MAKE A HEALTH INSURANCE CLAIM

The excess is the amount of money you pay towards the cost of a claim which applies to every person covered by the policy. You pay an excess only once each policy year, regardless of how many claims you make.

Your excess will renew at the beginning of each policy year, even if you’re midway through a claim. So, your excess could apply twice to a single claim if your treatment begins in one policy year and continues into the next.

It is likely that you’ll pay your excess to the hospital or specialist and we’ll then pay the remainder (if applicable) of the claim, once this has been deducted.

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.

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).

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%

If you make a claim that causes your NCD to reduce at renewal, there may be an option to pay this back. We can then recalculate your premium so you can continue to benefit from the NCD.

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

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.

Like other private health insurance policies in the UK, Saga HealthPlans cover the costs of treating medical conditions that arise after you join. Our Policy Books explain how we assess pre-existing conditions and outline the three methods of underwriting we use.

Generally, we exclude treatment for any medical condition or specified conditions you (or anyone you wish to cover) have experienced or had symptoms of during the three years before joining. Regardless of the underwriting method you choose, you’ll be covered for new, eligible conditions that arise after the policy starts. When you come to claim, we may require your GP to complete a form to check the history of the condition you’re claiming for.

If you have a pre-existing medical condition and want to discuss available cover options, please call our friendly health insurance team on 0330 094 6361.