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Aviva - Solutions

The Solutions product is available for companies with 2 - 249 employees. Solutions is a modular product offering extensive core cover with the flexibility to add or remove benefit modules.

The following options are available:

Psychiatric Cover - see Key Facts In-patient, Day-case and Out-patient charges (Option 1)
GP Referred Services- see Key Facts out-patient charges (Option 2)
Hospital Lists - Key, Signature (Scotland and N Ireland only) Trust (for groups of less than 50 members) and Extended (Option 3)
Dental & Optical - Optical Benefit £300, Routine Dental Benefit £500, Accidental Dental Benfit £600 (each subject to a separate £50 excess per person per policy year) (Option 4)
Six Week option is available on this product and applies to in-patient and day-patient treatment and NHS cash benefit. (Option 5)
Excess options available at £50, £100, £150, £200 (Option 6)
Selected Benefit Reduction (Option 7)
Reduced Out-Patient Cover (Option 8)

Benefits

Option 1 - Mental Health Cover	All 28 Days 45 Days None
Option 2 - Routine & GP Referred Services	All Yes No
Option 3 - Dental & Optical	All Yes No
Option 4 - Six Week Option	All Yes No
Option 6 - Selected Benefit Reduction	All Yes No
Option 7 - Reduced Out-Patient & Benefit	All £0 £1000 £1500 No
Expert Select	All Yes No
Hospital	All Key Extended Signature Trust n/a

