BHF 12619
BHF 12619
Products at
a glance
Quick guide to Bupa health
insurance, dental insurance
and cash plan
For clients of intermediaries
From 1 September 2023
This document is designed to give a high level overview of the various products we provide. It should
be read alongside the relevant policy information for each of the products listed below.
Bupa Select health insurance – Select Key, Enhanced, Complete and Custom
Full policy terms are available in the Bupa Select membership guide including a full list of exclusions and exceptions.
These guides will be provided to you by your intermediary partner. Our healthcare options have been designed with
the needs of small and medium businesses in mind. Choose the cover that’s relevant to your work and budget.
To customise your cover options, please see Select Custom on page 5.
Select
Comprehensive healthcare cover
Cancer treatment
Page 2
Select
Comprehensive healthcare cover
Additional benefits
Direct Access for certain medical conditions you can contact us directly without consulting a GP for a
No GP referral needed for remote assessment with a trained advisor, therapist, mental health and wellbeing therapist
certain conditions or other clinician who specialises in your condition. This may lead to a referral for a
consultation or treatment. Call us or go to bupa.co.uk/referrals for more information
Home Nursing £2,000 each year for medical treatment carried out under the supervision of your consultant.
When immediately following private Our written agreement is needed before treatment starts. Eligibility criteria apply – see
eligible in-patient treatment membership guide for details
Ambulance Cover up to £80 each single trip – no annual limits
When related to private eligible
in-patient, day-patient treatment
NHS Cash Benefit £50 a night for up to 35 nights a year for treatment that would have otherwise been
If you choose to have in-patient covered for private in-patient treatment
treatment under the NHS rather
than privately
Procedure Specific NHS cash benefit applies to treatment that would otherwise have been covered under your benefits.
If you choose to have certain eligible The amount we pay depends on the procedure you are having. Call us or go to
treatment under the NHS rather bupa.co.uk/pscb for more information
than privately
Options to enhance cover (additional subscriptions apply)
for residents of Jersey, Guernsey or the Isle of Man only – includes travel to UK mainland.
Island cover
This option cannot be selected with the Guided Care option
Options to manage costs
Excess options £0, £100, £150, £200, £500
Six week scheme if the NHS can provide day-patient or in-patient treatment (including diagnostic procedures)
within six weeks of the date the consultant recommends it, then treatment takes
place in the NHS. If not, the treatment or tests will be covered by Bupa.
This option gives 15% to 25% discount on the cost of cover – subject to member’s age
Fixed rate the fixed rate option allows you to fix the rates you pay per member for two years at an
extra cost. However, this is not protected from any increases in Insurance Premium Tax (IPT)
when your policy is next renewed. Changes to membership made during the two-year fixed
rate period will not affect the fixed rates but may affect the price you pay for the policy
after renewal. Please note: you may not be able to amend your benefit options at your
first renewal after choosing this option
Add-ons (optional benefits you can add to your cover, additional subscriptions apply)
Family cash benefit £200 for each birth or adoption – applies to main member only
The following benefits are not available for members under 16 years old
Optical cash benefit up to £100 in any two year benefit period, when provided to or prescribed
for you by a scheme recognised optician or consultant
Accidental dental injury cash benefit up to £900 each year, with a scheme recognised dentist or orthodontist
Prescription cash benefit up to £20 each year for eligible treatment
Page 3
Select
Comprehensive healthcare cover
1
Check your Facility Access to see if the Guided Care option has been chosen:
g
If the Guided Care option has not been chosen – the benefit limit is for eligible treatment on your core health insurance when you use a Bupa recognised
consultant or therapist or complementary medicine practitioner and a healthcare facility within the Bupa network that applies to your policy.
g
If the Guided Care option has been chosen – the benefit limit is for eligible treatment on your core health insurance when you use a consultant in our list
of Open Referral Network consultants or a Bupa recognised therapist or complementary medicine practitioner, and a healthcare facility within our
participating facility network.
