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How to make a claim
How to make a claim
(If you have chosen Fixed Fast Track as your hospital option, or would like to claim using the Working Body Service you can find out more below.)
| Making a claim | |
|---|---|
| Step One | Your GP or dentist refers you to a specialist for private treatment. (For muscle, bone and joint pain refer to the 'Working Body' explanation on this page.) |
| Step Two |
Call the Saga Health Insurance claims team on 0800 027 1331 to check that treatment is eligible but please remember that cover for your claim can only be confirmed once we have received the completed claim form. Please help us by having the following details available: Specialist/specialist type or group practice name Hospital name and any admission dates A procedure code if you are having a surgical procedure Details of your medical condition, particularly if your policy excludes cover for treatment of pre-existing conditions. |
| Step Three |
We will then: Check that we will pay the specialist's fee in full or find a specialist for you Confirm which hospitals are covered Send you a partially completed claim form. |
| Step Four |
Complete your section of the Saga Health Insurance claim form, answering all the questions. Ensure you include the date you first became aware of the condition you are claiming for, and if you have experienced similar symptoms before, tell us when. Ask your GP to complete the remainder of the claim form and return it to us at the address shown on the form. |
| Step Five |
Once we have received your completed claim form we will then: Assess the claim and confirm whether we will cover the treatment Remind you of any benefit restrictions that may affect your claim. |
| Step Six | Send in any outstanding accounts for treatment to our Claims Personal Advisory Team. |
| Please send any correspondence to: Saga Claims Personal Advisory Team, Phillips House, Crescent Road, Tunbridge Wells, Kent, TN1 2PL. | |
Fixed Fast Track
If you need to make a claim and have chosen Fixed Fast Track, follow the six simple steps below:
| Making a claim | |
|---|---|
| Step One | Your GP provides an open referral for private treatment. (For muscle, bone and joint pain refer to the 'Working Body' explanation on this page.) |
| Step Two |
You need to call us on 0800 027 1331 to check that treatment is eligible but please remember that cover for your claim can only be confirmed once we have received the completed claim form. Please help us by having the following details available: Specialist type Preferred hospital name and any admission dates A procedure code if you need a surgical procedure Details of your medical condition, particularly if your policy excludes cover for treatment of pre-existing conditions. |
| Step Three |
We will then: Check that the treatment is eligible based on the information provided over the phone Send you a claim form (if required) Find up to three selected providers, who can oversee your treatment, for you to choose from Provide you with details of the chosen selected provider. If you need to see a specialist, we can book the appointment for you. In order to book your appointment with the specialist we will need to share some personal information with them, including medical information. In some circumstances, it may be necessary or you may prefer to make the appointment with the specialist yourself. |
| Step Four |
Complete your section of the claim form, answering all the questions. Ensure you include the date you first became aware of the condition you are claiming for, and if you have experienced similar symptoms before, tell us when. Ask your GP to complete the remainder of the claim form and return it to us at the address shown on the form. |
| Step Five |
Once we have received your completed claim form we will then: Assess the claim and confirm whether we will cover the treatment Remind you of any benefit restrictions that may affect your claim. In most of the cases - and provided that your claim form has been completed correctly - we should be able to give you an answer within two working days. |
| Step Six | Send in any outstanding accounts for treatment to our Claims Personal Advisory Team. |
| Please send any correspondence to: Saga Claims Personal Advisory Team, Phillips House, Crescent Road, Tunbridge Wells, Kent, TN1 2PL. | |
Working Body
If you are experiencing muscle, bone or joint pain and would like to claim, you can get access to advice and eligible treatment without having to visit your GP to get a referral.
As soon as you experience a problem, just call us. We will check what cover you have and call you back by the end of the next working day to arrange a telephone assessment.
During your phone assessment, a physiotherapist will listen to your concerns, take you through an initial assessment and then advise the most appropriate treatment for you.