Key Facts - In-patient & Day Case Charges
Hospital accommodation charges including theatre fees, nursing costs, prosthesis, in-patient drugs & dressings
Hospital - Key	Core Cover Paid in full (The Key hospital list - AVIVA's standard wide range of hospitals)
Hospital - Extended	Paid in full (The Extended hospital list, building on the Key list the extended Hospital list offers a wider choice, predominantly in the Greater London area.)
Hospital - Signature	Paid in full (The Signature hospital list offers private hospitals in Scotland and Northern Ireland only.)
Hospital - Trust	Paid in full (The Trust hospital list includes mostly private patient units of NHS Trust and Partnership hospitals. Please note that you must live within the catchment area of a Trust hospital to qualify for this list.)
Expert Select - Yes	Expert Select Guided hospital approach, We will pay charges in full for treatment carried out at the hospital confirmed by us. (See hospital charges benefit term).
Surgeon / Consultant / Specialist & Anaesthetists fees
Expert Select - Yes	We will pay charges in full for consultations with the specialist confirmed by us
Expert Select - No	If you have a hospital list: we will pay up to the limits in our fee schedule
Physicians fees & diagnostic tests
	In full
Cancer Treatment Costs - Chemotherapy / Radiotherapy
	In full (See AVIVA Cancer Pledge below)
Psychiatric treatment
Option 1 - Mental Health Cover - None	Not covered
Option 1 - Mental Health Cover - 28 Days	Option 1a - Mental Health Cover Maximum of 28 days combined in/day-patient treatment per policy year includes benefit for specialists’ fees for in-patient treatment of up to the limits in the AVIVA fee schedule
Option 1 - Mental Health Cover - 45 Days	Option 1b - Mental Health Cover Maximum of 45 days combined in/day-patient treatment per policy year includes benefit for specialists’ fees for in-patient treatment of up to the limits in the AVIVA fee schedule
Six week option
Option 4 - Six Week Option - Yes	Option 5 - 6 Week Option A member cannot claim for private treatment as an in-patientor day-patient, NHS cash benefit, NHS cancer cash benefit or for the cost of an NHS amenity bed, if their treatment is available on the NHS (including accident or emergency admissions) within six weeks from the date their specialist recommends it
Option 4 - Six Week Option - No	Available but not selected
Key Facts - Out-patient Charges
Complementary medicine
Option 7 - Reduced Out-Patient & Benefit - No	In full - must be Specialist referred with Specialist to remain in direct control
Option 7 - Reduced Out-Patient & Benefit - £0	Option - Reduced out-patient cover Nil cover
Option 7 - Reduced Out-Patient & Benefit - £1000	Option - Reduced out-patient cover Only on a Specialist referral. Subject to a combined o/p benefit limit of £1,000
Option 7 - Reduced Out-Patient & Benefit - £1500	Option - Reduced out-patient cover Only on a Specialist referral, Subject to a combined o/p benefit limit of £1,500
Diagnostic tests (excluding scans)
Option 7 - Reduced Out-Patient & Benefit - No	In full
Option 7 - Reduced Out-Patient & Benefit - £0	Option - Reduced out-patient cover Nil cover
Option 7 - Reduced Out-Patient & Benefit - £1000	Option - Reduced out-patient cover Subject to a combined out-patient benefit limit of £1,000
Option 7 - Reduced Out-Patient & Benefit - £1500	Option - Reduced out-patient cover Subject to a combined out-patient benefit limit of £1,500
GP referred consultations
Option 2 - Routine & GP Referred Services - Yes	Option 2 - GP Referred Services (Overall limit of £1,000 per one yr period of cover) Specialists' fees for consultations and diagnostic tests for conditions that are not acute (including diabetes, epilepsy, hypertension, glaucoma)
Option 7 - Reduced Out-Patient & Benefit - No	In full for acute conditions only
Option 7 - Reduced Out-Patient & Benefit - £0	Option - Reduced out-patient cover Nil cover
Option 7 - Reduced Out-Patient & Benefit - £1000	Option - Reduced out-patient cover Subject to a combined out-patient benefit limit of £1,000 (we will pay specialist fees in full for treatment carried out by the specialist confirmed by us)
Option 7 - Reduced Out-Patient & Benefit - £1500	Option - Reduced out-patient cover Subject to a combined out-patient benefit limit of £1,500 (we will pay specialist fees in full for treatment carried out by the specialist confirmed by us)
Physiotherapy consultant referred
Option 7 - Reduced Out-Patient & Benefit - No	In full
Option 7 - Reduced Out-Patient & Benefit - £0	Option - Reduced out-patient cover £0 Outpatient- In full, however for any condition other than pain in the back, neck, muscles or joints – musculoskeletal conditions are subject to the reduced outpatient limit of £0 combined.
