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Cover Options

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Flexible cover to suit your business

You can choose other cover options for your plan. This means you can create a plan to suit your employees and your budget. All benefits are per insured member, per plan year, unless stated otherwise. Treatment must take place at a hospital eligible under your plan.

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Cover Options

You can tailor your plan to suit your employees' lifestyles by selecting the level of Out-patient Cover and Therapies Cover

Out-patient Cover

Out-patient Cover pays for costs such as consultant appointments and physiotherapy, and diagnostic tests like MRI scans, blood tests and x-rays
The costs we cover depend on what you add to your plan:

  • Out-patient cover with a limit. We can pay for diagnostic tests, consultant appointments and out-of-network physiotherapy up to a set limit.
    A limit of £500, £750, £1,000, £1,250 or £1,500 can be chosen.
  • Full Out-patient Cover. We pay for all the out-patient treatment, consultant fees and diagnostic tests needed.
MRI, CT and PET scans
We pay for these scans, as long as your employees have been referred by a consultant.

MRI, CT and PET scans will be paid in full, and not treated as part of the employees' Out-patient Cover limit.
Physiotherapy Cover
The VitalityHealth physiotherapy network includes over 1,400 accredited physiotherapy clinics across the UK. This means that, more often than not, your employees will be able to have treatment at a convenient location, less than 10 minutes’ drive away from their home or place of work.

Cover for a physiotherapist within our network
Treatment will be covered in full, and will not form part of the Out-patient Cover limit.

Cover for a physiotherapist outside of our network
Treatment will continue to be deducted from your employees Out-patient Cover limit and will be limited to £35 per session. 
Out-patient Diagnostics
If you have chosen a limited Out-patient Cover option, you can choose to add on full cover for diagnostics – you can upgrade your Out-patient Cover so that out-patient diagnostic tests would be covered in full, and only consultant appointments and out-of-network physiotherapy would be covered by your chosen Out-patient Cover limit.

Out-patient diagnostics will be covered in full. Consultant appointments and out-of-network physiotherapy will continue to be covered up to the limit you’ve chosen for your employees.
Psychiatric Cover
We pay for consultations and treatment with a psychiatrist or psychologist. If your employees need it, we can pay for hospital stays. All psychiatric claims are managed on a case-by-case basis.

£15,000 or £20,000 for each plan year.
Up to £1,500 of this total can be used for out-patient psychiatric treatment
Therapies Cover
Chiropractic treatment, osteopathy, chiropody/podiatry, acupuncture, homeopathy, and two consultations with a dietician following GP or consultant referral.

£350 or Full Cover
Employee Assistance Programme

At some point, everyone faces emotional problems such as relationship or money worries, stress, and bereavement. If your employees have problems like these and are finding it hard to cope, an Employee Assistance Programme can help.
With the programme, your employees get:

  • Debt counselling, legal and financial advice through our 24-hour helpline
  • Up to six confidential, face-to-face counselling sessions per year 

Our Employee Assistance Programme is provided by Health Assured.

Unlimited access to a confidential telephone advice service, 24 hours a day, 365 days a year
Cancer Cover

All our plans come with comprehensive Cancer Cover as standard. For an additional premium, you can choose our Extended Cancer Cover, which provides full cover for biological therapies, and hormone or bisphosphonate therapies. It also provides:

  • Follow-up consultations – Full cover
  • End-of-life home nursing care – Up to £1,000 per day for a maximum of 14 days
  • Wigs and restyling – Up to £300 per condition
  • Scalp cooling – Full cover
  • Mastectomy bras and external prostheses – Up to £200 per condition

Additional Benefits

Choose whether you want to give your employees a Personal Health Fund or add dental or travel cover

Personal Health Fund (PHF)
You can give your employees a Personal Health Fund to help pay for everyday healthcare bills that aren’t usually covered by private medical insurance. Your employees can use their Personal Health Fund for:
Optical Treatment Includes fees for sight tests, fitting, spectacle repairs, prescription swimming or diving goggles. The can also claim for glasses, lenses, spectacle frames, contact lenses, and prescription sunglasses.
Dentistry Claims Check ups and treatment at a UK dentist, including braces, fillings, crowns and bridges, plus hygienist fees.
Health Screens They can claim back up to 50% of the cost of a health screen.
Chronic Prescriptions If they have a chronic condition, they can use their PHF to cover the cost of a prescription prepayment certificate (PPC), which will cover the cost of NHS prescriptions for 3 or 12 months. This is the only healthcare expense they need us to authorise for payment from the PHF beforehand.
Private GP appointments They can use their PHF to pay for a face-to-face appointment with a private GP.
Medical aids and devices Your employees will be able to claim back 50% of the costs of a range of medical aids and devices including hearing aids, blood pressure monitors and TENS machines.
£100 towards a fitness device They can use £100 of their fund to pay for a device which can be used to record Vitality points. Maximum of one claim of up to £100 per adult every three plan years.

Vitality status Personal Health Fund
Start off at Bronze £75
Reach Silver Add £50
Silver £125
Reach Gold Add another £50
Gold £175
Reach Platinum Add another £50
Platinum £225
(Any unused balance will be rolled over to the following year. A maximum Personal Health Fund balance of £1,000 per adult member will apply)
Dental Cover
You can choose between two levels of dental cover for your employees, depending on how much you want to spend, and how much cover you want to offer them.

All benefits are per insured member, per plan year unless otherwise stated.

