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Frequently asked questions

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

As a starting point, your clients should think about their lifestyle, budget and the conditions or illnesses which concern them the most.

Comprehensive covers eligible medical costs from diagnosis to treatment for acute conditions including cancer, for as long as you’re a Bupa member.

Treatment and care covers all your eligible treatment for acute conditions after an initial diagnosis by a consultant through the NHS or self funded, for as long as you’re a Bupa member.

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 Bupa health insurance. If you have health insurance provided by your employer and your employer has selected an overall annual maximum benefit, eligible costs will be paid up to that limit. You must use a healthcare facility from your chosen Bupa network and a Bupa-recognised consultant who agrees to charge within our limits (a fee-assured consultant).
Bupa By You covers your clients for new eligible conditions that occur once the cover has started - so they won't be able to use it for medical conditions that were apparent before they took out cover. There are also certain conditions that, whichever plan your clients choose, will not be covered, for example chronic long-standing conditions or cosmetic surgery. Details of all of the exclusions in place can be found in the Bupa By You membership guide that will be sent to your clients once they have taken their cover out.
They’ll be covered from the moment they’ve agreed on the level of cover that's right for them and they’ve set up their monthly Direct Debit. Once their cover has started, they can cancel it within 21 days of the cover starting and receive a full refund providing they’ve not made a claim. Once they’re a member they’ll be sent all of the documentation that details what is and isn't covered and how they can get in touch with us should they need to claim.

Before your client’s renewal we’ll send them renewal details including their new subscription price.
Your clients can add their partner and/or their children (including newborn or adopted children) as dependants on their membership at any time.
We’ll write to your client at least 28 days before their renewal date, and your client's annual cover will automatically be renewed unless they decide to end their cover. Bupa By You is adaptable health insurance so each year at renewal your client can change elements of their cover if their circumstances change.
If one of your clients already has Bupa health insurance and wants to find out more about their policy, please visit our members’ area.
If your client attends a hospital or clinic as an ‘out-patient’ it means they are not admitted to hospital and don’t need to stay overnight for the appointment.

A ‘day-patient’ is when your client is admitted to hospital for their appointment, but doesn’t need to stay overnight and they also require medical observation for a short period of time afterwards. An ‘in-patient’ is when your client attends hospital for treatment, and stays in hospital overnight or longer.

By adding an out-patient limit, you are able to reduce your monthly costs.

A lower limit would reduce the cost of your cover and a higher limit will increase the cost. Watch this video to find more about our outpatient benefit limits and how they can impact the cost of your monthly payments.

View our ‘what are out-patient benefit limits?' video



Our out-patient limits apply to tests like x-rays, consultations with a specialist surgeon or doctor, or therapies like physiotherapy. Once you have exceeded your annual out-patient limit, you would need to fund further private tests, consultations and therapies as on out-patient yourself. MRI, PET and CT scans are paid in full as long as you use a Bupa-recognised facility.
With Bupa By You, full cancer cover# comes as standard with Comprehensive 500, Comprehensive 1000 and Comprehensive and Treatment and Care.

If your clients would like to reduce their costs, and are willing to reduce their level of cover, they can either:

  • Select our Treatment and Care option, which means your client's cover will be diagnosed through the NHS, and any subsequent eligible treatment they need will be covered by us.
  • Select our NHS Cancer Cover Plus which means they’ll be treated by the NHS if they develop cancer. However, if your clients need chemotherapy, radiotherapy or a surgical operation that is not available on the NHS, we will step in to cover these treatments for them if this treatment is eligible and recommended by your consultant.

#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 Bupa health insurance. If you have health insurance provided by your employer and your employer has selected an overall annual maximum benefit, eligible costs will be paid up to that limit. You must use a healthcare facility from your chosen Bupa network and a Bupa-recognised consultant who agrees to charge within our limits (a fee-assured consultant).
Bupa membership gives your clients access to eligible breakthrough cancer drugs and treatments often before they are available on the NHS or approved by NICE as long as they are evidence-based.
We will always evaluate requests to fund new or experimental treatment.
Whereas some insurers only provide treatment for the primary cancer (the cancer your clients are initially diagnosed with), Bupa will cover them even if their cancer spreads, if they have selected full cancer cover#.

#When we say full cancer cover it means your clients have no limit to how much they can claim for eligible treatment provided that they use a Bupa recognised consultant we have already agreed our fees with (fee assured), within their chosen Bupa hospital network.
As long as there is sound clinical evidence to demonstrate benefit, we will fund it.
If your clients select full cancer cover#, we will provide cover and support at every stage of their cancer, including palliative treatment, even if their cancer is incurable. If your clients select NHS Cancer Cover Plus, the NHS will provide palliative treatment but if the palliative treatment (surgery, radiotherapy or chemotherapy) recommended by their oncologist is not available on the NHS, Bupa will cover this as long as it is eligible treatment

#When we say full cancer cover it means your clients have no limit to how much they can claim for eligible treatment provided that they use a Bupa recognised consultant we have already agreed our fees with (fee assured), within their chosen Bupa hospital network.
No - We don’t take family history of cancer into account when deciding whether or not to offer cover to a new customer.
We don’t pay for treatments that are not evidence-based. The only exception is when the treatment is part of a clinical trial, the protocols of which have been reviewed and approved by us. If your clients select NHS Cancer Cover Plus, we won’t cover treatments that are available on the NHS.
Our support team is able to give members and their carers or family, advice related to their specific situation and discuss options for being treated at home (where your client’s consultant feels this is clinically appropriate). Our informed decision making service helps members understand the options available to them and the information they need to be able to make decisions about their own care.
If your clients are treated by a Bupa fee assured consultant in a Bupa recognised facility that is within their chosen Bupa hospital network, we will fund all of their eligible diagnostic tests and investigations and all eligible treatment for cancer providing they have selected our full cancer cover#.

