What’s covered and what’s not?
Here’s the answer, plain and simple.
What is this type of insurance?
- This insurance is designed to provide quick access to private healthcare in the UK, for acute conditions that are likely to respond to treatment.
Who is covered?
- All applicants must live in England, Scotland, Wales or Northern Ireland. Cover is provided for private medical treatment received at a hospital on the list they choose.
What are their obligations?
- Members must take reasonable care to answer any questions asked about them or any other insured person when they take out this policy or make a claim
- Members should check their Policy Documents to make sure they have the cover they expect, and should review cover regularly
- Claims must be authorised by us before members go ahead with any consultations, tests or treatment
- Members must pay the premiums when required
- In the event of a claim, members must pay any annual excess stated in their Policy Certificate
- Members must inform us if any of their personal details change.
When and how do they pay?
- Members can pay premiums monthly by Direct Debit or annually by either Direct Debit or debit or credit card.
When does the cover start and end?
- From the start date shown on the Policy Certificate. It will last for a period of 12 months, unless cancelled by a member or us at an earlier date, and is renewable annually.
How do they cancel the contract?
- Members can cancel at any time. If they cancel within 30 days from the start date, provided no claims have been made, they will receive a full refund of the premium.
In-patient and day-patient benefits
- Consultant and specialist fees
- Diagnostic tests
- Hospital charges (including any necessary medical aids or take-home drugs).
Out-patient benefits
- CT, MRI and PET scans, including professional fees where appropriate
- Out-patient surgery
- Up to three sessions of post-operative physiotherapy.
Cancer cover
- Cover for all stages of cancer once diagnosed, including palliative and terminal treatment, with no time or financial limit.
Benefit add-ons (optional)
- Out-patient cover – specialist consultation fees and diagnostic tests
- Unlimited out-patient diagnostics – covers out-patient diagnostics tests in full
- Therapies cover – treatment by a Physiotherapist, Chiropractor, Osteopath, Acupuncturist, Podiatrist, Speech therapist, Pain clinic or Dietician (maximum of two consultations)
- Mental health – treatment as an in-patient, day-patient or out-patient. In-patient and day-patient cover limited to 28 days of treatment and hospital charges.
Policy choices
- A choice of three hospital lists, Essential, Standard and Extended
- A No Claims Discount, where members earn discounts on premiums if they stay healthy and don’t claim
- A choice of excess options, which apply to each member in each policy year
- A choice of underwriting options, whether members are switching from another insurer or are new to health insurance.
Additional benefits
- Private ambulance
- Home nursing
- Parental accommodation
- Hospice donation
- NHS cash benefit – £150 per night for up to 30 nights
- Members of The Exeter have access to membership benefits that offer additional care and support.
Policy exclusions
- Alcohol, drug or substance abuse
- Convalescence & rehabilitation
- Cosmetic and plastic surgery, bariatric and weight loss surgery
- Deliberate self-inflicted injury or suicide attempt
- Emergency treatment, until your consultant has decided you can transfer to private facilities and you have authorisation from us
- Experimental treatment
- Learning and developmental disorders
- Major organ transplants
- Mental & psychological treatment (unless the policy includes the mental health benefit add-on)
- Out-patient drugs, dressings and medical aids
- Pre-existing conditions – subject to underwriting type
- Pregnancy and fertility
- Preventative screening procedures, treatment & tests
- Professional sports injuries
- Renal dialysis
- Self-elected treatments
- Sex change / gender re-assignment
- Sight, hearing or dental disorders
- Treatment by your GP, optician or dentist
- Treatments in nursing homes
- Treatment or monitoring of ongoing, recurrent and long term conditions (also known as ‘chronic conditions’).
Cover restrictions
- If there is an excess on the policy, this will be deducted from the eligible benefits for each person, each policy year
- There is a choice of hospitals and clinics throughout the UK that members can use, depending on the list they choose
- We publish a fee schedule, which sets out the maximum fees we will pay specialists for the treatment they provide
- Some cover options may be excluded or limited based on the choices members make.
Plus all Health+
members also get access to:
The free members app that provides quick and convenient medical advice and treatments via their smartphone or tablet and can be accessed from anywhere in the world.
- GP on demand and prescription service
- Second medical opinion
- Physiotherapy
- Mental health support
For a fast and convenient introduction to our products, simply request a 20 minute briefing via video conference.