Option 7 - Reduced Out-Patient & Benefit - £1000	Option - Reduced out-patient cover £1000 Outpatient- In full, however for any condition other than pain in the back, neck, muscles or joints – musculoskeletal conditions are subject to the reduced outpatient limit of £1000 combined.
Option 7 - Reduced Out-Patient & Benefit - £1500	Option - Reduced out-patient cover £1500 Outpatient- In full, however for any condition other than pain in the back, neck, muscles or joints – musculoskeletal conditions are subject to the reduced outpatient limit of £1500 combined.
Physiotherapy GP referred
Option 2 - Routine & GP Referred Services - No	BacktoBetter: Claims for musculoskeletal conditions are managed through our BacktoBetter service. Musculoskeletal conditions are • pain • stiffness • weakness • spasm • a pull or strain, or • other discomfort in the back, neck, muscles or joints. Members do not need to see a GP before making a claim for a musculoskeletal condition. Members should contact us before treatment begins and our recognised clinical providers will arrange the most appropriate treatment for the member’s condition.
Option 2 - Routine & GP Referred Services - Yes	Option 2 - GP Referred Services (Overall limit of £1,000 per one yr period of cover) GP referred Physiotherapy, Osteopathy, Chiropractic and Acupuncture treatment is limited to ten sessions per condition in combined total, GP referred chiropodist, podiatrist or homeopathy, Minor surgery by a GP up to £100 per procedure (payable to GP)
Psychiatric cover
Option 7 - Reduced Out-Patient & Benefit - No	No need for a GP referral, Members can refer themselves for an assessment by a mental health practitioner. Mental health treatment through the mental health 'Pathway'. No impact on out-patient limits
Option 7 - Reduced Out-Patient & Benefit - £0	Option - Reduced out-patient cover Nil cover
Option 7 - Reduced Out-Patient & Benefit - £1000 Option 7 - Reduced Out-Patient & Benefit - £1500	Option - Reduced out-patient cover No need for a GP referral, Members can refer themselves for an assessment by a mental health practitioner. Mental health treatment through the mental health 'Pathway'. No impact on reduced out-patient limits
Radiotherapy / Chemotherapy
Option 7 - Reduced Out-Patient & Benefit - No	In full
Option 7 - Reduced Out-Patient & Benefit - £0 Option 7 - Reduced Out-Patient & Benefit - £1000 Option 7 - Reduced Out-Patient & Benefit - £1500	Option - Reduced out-patient cover In full but only if carried out at a diagnostic centre (Ref to the Cancer pledge)
Scans - MRI / CT / PET
Option 7 - Reduced Out-Patient & Benefit - No	In full
Option 7 - Reduced Out-Patient & Benefit - £0 Option 7 - Reduced Out-Patient & Benefit - £1000 Option 7 - Reduced Out-Patient & Benefit - £1500	Option - Reduced out-patient cover In full but only if carried out at a diagnostic centre
Surgical Procedures
	Covered up to the limit of your out-patient cover - Specialists' fees subject to AVIVA guidelines
Key Facts - Additional Benefits
NHS cash benefit
	£100 per night (up to 25 nights per policy year) Not covered for the first 3 nights of an accident or emergency admission
Nursing at home
	In full on Specialist recommendation following eligible in-patient or day-patient treatment.
Parental accommodation
	In full (Child under 15 undergoing eligible treatment; 1 parent only)
Primary care
	Not covered
Private ambulance
	In full (reasonable charges)
Additional Benefits
Alcohol & drug abuse
	Not covered
Annual maximum limit
	None
Children covered
	Can be insured as a single member upto 30 years old providing all OAD (overage dependants) are treated the same way.
Chiropractors & Osteopaths
	In full - must be Specialist referred with Specialist to remain in direct control
Option 2 - Routine & GP Referred Services - Yes	Option 2 - GP Referred Services (Overall limit of £1,000 per one yr period of cover) In full - must be specialist referred with Specialist to remain in direct control. However, if GP referred up to 10 sessions max pa for Chiropractic and Osteopathic treatment
Option 7 - Reduced Out-Patient & Benefit - £0	Option - Reduced out-patient cover Nil cover
Option 7 - Reduced Out-Patient & Benefit - £1000	Option - Reduced out-patient cover Only on a Specialist referral. Subject to a combined o/p benefit limit of £1,000
Option 7 - Reduced Out-Patient & Benefit - £1500	Option - Reduced out-patient cover Only on a Specialist referral, Subject to a combined o/p benefit limit of £1,500
Dental treatment
Option 6 - Selected Benefit Reduction - No	Oral surgery only
Option 3 - Dental & Optical - Yes	Option 4 - Optical & Dental Routine dental treatment carried out in dental surgery, up to £450 with a £50 excess. Excess does not apply to accidental dental injury. Accidental dental benefit up to £600 with the first £50 per person per policy year deducted from this benefit. Oral surgical procedures covered outside of Option 4
