Home > PHC - HealthCover 4 Life (Plan 3) - option b

PHC - HealthCover 4 Life (Plan 3) - option b

Four plans are available providing a choice of uncomplicated yet comprehensive insurance to suit your clients' needs in terms of both cover and budget. We provide our group clients with even greater flexibility by offering a number of options with each plan.

Clients can chose between different levels of benefits, excesses, hospitals, and travel insurance and these options can even be different for each employee. Starting with the comprehensive cover of the Plan 1 through to the budget option of Plan 4.

Six Week wait plan option

Benefits

Key Facts - In-patient & Day Case Charges
Hospital accommodation charges including theatre fees, nursing costs, prosthesis, in-patient drugs & dressings
	Full cover - subject to the 6 week waiting rule
Surgeon / Consultant / Specialist & Anaesthetists fees
	Full cover - subject to fees being reasonable and customary
Physicians fees & diagnostic tests
	Full cover - subject to the 6 week waiting rule
Cancer Treatment Costs - Chemotherapy / Radiotherapy
	Full cover - subject to the 6 week waiting rule
Psychiatric treatment
	Not covered
Six week option
	Six week wait definition: If your policy has a 6 week wait option, as Plan 3b, then any in-patient treatment, day-patient treatment or, out-patient surgical treatment listed in your benefit table will not be covered unless it is unavailable on the NHS for a period of at least 6 weeks from the date your specialist/consultant confirms that treatment is required
Key Facts - Out-patient Charges
Complementary medicine
	Up to £250 for Acupuncture, Chiropractic, Homeopathy and Osteopathy - This is part of the overall out-patient limit of £1,000
Diagnostic tests (excluding scans)
	Up to £1,000 - This is part of the overall out-patient limit of £1,000
GP referred consultations
	Up to £1,000 - This is part of the overall out-patient limit of £1,000
Physiotherapy consultant referred
	Up to £250 - This is part of the limit for Physiotherapy treatment of £250 and the overall out-patient limit of £1,000
Physiotherapy GP referred
	Up to £250 - This is part of the limit for Physiotherapy treatment of £250 and the out-patient limit of £1,000 (limited to 6 sessions pa for GP referred treatment thereafter referrals must be made by a specialist / consultant)
Psychiatric cover
	Not covered
Radiotherapy / Chemotherapy
	Full cover
Scans - MRI / CT / PET
	Full cover
Surgical Procedures
	Full cover - subject to the 6 week waiting rule
Key Facts - Additional Benefits
NHS cash benefit
	£100 per night (following treatment as an NHS patient* up to a maximum of £2,000 pa) NHS day care benefit £50 per claim*
Nursing at home
	Full cover with consultant's approval only if following a period of covered in-patient treatment (Limitations apply refer to member guide)
Parental accommodation
	Full cover for a parent to accompany a child up to age 16. Plus £100 a night up to 5 nights for a close relative stay in a hotel
Primary care
	Not covered
Private ambulance
	£250 per person per policy year for transport to / from a hospital for medical reasons
Additional Benefits
Alcohol & drug abuse
	Not covered
Annual maximum limit
	No annual maximum
Children covered
	children can be covered as dependants on a policy until the renewal date following their 25th birthday
Chiropractors & Osteopaths
	Up to £250 - This is part of the overall out-patient limit of £1,000
Dental treatment
	Specified oral procedures only in hospital
Discretionary Benefit Option (DBO)
	Not covered
GP minor surgery
	Not covered
GP Referred Chiropody, Podiatry or Homeopathy
	Only Homeopathy up to £250 - This is part of the overall out-patient limit of £1,000
Hospice donation
	Not covered
Infertility investigations
	Not covered
Maternity cash benefit
	Not covered
Optional cash benefit
	Not covered
Out of pocket expenses
	Not covered
Overseas cover
	Not covered
Personal & total disability benefit
	Not covered
Post hospital recovery bonus
	Not covered
Pregnancy
	Full cover for specified abnormal pregnancy conditions
Stress counselling helpline
	24-hour claims stress counselling and medical advice line. Only available to members aged 16 years or over
Transplants
	Not covered
Other benefits
	Cancer Enhancements Comprehensive cover enhancments when associated with cancer treatment: * up to £5,000 per policy year - Provision of external prosthesis * up to £150 per policy year - Purchase of wigs * New/experimental procedures - these will now be reviewed by the clinical team and considered for benefit * Experimental drug treatment - will be covered if part of an ethical trial and pre-agreed by us * Cancer follow-ups - No limit on cancer follow ups. * Radiotherapy and chemotherapy cash benefit - £50 up to £2,000 per year when you receive free treatment that would have been eligible for benefit privately * all out-patient consultations or diagnostic tests for cancer will not count towards the £1,000 out-patient limit on Plan 3.

