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PHC - HealthCover 4 Life (Plan 2)

Four plans are available providing a choice of uncomplicated yet comprehensive insurance to suit your clients' needs in terms of both cover and budget. We provide our group clients with even greater flexibility by offering a number of options with each plan.

Clients can chose between different levels of benefits, excesses, hospitals, and travel insurance and these options can even be different for each employee. Starting with the comprehensive cover of the Plan 1 through to the budget option of Plan 4.

Benefits

Psychiatric cover All Yes No
PHC Plus All Yes No

Key Facts - In-patient & Day Case Charges

Hospital accommodation charges including theatre fees, nursing costs, prosthesis, in-patient drugs & dressings
Full cover
Surgeon / Consultant / Specialist & Anaesthetists fees
Full cover - subject to fees being reasonable and customary
Physicians fees & diagnostic tests
Full cover
Cancer Treatment Costs - Chemotherapy / Radiotherapy
Full cover
Psychiatric treatment
Psychiatric cover - Yes
Full cover (for up to 28 days for in-patient psychiatric treatment per policy year)
Psychiatric cover - No
The benefit has been removed
Six week option
Not available

Key Facts - Out-patient Charges

Complementary medicine
Psychiatric cover - Yes
Up to £1,500 per person per year (limited to 10 sessions pa for GP-referred treatment after that referrals must be made by a specialist/consultant) - part of the overall £1,500 limit for Physiotherapy treatment, Therapies, and O/P Psychiatric
Psychiatric cover - No
Up to £1,500 per person per year (limited to 10 sessions pa for GP-referred treatment after that referrals must be made by a specialist/consultant) - part of the overall £1,500 limit for Physiotherapy treatment and Therapies,
Diagnostic tests (excluding scans)
Full cover
GP referred consultations
Psychiatric cover - Yes
Up to £1,500 per person per year (limited to 10 sessions pa for GP-referred treatment after that referrals must be made by a specialist/consultant) - part of the overall £1,500 limit for Physiotherapy treatment, Therapies, and O/P Psychiatric
Psychiatric cover - No
Up to £1,500 per person per year (limited to 10 sessions pa for GP-referred treatment after that referrals must be made by a specialist/consultant) - part of the overall £1,500 limit for Physiotherapy treatment and Therapies,
Physiotherapy consultant referred
Psychiatric cover - Yes
Up to £1,500 per person per year (limited to 10 sessions pa for GP-referred treatment after that referrals must be made by a specialist/consultant) - part of the overall £1,500 limit for Physiotherapy treatment, Therapies, and O/P Psychiatric
Psychiatric cover - No
Up to £1,500 per person per year (limited to 10 sessions pa for GP-referred treatment after that referrals must be made by a specialist/consultant) - part of the overall £1,500 limit for Physiotherapy treatment and Therapies,
Physiotherapy GP referred
Psychiatric cover - Yes
Up to £1,500 per person per year (limited to 10 sessions pa for GP-referred treatment after that referrals must be made by a specialist/consultant) - part of the overall £1,500 limit for Physiotherapy treatment, Therapies, and O/P Psychiatric
Psychiatric cover - No
Up to £1,500 per person per year (limited to 10 sessions pa for GP-referred treatment after that referrals must be made by a specialist/consultant) - part of the overall £1,500 limit for Physiotherapy treatment and Therapies,
Psychiatric cover
Psychiatric cover - Yes
Up to £1,500 per person per year - part of the overall £1,500 limit for Physiotherapy treatment, Therapies, and O/P Psychiatric
Psychiatric cover - No
The benefit has been removed
Radiotherapy / Chemotherapy
Full cover
Scans - MRI / CT / PET
Full cover
Surgical Procedures
Full cover

Key Facts - Additional Benefits

NHS cash benefit
£100 per night (following treatment as an NHS patient* up to a maximum of £2,000 pa) NHS day care benefit £50 per claim*
Nursing at home
Full cover with consultant's approval only if following a period of covered in-patient treatment (Limitations apply refer to member guide)
Parental accommodation
Full cover for a parent to accompany a child up to age 16. Plus £100 a night up to 5 nights for a close relative stay in a hotel
Primary care
Not covered
Private ambulance
£250 per person per policy year for transport to / from a hospital for medical reasons

Additional Benefits

Alcohol & drug abuse
Not covered
Annual maximum limit
No annual maximum
Children covered
children can be covered as dependants on a policy until the renewal date following their 25th birthday
Chiropractors & Osteopaths
Psychiatric cover - Yes
Up to £1,500 per person per year - part of the overall £1,500 limit for Physiotherapy treatment, Therapies, and O/P Psychiatric
Psychiatric cover - No
Up to £1,500 per person per year - part of the overall £1,500 limit for Physiotherapy treatment, and Therapies.
Dental treatment
Specified oral procedures only in hospital
GP minor surgery
Not covered
GP Referred Chiropody, Podiatry or Homeopathy
Not covered
Hospice care cash benefit
Cancer only - £75 a day up to a maximum of 15 days for the lifetime of your membership
Infertility investigations
Not covered
Maternity cash benefit
£100 for each birth
Optional cash benefit
Not covered
Out of pocket expenses
Not covered
Overseas cover
Not covered
Personal & total disability benefit
Not covered
Post hospital recovery bonus
Not covered
Pregnancy
Full cover for specified abnormal pregnancy conditions
Stress counselling helpline
24-hour claims stress counselling and medical advice line. Only available to members aged 16 years or over
Transplants
Not covered
Other benefits
Cancer Enhancements
Comprehensive cover enhancments when associated with cancer treatment:
* up to £5,000 per policy year - Provision of external prosthesis
* up to £150 per policy year - Purchase of wigs
* New/experimental procedures - these will now be reviewed by the clinical team and considered for benefit
* Experimental drug treatment - will be covered if part of an ethical trial and pre-agreed by us
* Cancer follow-ups - No limit on cancer follow ups.
* Radiotherapy and chemotherapy cash benefit - £50 up to £2,000 per year when you receive free treatment that would have been eligible for benefit privately
PHC Plus - Yes
Out of Hospital Network
Paid up to the normal daily rates published and charged for a private hospital or day-patient unit not listed in the Directory of Hospitals.
PHC Plus - Yes
Specialist Fees
We will pay eligible treatment charges in full when they are made by a specialist or anaesthetist who is recognised.
PHC Plus - Yes
Routine out-patient management of specified chronic conditions
We will pay for out-patient routine follow-up consultations and associated diagnostic tests with a specialist for the purpose of monitoring the on-going control of a specified chronic condition.
Specified chronic conditions are: angina, asthma, diabetes, epilepsy, heart valve problems, high blood pressure, glaucoma, osteoarthritis, rheumatoid arthritis, thyroid problems and ulcerative colitis.
PHC Plus - Yes
Fees for visits for a private GP for consultations and GP minor surgery
Up to £500 per person per year
Health at Hand
Unlimited video or telephone consultations through the AXA Doctor at Hand service, an online, private GP.
 
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