Option 6 - Selected Benefit Reduction - Yes	Option - Selected Benefit Reduction Oral surgical procedures - Removed
GP minor surgery
Option 2 - Routine & GP Referred Services - No	Not covered
Option 2 - Routine & GP Referred Services - Yes	Option 2 - GP Referred Services (Overall limit of £1,000 per one yr period of cover) GP referred Physiotherapy, Osteopathy, Chiropractic and Acupuncture treatment is limited to ten sessions per condition in combined total, GP referred chiropodist, podiatrist or homeopathy, Minor surgery by a GP up to £100 per procedure (payable to GP)
GP Referred Chiropody, Podiatry or Homeopathy
Option 2 - Routine & GP Referred Services - No	Not covered
Option 2 - Routine & GP Referred Services - Yes	Option 2 - GP Referred Services (Overall limit of £1,000 per one yr period of cover) GP referred treatment by a Chiropodist, Podiatrist or Homeopath
Hospice care cash benefit
	£70 per day donation to hospice up to 10 Days
Infertility investigations
Option 6 - Selected Benefit Reduction - No	Reasonable costs into the cause of infertility
Option 6 - Selected Benefit Reduction - Yes	Option - Selected Benefit Reduction Infertility investigations - Removed
Maternity cash benefit
	£100 each birth (provided expectant mother has been a member for 10 months)
Optional cash benefit
	Not covered
Option 3 - Dental & Optical - Yes	Option 4 - Optical & Dental Optical benefit up to £250 with a £50 excess
Out of pocket expenses
	Not covered
Overseas cover
	Not covered
Personal & total disability benefit
	Not covered
Post hospital recovery bonus
	Not covered
Pregnancy
Option 6 - Selected Benefit Reduction - No	Complications of pregnancy and childbirth are covered if arising at least 10 months after the mother's entry on the policy
Option 6 - Selected Benefit Reduction - Yes	Option - Selected Benefit Reduction Abnormal conditions of pregnancy - Removed
Stress counselling helpline
	Telephone counselling, unlimited calls 24/7 for 16+ years only to use
Transplants
	In full relating to cancer stem cell treatment
Other benefits
	Cancer Pledge Post surgery services: Includes specialist services immediately following surgery, such as consultations with a dietician or stoma nurse Up to £100 towards the cost of a wig if one is needed due to hair loss caused by cancer treatment, once per member, not per policy year Up to £5,000 towards the cost of the first external prosthesis following surgery for cancer Cover for Stem cell and bone marrow transplants, Including collection, storage, and implantation Up to ten years monitoring and up to five years on-going needs, such as regular replacement of tubes or drains (out-patient policy limits would be applied) Preventative treatment for cancer (see policy wording for eligibility) End of Life care * In a hospital if it is medically necessary - covered * £100 per night, up to £10,000 - Donation to a hospice * £50 per day, up to £10,000 - Donation to a registered charity
	Policy member excess options no longer impact out-patient limits and/or other benefits with financial limits. Plus, if the Dental & Optical option is selected then an Excess no longer impacts dental and optical benefit limits
	BacktoBetter Claims for musculoskeletal conditions are managed through our BacktoBetter service. Musculoskeletal conditions are * pain * stiffness * weakness * spasm * a pull or strain, or other discomfort in the back, neck, muscles or joints. Members do not need to see a GP before making a claim for a musculoskeletal condition. Members should contact AVIVA before treatment begins and AVIVA recognised clinical providers will arrange the most appropriate treatment for the member’s condition. Treatment may include, for example: * telephone and/or online support * treatment provided by physiotherapists * referral to a specialist. Treatment related to musculoskeletal conditions will not be an eligible claim under any other benefit on this policy, except for NHS cash benefit. Please note: if the member is referred to an osteopath or chiropractor, we will need to check that they have been referred to a practitioner recognised by AVIVA. If the member receives treatment from an osteopath or chiropractor it will be limited to 10 sessions per condition per policy year and we will pay up to the limits in our fee schedule for each session.•physiotherapy for musculoskeletal conditions will not be subject to the out-patient limit (if one applies).•BacktoBetter is not a network. All treatment for musculoskeletal conditions must be managed and received through the BacktoBetter pathway
	Mental health pathway Claims for mental health conditions are managed through the mental health pathway. We cover treatment for acute mental health conditions. This means we will pay for treatment which aims to lead to a member’s full recovery.

