Guide to making a health insurance claim
Do your symptoms fall into any of these categories?
If you're experiencing any of the below symptoms, our Direct Access service is here to help. If these symptoms are covered under your policy, you can call us directly for advice and treatment usually without the need for a GP referral.†.
Step 1:
See a GP
If your symptoms aren't covered by our Direct Access service, you should speak to a GP first.
Book an appointment with your own GP or through Digital GP. They can advise you if you need to see a specialist or healthcare professional for your health needs.
Speak to a GP within 24 hours from anywhere
With our Digital GP provided by Babylon‡, you can get professional advice at a time to suit you, wherever you are in the UK.
24/7 health advice
With our Anytime HealthLine, you can get access to health advice from a trained nurse on a variety of problems.
Step 2:
Ask the GP for a referral
If you have a condition that requires a GP referral, we recommend you ask for an ‘Open Referral letter'. This will detail the care your GP would like you to have, but will not be addressed to a specific consultant, hospital or healthcare professional.
The referral needs to include the type of speciality that you have been referred to.
We aim to offer a choice of two or three specialists. If the first choice consultant is unavailable, you'll see an alternative specialist without having to return to your GP for a second referral.
You can also choose to speak to a specialist over the phone or by video. You can call us on 0345 609 0111 to discuss your options. Lines are open 8am -8pm Monday to Friday, 8am-4pm Saturdays.
Important: Open Referral is mandatory on some personal, corporate and company schemes. Please call us on 0345 609 0444^ if you're unsure.
Step 3:
Contact us
As soon as you've seen your GP please contact us so that we can discuss your options and explain which specialists and healthcare professionals are covered under your Bupa membership. We'll let you know what you need to do next and send you any pre-treatment forms you may need to complete.
Here's what you'll need when you contact us:
- Your Bupa membership number
- Details of when your symptoms first began
- Details of when you first consulted your GP about your symptoms
- The symptoms you're suffering from
- Details of the treatment your GP has recommended
Speak to one of our advisors today
0345 609 0111
Lines are open 8am - 8pm Monday to Friday, 8am-4pm Saturdays. We may record or monitor our calls.
Got a referral and need help finding a consultant?
You can use our online care directory, Finder, to search for local hospital and consultant availability.
What happens next?
Pre authorisation
When we've confirmed that your treatment is covered, we'll discuss your claim with you and give you a pre-authorisation number. You can then contact your consultant or healthcare professional to arrange an appointment, giving them your preauthorisation number.
Medical Reports
When we need to ask your doctor for more information about your consultation, tests or treatment, we'll need your permission to see your medical reports.
Invoicing
If (for any reason) you are sent an invoice, simply send it to:
Bupa Place, 102 The Quays,
Salford, M50 3SP
^Lines are open 8am - 8pm Monday to Friday, 8am-4pm Saturdays. We may record or monitor our calls.
†Direct Access telephone services are available as long as the symptoms are covered under the policy. If your cover excludes conditions you had before your policy started, we'll ask you to provide evidence from your GP that your symptoms are not pre-existing for a period of up to two years from policy start date (or five years in the case of mental health) before we can refer you to a consultant through the Direct Access service. Always call us first to check your eligibility.
Digital GP and the Anytime HealthLine are not regulated by the Financial Conduct Authority or the Prudential Regulation Authority.
‡Digital GP services are provided by Babylon Healthcare Services Limited. Registered in England and Wales No. 09229684. Registered office: 1 Knightsbridge Green, London, SW1X 7QA. Customers who live in the Isle of Man do not have access to Digital GP provided by Babylon but can access GP24 provided by HealthHero.
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. Anytime HealthLine is not regulated by the Financial Conduct Authority.