2
Check your Facility Access to see if the Guided Care option has been chosen:
g
If the Guided Care option has not been chosen – when we say benefits are paid in full, this is for eligible treatment on your core health insurance when you
use a healthcare facility within your chosen Bupa network using a Bupa recognised consultant who agrees to charge within Bupa limits (a fee-assured
consultant) or a Bupa recognised complementary medicine practitioner.
g
I f the Guided Care option has been chosen – when we say benefits are paid in full, this is for eligible treatment on your core health insurance when you use
a healthcare facility within our Participating facility network using a consultant in our list of Open Referral Network consultants who agrees to charge
within Bupa limits (a fee-assured consultant) or a Bupa recognised complementary medicine practitioner.
3
Any treatment for learning difficulties, behavioural or developmental conditions (LBD) will remain ineligible. However, we will now cover any related mental
health condition in relation to an LBD, for example anxiety or depression. Related mental health conditions will be eligible under Benefit 5.3 Exclusion GE20.
4
With the Guided Care option: participating facility is the network of recognised facilities for which you are covered under your benefits;and the Open Referral
service applies to your benefits. This means that you must be referred to a consultant or to treatment either by our Direct Access service (if it is available for
your condition), or by obtaining an open referral letter from a GP. This is a referral that details the care you need but is not addressed to a named consultant
or healthcare practitioner. You then must call us to pre-authorise your consultation or treatment and use a consultant in our list of Open Referral Network
consultants that applies to your benefits, or a Bupa recognised practitioner (as relevant), from the choice we give you. There are no extra bills for treatment
provided by the surgeons or anaesthetists we offer you. Excess and benefit limits still apply. The Open Referral service doesn’t apply to children aged 17 or under.
Page 4
Our levels of cover – Select Custom
Our healthcare options have been designed with your needs in mind. You can choose the customised cover that is
relevant to your work and to your budget.
Select
Comprehensive healthcare cover
Facilities
Cancer treatment
NHS cancer cash benefit £100 each night for NHS in-patient treatment
If you choose to have eligible cancer or
treatment under the NHS rather £100 for NHS out-patient, NHS day-patient, or NHS home treatment for cancer
than privately or
£100 for each three-weekly interval, or part thereof, during which you take oral chemotherapy,
or oral anti-hormone therapy that is not available from a GP
1
Check your Facility Access to see if the Guided Care option has been chosen:
g
If the Guided Care option has not been chosen – the benefit limit is for eligible treatment on your core health insurance when you use a Bupa recognised
consultant or therapist or complementary medicine practitioner and a healthcare facility within the Bupa network that applies to your policy
g
If the Guided Care option has been chosen – the benefit limit is for eligible treatment on your core health insurance when you use a consultant in our list
of Open Referral Network consultants or a Bupa recognised therapist or complementary medicine practitioner, and a healthcare facility within our
participating facility network.
2
Check your Facility Access to see if the Guided Care option has been chosen:
g
I f the Guided Care option has not been chosen – when we say benefits are paid in full, this is for eligible treatment on your core health insurance when you
use a healthcare facility within your chosen Bupa network using a Bupa recognised consultant who agrees to charge within Bupa limits (a fee-assured
consultant) or a Bupa recognised complementary medicine practitioner.
g
I f the Guided Care option has been chosen – when we say benefits are paid in full, this is for eligible treatment on your core health insurance when you use
a healthcare facility within our Participating facility network using a consultant in our list of Open Referral Network consultants who agrees to charge
within Bupa limits (a fee-assured consultant) or a Bupa recognised complementary medicine practitioner.
*Please note: For renewal customers buying directly from Bupa, and for customers purchasing via an intermediary or asking for a comparable quote directly from
Bupa. A different version of Select Custom is available for new customers purchasing directly from Bupa. Speak to your Bupa representative for further information.
Page 5
Select
Comprehensive healthcare cover
Bupa Blua Health unlimited access to GP consultations 24/7 via phone or video call, clinical triage powered
Smartphone application for diagnosis, by artificial intelligence, and private prescription writing (prescription costs not included)
GP appointments and prescriptions with delivery or collection from a chosen pharmacy
Bupa Anytime HealthLine unlimited 24/7 calls and unlimited call time. Provides guidance to members and their
Telephone service for medical advice immediate family on any medical issue
with a qualified nurse
Bupa Family Mental HealthLine unlimited calls and unlimited call time between 8am and 6pm Monday to Friday.
