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Frequently asked questions about our health insurance

Experience tells us that when it comes to health insurance, the more information the better. Here are some of the questions we are asked most about our health insurance cover.

Before you buy...

What affects the cost of my cover?

We calculate the basic cost of your cover by taking into account which Saga HealthPlan and hospitals you have access to, 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).

We also take into account a range of statistical factors including the age of the eldest person to be covered and the geographical region you live in.

The cost can be reduced if you choose to add an excess to your policy or choose our unique 4 week wait option on your chosen Saga HealthPlan.

Is there anything that isn't covered?

You should be aware there are a number of exclusions that are commonly applied to most private health insurance policies. Common exclusions include treatment of incurable long-term illnesses (chronic conditions), pre-existing conditions and cosmetic surgery.

Full details of these exclusions can be found in the ABI Guide to Buying Private Health Insurance.

Am I covered for pre-existing medical conditions?

Like most other private health insurance policies in the UK, all Saga HealthPlans are intended to cover the costs of treating medical conditions that arise after the date you join. Please refer to our Policy Books which help explain how we assess any pre-existing conditions that you may have, and also explains in more detail the three methods of underwriting that we use.

Generally, we automatically exclude treatment for any medical condition or certain specified conditions you (or anyone you wish to be covered) have experienced or had symptoms of during the three years prior to joining. Whichever method of underwriting you choose, you will of course be covered for any new, eligible conditions that arise after the policy starts.

If you have a pre-existing medical condition and would like to speak to one of our friendly health insurance team about the cover options available please call 0330 094 6361

What are my underwriting options?

When you are considering health insurance, it's important to understand all the options available to you.

We offer a choice of three types of underwriting method:

  • Moratorium - we will provide cover for new medical conditions that occur after the policy begins. However, any pre-existing conditions you had, or experienced symptoms of, during the three years before your policy started will be excluded.
  • Full Medical Underwriting - this option is similar to Moratorium. However, when it comes to exclusions for pre-existing conditions, we will base these on the answers provided in response to our full medical history assessment.
  • Continued Personal Medical Exclusions - this option is only available if you already have cover with another health insurance provider, subject to your medical history over the last 12 months.

Depending on which option you choose, we may be able to cover you for pre-existing medical conditions.

Read more about our health insurance underwriting methods.

If you have completed a quote online the Moratorium method is used. This is because no medical declaration is necessary. We'll simply exclude treatment for any medical condition and certain specified conditions you or anyone on your policy has had in the three years prior to joining.

If you have pre-existing medical conditions and you'd like to speak our friendly health insurance team about our Full Medical Underwriting or Continued Personal Medical Exclusions please call 0330 094 6361

Do Saga HealthPlans offer No Claim Discount protection?

Yes, choosing to add No Claim Discount protection allows you to make one claim without adversely 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.

Which cancer treatments do you offer?

Saga HealthPlans Super, Secure and Saver Plus all provide cancer cover for the access to latest drugs and treatments. This includes chemotherapy and radiotherapy treatments as standard, with up to 18 months cover for biological therapies.

For customers who want total peace of mind, our Extended Cancer Cover option removes the time limit completely for cancer drugs that are used within the terms of their licence.

For more information about our cover for cancer, simply call our friendly, UK-based team on 0330 094 6361

Alternatively, you can get a quote online in minutes.

How can health insurance help if I'm self employed?

Health insurance covers the cost of private healthcare when you've been referred by a GP for an eligible condition. If you're self-employed or work as a freelancer, fast access to a specialist for diagnosis and treatment can be a great help if you need to get back to work as soon as possible.

Private healthcare also gives you plenty of flexibility – with the option to choose a specialist who works close to your place of work and appointment times that suit you and the needs of your business, you're in control.

Why should I consider Saga Health Insurance if I'm self-employed?

Saga Health Insurance gives you fast and easy access to specialists for medical investigations and hospital treatment for eligible conditions, so you can get back to work more quickly. Plus, our range of health plans can be tailored to suit your specific needs and budget.

The Saga GP Service gives you the added convenience of being able to consult a doctor as soon as you have any health concerns, whatever the time and wherever you are in the world.

All our health plans (except support) also include the Working Body Service, enabling you to access physiotherapy services quickly if you have musculoskeletal problems.

For existing policyholders...

How do I make a claim?

As soon as your GP refers you to a specialist, call our Claims Personal Advisory Team on 0800 027 1331

One of our advisers will be able to assist you regarding your cover and forward a claim form to you, if required.

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.

Visit how to make a claim to see a simple step by step guide.

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 policy year.

If you select our Super HealthPlan we will pay you £150 for every night you spend as an NHS in-patient, up to a maximum of £3,000 every policy year.

What happens if I change my mind?

You have 14 days to change your mind from the date you purchase your policy or receive your membership pack, whichever is the later.

How can I reduce my premium?

There are many ways you can reduce your premium whilst still maintaining a great level of cover.

Our unique 4-Week Wait and Guided Care options will give you a lower premium when selected. Plus, you can opt to increase the excess you have to pay if you make a claim which helps to reduce your overall premium without affecting your chosen level of cover.

Take a look at options to reduce your premium to find out more.

How do I renew my policy?

We will contact you by post at least 21 days prior to the date your policy is due for renewal.

You can renew your policy by calling 0800 056 9271

If you pay by Direct Debit, your policy will automatically renew without you having to do anything.

Why has my renewal premium increased?

Like other health insurance providers, we regularly review our policies and their cost to ensure that we can continue to give you fast access to diagnosis and treatment. There are a number of factors taken into account when calculating your renewal price, including:

Increased use of health insurance

This year, the main impact on our pricing is the overall cost and increase in the number of health insurance claims.

The additional financial challenges facing our NHS has put further pressure on services resulting in longer waits, with operations being cancelled or delayed causing backlogs for hospital treatment. This means health insurance customers are more likely to use their private cover to avoid increasing NHS waiting times for in-patient treatment and non-urgent operations such as joint replacements or cataract surgery.

People have been relying more and more on their health insurance to provide these important procedures and help lighten the load on the NHS. As a result, we’ve had to increase our prices.

Medical advances

New drug therapies, treatments and procedures are becoming increasingly expensive and as a result some may not be available on the NHS. Health insurance generally gives patients access to more expensive treatment options if they're proven to be effective, and this again leads to increased use of health cover and increased costs for us.

Age-related changes

As people grow older, they are more likely to require medical treatment, so this is also reflected in our renewal prices.

Your claims

Your premium could also be affected if you make a claim, which reduces your No Claim Discount. Saga policies begin with a No Claim Discount that can increase to 60% over time, but each time you claim your discount is reduced until you reach zero. You can find full details in your Policy Book. However, for an additional payment and subject to your recent claims history, you can take advantage of our optional No Claim Discount protection, which allows you to make one claim without reducing your discount.