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How does it work?

This page contains answers to a variety of common questions about our Company plan.

If you have a question that you don't see answered here, please send us an email enquiry or call us on +44 (0) 1273 718 313.

 

How does this plan work?

  1. Where can I be treated?
  2. How do I arrange treatment?
  3. How does the claims process work?
  4. How does Bupa International make claim payments?
  5. How do deductibles work?
  6. What treatment and conditions are not covered?
  7. Do you have a limit for the cost of treatment I may receive?

Services available to you

  1. How can I track the progress of my claim?
  2. How can I contact Bupa International?
  3. What is your complaints process?
  4. Can I access my plan online?
  5. As a group secretary, can I manage the group plan online?

Managing your plan

  1. How are subscriptions paid?
  2. How can I renew my plan?
  3. Can I add other people to my plan?
  4. What is a group insurance plan?
  5. How is the plan cancelled?
  6. Can I transfer to a personal plan if my group plan ends?
  7. I haven't been able to find the answer to my question

How does this plan work?

Where can I be treated? Hide

You can receive treatment from any recognised hospital, clinic, or legally qualified medical practitioner.

We also have a network of more than 7,500 hospitals and clinics which we can often arrange to pay directly on your behalf (this is known as direct settlement).

Our Healthline service will help you find a suitable medical professional.

How do I arrange treatment? Hide

When you know that you need to seek medical advice and/or treatment, we ask that you contact us first. This allows us to check your cover, confirm that your proposed treatment is eligible for payment, and in many cases, contact your medical provider to arrange direct settlement.

How does the claims process work? Hide

There are two ways that your medical treatment can be paid:

Direct settlement

  • You contact us to advise what treatment you intend to receive.
  • We confirm that treatment is eligible and that we can ‘pre-authorise’ (guarantee payment) of it.
  • We send pre-authorisation to you and the provider of your treatment.
  • You complete and sign the pre-authorisation form.
  • Your medical provider attaches the invoice(s) for your treatment and returns with the pre-authorisation documents to us.
  • We process the claim and pay your medical provider directly.
  • We send you a ‘payment statement’ advising when and how it was paid, and who received the payment.
  • You settle any shortfall with your medical provider.

Pay and claim

  • You contact us to advise what treatment you intend to receive.
  • We confirm your cover and benefit limits.
  • You receive treatment and pay your medical provider (usually at time of treatment).
  • You and your medical provider fully complete a claim form and return the claim form to us.
  • We process the claim and pay you*.
  • We send you a ‘payment statement’ advising when and how it was paid, and who received the payment.
How does Bupa International make claim payments? Hide

Wherever possible, we will follow the instructions given to us in the payment section of the claim form.

  • We can pay you, the principle member (applicant) or your medical provider.
  • We can pay by cheque or by electronic bank transfer.
  • We can pay in more than 80 currencies.
How do deductibles work? Hide

A deductible is the amount you must pay towards covered medical expenses before we will start paying for your treatment.

Once your deductible amount has been reached, all covered expenses will be paid in line with your policy’s benefit limits.

For example, if you have an annual deductible of £Sterling 500, the total value of your eligible claims must reach £Sterling 500 before we will pay any benefit.

The annual deductible applies separately to each person on your membership, and is not cumulative.

What treatment and conditions are not covered? Hide

There are certain conditions and treatments that we do not pay for on any level of coverage.

We always ask that you contact us before arranging or receiving any treatment so we can confirm coverage.

Excluded conditions and treatments:

  • addictive conditions and disorders
  • ageing and puberty
  • allergies and allergic conditions
  • artificial life maintenance
  • birth control
  • conflict and disaster
  • congenital conditions
  • convalescence and admission for general care
  • cosmetic treatment
  • deafness
  • dental treatment/gum disease
  • developmental problems
  • donor organs
  • experimental treatment
  • eyesight
  • footcare
  • genetic testing
  • health hydros (health spa treatments such as floatation therapy and reflexology), nature cure clinics and related treatments
  • hereditary conditions
  • HIV/AIDS
  • infertility treatment
  • obesity
  • personality disorders
  • physical aids and devices
  • pre-existing conditions
  • preventive and wellness treatment
  • reconstructive or remedial surgery
  • self-inflicted injuries
  • sexual problems/gender issues
  • sleep disorders
  • speech disorders
  • surrogate parenting
  • travel costs for treatment
  • treatment from unrecognised physicians or facilities
  • USA treatment (unless USA cover is purchased separately)
Do you have a limit for the cost of treatment I may receive? Hide

We will pay for reasonable and customary costs. This means that the costs charged by your treatment provider should not be more than they would normally charge and be representative of charges by other treatment providers in the same area***.

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Services available to you

How can I track the progress of my claim? Hide

We will process your claim as quickly as possible. You can check the progress of claims* you have made via our MembersWorld website or by contacting General Enquiries on +44 (0) 1273 323 563.