Telephone service for mental health Provides guidance to parents and carers who are concerned about their child’s
support with a trained adviser emotional wellbeing and/or mental health
Bupa Menopause HealthLine unlimited calls and unlimited call time between 8am and 8pm, 365 days a year.
Telephone service for clinical advice and Provides guidance and support to members and their named dependants on the
support with a menopause trained nurse policy to help understand and manage menopause symptoms
Additional benefits
Direct Access for certain medical conditions you can contact us directly without consulting a GP for
No GP referral needed for a remote assessment with a trained advisor, therapist, mental health and wellbeing therapist
certain conditions or other clinician who specialises in your condition. This may lead to a referral for
a consultation or treatment. Call us or go to bupa.co.uk/referrals for more information
Home Nursing £2,000 each year for medical treatment carried out under the supervision of your consultant.
When immediately following private You need to have our written agreement before the treatment starts
eligible in-patient treatment
Ambulance Cover up to £80 each single trip – no annual limits
When related to private eligible
in-patient, day-patient treatment
NHS Cash Benefit £50 a night for up to 35 nights a year for treatment that would have otherwise been
If you choose to have in-patient covered for private in-patient treatment
treatment under the NHS rather
than privately
Procedure Specific NHS cash benefit applies to treatment that would otherwise have been covered under your benefits.
If you choose to have certain eligible The amount we pay depends on the procedure you are having. Call us or go to
treatment under the NHS rather bupa.co.uk/pscb for more information
than privately
Add-ons (optional benefits you can add to your cover, additional subscriptions apply)
Family cash benefit £200 for each birth or adoption – applies to main member only
The following benefits are not available for members under 16 years old
Optical cash benefit up to £100 in any two year benefit period, when provided to or prescribed
for you by a scheme recognised optician or consultant
Accidental dental injury up to £900 each year, with a scheme recognised dentist or orthodontist
cash benefit
Surgeon and Anaesthetist fees full refund for consultants’ fees for eligible out-patient, day-patient and in-patient
surgical operations with a Bupa recognised consultant – irrespective of consultant
partnership status – in a scheme recognised facility.
This option cannot be select with the Guided Care option
Island cover for residents of Jersey, Guernsey or the Isle of Man only – includes travel to UK mainland.
This option cannot be selected with the Guided Care option
Page 6
Select
Comprehensive healthcare cover
Six week scheme if the NHS can provide day-patient or in-patient treatment (including diagnostic procedures)
within six weeks of the date the consultant recommends it, then treatment takes
place in the NHS. If not, the treatment or tests will be covered by Bupa.
This option gives 15% to 25% discount on the cost of cover – subject to member’s age
Fixed rate the fixed rate option allows you to fix the rates you pay per member for two years at an extra
cost. However, this is not protected from any increases in Insurance Premium Tax (IPT)
when your policy is next renewed. Changes to membership made during the two-year fixed
rate period will not affect the fixed rates but may affect the price you pay for the policy
after renewal. Please note: you may not be able to amend your benefit options at your
first renewal after choosing this option
The following option only applies to groups classified by Bupa as sports clubs
Key notes
3
ny treatment for learning difficulties, behavioural or developmental conditions (LBD) will remain ineligible. However, we will now cover any related mental
A
health condition in relation to an LBD, for example anxiety or depression. Related mental health conditions will be eligible under Benefit 5.3 Exclusion GE20.
4
With the Guided Care option: participating facility is the network of recognised facilities for which you are covered under your benefits; and the Open Referral
service applies to your benefits. This means that you must be referred to a consultant or to treatment either by our Direct Access service (if it is available for
your condition), or by obtaining an open referral letter from a GP. This is a referral that details the care you need but is not addressed to a named consultant
or healthcare practitioner. You then must call us to pre-authorise your consultation or treatment and use a consultant in our list of Open Referral Network
consultants that applies to your benefits, or a Bupa recognised practitioner (as relevant), from the choice we give you. There are no extra bills for treatment
provided by the surgeons or anaesthetists we offer you. Excess and benefit limits still apply. The Open Referral service doesn’t apply to children aged 17 or under.
