Questions & Answers for Saga HealthPlans
What affects the cost of my cover?
We calculate the basic cost of your cover by taking into account which Saga HealthPlan and Saga hospital list you choose, whether you require cover for just yourself, yourself and spouse, or your children as well (up to the age of 21, or 25 if in full–time education), and also the age of the eldest person to be covered. The cost can then be reduced if you elect to pay an excess on any claim you may make, take a 4–week wait option on your chosen Saga HealthPlan, or pay your premium annually.
Is there anything that isn’t covered?
You should be aware that there are a number of exclusions that are commonly applied to most private medical insurance policies. Common exclusions include treatment of incurable long–term illnesses (chronic conditions) and cosmetic surgery. Full details of these exclusions can be found in the ABI guide to buying Private Medical Insurance.
What if I have a pre–existing condition?
Like other private medical insurance policies, all Saga HealthPlans are intended to cover the costs of treating medical conditions that arise after the date you join. Please refer to Underwriting methods and chronic conditions which helps explain how we assess any pre-existing conditions that you may have, and also explains in more detail the two methods of underwriting terms that we use.
Generally though, we automatically exclude treatment for any medical condition or certain specified related conditions that you (or other people you wish to be covered) have experienced during the previous three years. Whichever method of underwriting you choose, you will of course be covered for any new, eligible conditions that arise after the policy starts
How do I make a claim?
Your Membership Handbook will contain a step-by-step guide to making a claim. As soon as your GP refers you to a specialist, call our Claims Personal Advisory Team. One of our advisers will be able to assist you regarding your cover and forward a claim form to you. When you have received your treatment we usually make payment directly to your hospital or specialist so you do not have to pay any bills yourself.
What happens if I don't make a claim?
With Saga HealthPlan Super, Saga HealthPlan Secure, Saga HealthPlan Saver and Saga HealthPlan Support, we operate a No Claim Discount scheme. When you join, you will start with a 30% No Claim Discount (Level 4 on the scale below). Then, for every subsequent year that you do not claim, your discount rises by 5% until you reach a maximum discount of 50%. If you do make a claim, you simply move back two levels on the scale. No matter how many claims you make you will never fall below Level 0.
| Level | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| % Discount off basic premium rate | 0% | 10% | 20% | 25% | 30% | 35% | 40% | 45% | 50% |
Saga HealthPlans offer No Claim Discount Protection.
This allows you to make one claim without affecting your No Claim Discount. If you remain claim-free you still go up the No Claim Discount scale until you reach the maximum. It is available for an additional premium to all customers on our moratorium or full medical history underwriting terms. Unlike other providers that offer a No Claim Discount scheme, our protection allows you to budget for, and alleviate, future premium increases if you make a claim.
What happens if I receive NHS treatment?
If you need to be admitted to an NHS hospital for a condition covered under your plan, your Saga HealthPlan will pay you £100 for every night you spend as an NHS in–patient, up to a maximum £2,000 every membership year.
What happens if I change my mind?
You have 14 days from the day you receive your membership pack to read and review it. If you find that the policy is not suitable for you needs you may cancel it and we will refund your full premium within 30 days, unless you have made a claim. If you have made a claim in the first 14 days, we will give you a pro-rata refund on your premium based on the cover you have had.