The SecureHealth private medical insurance plan
– at a glance

 

What is SecureHealth Ultimate?

The SecureHealth Ultimate policy is a private medical insurance policy, which allows you to choose the Modules you require. SecureHealth Ultimate always includes 'Core cover', but you may have chosen additional Modules in the following combinations. Details of the benefits that each of the Modules contain are shown below.

What is SecureHealth Ultimate 6?

The SecureHealth Ultimate 6 policy offers you the same benefits as SecureHealth Ultimate. With SecureHealth Ultimate 6, if the NHS can give you the hospital treatment you need within six weeks of the date on which the treatment should be undertaken, then you must use the NHS. However, you have immediate access for those operations listed in the benefits table section in the membership handbook and for radiotherapy or chemotherapy performed as day-patient or out-patient treatment.

 

Core cover

Core cover offers you cover as a UK resident for private medical treatment in the UK of new medical conditions that arise after you join. This includes in-patient and day-patient treatment and associated specialists’ charges. In addition, it provides you with cover for out-patient surgical procedures, computerised tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), radiotherapy and chemotherapy. There is also cover for chemotherapy treatments given over a prolonged period of time for up to one year.

Core Cover	Cover
In-patient and day-patient treatment: Charges for accommodation, operating theatre charges, nursing care, drugs and dressings, diagnostic tests,CT, MRI, PET scans, radiotherapy, Chemotherapy, physiotherapy Specialist fees (surgeons, anaethetists and physicians) and consultations	Paid in full at a hospital listed in the Directory of Hospitals No annual maximum
NHS Hospital cash benefit: In-patient Day-patient	£250 a night up to £2,000 a year £150 per day up to £300 a year
Health at Hand	Health information and counselling service available 24 hours a day, 365 days a year
Hospital at Home	Paid in full
Private ambulance transport	Paid in full
Out-patient treatment: i) Out-patient surgical procedures ii) CT,MRI, PET scans iii) Radiotherapy/chemotherapy	No annual maximum Paid in full at a scanning centre listed in the Directory of Hospitals No annual maximum (including 12 months cover for licenced drug treatments given for a prolonged period of time such as Herceptin or Avastin)
Emergency evacuation/repatriation to the UK Immediate emergency in-patient treatment received while travelling abroad which relates to an evacuation or repatriation we have arranged for you.	Paid in full when arranged by us Up to £40,000 a year

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Choose a level of out-patient cover to suit you

You can tailor your plan even closer to your specific requirements by chosing from any of the following modules

Module 1

Out patient consultations and diagnostics

A - three specialist consultations, no annual maximum for diagnostic tests.

B - £1,000 combined annual limit for out-patient consultations, clinical practitioner charges and diagnostic tests.

C - No annual maximum for out-patient consultations, clinical practitioner charges and diagnostic tests.

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Choose extra benefits

You can tailor your plan even closer to your specific requirements by choosing from any of the following modules:

Module 2

Therapies cover No annual maximum for physiotherapy, osteopathy, acupuncture, homeopathy, chiropractor. However, we will only pay for up to an overall maximum of 10 sessions of treatment per year for GP referred physiotherapy and/or complementary practitioner treatment.

Module 3

Additional benefits Recuperative Care up to £280 per year within three months of eligible in-patient treatment. Parental accommodation for children up to 14 years old. Oral surgery – paid in full. Investigations into infertility and treatment of medical conditions found during those investigations, subject to a two year qualifying period.

Module 4

Psychiatric cover * 28 days in-patient/day-patient treatment.Out-patient treatment up to £1,500 a year.

Module 5

Extended cancer cover ** Core cover includes one year’s cover for licenced cancer drugs. Module 5 extends your cover for an additional two years.

Module 6

Routine optical and dental cover Cash benefit towards the cost of prescription glasses or contact lenses. £25 per year for eyesight tests. Specified dental procedures.

Module 7

Travel cover Travel Cover for business or personal trips.

* This module is only available if you choose Module 1B or C.
** This module is only available if you choose Module 1C.