5
Does not apply if the Mental health treatment option is included.
*Please note: For renewal customers buying directly from Bupa, and for customers purchasing via an intermediary or asking for a comparable quote directly from
Bupa. A different version of Select Custom is available for new customers purchasing directly from Bupa. Speak to your Bupa representative for further information.
Page 7
Bupa Dental Plan
The Dental Plan Tables of Cover show the maximum amount you and anyone covered on your policy can claim up
to in each policy year. These benefit allowances are per person and according to your level of cover.
Please also refer to Section 3 in the membership guide for full details of what is and isn’t covered and any
limitations on cover by treatment type.
Worldwide preventative and restorative benefits
Level 1 Level 2 Level 3 Level 4 Level 5
Worldwide preventative dental treatment
Routine examination £80 £100 £140 £160 £220
up to £40 up to £50 up to £70 up to £80 up to £110
for each visit for each visit for each visit for each visit for each visit
maximum of two visits in each policy year
Scale and polish £100 £120 £180 £200 £260
(by your dentist or hygienist) up to £50 up to £60 up to £90 up to £100 up to £130
for each visit for each visit for each visit for each visit for each visit
maximum of two visits per policy year
Virtual routine examination £20 for each policy year
Dental X-rays and scans £40 £50 £80 £90 £100
Oral cancer treatment paid in full to diagnose and to treat oral cancer when using
UK only a fee-assured consultant in a partnership facility
Cash benefit for hospital stay £100 for each night you stay in hospital,
UK only up to £1,000 in each policy year
For full details of your cover, please refer to the membership guide.
We have a nationwide network of Bupa owned and Bupa approved dental practices. It aims to offer our dental insurance customers hassle-free access to quality
care and discounts on treatment.
Up to 20% discount† is available on general dental treatment costs at selected Bupa-owned and approved network dental practices. Please note, not all
Bupa Dental Care practices are part of the Bupa Dental Insurance Network.
†You must inform the dentist you have Bupa dental insurance and provide your membership number prior to your appointment to benefit from this offer. 10% or
20% discounts are available depending on the practice and the dentist you are seeing. To find the selected Bupa-owned and approved network dental practices
where this offer is available visit finder.bupa.co.uk and search Bupa Insurance Network. Discount excludes laboratory fees and specialist treatment and cannot
be used against NHS and Bupa Essentials services.
Page 8
Bupa Dental Choice
The Dental Choice Tables of Cover show the maximum amount you and anyone covered on your policy can claim
up to in each policy year. These benefit allowances are per person and according to your level of cover.
Where we say for each course of treatment, we mean all visits needed to complete this treatment. This includes
preparation, supply and fit for each tooth restoration and any associated laboratory costs needed for this.
Please also refer to Section 3 in the membership guide for full details of what is and isn’t covered and any
limitations on cover by treatment type.
Page 9
Worldwide restorative benefits (continued)
Choice 1 Choice 2 Choice 3 Choice 4 Choice 5
Worldwide restorative dental treatment (continued)
Veneer up to £215 up to £240 up to £270 up to £390 up to £425
for each tooth, for each course of treatment
Crown up to £210 up to £250 up to £325 up to £480 up to £500
for each tooth, for each course of treatment
Bridge up to £425 up to £600 up to £750 up to £900 up to £1,100
for each course of treatment
Repair of bridge or crown up to £25 up to £30 up to £35 up to £55 up to £75
for each course of treatment
Post for crown (cast post and core, up to £35 up to £56 up to £90 up to £110 up to £125
or prefabricated post and core)
for each course of treatment
Denture
Upper or lower denture up to £360 up to £450 up to £500 up to £650 up to £800
(partial or full)
for each denture, for each course of treatment
Repair or reline of a denture up to £30 up to £35 up to £40 up to £50 up to £60
(partial or full)
for each repair
Other treatment
Mouthguard (partial or full) up to £82 up to £150 up to £175 up to £200 up to £225
one mouthguard for each policy year
Any other clinically necessary up to £65 up to £75 up to £85 up to £115 up to £125
restorative dental treatment
for each policy year
Oral cancer treatment paid in full to diagnose and to treat oral cancer when using
UK only a fee-assured consultant in a partnership facility
Cash benefit for hospital stay £100 for each night you stay in hospital
UK only up to £1,000 in each policy year
For full details of your cover, please refer to the membership guide.