  Major dental treatment Major and routine dental treatment
Routine examinations
Maximum of two claims per plan year
  Up to £30 per claim
Routine scaling and polishing
Maximum of two claims per plan year
  Up to £40 per claim
Dental x-ray (radiography of the teeth or jaw)
Charges for radiography of teeth or jaw
Maximum of two claims per plan year
  Up to £40 per claim
Maximum of two claims per plan year
  Up to £40 per claim
New or replacement crowns Up to £300 Up to £400
New or replacement inlays, onlays and overlays Up to £100
New or replacement bridges or implants Up to £200 Up to £300
Root canal treatment Up to £150 Up to £250
Apicectomy Up to £100 Up to £150
Extractions Up to £150 Up to £250
New or replacement dentures Up to £250 Up to £350
Emergency treatment from a specialist if you have a dental accident
We can cover up to four claims for each year of your plan
Up to £2,500 per claim Up to £2,500 per claim
Emergency dental treatment for severe pain, a haemorrhage or an infection
We can cover up to two claims for each year of your plan

Up to £300 per claim
 Emergency call-out fees  Up to £50 per claim  Up to £50 per claim

To get his cover, your employees need to have had a check-up with their regular dentist and finished any recommended treatment within twelve months before their cover starts. If they haven’t done this, then they’ll only be covered once they have had a check-up and finished any recommended treatment.
Separate terms, conditions and exclusions apply to our Dental Cover – please speak to your adviser to find out more
Worldwide Travel Cover
This covers trips of up to 120 days and includes things like emergency medical expenses to a lost passport. You can apply to include this benefit to cover at the plan start date, or a future renewal date, provided all applicants are aged 79 or under at the time the benefit is included.
Overseas medical expenses
Medical cover if taken ill overseas
Including accommodation costs and travel expenses for one person to remain behind with the sick or injured member*
Repatriation expenses*
Transfer of body or ashes back to the UK
Cost of burial or cremation outside the UK
Up to £10 million

Up to £1,000
Other travel expenses
Loss of or damage to personal belongings* Up to £2,000
Loss of personal money* Up to £1,000
Loss of or damage to business machines* Up to £1000
Delayed departure Up to £100
Missed departure* Up to £500
Cancelling the trip or cutting it short* Up to £4,000
Personal accident Up to £25,000
Personal liability Up to £2 million
Loss of passport* Up to £250
Delayed baggage* Up to £200
Legal expenses Up to £25,000
Replacement employee travelling costs* Up to £1,000
Winter Sports Cover (cover is limited to 21 days in total each plan year)
Loss of or damage to ski or snowboarding equipment* Up to £500 per plan year
Loss of ski pass* Up to £500 per plan year
Piste closure(£30 a day)* Up to £500 per plan year
Loss of use of hired skis and ski pass due to illness or injury* Up to £500 per plan year

*Your employees will need to pay a £50 excess on these benefits

Unless we agree otherwise, the benefits are for each insured member on your plan, per trip. Separate terms, conditions and exclusions apply to our Worldwide Travel Cover – please speak to your adviser to find out more.

Control Premiums

Premiums can be reduced with a range of excess levels and a choice of where your employees are treated.

Choose where your employees can get treatment

We offer your employees access to the best possible medical care and when they need treatment we ensure it’s at a hospital which offers clean and comfortable surroundings. There are two options as to where they may be treated and you can choose which options suits you and your employees best.

  1. Consultant Select - a consultant on our provider panel chooses the most appropriate hospital for your employees' treatment
  2. Hospital lists – you choose which hospitals your employees can use:
    • Local Hospital List
    • Countrywide Hospital List
    • Countrywide Plus Hospital List
You can choose for your employees to contribute to the cost of their treatment up to a maximum amount. We then pay for the rest of their treatment, up to any limits on your plan.

The higher contribution your employees pay, the smaller we can make your premiums. You can choose this maximum contribution to be £0, £100, £250, £500 or £1,000

Once you’ve chosen an excess, you choose whether your employees pay once per plan year or each time they make a claim.

Vitality status-linked excess

For Business Healthcare plans with five or more employees you can link your employees' excess to their Vitality status. As they improve their Vitality status, we reduce the amount of excess they need to pay without changing your premiums.

The excess levels do not apply when making claims for NHS Hospital Cash Benefit, Childbirth Cash Benefit and Lifestyle Surgery or costs relating to Vitality GP.

This excess would also not be applied to claims made under the Dental Cover option and also the Worldwide Travel Cover and Emergency Overseas Cover options where a different excess may apply.

When we’re working out whether we can cover your employees, what we can cover them for and how much their cover will cost, we go through a process called underwriting.
There are four different kinds of underwriting that you can choose from. Which one’s right for your business depends on whether you’ve already got a company plan with someone else, how much information you want us to ask your employees  for, and how large your business is.

  1. Full Medical Underwriting
    If you’re happy for us to ask your employees about their medical history, you can choose Full Medical Underwriting. We might need to exclude some pre-existing conditions from their cover, but we always tell them upfront exactly what they’re covered for.
  2. Moratorium Underwriting
    If you don’t want us to ask your employees’ medical history, we tell them whether they’re covered at the time they make the claim. Your employees won't initially be covered for any condition that they have had within the five years prior to the start of their cover.
  3. Continued Personal Medical Exclusions Underwriting
    If you’ve already got a company health insurance plan with another provider, you could choose Continued Personal Medical Exclusions Underwriting which means we will apply the same personal medical exclusions as your current insurer.
  4. Medical History Disregarded Underwriting
    If you’ve already got a company health insurance plan with another provider and all members are currently insured on a Medical History Disregarded basis, or your company is currently uninsured but wish to ensure 20 or more employees, you could choose Medical History Disregarded Underwriting. 
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