Key Facts - In-patient & Day Case Charges

Hospital accommodation charges including theatre fees, nursing costs, prosthesis, in-patient drugs & dressings

Full cover - subject to the 6 week waiting rule

Surgeon / Consultant / Specialist & Anaesthetists fees

Full cover - subject to fees being reasonable and customary

Physicians fees & diagnostic tests

Full cover - subject to the 6 week waiting rule

Cancer Treatment Costs - Chemotherapy / Radiotherapy

Full cover - subject to the 6 week waiting rule

Psychiatric treatment

Not covered

Six week option

Six week wait definition: If your policy has a 6 week wait option, as Plan 3b, then any in-patient treatment, day-patient treatment or, out-patient surgical treatment listed in your benefit table will not be covered unless it is unavailable on the NHS for a period of at least 6 weeks from the date your specialist/consultant confirms that treatment is required

Key Facts - Out-patient Charges

Complementary medicine

Up to £250 for Acupuncture, Chiropractic, Homeopathy and Osteopathy - This is part of the overall out-patient limit of £1,000

Diagnostic tests (excluding scans)

Up to £1,000 - This is part of the overall out-patient limit of £1,000

GP referred consultations

Up to £1,000 - This is part of the overall out-patient limit of £1,000

Physiotherapy consultant referred

Up to £250 - This is part of the limit for Physiotherapy treatment of £250 and the overall out-patient limit of £1,000

Physiotherapy GP referred

Up to £250 - This is part of the limit for Physiotherapy treatment of £250 and the out-patient limit of £1,000 (limited to 6 sessions pa for GP referred treatment thereafter referrals must be made by a specialist / consultant)

Psychiatric cover

Not covered

Radiotherapy / Chemotherapy

Full cover

Scans - MRI / CT / PET

Full cover

Surgical Procedures

Full cover - subject to the 6 week waiting rule

Key Facts - Additional Benefits

NHS cash benefit

£100 per night (following treatment as an NHS patient* up to a maximum of £2,000 pa) NHS day care benefit £50 per claim*

Nursing at home

Full cover with consultant's approval only if following a period of covered in-patient treatment (Limitations apply refer to member guide)

Parental accommodation

Full cover for a parent to accompany a child up to age 16. Plus £100 a night up to 5 nights for a close relative stay in a hotel

Primary care

Not covered

Private ambulance

£250 per person per policy year for transport to / from a hospital for medical reasons

Additional Benefits

Alcohol & drug abuse

Not covered

Annual maximum limit

No annual maximum

Children covered

children can be covered as dependants on a policy until the renewal date following their 25th birthday

Chiropractors & Osteopaths

Up to £250 - This is part of the overall out-patient limit of £1,000

Dental treatment

Specified oral procedures only in hospital

Discretionary Benefit Option (DBO)

Not covered

GP minor surgery

Not covered

GP Referred Chiropody, Podiatry or Homeopathy

Only Homeopathy up to £250 - This is part of the overall out-patient limit of £1,000

Hospice donation

Not covered

Infertility investigations

Not covered

Maternity cash benefit

Not covered

Optional cash benefit

Not covered

Out of pocket expenses

Not covered

Overseas cover

Not covered

Personal & total disability benefit

Not covered

Post hospital recovery bonus

Not covered

Pregnancy

Full cover for specified abnormal pregnancy conditions

Stress counselling helpline

24-hour claims stress counselling and medical advice line. Only available to members aged 16 years or over

Transplants

Not covered

Other benefits

Cancer Enhancements
Comprehensive cover enhancments when associated with cancer treatment:
* up to £5,000 per policy year - Provision of external prosthesis
* up to £150 per policy year - Purchase of wigs
* New/experimental procedures - these will now be reviewed by the clinical team and considered for benefit
* Experimental drug treatment - will be covered if part of an ethical trial and pre-agreed by us
* Cancer follow-ups - No limit on cancer follow ups.
* Radiotherapy and chemotherapy cash benefit - £50 up to £2,000 per year when you receive free treatment that would have been eligible for benefit privately
* all out-patient consultations or diagnostic tests for cancer will not count towards the £1,000 out-patient limit on Plan 3.


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