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HOW TO MAKE A HEALTH INSURANCE CLAIM

Making a claim with Saga Health Insurance

Step one

Being referred for treatment

Your consultation or treatment must follow an initial referral by a GP (including via a digital GP service) or dentist or another healthcare practitioner. The situations in which we will accept such a referral are set out on Bupa's website.

For muscle, bone or joint pain, see the ‘MSK Direct Access’ explanation on this page.

Step two

You need to call us on 0330 018 0778 or you can contact us digitally by visiting Bupa's website or downloading the Bupa Touch App.

To help us make the claims process as simple and swift as possible, please have the following information close to hand when you call us:

  • your policy number
  • details of the condition you are suffering from
  • details of when your symptoms first began
  • details of when you first consulted a GP about your condition
  • details of the treatment that has been recommended.

Step three

We will explain which nearby specialists, facilities and healthcare professionals are available under your benefits and provide you with a pre-authorisation number so your healthcare provider can send the bill directly to us.

If your specialist recommends further tests or treatment, it is important you check back with us to obtain further pre-authorisation.

We strongly advise you to call us before arranging or receiving any treatment to pre-authorise it, as you will be responsible for paying any fees or charges that are not covered under your benefits.

Step four

Usually, we will pay the providers of your treatment directly

Please send any correspondence to: Bupa Claims, Bupa Place, 102 The Quays, Salford M50 3SP.

Guided care claims

Step one

Being referred for treatment

Your consultation or treatment must follow an initial referral by a GP (including via a digital GP service) or dentist or another healthcare practitioner. The situations in which we will accept such a referral are set out on Bupa's website.

For muscle, bone or joint pain, see the ‘MSK Direct Access’ explanation on this page.

Step two

You need to call us on 0330 018 0778 or you can contact us digitally by visiting Bupa's website or downloading the Bupa Touch App.

To help us make the claims process as simple and swift as possible, please have the following information close to hand when you call us:

  • your policy number
  • details of the condition you are suffering from
  • details of when your symptoms first began
  • details of when you first consulted a GP about your condition
  • details of the treatment that has been recommended.

Step three

We will explain which nearby specialists, facilities and healthcare professionals are available under your benefits and provide you with a pre-authorisation number so your healthcare provider can send the bill directly to us.

If your specialist recommends further tests or treatment, it is important you check back with us to obtain further pre-authorisation.

We strongly advise you to call us before arranging or receiving any treatment to pre-authorise it, as you will be responsible for paying any fees or charges that are not covered under your benefits.

Step four

Usually, we will pay the providers of your treatment directly

Please send any correspondence to: Bupa Claims, Bupa Place, 102 The Quays, Salford M50 3SP.

Dental claims

To claim on the dental element of you Health Cash Benefits Cover, please download the claim form and follow the instructions.

All other claims

For all the other elements of your Health Cash Benefits cover a claim form is not required. Instead, we just require a receipt or invoice that shows the following details:

  • name of the person receiving treatment
  • date treatment took place
  • details of treatment received including cost of each
  • the service provider name
  • proof that you paid for the treatment

Please send all correspondence (including your name and policy number) to:

Bupa Claims, Bupa Place, 102 The Quays, Salford M50 3SP.

MSK Direct Access

When you experience muscle, bone or joint pain, it is important that you get the most appropriate support early. With ‘MSK Direct Access’ you can get access to advice and treatment without the need for a GP referral.

If you develop a problem, call the Bupa helpline on 0330 018 0778, so they can first check your cover and then offer a free telephone or video physiotherapist assessment, within 48 hours.

Anytime HealthLine

With the Anytime HealthLine you have access to a qualified nursing team 24 hours a day, 365 days a year.

Our qualified nursing team is on hand to give you the benefit of their expertise. They can answer your questions and give you all the latest information on specific illnesses, treatments and medications as well as details of local and national organisations.

The Anytime HealthLine is available to you any time – day or night, 365 days a year

Call 0330 018 0779

Please remember to have your policy number to hand before you call.

Health claims FAQs

We know it can be hard to take everything in when you’re worried about your health, so here are the answers to some of the most common questions our customers have.
What's an excess?

This is the amount you’ve chosen to contribute towards your treatments. You’ll only pay this once a year for each person who claims. Having an excess lowers your premium.

What is a ‘4-week’ or a ‘6-week’ rule?

If the procedure or invasive diagnostic test is not available for you through the NHS within four or six weeks of when you need it, depending on the option you've selected, we’ll get you seen privately.

You’ll have chosen this to lower your premium when you signed up to your Saga plan.

What is a No Claim Discount (NCD)?

This is a discount added to your policy each year based on your claims history. The No Claim Discount rises annually by 5% to a maximum of 60% if no claims are made. (Please see your Policy Book for more information on NCD).

How is the No Claim Discount (NCD) calculated?

Your current NCD level is shown on your Policy Schedule. This is how the NCD level is calculated:

  • Where nobody covered on the policy makes a claim - The NCD for the policy is increased by one level at the following policy renewal date until level 10 is reached
  • For each claim made on the policy - The NCD for the policy is reduced by two levels at the following policy renewal date for each claim made until level 0 is reached.

These are the NCD levels and their discount percentage on a basic premium rate:

  • Level 0 = 0%
  • Level 1 = 10%
  • Level 2 = 20%
  • Level 3 = 25%
  • Level 4 = 30%
  • Level 5 = 35%
  • Level 6 = 40%
  • Level 7 = 45%
  • Level 8 = 50%
  • Level 9 = 55%
  • Level 10 = 60%
Can I make a claim online?

You can create an account online by visiting Bupa online or download the Bupa Touch App. From here you can call or use Webchat to get in touch, pre-authorise treatment and view your claims history.

Do I have to pay for my treatment?

Not if you see one of our fee-assured specialists and your treatment is covered by your policy. If you choose a specialist that is not approved by us, or one that charges more than our approved fee limits, you may have to pay some or all of your treatment costs yourself.

Check your Policy Book for more details on treatments and what is and isn’t covered by your policy.