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Ways to reduce your premium

An excess on a medical insurance policy enables members to enjoy lower premiums in exchange for agreeing to pay a set amount

Excesses
Choose from:	£0	£100	£250	£500
No Claims Discount
With SecureHealth Ultimate you will be entitled to a no claims discount provided you don’t make a claim. There are eight levels from 0% to 50%. When you join we will tell you the initial discount level to which you are entitled. If you need to make a claim, you have the option of paying for treatment yourself, and keeping your no-claims discount. If a person covered by the policy chooses to make a claim, the level of discount for that person drops. But it will go up again if that person doesn’t make a claim for the following policy year. In any year when a person covered by the policy makes one or more claims, the no claims discount for that person drops by three levels.
6 week option
If the NHS cannot provide the in-patient or day-patient treatment or out-patient surgical procedure you need within six weeks of the date on which it should be undertaken, you will then qualify for eligible private treatment. (Only available with NCD.)

 

What are the main exclusions and limitations of SecureHealth Ultimate and SecureHealth Ultimate 6?

As with all insurance policies general exclusions apply. The following is a summary of the main exclusions and limitations of the policy.

What are the main exclusions and limitations of cover	Where can I find more information
Treatment of medical conditions that existed, or you had symptoms of, before joining.	‘Existing medical conditions’ section of the membership handbook.
Ongoing, recurrent or long term treatment of long term illnesses (usually referred to as 'chronic conditions').	'Recurrent, continuing and longterm treatment' section of the membership handbook.
Outpatient diagnostic tests, and outpatient consultations unless you have Module 1A, B or C. Outpatient clinical practitioner charges unless you have Module 1B or C.	'Your cover for certain types of treatment' section of the membership handbook.
Outpatient complementary practitioner and physiotherapist charges, unless you have Module 2.	'Who we pay for treatment' section of the membership handbook.
General dental procedures.	'Your cover for certain types of treatment' section of the membership handbook.
Psychiatric treatment, unless you have Module 5.	'Recurrent, continuing and longterm treatment' section of the membership handbook.
Routine pregnancy and childbirth.	'Your cover for certain types of treatment' section of the membership handbook.
Inpatient or daypatient treatment, MRI, CT or PET scans, oral surgical procedures or cataract surgical procedures not received in a hospital, scanning centre or facility listed in the Directory of Hospitals.	'Where you are covered for treatment' section of the membership handbook.
Fee charges by specialist, complementary practitioners or clinical practitioners above the level within our published schedule of procedures and fees	'Who we pay for treatment' section of the membership handbook.
Emergency or urgent treatment.	'Your cover' section of the membership handbook.

 

An optional excess is available with this policy. If you select an excess you pay the first £100, £250, or £500 of eligible claims, once each policy year, for each person covered by your policy. Full details of how the excess is applied can be found in the 'Additional information' section of your membership handbook. As detailed in the 'Main exclusions and limitations' section of this policy summary your cover is restricted for treatment of conditions you had prior to joining. How this applies to your cover will depend on the basis on which you join. Whichever method you join on will be confirmed on your membership statement. Further details can be found in the 'Existing medical conditions' section of your membership handbook or any addendum we may send you.

How long will my cover last?

Your policy will be arranged for 12 months from the effective date on your membership statement.

What do I do if I want to make a claim?

If you need to make a claim simply call the Customer Helpline on 0845 607 6163. Full details of how to make a claim are included in the membership handbook.

How do I complain?

We aim to provide you with the highest possible standards of service but accept there may be occasions when you feel that things have gone wrong for you and you are unhappy with us. If you have a complaint about any matter please contact us and we will do our best to address your concerns. Your feedback is vital to helping us improve. Further details on how to complain can be found in the 'Complaint and regulatory information' section of your membership handbook. If you are dissatisfied with the outcome of our investigation, you can ask the Financial Ombudsman Service to consider your complaint.

The Financial Services Compensation Scheme (FSCS)

We are also participants in the Financial Services Compensation Scheme established under the Financial Services and Markets Act 2000. The scheme is administered by the Financial Services Compensation Scheme Limited (FSCS), a body established by the FSA. The scheme is governed by FSA Rules and may act if it decides that an insurance company is in such serious financial difficulties that it may not be able to honour its contracts of insurance. The scheme may assist by providing financial assistance to the insurer concerned, by transferring policies to another insurer, or by paying compensation to eligible policyholders. Further information about the operation of the scheme is available on the FSCS website:
www.fscs.org.uk

What if I change my mind?

You have a 14 day cancellation period. During this period you have the right to cancel your policy and have your premium returned in line with the terms for cancellation at renewal, as detailed in the 'Legal rights and responsibilities' part of the 'Complaint and regulatory information' section of your membership handbook. The cancellation period begins on the day your contract is agreed, or the day you received your full policy terms and conditions if this is later, and will also apply from each renewal date.