Provider: PPP Healthcare Product: Healthy Outlook Main benefits: Healthy Outlook is a plan for...
Provider: PPP Healthcare
Product: Healthy Outlook
Main benefits: Healthy Outlook is a plan for people who need all the benefits of comprehensive-type health cover. It is designed for people who want a degree of control over their healthcare costs, but would rather take some of the risk themselves ' in exchange for lower premiums.
There is a one-off plan excess of £5,000 per person covered. Before the excess is breached, policyholders can benefit from PPP healthcare's personal advisory service and their Health at Hand 24 hour health information service.
Once the total paid by a policyholder reaches £5,000, the excess is breached and they then start to benefit from comprehensive cover, at a premium that increases from its pre-breach level. However, the cost is still much less than the standard premium for comparable comprehensive plans.
Maximum age for a dependant child to be covered: No maximum child age, but adult pricing starts from age 21.
Maximum age for a full-time student to be covered: No maximum student age, but adult pricing from age 21.
Premiums can be paid monthly: Premiums payable monthly, quarterly or annually.
Minimum acceptable monthly premium: £16.15 per month.
Premiums paid by direct debit: Premiums payable by direct debit mandate, cheque or by credit card (Visa or Mastercard).
Plan is fully underwritten: If the member has completed a medical history declaration, their membership statement will clearly show the specific medical conditions for which they are not covered.
If they have any such exclusions on their membership, underwriters may be able to review them provided that the medical condition in question is completely cured and at least two years have elapsed free of any problems without treatment or medications being required.
Switch schemes on no worse terms basis: Only if switching from a PPP healthcare corporate plan.
Compulsory excess applied: One-off compulsory excess of £5,000.
Optional excess available: No
Discount given based on premium frequency: Yes. Payment of premiums annually results in a 5% discount.
Claims pre-authorisation service: As soon as the assured's GP refers them to a specialist for their initial consultation, they must call for entitlement confirmation.
Claims settled direct with hospital: Many hospitals have an arrangement to invoice PPP Healthcare direct.
Number of hospital bands available: A directory of hospitals is published which lists the private hospitals whose charges are eligible for benefits.
Inpatient nursing and accommodation costs: Full refund
Inpatient consultations costs: Full refund
Inpatient surgeons fees: Full refund
Inpatient anaesthetist fees: Full refund
Inpatient physicians fees: Full refund
Inpatient drugs and dressings: Full refund
Inpatient X-rays (radiology): Full refund
Inpatient pathology: Full refund
Inpatient radiotherapy: Full refund
Inpatient chemotherapy: Full refund
Inpatient computer tomography: Full refund
Inpatient physiotherapy: Full refund
Inpatient intensive care costs: Full refund
Costs of parent accompanying a child: Full refund for accommodation charges for one parent staying with a member who is under 11 years old.
Inpatient psychiatric treatment: Not covered
Complex major operation fees: Full refund
Major operation fees: Full refund
Intermediate operation fees: Full refund
Minor operation fees: Full refund
Outpatient consultation costs: Full refund
Outpatient X-rays (radiology): Full refund
Outpatient pathology: Full refund
Outpatient radiotherapy: Full refund
Outpatient chemotherapy: Full refund
Outpatient computer tomography: Full refund
Outpatient physiotherapy: Full refund
Daycare treatment: Full refund
Alternative medicine Osteopath: Full refund
Alternative medicine Chiropractor: Full refund
Alternative medicine Acupuncture: Full refund
Alternative medicine Homeopath: Full refund
NHS cash benefit ' band A: n/a
NHS cash benefit ' band B: Hospital Cover 2 ' £200 per night up to £2,000 each year, for each night the member receives free treatment under the NHS.
Maximum annual benefit amount: No overall maximum benefit.
Cover for cost of maternity complications: PPP healthcare will pay for treatment of a medical condition that is due to and occurs during the pregnancy or childbirth provided that the medical condition has not occurred during a previous pregnancy.
They will not pay for treatment of any medical condition which arises during pregnancy of childbirth if the pregnancy was a result of any form of assisted conception except artificial insemination.
Cover for cost of ambulance services: Full refund to pay for the cost of a private road ambulance to go to or from hospital or between hospitals when it is medically necessary to use an ambulance in connection with treatment being received privately.
Cover for home nursing costs: Full refund. Skilled nursing services given by a registered nurse at home immediately after or instead of inpatient or daycare treatment.
Worldwide cover and repatriation: If the policyholder is taken ill or injured while they are abroad, PPP healthcare provide up to £40,000 of cover. They will arrange the nearest appropriate treatment, even if this means bringing the policyholder home, provided that it is medically safe to do so.
Other benefits available: PPP Health at Hand gives assured access to a team of healthcare professionals, on call 24 hours a day, 365 days a year, free of charge. Registered nurses, paediatric nurses and pharmacists will be on hand to answer questions.
International Emergency Assistance Service is a control centre manned 24 hours a day to give assistance in any part of the world.
Aggregation benefit: If the assured can claim any of the expenditure under another insurance company policy, PPP will only pay their proper proportion.