We have a nationwide network of Bupa owned and Bupa approved dental practices. It aims to offer our dental insurance customers hassle-free access to quality
care and discounts on treatment.
Up to 20% discount† is available on general dental treatment costs at selected Bupa-owned and approved network dental practices. Please note, not all
Bupa Dental Care practices are part of the Bupa Dental Insurance Network.
†You must inform the dentist you have Bupa dental insurance and provide your membership number prior to your appointment to benefit from this offer. 10% or
20% discounts are available depending on the practice and the dentist you are seeing. To find the selected Bupa-owned and approved network dental practices
where this offer is available visit finder.bupa.co.uk and search Bupa Insurance Network. Discount excludes laboratory fees and specialist treatment and cannot
be used against NHS and Bupa Essentials services.
Page 10
Cash plan
Because health expenses are often unplanned, you can’t always budget for them. If you knew you could claim cash
back for everyday expenses such as dental and optical bills, it could make life a little easier.
Bupa health assessments up to £100 up to £150 up to £200 all members aged 100%
18 and over
*Individual plus membership is for the main member and up to four child dependants. Family membership is for the main member, their partner and up to four
child dependants.
**EAP Key and EAP Premier options available. The option chosen will determine the benefits available to your employees and will also affect your premium.
Please see the applicable Bupa Wellbeing Health Expenses table of cover for more information.
All benefit limits represent the maximum amount that we will pay for each benefit under the cash plan during each benefit year. Pre-existing conditions are
covered for all benefits. You will be required to provide any information or proof to support your claim if we make a reasonable request for you to do so.
Terms and conditions apply. Please see the applicable Bupa Wellbeing Health Expenses table of cover and the Bupa Cash Plan membership guide for
more information.
Page 11
Helpful information
Privacy notice
Our privacy notice explains how we take care of
your personal information and how we use it to provide
your cover. A brief version of the notice can be found in
your membership guide and the full version is online
at bupa.co.uk/privacy
Everyday Rewards by Bupa is promoted by Bupa Investments Limited, 1 Angel Court, London EC2R 7HJ and administered by Paragon Customer
Communications Limited, Evolution House, 12 Choats Road, Barking, Dagenham, RM9 6BF
Terms and conditions can be found at bupa-rewards.bupa.co.uk/terms-conditions
Bupa Investments Limited and Paragon Customer Communications Limited will use your information for the purposes of the administration of Everyday
Rewards. For details of how your information will be processed by Bupa, please visit: bupa.co.uk/privacy
Page 12
Notes
Page 13
Notes
Page 14
Notes
Page 15
Bupa Blua Health, Bupa Anytime HealthLine, Bupa Family Mental
HealthLine, Bupa Employee Assistance Programmes,
Bupa Health Assessments and Everyday Rewards by Bupa
are not regulated by the Financial Conduct Authority or the
Prudential Regulation Authority.
Bupa Anytime HealthLine, Bupa Employee Assistance
Programmes and Bupa Health Assessments are provided by:
Bupa Occupational Health Limited. Registered in England
and Wales No. 631336.
Registered office: 1 Angel Court, London EC2R 7HJ
Bupa health insurance, dental insurance and cash plan are
provided by:
Bupa Insurance Limited. Registered in England and Wales
No. 3956433. Bupa Insurance Limited is authorised by the
Prudential Regulation Authority and regulated by the Financial
Conduct Authority and the Prudential Regulation Authority.
Arranged and administered by:
Bupa Insurance Services Limited, which is authorised and
regulated by the Financial Conduct Authority. Registered in
England and Wales No. 3829851.
Registered office: 1 Angel Court, London EC2R 7HJ
© Bupa 2023
bupa.co.uk