Key Facts - In-patient & Day Case Charges

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

Hospital - Key

Core Cover
Paid in full (The Key hospital list - AVIVA's standard wide range of hospitals)

Hospital - Extended

Paid in full (The Extended hospital list, building on the Key list the extended Hospital list offers a wider choice, predominantly in the Greater London area.)

Hospital - Signature

Paid in full (The Signature hospital list offers private hospitals in Scotland and Northern Ireland only.)

Hospital - Trust

Paid in full (The Trust hospital list includes mostly private patient units of NHS Trust and Partnership hospitals. Please note that you must live within the catchment area of a Trust hospital to qualify for this list.)

Expert Select - Yes

Expert Select Guided hospital approach, We will pay charges in full for treatment carried out at the hospital confirmed by us. (See hospital charges benefit term).

Surgeon / Consultant / Specialist & Anaesthetists fees

Expert Select - Yes

We will pay charges in full for consultations with the specialist confirmed by us

Expert Select - No

If you have a hospital list: we will pay up to the limits in our fee schedule

Physicians fees & diagnostic tests

In full

Cancer Treatment Costs - Chemotherapy / Radiotherapy

In full (See AVIVA Cancer Pledge below)

Psychiatric treatment

Option 1 - Mental Health Cover - None

Not covered

Option 1 - Mental Health Cover - 28 Days

Option 1a - Mental Health Cover
Maximum of 28 days combined in/day-patient treatment per policy year includes benefit for specialists’ fees for in-patient treatment of up to the limits in the AVIVA fee schedule

Option 1 - Mental Health Cover - 45 Days

Option 1b - Mental Health Cover
Maximum of 45 days combined in/day-patient treatment per policy year includes benefit for specialists’ fees for in-patient treatment of up to the limits in the AVIVA fee schedule

Six week option

Option 4 - Six Week Option - Yes

Option 5 - 6 Week Option
A member cannot claim for private treatment as an in-patientor day-patient, NHS cash benefit, NHS cancer cash benefit or for the cost of an NHS amenity bed, if their treatment is available on the NHS (including accident or emergency admissions) within six weeks from the date their specialist recommends it

Option 4 - Six Week Option - No

Available but not selected

Key Facts - Out-patient Charges

Complementary medicine

Option 7 - Reduced Out-Patient & Benefit - No

In full - must be Specialist referred with Specialist to remain in direct control

Option 7 - Reduced Out-Patient & Benefit - £0

Option - Reduced out-patient cover
Nil cover

Option 7 - Reduced Out-Patient & Benefit - £1000

Option - Reduced out-patient cover
Only on a Specialist referral. Subject to a combined o/p benefit limit of £1,000

Option 7 - Reduced Out-Patient & Benefit - £1500

Option - Reduced out-patient cover
Only on a Specialist referral, Subject to a combined o/p benefit limit of £1,500

Diagnostic tests (excluding scans)

Option 7 - Reduced Out-Patient & Benefit - No

In full

Option 7 - Reduced Out-Patient & Benefit - £0

Option - Reduced out-patient cover
Nil cover

Option 7 - Reduced Out-Patient & Benefit - £1000

Option - Reduced out-patient cover
Subject to a combined out-patient benefit limit of £1,000

Option 7 - Reduced Out-Patient & Benefit - £1500

Option - Reduced out-patient cover
Subject to a combined out-patient benefit limit of £1,500

GP referred consultations

Option 2 - Routine & GP Referred Services - Yes

Option 2 - GP Referred Services (Overall limit of £1,000 per one yr period of cover)
Specialists' fees for consultations and diagnostic tests for conditions that are not acute (including diabetes, epilepsy, hypertension, glaucoma)

Option 7 - Reduced Out-Patient & Benefit - No

In full for acute conditions only

Option 7 - Reduced Out-Patient & Benefit - £0

Option - Reduced out-patient cover
Nil cover

Option 7 - Reduced Out-Patient & Benefit - £1000

Option - Reduced out-patient cover
Subject to a combined out-patient benefit limit of £1,000 (we will pay specialist fees in full for treatment carried out by the specialist confirmed by us)

Option 7 - Reduced Out-Patient & Benefit - £1500

Option - Reduced out-patient cover
Subject to a combined out-patient benefit limit of £1,500 (we will pay specialist fees in full for treatment carried out by the specialist confirmed by us)

Physiotherapy consultant referred

Option 7 - Reduced Out-Patient & Benefit - No

In full

Option 7 - Reduced Out-Patient & Benefit - £0

Option - Reduced out-patient cover
£0 Outpatient- In full, however for any condition other than pain in the back, neck, muscles or
joints – musculoskeletal conditions are subject to the reduced outpatient limit of £0 combined.

Option 7 - Reduced Out-Patient & Benefit - £1000

Option - Reduced out-patient cover
£1000 Outpatient- In full, however for any condition other than pain in the back, neck, muscles or
joints – musculoskeletal conditions are subject to the reduced outpatient limit of £1000 combined.

Option 7 - Reduced Out-Patient & Benefit - £1500

Option - Reduced out-patient cover
£1500 Outpatient- In full, however for any condition other than pain in the back, neck, muscles or
joints – musculoskeletal conditions are subject to the reduced outpatient limit of £1500 combined.

