Provider: Standard Life Healthcare (SLH) Product: Primecare Gold. SLH's most exclusive personal h...
Provider: Standard Life Healthcare (SLH)
Product: Primecare Gold. SLH's most exclusive personal health plan offers much more than basic medical insurance. Cover is extended to include cash benefit for major dental expenses and private maternity cover, together with worldwide travel insurance.
Minimum acceptable age at commencement: 18
Maximum acceptable age at commencement: 74
Age cover ceases for existing clients: None
Maximum age for a dependant child to be covered: Under 21 (25 if in full-time education) and unmarried at the cover start date and at each annual renewal date.
Cover for insured dependent children will stop on the first annual renewal date on or after their 21st birthday or marriage, whichever is first. For insured children who remain unmarried and in full-time education after age 21, cover is extended until the first annual renewal date on or after their 25th birthday. At that annual renewal date, children will be allowed 30 days to join as the policyholder of an individual Primecare Gold Plan. If they join within that period, they can continue with the same medical underwriting terms that applied under the policy. Cover must be continuous and any existing special terms will continue to apply.
Waiver of premium available: Yes. Premium waiver following in-patient hospital treatment: this benefit only applies to the policyholder. If, straight after discharge from a period of in-patient treatment covered by the policy, the policyholder is totally unable to work, and still unable to go back to work after six months from the date of discharge, as a direct result of the condition which required in-patient treatment, then they will not have to pay any normal premiums due after this time. SLH will pay premiums until the earliest of the following:
• 60th birthday.
• The date their general practitioner confirms the policyholder is fit to go back to work or do any other work they are reasonably suited for by education, training or experience.
• Five years passing from when the policyholder is first entitled to this benefit, whether or not they have further periods of related in-patient treatment.
Optional excess available: Premium discounts are available if the insured chooses one of the voluntary excess options. By paying the first £100 of each claim, SLH will reduce the annual premium by 10% or for an excess of £250 will reduce the annual premium by 25%.
As a special allowance, claims for the following benefits are free from this excess: maternity cash benefit, NHS hospital cash benefit, permanent total disablement benefit, critical illness benefit, major dental cash benefit, GP completion of claim form and UK emergency assistance benefit. Separate excesses apply to the worldwide travel insurance benefits.
No-claims discount available: Yes. See provider for details.
Claims for the following benefit will not affect the no-claims discount: NHS hospital cash benefit.
Discount given on health screening: Yes
Discount given based on premium frequency: Payment of premiums annually results in a 7.5% discount.
Inpatient nursing and accommodation costs: Full cover for accommodation, nursing, drugs prescribed in a ward and intensive care.
Inpatient consultations costs: Full cover for physicians' fees and specialist consultations.
Inpatient surgeons/anaesthetist fees: Full cover for surgeons' and anaesthetists' fees for operations/surgical procedures performed on an in-patient or day care basis.
Inpatient physicians fees: Full cover.
Inpatient drugs and dressings: Full cover.
Inpatient x-rays (radiology, pathology, radiotherapy, chemotherapy, tomography, physiotherapy): Full refund for specialist consultations and diagnostic tests including pathology and radiology, CT and MRI scans, physiotherapy, radiotherapy and chemotherapy for the treatment of cancer.
Inpatient intensive care costs: Full cover for accommodation, nursing, drugs prescribed in a ward and intensive care.
Costs of parent accompanying a child: Full cover for accommodation for an insured member or insured spouse/partner to stay with an insured dependent child under age 14.
Inpatient psychiatric treatment: Full cover in any psychiatric hospital on the member's hospital list up to a maximum of 28 days per policy year for inpatient treatment in respect of accommodation, nursing, drugs prescribed in a ward, diagnostic tests including pathology and radiology, physicians' fees and specialist consultations.
Outpatient consultation costs: Full refund for specialist consultations and diagnostic tests including pathology and radiology.
Outpatient radiotherapy, chemotherapy: Full refund for radiotherapy and chemotherapy for the treatment of cancer.
Outpatient computer tomography: Full refund for specialised consultations and diagnostic tests including CT and MRI scans.
Outpatient physiotherapy: Full cover.
Outpatient psychiatric treatment: Up to £1,200, in any psychiatric hospital on the member's hospital list, per policy year in respect of specialist consultations, ECT, diagnostic tests including pathology and radiology.
Day-care treatment: Full cover for day-patient treatment for accommodation, nursing, operating theatre charges, surgical dressings, drugs and surgical appliances needed as a vital part of an operation. Diagnostic tests such as pathology and radiology, radiotherapy and chemotherapy for the treatment of cancer.
Alternative medicine: Up to £1,000 for each insured member per policy year for osteopathy, chiropractic, acupuncture, homeopathy. Chiropody ' up to £250 for each member per policy year for consultations with a State-registered chiropodist.
NHS cash benefit: £250 a night up to a maximum of £2,000 for each insured member per policy year where inpatient treatment for a medical condition covered by the plan has been undertaken as a non-paying NHS patient.
Cash benefit on childbirth: £250 will be paid for each child in respect of maternity cash benefit, if an insured member gives birth while confined in an NHS hospital as a non-paying patient. A claim will only be considered for this benefit if:
• No claim is made for private maternity benefit or for private treatment for complications of pregnancy.
• Expectant mother has been a member of the policy for the last 10 months.
Cover for cost of maternity complications: Full cover providing the mother has been a member for at least 10 months.
Cover for cost of normal maternity: Up to £3,000 towards the costs per pregnancy for private ante-natal and post-natal care, including specialist consultations, diagnostic tests and investigations and delivery for a normal pregnancy.
Cover for cost of ambulance services: Full refund for private ambulance to and from hospital where recommended by a specialist as medically necessary
Cover for home nursing costs: Full cover up to a total of 13 weeks for each insured member per policy year. To qualify for this benefit, all home nursing must:
• Immediately follow a period of inpatient hospital treatment for a medical condition covered by the policy.
• Be certified by the insured member's specialist as necessary for medical (not domestic) reasons.
• Be skilled nursing care provided at the insured member' s home which would otherwise be provided in hospital as an in-patient.
• Be full-time ' at least seven hours a day.
• Be given by a qualified nurse and carried out under the direction of the insured member's specialist.
Worldwide and repatriation cover: Worldwide travel insurance benefit ' cover for any number of holidays or business trips of up to 90 days each, per policy year. No cover will apply beyond the 90th day of any one trip.
In the case of cover under the winter sports section, this is limited to a total of 17 days per insured member in any one year.
Stresscare counselling available: Yes
Other benefits available: Helpline services, GP advice Line and UK emergency assistance.
Optional add-on benefits (available for an additional premium): Critical illness, hospital cash and personal accident.
Maximum annual benefit amount: No overall limit.
Aggregation benefit: If the member has any other private medical expenses insurance policy that provides benefit for the medical condition they are claiming for under this policy, SLH will only pay for their share of the claim.
