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 included treatment of incurable long–term illnesses (chronic conditions), cosmetic surgery, treatment for AIDS and related illnesses, regular renal dialysis and routine visits to your GP or dentist. Full details of these common exclusions can be found in the Independent guide to buying Private Medical Insurance which will be sent to you with your written quotation.
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. They are not intended to cover medical conditions which you may already have when your policy starts, or have had in the recent past. These are known as pre–existing conditions, and the ways that we assess their impact on your cover can be found in our Underwriting methods ' chronic conditions leaflet, which will be enclosed with your written quotation.
Generally though, any condition or related conditions you have had in the three years before the start of your plan will be excluded from cover. This includes any conditions you have received medical treatment and advice for, had any symptoms of, or were aware existed. However, existing medical conditions may become eligible for benefit once you have remained free from any advice, medication or treatment for the condition, for a continuous period of two years since the start of your policy.
How do I make 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. Treatment must be pre–authorised by AXA PPP healthcare. Your membership pack will contain a step–by–step guide to making a claim.
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 automatically receive a starter discount of 30%. For every year that you do not claim your discount rises on the scale shown below by one level, which means it could increase to the maximum 50% discount after four years. If you do need to make a claim you do not necessarily lose your entire discount, you just move back two levels. Regardless of how many claims you make you will never go below Level 0.
| Level | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Discount | 0% | 10% | 20% | 25% | 30% | 35% | 40% | 45% | 50% |
Saga HealthPlans are unique in offering 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?
If, within 14 days of taking out the policy, you change your mind, any premiums you have paid will be refunded in full, providing no claim has been made. If you have made a claim in the first 14 days, we will give you a pro–rata refund.