Physiotherapy GP referred

Option 2 - Routine & GP Referred Services - No

BacktoBetter: Claims for musculoskeletal conditions are managed through our BacktoBetter service. Musculoskeletal conditions are • pain • stiffness • weakness • spasm • a pull or strain, or • other discomfort in the back, neck, muscles or joints.
Members do not need to see a GP before making a claim for a musculoskeletal condition. Members should contact us before treatment begins and our recognised clinical providers will arrange the most appropriate treatment for the member’s condition.

Option 2 - Routine & GP Referred Services - Yes

Option 2 - GP Referred Services (Overall limit of £1,000 per one yr period of cover)
GP referred Physiotherapy, Osteopathy, Chiropractic and Acupuncture treatment is limited to ten sessions per condition in combined total, GP referred chiropodist, podiatrist or homeopathy, Minor surgery by a GP up to £100 per procedure (payable to GP)

Psychiatric cover

Option 7 - Reduced Out-Patient & Benefit - No

No need for a GP referral, Members can refer themselves for an assessment by a mental health practitioner.
Mental health treatment through the mental health 'Pathway'. No impact on out-patient limits

Option 7 - Reduced Out-Patient & Benefit - £0

Option - Reduced out-patient cover
Nil cover

Option 7 - Reduced Out-Patient & Benefit - £1000

Option 7 - Reduced Out-Patient & Benefit - £1500

Option - Reduced out-patient cover
No need for a GP referral, Members can refer themselves for an assessment by a mental health practitioner.
Mental health treatment through the mental health 'Pathway'. No impact on reduced out-patient limits

Radiotherapy / Chemotherapy

Option 7 - Reduced Out-Patient & Benefit - No

In full

Option 7 - Reduced Out-Patient & Benefit - £0

Option 7 - Reduced Out-Patient & Benefit - £1000

Option 7 - Reduced Out-Patient & Benefit - £1500

Option - Reduced out-patient cover
In full but only if carried out at a diagnostic centre (Ref to the Cancer pledge)

Scans - MRI / CT / PET

Option 7 - Reduced Out-Patient & Benefit - No

In full

Option 7 - Reduced Out-Patient & Benefit - £0

Option 7 - Reduced Out-Patient & Benefit - £1000

Option 7 - Reduced Out-Patient & Benefit - £1500

Option - Reduced out-patient cover
In full but only if carried out at a diagnostic centre

Surgical Procedures

Covered up to the limit of your out-patient cover - Specialists' fees subject to AVIVA guidelines

Key Facts - Additional Benefits

NHS cash benefit

£100 per night (up to 25 nights per policy year) Not covered for the first 3 nights of an accident or emergency admission

Nursing at home

In full on Specialist recommendation following eligible in-patient or day-patient treatment.

Parental accommodation

In full (Child under 15 undergoing eligible treatment; 1 parent only)

Primary care

Not covered

Private ambulance

In full (reasonable charges)

Additional Benefits

Alcohol & drug abuse

Not covered

Annual maximum limit

None

Children covered

Can be insured as a single member upto 30 years old providing all OAD (overage dependants) are treated the same way.

Chiropractors & Osteopaths

In full - must be Specialist referred with Specialist to remain in direct control

Option 2 - Routine & GP Referred Services - Yes

Option 2 - GP Referred Services (Overall limit of £1,000 per one yr period of cover)
In full - must be specialist referred with Specialist to remain in direct control. However, if GP referred up to 10 sessions max pa for Chiropractic and Osteopathic treatment

Option 7 - Reduced Out-Patient & Benefit - £0

Option - Reduced out-patient cover
Nil cover

Option 7 - Reduced Out-Patient & Benefit - £1000

Option - Reduced out-patient cover
Only on a Specialist referral. Subject to a combined o/p benefit limit of £1,000

Option 7 - Reduced Out-Patient & Benefit - £1500

Option - Reduced out-patient cover
Only on a Specialist referral, Subject to a combined o/p benefit limit of £1,500

Dental treatment

Option 6 - Selected Benefit Reduction - No

Oral surgery only

Option 3 - Dental & Optical - Yes

Option 4 - Optical & Dental
Routine dental treatment carried out in dental surgery, up to £450 with a £50 excess. Excess does not apply to accidental dental injury.
Accidental dental benefit up to £600
with the first £50 per person per policy year deducted from this benefit.
Oral surgical procedures covered outside of Option 4

