Home > Simplyhealth (Formerly known as Groupama Healthcare) - Carte Blanche

Simplyhealth (Formerly known as Groupama Healthcare) - Carte Blanche

Closed to new business customers

Carte Blanche is a private medical insurance plan that covers the cost of private medical treatment needed as a result of an unexpected acute illness or injury. The terms, conditions and exclusions contained in the policy booklet apply to the cover.

Carte Blanche offers a full refund for all inpatient and outpatient treatment, a cash benefit for NHS care, private ambulance and cover for certain pregnancy complications. In addition Carte Blanche offers cover for routine optical and dental treatment and private maternity.

There is also a choice of three hospital bands (A, B and C) and a range of excess and co-insurance options.

Benefits

Key Facts - In-patient & Day Case Charges
Hospital accommodation charges including theatre fees, nursing costs, prosthesis, in-patient drugs & dressings
	Full refund (within Groupama's fee schedule limits)
Surgeon / Consultant / Specialist & Anaesthetists fees
	Full refund (within Groupama's fee schedule limits)
Physicians fees & diagnostic tests
	Full refund
Cancer Treatment Costs - Chemotherapy / Radiotherapy
	Full refund
Psychiatric treatment
	Up to 35 days for in-patient Psychiatric pa
Key Facts - Out-patient Charges
Complementary medicine
	Up to £600 for complementary therapies not otherwise covered
Diagnostic tests (excluding scans)
	Full refund
GP referred consultations
	Full refund
Physiotherapy consultant referred
	Full refund
Physiotherapy GP referred
	Full refund
Psychiatric cover
	£1,500 per person (pa)
Radiotherapy / Chemotherapy
	Full refund
Scans - MRI / CT / PET
	Full refund
Surgical Procedures
	Full refund on Specialist referral
Key Facts - Additional Benefits
NHS cash benefit
	£200 per night (all bands) - maximum 28 days pa
Nursing at home
	Full refund up to a max of 13 weeks (on Specialist recommendation)
Parental accommodation
	Child under 16 - All bands £80 per night
Private ambulance
	Full refund
Additional Benefits
Alcohol & drug abuse
	Not covered
Annual maximum limit
	No annual maximum
Children covered
	Up to age 25 and unmarried
Chiropractors & Osteopaths
	Full refund for Acupuncture, Chiropractic, Homeopathy, Osteopathy and Podiatry (no GP referral required)
Dental treatment
	Costs up to £1,000 for routine dentistry - including check ups, fillings, crowns etc (oral surgery covered under in-patient treatment)
Hospice donation
	Not covered
Infertility investigations
	Not covered
Maternity cash benefit
	£700 per child. Plus £4,000 towards the cost of private maternity for normal delivery
Optional cash benefit
	Not covered
Out of pocket expenses
	£5 per night with a maximum of £50 per stay
Overseas cover
	Not covered
Personal & total disability benefit
	Not covered
Post hospital recovery bonus
	Not covered
Pregnancy
	Cover for specified abnormalities of pregnancy and childbirth after 10 month waiting period. £4,000 towards private maternity costs for "normal" pregnancy (this is not a cash benefit)
Transplants
	Covered for bone marrow and stem cell transplants as part of our cancer cover
Other benefits
	* specialist monitoring of a chronic condition - £250 pa * routine optical treatment - £200 pa (max £85 for glasses) * GP minor surgery - £100 per procedure * GP consultations, screenings and complementary therapies - £600 pa * Prescriptions - £300 pa * GP completing claim forms and medical reports - £25 per item

Key Facts - In-patient & Day Case Charges

Hospital accommodation charges including theatre fees, nursing costs, prosthesis, in-patient drugs & dressings

Full refund (within Groupama's fee schedule limits)

Surgeon / Consultant / Specialist & Anaesthetists fees

Full refund (within Groupama's fee schedule limits)

Physicians fees & diagnostic tests

Full refund

Cancer Treatment Costs - Chemotherapy / Radiotherapy

Full refund

Psychiatric treatment

Up to 35 days for in-patient Psychiatric pa

Key Facts - Out-patient Charges

Complementary medicine

Up to £600 for complementary therapies not otherwise covered

Diagnostic tests (excluding scans)

Full refund

GP referred consultations

Full refund

Physiotherapy consultant referred

Full refund

Physiotherapy GP referred

Full refund

Psychiatric cover

£1,500 per person (pa)

Radiotherapy / Chemotherapy

Full refund

Scans - MRI / CT / PET

Full refund

Surgical Procedures

Full refund on Specialist referral

Key Facts - Additional Benefits

NHS cash benefit

£200 per night (all bands) - maximum 28 days pa

Nursing at home

Full refund up to a max of 13 weeks (on Specialist recommendation)

Parental accommodation

Child under 16 - All bands £80 per night

Private ambulance

Full refund

Additional Benefits

Alcohol & drug abuse

Not covered

Annual maximum limit

No annual maximum

Children covered

Up to age 25 and unmarried

Chiropractors & Osteopaths

Full refund for Acupuncture, Chiropractic, Homeopathy, Osteopathy and Podiatry (no GP referral required)

Dental treatment

Costs up to £1,000 for routine dentistry - including check ups, fillings, crowns etc (oral surgery covered under in-patient treatment)

Hospice donation

Not covered

Infertility investigations

Not covered

Maternity cash benefit

£700 per child. Plus £4,000 towards the cost of private maternity for normal delivery

Optional cash benefit

Not covered

Out of pocket expenses

£5 per night with a maximum of £50 per stay

Overseas cover

Not covered

Personal & total disability benefit

Not covered

Post hospital recovery bonus

Not covered

Pregnancy

Cover for specified abnormalities of pregnancy and childbirth after 10 month waiting period.
£4,000 towards private maternity costs for "normal" pregnancy (this is not a cash benefit)

Transplants

Covered for bone marrow and stem cell transplants as part of our cancer cover

Other benefits

* specialist monitoring of a chronic condition - £250 pa
* routine optical treatment - £200 pa (max £85 for glasses)
* GP minor surgery - £100 per procedure
* GP consultations, screenings and complementary therapies - £600 pa
* Prescriptions - £300 pa
* GP completing claim forms and medical reports - £25 per item


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