BUPA Health Insurance

Who Is Eligible?

All permanent full-time and part-time Insured Firm’s employees on the UK Payroll and their immediate dependants are eligible to enrol in the scheme on joining the Firm or at any time in the year. Eligible dependants include spouse or partner (including same sex partner) and dependent children up to the age of 21 (or 24 if they are unmarried and a full time student). Members do not have to be medically fit to join the plan and pre-existing medical conditions are covered.

Electing This Benefit

Although membership of the scheme is voluntary, you must make an election on YBR. You must either elect to join the scheme or to opt out. The cover will be effective from the date of your election for yourself and any dependants. All medical treatment must be pre-authorised by the insurer before treatment begins. Please see 'Pre-authorising Treatment' for details of how to do this. A letter will be sent to you by BUPA confirming membership and your personal registration number within six weeks of joining the scheme.

Pre-Authorising Treatment

All treatment must be pre-authorised by BUPA in order to be covered. If treatment is not pre-authorised, you may be liable for the full cost of the treatment. Please follow this pre-authorisation procedure when making a claim:

1. Before you can receive private medical treatment you will need a referral from your GP.
2. If your GP recommends consultant treatment or refers you to a hospital, let him/her know that you are covered under a PMI scheme.
3. Call the Insured Firm’s BUPA Helpline on +44 (0)845 603 9411. Quote your name, date of birth and say that you are an employee of Insured Firm’s.
4. The Helpline will discuss your treatment and explain what you are covered for.
5. The Helpline will give you a pre-authorisation number for the agreed treatment that you will need to quote when seeing the consultant or the hospital – no claim form is needed.
6. If further treatment is needed, you will have to pre-authorise this with the Helpline.
7. BUPA will explain the procedure for paying any fees or excess directly.

Please remember that all treatments must be pre-authorised by BUPA. Changing Your Cover You may elect to change your cover, including adding or removing dependants, at any time. Changes will take effect on the date of your election. When Cover Ends UK Private Medical Insurance cover will cease immediately if you cancel your membership, leave the Firm or retire.

Continuing Cover After Leaving

If you leave Insured Firm’s, you can request a quotation for continuation of cover for you and your eligible dependants with your current insurer or assistance with reviewing the other options available. Please note any arrangement entered into with an insurer will be a private arrangement between yourself and the insurer. In order to provide quotations, the following information is usually required:

• Name, address and date of birth
• Details of family members to be covered
• Date of joining and leaving the Insured Firm’s scheme
• Membership number (if known)
• Details of your medical history

You can request a quotation or other information by contacting the Lorica Personnel Lines Department on 0870 458 8000 or by email at personalpmi@lorica.com. Please note that continuation of cover after leaving Insured Firm’s is at your own cost.

Continuing Cover for Dependants Exceeding Age Restrictions

If your dependant children exceed the age of 21 (or 24 if they are unmarried and in full-time education), you or your dependant can request a quotation for continuation of cover for them with your current insurer or assistance with reviewing the other options available. Please note any arrangement entered into with an insurer will be a private arrangement between yourself and the insurer. In order to provide quotations, the following information is usually required:

• Details of family members to be covered
• Date of joining and leaving the Insured Firm’s scheme
• Membership number (if known)
• Details of your dependants’ medical history

You can request a quotation or other information by contacting the Lorica Personnel Lines Department on 0870 458 8000 or by email at personalpmi@lorica.com. Please note that continuation of cover for your dependants is at your own cost and you must pay all related premiums direct to the provider.

How Much Does It Cost?

The Firm pays for the full annual premium regardless of the level of cover or the number of dependants insured. Premium rates change annually on 1 January. Please note that there is a £100 excess of medical expenses per insured person (defined as the employee and where applicable, the spouse and each dependant), per scheme year (1 January - 31 December). This annual excess is reapplied each 1 January regardless of when you first join the scheme. It is the insured person's responsibility to pay the excess.

See Also

• BUPA Health Insurance FAQs
• National Insurance
• Marketing of life insurance in India
• When to apply for an NI Number

External Links

For further information please refer to the official Website of BUPA http://www.bupa.co.uk/