Option 6 - Selected Benefit Reduction - Yes

Option - Selected Benefit Reduction
Oral surgical procedures - Removed

GP minor surgery

Option 2 - Routine & GP Referred Services - No

Not covered

Option 2 - Routine & GP Referred Services - Yes

GP Referred Chiropody, Podiatry or Homeopathy

Option 2 - Routine & GP Referred Services - No

Not covered

Option 2 - Routine & GP Referred Services - Yes

Option 2 - GP Referred Services (Overall limit of £1,000 per one yr period of cover)
GP referred treatment by a Chiropodist, Podiatrist or Homeopath

Hospice care cash benefit

£70 per day donation to hospice up to 10 Days

Infertility investigations

Option 6 - Selected Benefit Reduction - No

Reasonable costs into the cause of infertility

Option 6 - Selected Benefit Reduction - Yes

Option - Selected Benefit Reduction
Infertility investigations - Removed

Maternity cash benefit

£100 each birth (provided expectant mother has been a member for 10 months)

Optional cash benefit

Not covered

Option 3 - Dental & Optical - Yes

Option 4 - Optical & Dental
Optical benefit up to £250 with a £50 excess

Out of pocket expenses

Not covered

Overseas cover

Not covered

Personal & total disability benefit

Not covered

Post hospital recovery bonus

Not covered

Pregnancy

Option 6 - Selected Benefit Reduction - No

Complications of pregnancy and childbirth are covered if arising at least 10 months after the mother's entry on the policy

Option 6 - Selected Benefit Reduction - Yes

Option - Selected Benefit Reduction
Abnormal conditions of pregnancy - Removed

Stress counselling helpline

Telephone counselling, unlimited calls 24/7 for 16+ years only to use

Transplants

In full relating to cancer stem cell treatment

Other benefits

Cancer Pledge
Post surgery services: Includes specialist services immediately following surgery, such as consultations with a dietician or stoma nurse
Up to £100 towards the cost of a wig if one is needed due to hair loss caused by cancer treatment, once per member, not per policy year
Up to £5,000 towards the cost of the first external prosthesis following surgery for cancer
Cover for Stem cell and bone marrow transplants, Including collection, storage, and implantation
Up to ten years monitoring and up to five years on-going needs, such as regular replacement of tubes or drains (out-patient policy limits would be applied)
Preventative treatment for cancer (see policy wording for eligibility)
End of Life care
* In a hospital if it is medically necessary - covered
* £100 per night, up to £10,000 - Donation to a hospice
* £50 per day, up to £10,000 - Donation to a registered charity

Policy member excess options no longer impact out-patient limits and/or other benefits with financial limits. Plus, if the Dental & Optical option is selected then an Excess no longer impacts dental and optical benefit limits

BacktoBetter
Claims for musculoskeletal conditions are managed through our BacktoBetter service. Musculoskeletal conditions are
* pain
* stiffness
* weakness
* spasm
* a pull or strain, or other discomfort in the back, neck, muscles or joints.
Members do not need to see a GP before making a claim for a musculoskeletal condition. Members should contact AVIVA before treatment begins and AVIVA recognised clinical providers will arrange the most appropriate treatment for the member’s condition. Treatment may include, for example:
* telephone and/or online support
* treatment provided by physiotherapists
* referral to a specialist.
Treatment related to musculoskeletal conditions will not be an eligible claim under any other benefit on this policy, except for NHS cash benefit.

Please note: if the member is referred to an osteopath or chiropractor, we will need to check that they have been referred to a practitioner recognised by AVIVA. If the member receives treatment from an osteopath or chiropractor it will be limited to 10 sessions per condition per policy year and we will pay up to the limits in our fee schedule for each session.•physiotherapy for musculoskeletal conditions will not be subject to the out-patient limit (if one applies).•BacktoBetter is not a network. All treatment for musculoskeletal conditions must be managed and received through the BacktoBetter pathway

Mental health pathway
Claims for mental health conditions are managed through the mental health pathway. We cover treatment for acute mental health conditions. This means we will pay for treatment which aims to lead to a member’s full recovery.


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