How can I contact Bupa International? Hide

As a Bupa International member, you can call our Medical Centre at any time of the day or night, and day of the year, and speak to medically trained people who understand your situation and can give you the healthcare advice, support and assistance you need.

We also have a team of expertly trained people ready to help with any general enquiries you may have.

Medical Centre: +44 (0)1273 333 911

General Enquiries: +44 (0)1273 323 563

Email us via our MembersWorld website

What is your complaints process? Hide

We are always pleased to hear about aspects of your membership that you have particularly appreciated, or that you have had problems with. If something does go wrong, here is our simple procedure to ensure your concerns are dealt with as quickly and effectively as possible.

Getting in touch

If you have any comments or complaints, you can call the Bupa International customer helpline on +44 (0) 1273 323563, 24 hours a day, 365 days a year. Alternatively, you can email via www.bupa-intl.com/membersworld, or write to us at:

Bupa International

Russell Mews

Brighton

BN1 2NR

UK

We want to make sure that members with special needs are not excluded in any way. For hearing and speech impaired members who have a textphone, please call +44 (0) 1273 866557.

We also offer a choice of Braille, large print, or audio for our letters and literature. Please let us know which you would prefer.

Taking it further

If we have not been able to resolve the problem and you wish to take your complaint further, please call the Bupa International customer helpline on +44 (0) 1273 323 563 or write to the Head of Customer Relations at:

Bupa International

Russell Mews

Brighton

BN1 2NR

UK

It’s very rare that we can’t settle a complaint, but if this does happen, you may refer your complaint to the Financial Ombudsman Service.

You can:

write to them at:

South Quay Plaza

183 Marsh Wall

London

E14 9JR

Call them on:

0845 080 1800 (from inside the UK only)

+44 (0) 20 7964 1000 (from outside the UK)

Find details at their website:

www.financial-ombudsman.org.uk

Please let us know if you want a full copy of our complaints procedure. (None of these procedures affect your legal rights).

Can I access my plan online? Hide

Yes, as a Bupa International member you will have access to our MembersWorld website where you can:

  • view your policy
  • update your personal details
  • track the progress of your claims*
  • make payments online
  • search our international hospital directory
  • download claim forms and other useful documents
  • talk to us online using our free Webchat service
As a group secretary, can I manage the group plan online? Hide

Yes, as a group secretary of a Company policy, you will have access to our CorporateWorld website where you can:

  • manage employee details
  • manage payment details
  • access useful documents such as membership guides and claim forms

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Managing your plan

How are subscriptions paid? Hide

Your sponsor (your organisation) has to pay any and all subscriptions due to Bupa International, together with any other charges (such as insurance premium tax) that may be payable.

How can I renew my plan? Hide

The renewal of your membership is subject to your sponsor renewing your membership.

Can I add other people to my plan? Hide

If your sponsor agrees, you may apply to include any of your family members under your membership as one of your dependents. To apply, you will need to complete an Additional Members form.

Newborn children can only be included on your membership from their date of birth once you have completed an Additional Members form, provided the child has not been adopted or born to a surrogate.

Newborn children adopted or born to a surrogate can be included once they are 90 days old, on completion of an Additional Members or Enrolment form.

What is a group insurance plan? Hide

The Bupa International Company plan is a group insurance plan. You are therefore one of a group of members, which has a sponsor (normally the company you work for). The person who runs the membership within your organisation is usually referred to as the group secretary.

The plan is governed by an agreement between your sponsor and Bupa International, which covers the terms and conditions of your membership. This means that there is no legal contract between you and Bupa International. Only the sponsor and Bupa International have legal rights under the agreement relating to your cover, and only they can enforce the agreement.

As a member of the plan, you do have access to our complaints process. This includes the use of any dispute resolution scheme we have for our members.

How is the plan cancelled? Hide

Your sponsor (organisation) can end your membership, or that of any of your dependents, from the first day of a given month by writing to us. We cannot backdate the cancellation of your membership.

Can I transfer to a personal plan if my group plan ends? Hide

Yes, if for whatever reason your group policy ends, you can apply to transfer to a personal Bupa International plan. You can also apply for your dependents to transfer with you.

I haven't been able to find the answer to my question Hide

We are continuously adding information to this website and are sorry that you haven’t found the information you were looking for on this occasion.

Please call us on (+44 (0)1273 208200) or send us an email enquiry where an adviser will be ready to help

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Next steps

  • *Via cheque or electronic bank transfer, as applicable.

    **MembersWorld may not track claims in the USA as we use a third party here.

     ***Guidelines for fees and medical practice (including established treatment plans, which outline the most appropriate course of care for a specific condition, operation or procedure) may be published by a government or official medical body. In such cases, or where published insurance industry standards exist, Bupa International may refer to these when assessing and paying claims. Charges in excess of published guidelines or reasonable and customary costs may not be paid.