#When we say full cancer cover it means your clients have no limit to how much they can claim for eligible treatment provided that they use a Bupa recognised consultant we have already agreed our fees with (fee assured), within their chosen Bupa hospital network.
If your client has full cancer cover# and they opt to receive their cancer treatment in an NHS hospital and the treatment is funded by the NHS, we offer an NHS cash benefit which allows members to claim £100 for every day/night or session for eligible cancer treatment. If they’ve selected NHS Cancer Cover Plus, being treated by the NHS is standard unless they need chemotherapy, radiotherapy or a surgical operation that the NHS cannot provide.

#When we say full cancer cover it means your clients have no limit to how much they can claim for eligible treatment provided that they use a Bupa recognised consultant we have already agreed our fees with (fee assured), within their chosen Bupa hospital network.
Yes – if they have full cancer cover# or they have NHS cancer cover plus and treatment is not available on the NHS, Bupa gives them the option to receive their chemotherapy at home (where your client’s consultant feels this is clinically appropriate) safely and from a specialist nurse. Treatment at home means there is as little disruption to their life as possible. If they have NHS cancer cover plus and the treatment is not available at home on the NHS but is available in hospital, we will not pay for them to have this at home. We will only pay if it is unavailable on the NHS.

#When we say full cancer cover it means your clients have no limit to how much they can claim for eligible treatment provided that they use a Bupa recognised consultant we have already agreed our fees with (fee assured), within their chosen Bupa hospital network.
If they have full cancer cover#, treatment for the most commonly diagnosed cancers (breast, bowel, prostate and gynaecological) is provided through our unique network of specialist cancer centres, which guarantee they will be treated by a cancer specialist team. If they have NHS Cancer Cover Plus, they will have access to specialists through the NHS.

#When we say full cancer cover it means your clients have no limit to how much they can claim for eligible treatment provided that they use a Bupa recognised consultant we have already agreed our fees with (fee assured), within their chosen Bupa hospital network.
Payments are usually made directly by Bupa when they use our fee assured consultants and their chosen Bupa hospital network for eligible treatment. So there is no need to pay any costs themselves (except where an excess payment is applicable).
Our online cancer health hub contains information which has been developed to provide our members and their friends and families with helpful information about how and why cancer develops and details of the range of cancer treatments available.
No. However, we will need to ask some questions about:

  • their age, sex and medical history
  • whether they smoke
  • their current state of health
  • their occupation
Health insurance does not generally cover pre-existing conditions. If they’ve never had health insurance, we’ll need to base our decision on the cover we can offer your clients on their past seven years’ medical history. So, if they have symptoms which they know could cause problems in the future, they’ll need to tell us straightaway.

For clients joining with Moratorium underwriting the applicant is not required to complete the medical history declaration as part of their application on the understanding that they’ll not be immediately covered for any medical conditions that existed in the five years prior to joining. New medical conditions arising after the start of the policy will be covered immediately subject to the policy terms and conditions.
The No Claims Discount scale below shows the levels available and discounts which apply to each level. As a new member your client will have entered at level 12 (65% discount highlighted below). If we have paid no claims for your client during the 12 months (10 months in their first year of cover) prior to their renewal subscription being calculated, their No Claims Discount will increase by one level on the scale. The maximum No Claims Discount available is level 14 (70% discount).

The maximum number of levels your client can decrease at renewal is three.

The No Claims Discount only applies to subscriptions for their core health insurance. Claims they may make in relation to any Add ons, NHS cash Benefit or Travel and Emergency Medical Cover do not count as claims in the assessment of the no claims discount. In addition, claims we pay that fall entirely within any excess will not be counted.

No claims discount level

Discount applied on premium

1

0%

2

10%

3

20%

4

27.5%

5

35%

6

40%

7

45%

8

50%

9

55%

10

59%

11

62%

12

65%

13

68%

14

70%



The No Claims Discount scale works as follows:

Claims payments made during the year before we calculate the premium for the next insurance year

Movement on the scale at the next renewal date (subject to a maximum of level 14 and a minimum of level 1)

£0 paid

Move up the scale by one level

Between £0.01 - £250 paid

Move down the scale by one level

Between £250.01 - £500 paid

Move down the scale by two levels

More than £500 paid

Move down the scale by three levels

The No Claims Discount is only based on claims paid by us and so any claim your client makes won’t be taken into account until the payment has been processed.

Any claim that falls entirely within their excess will not impact their No Claims Discount level.

For more detail please refer to the Bupa By You Membership Guide.
^Lines are open 8am to 5pm Monday to Friday. We may record or monitor our calls.

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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