You may not need a GP referral to claim on your health insurance if you’ve got a muscle, bone or joint problem, suspected cancer symptoms, concerns about your mental health, or cataracts. Find out more about direct access.

What is open referral?

Open referral means that your GP decides the type of consultant (eg orthopaedic surgeon or gynaecologist) you need to see for tests and/or treatment*. When you call us to arrange your consultation or treatment, we use the information from your GP to offer you a choice of up to three Bupa recognised consultants with the appropriate medical skills and expertise.

While we ask all Bupa recognised consultants to meet our affordability, quality and customer experience criteria, the consultants we’ll offer you are in our Open Referral Consultant Network, which means they demonstrate high quality care, offer good value healthcare and customer experience of consultants in their speciality.

*If the claim is for someone under 16 we’re unable to offer an open referral, so please ask the GP to recommend a paediatrician by name. We may accept named referrals for people older than 16 years too, but this depends on your scheme so please call us to find out.

The benefits

With open referral, as well as getting the benefits of your consultant being a member of our Open Referral Consultant Network, you’ll also get…

  • a choice of the most appropriate consultants for your medical needs – and all the consultants we offer you are on our online directory, Finder, so you can look up more info about them before you decide who to see.
  • help booking your appointment - we can book appointments with some consultants for you while you’re on the phone to us. Or we can send you links to their online diaries so you can book one yourself once you’ve decided who to see.
  • certainty about costs - we‘ll always offer you consultants who have agreed to charge within your policy benefits. And we’ll let you know whether you have an excess to pay or you’re likely to run out of any out-patient benefit you may have on your policy, so you’re not faced with any unexpected costs.
  • specialist support if you need treatment for cancer, cardiac, or muscle, bone and joint conditions. We can offer health information and coaching from qualified healthcare professionals to help you decide which treatment is right for you.
  • convenient access to healthcare near your home or work - 90% of our members healthcare needs can be accessed within 45 minutes of their home address”.
  • Nine out of 10 of our customers who’ve used open referral said that the quality of care they received was “excellent” or “very good”.
  • Nine out of 10 customers also rated their open referral consultant as “excellent” or “good”.

 

How we choose the consultants we offer through open referral

We’ll offer you consultants from our Open Referral Consultant Network, who have been chosen specifically for the quality of care, value for money and customer experience they offer.

We’ve worked with Professor Elias Mossialos and Martina Orlovic of Imperial College London, and Professor Alistair McGuire of the London School of Economics, who have confirmed that the way we choose consultants in our Open Referral network is rigorous and fair.

Like all Bupa recognised consultants, Open Referral Consultant Network consultants must meet the following professional criteria:

  • hold or have held a substantive NHS consultant appointment
  • be on the General Medical Council/General Dental Council specialist register
  • hold a GMC license to practice
  • hold a certificate of Completion of Medical Training
  • have professional indemnity insurance for their private practices

 

Find out more

If you’d like to make a claim, you can find out more here, or for more information we can call you back at a convenient time . All calls are free of charge to both landlines and mobiles.

Contact our member services team for advice, treatment requests or if you have any general queries

^ We may record or monitor our calls.

Bupa Anytime HealthLine is not regulated by the Financial Conduct 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. 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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