capping

your outpatient limit,

please bear in mind that that may only cover a few consultations.

What is treatment and care, and what does it cover?

Treatment in care is a policy option that is more cost

effective than our full comprehensive cover. It will cover,

you have access to the digital gp, so you could use that to get a referral.

The main difference is that consultations and diagnostic tests of the

diagnosis side would be covered via the N H Ss.

Once you've been diagnosed with a condition and you need treatment and care,

you would use the policy to cover an operation In a private hospital,

you have a full therapies limit.

So we've covered physiotherapy or mental health therapies,

and once you've had your operation,

we would cover any follow-up consultations within six months of that treatment

and care.

How much does health insurance cost?

That's a really good question and one we get asked a lot.

It depends on a few factors. One of the factors is your age,

so as you get older, you're more likely to make claims.

Also, your lifestyle can affect the price.

How many people you have on your policy, the policy makeup.

So whether you have a comprehensive policy or your excesses,

there's various different options that you can pick to adjust the price.

The best thing you can do is you can go on our website or you can give us a call

and speak to our friendly team who can go through all the options with you.

Will the cost go up every year?

Yes, it's likely the cost will go up each year.

There's a few reasons for that.

The first reason would be age. So as you get older,

you are more likely to make claims, your risk goes up.

Another factor would be medical inflation.

So that is the advancement in technology of drugs and

treatments. And then another factor would be claims.

Claims can affect the cost of your policy.

At each renewal,

you have the option to review the cover and look at cost options,

and you can give our friendly team a call who can take you through those


What is a pre-existing condition?

Preexisting condition is a symptom or a medical condition that you

had prior to joining us. To give you an example,

if I've got a mobile phone and I crack the screen and I don't have insurance for

it, and I try to get insurance,

that insurance wouldn't cover the crack screen As part of the cover,

you can speak to a nurse or a GP about preexisting


If you have any questions about any preexisting conditions or to find

out what is or what isn't covered, please give us a call.

Can I pay extra to have a pre-existing condition covered?

You can't pay extra to have a preexisting condition covered as part of the

cover. You do have access to a nurse or a digital gp,

and if you've got any questions about what is and what isn't covered,

you can give us a call.

How does health insurance work?

Our articles give you more insight into health insurance. From excess to exclusions, discover everything you need to know from here.

Want to know more about health insurance?

Our jargon buster videos, insights articles and policy guide can help. Take a look to learn more about health insurance.

You'll be covered for treatment that’s covered by your policy from the moment you’ve chosen a policy and set up your Direct Debit. Once your cover has started, you can cancel it within 21 days. If you haven't made any claims in this time, we'll refund what you’ve paid for that month or year.

When you start your policy, you'll be sent documents with details of what is and isn't covered. We’ll also send details of how to get in touch if you need to claim. You can also find this information in our policy benefits and terms (PDF, 0.5MB).

Each year before your renewal we'll send your renewal details including any changes to the price of your policy.

Yes, you can add your partner and/or your children to your policy. This includes new born or adopted children or children you have responsibility for. If you already have Bupa health insurance, you can update your policy to add a partner and/or children at any time.

If you’d like to update your policy, please call us on 0333 331 4195. Lines are open Monday to Friday 8am to 8pm and Saturday 9am to 12.30pm. We may record or monitor our calls.

Families can save 10% when adding a child to their policy. This saving applies to new Bupa health insurance customers who take out a family policy with at least one adult and one child. Taking out one family policy is 10% cheaper than taking out individual policies for each family member. You may not be offered the same discount when you renew.

When you add more than one child under 20 years old to your policy, you'll only pay for the eldest, no matter how many children you add. They don't need to live at the same address as the main member either. This is on top of your 10% family saving. This only applies to new Bupa By You policies purchased since 11th September 2023.

Any children aged 20 and over can't be classed as the 'eldest child' for this offer. To benefit, there needs to be at least two children who are aged 19 or under on the policy. This offer may change or be unavailable when you renew.

Couples can save 5% when adding a partner to their policy. This saving applies to new Bupa health insurance customers. Taking out one policy as a couple is 5% cheaper than taking out two individual policies. You may not be offered the same discount when you renew.

Yes, your cover will renew every year, automatically.

We’ll write to you at least 28 days before your renewal date. Your cover will automatically renew unless you let us know that you’d like to end your cover.

When you renew your cover, you can make changes to your policy to reflect any changes in your circumstances.

If you choose not to renew your policy, you will no longer be covered for treatment or care for any condition.

The good news is you have the option to stay with us on a new, personal policy. Even better, we may continue to cover any ongoing or existing conditions if your new policy starts within three months of your old scheme ending. This will depend on your new policy’s benefits and terms. Just give us a call and we’ll talk through your options.

Find out more about leaving your company scheme or call us today on 0808 271 4693. Lines are open Monday to Friday 8am to 8pm. We may record or monitor our calls.

There are several benefits of taking out health insurance. If you develop a condition, you’ll have quick access to the treatment you need to help you back on the road to recovery.

Costs for treatment that’s covered by your policy could be paid in full, as long as you:

  • Use a fee-assured consultant. This means we have agreed to pay their fee in full.
  • Get treatment from a hospital in your chosen network.

This will be subject to the terms of your policy. For example, some policies have limits on the amount you can claim for some things. Some policies include an excess that you may have agreed to pay.

Digital GP services are provided by Babylon Healthcare Services Limited. Registered in England and Wales No 9229684. Registered office: 60 Sloane Avenue, London SW3 3DD.

Bupa Anytime HealthLine and Digital GP are not regulated by the Financial Conduct Authority or 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.

Anytime HealthLine is provided by Bupa Occupational Health Limited. Registered in England and Wales No. 631336. Registered office: 1 Angel Court, London, EC2R 7HJ.

Page last reviewed: 31/05/23

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