Bupa health insurance – what are outpatient benefit limits?


if you need treatment your GP may refer you to a specialist for further consultation or for certain conditions you may be able to speak to us directly for a referral without going to your GP. This sometimes means you need to go to a hospital as an outpatient for diagnostic tests treatments or therapies. Always check your policy to see what you’re covered for. An out patient is a patient who attends a hospital, a consulting room, an outpatient clinic or a treatment facility but doesn’t occupy a bed or stay overnight. When you take out a Bupa policy you will be able to choose an annual outpatient benefit limit from a number of set options. A lower limit will reduce the cost of your cover and a higher limit will increase the cost. Here’s an example of how it works david has a 1,000 pound annual limit on his outpatient cover. His GP recommends he sees a consultant so he visits a hospital for some treatment and tests. The cost for his blood tests and ultrasound treatment is £1100 and there are further costs of £200 for consultation fees: the total cost for his outpatient treatment is £1,300. As David is on a Bupa By You policy, Bupa will pay the £1,000 up to the benefit limit of his policy. David has agreed to pay an excess of £200 on his policy so he will pay that plus the remaining £100. If you don’t have a Bupa By You policy the value of the excess that you pay may get taken out of your outpatient benefit allowance you can check by either reviewing your policy documents or by calling us on 0345 609 0111. If David needs any further outpatient treatment for that year, he will either have to pay for this himself or use the NHS. Standard outpatient limits don’t apply to treatments for cancer as these are usually covered in full by our ‘Cancer Promise’

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