What is Treatment and Care health insurance?
Our Treatment and Care policy covers the cost of private treatment for those who are happy to be diagnosed by the NHS.
This means that if you have a health concern, you go to your NHS GP or other NHS service for a diagnosis. Once you’ve been diagnosed, you can then use your health insurance to access private treatment.
If you’d like to include private diagnosis in your cover, take a look at our Comprehensive health insurance.
How much does Treatment and Care cost?
The cost of the policy will depend on the level of cover you want. For example, if you choose the highest level of cancer cover, your policy may cost more. The cost also depends on things like your age, lifestyle and where you live.
To see exactly what your policy could cost, get a personalised quote for Treatment and Care cover.
What does Treatment and Care health insurance cover?
Hospital treatment
You’ll be covered for the cost of your care while you’re being treated in a hospital in your chosen network. We’ll pay the hospital costs in full if you stay for the day or overnight, or if you’re treated as an out-patient. Out-patient means you’re treated in hospital, but you don’t stay for the day or overnight.
Hospital costs for out-patient treatment are covered in full unless you’ve chosen to put a limit on your out-patient allowance.
If you have put a limit on your out-patient allowance, we’ll pay up to that amount. So, if you have an out-patient limit of £500, and your treatment costs £550, we’ll pay £500, and you’ll pay the remaining £50.
Mental health cover
You’ll be covered for mental health treatment from a consultant or mental health and wellbeing therapist. We’ll cover eligible treatment in full unless you’ve chosen to put a limit on your out-patient allowance.
If you have put a limit on your out-patient allowance, we’ll pay up to that amount. So, if you have an out-patient limit of £500, and your treatment costs £550, we’ll pay £500, and you’ll pay the remaining £50.
You may also be covered if you need to be admitted to hospital. This would depend on the terms of your individual policy.
Out-patient therapies
This means you’ll be covered for therapies such as physiotherapy. Out-patient means you’re treated in hospital, but you don’t stay for the day or overnight.
Treatment that's covered by your policy will be paid for in full unless you’ve chosen to put a limit on your out-patient allowance.
If you have put a limit on your out-patient allowance, we’ll pay up to that amount. So, if you have an out-patient limit of £500, and your treatment costs £550, we’ll pay £500, and you’ll pay the remaining £50.
Tests after treatment
These are tests that take place after treatment. They need to be linked to the treatment you’ve had. You may have these tests while you’re staying in hospital, or you may have them as an out-patient. Appointments are usually covered up to 6 months after your treatment.
These tests are covered in full unless you’ve chosen to put a limit on your out-patient allowance.
If you have put a limit on your out-patient allowance, we’ll pay up to that amount. So, if you have an out-patient limit of £500, and your treatment costs £550, we’ll pay £500, and you’ll pay the remaining £50.
Appointments after treatment
These are appointments that come after you've had private treatment in hospital. You'll be covered for these if they're linked to your treatment and if the treatment is covered by your policy. This includes appointments that come after private operations, even if you didn’t need to stay in hospital. Appointments are usually covered up to 6 months after your treatment.
These appointments are covered in full unless you’ve chosen to put a limit on your out-patient allowance.
If you have put a limit on your out-patient allowance, we’ll pay up to that amount. So, if you have an out-patient limit of £500, and your treatment costs £550, we’ll pay £500, and you’ll pay the remaining £50.
Scans after treatment
These are scans that take place after treatment. We’ll cover these in full if they’re linked to the treatment you’ve had. For example, you may need an MRI, CT, or PET scan. You may have these scans while you are staying in hospital, or you may have them as an out-patient. Appointments are usually covered up to 6 months after your treatment.
Choice of cancer cover
You can choose between three levels of cancer cover when you join:
- Cancer Cover
- NHS Cancer Cover Plus
- No cancer cover
This is our highest level of cancer cover. It fully covers the cost of eligible cancer treatments. This includes radiotherapy, chemotherapy, surgery, and stem cell transplants.
This level of cover pays for cancer treatment if the treatment you need isn’t available on the NHS. Cancer treatments that could be covered are radiotherapy, chemotherapy, drug therapy or operations.
You can choose to exclude cancer cover from your policy.
When you buy our health insurance online, we automatically include full Cancer Cover. If you’d like a quote for health insurance including NHS Cancer Cover Plus or with no cancer cover, you’ll need to call us on 0808 250 7825. Lines are open 8am to 6pm Monday to Friday.
Choice of three hospital networks
You can choose from three hospital networks when you join: Essential Access, Extended Choice, or Extended Choice with Central London. If you have treatment that’s covered by your policy at a hospital in your network, we’ll pay the hospital costs in full, as long as you use a fee assured consultant. This is a Bupa recognised consultant whose fees we have agreed to pay.
Anytime HealthLine
With this cover, you’ll get access to Bupa Anytime HealthLine, our 24-hour phone line. You can call day or night and talk to our GPs and nurses. And there’s no limit to the number of times you can call.
Parent accommodation
If a child needs to stay in hospital for treatment that’s covered under the policy, we’ll pay for one parent to stay with them. The child needs to be 17 or under and included on the policy.
Private ambulance
If you’re admitted to private hospital and it’s medically necessary for you to travel by ambulance, we’ll pay for this. We’ll pay up to £60 for each journey, as many times as you need it.
NHS cash benefit
If you have treatment through the NHS instead of using your health cover, we’ll pay a cash benefit into your bank account.
NHS cancer cash benefit
If you have treatment through the NHS rather than using your health cover, we’ll pay a cash benefit into your bank account. The amount depends on the treatment you have. For example, if you stay overnight in an NHS hospital for cancer treatment, we’ll pay £100 for each night.
You can also claim £100 for NHS treatment you have in hospital without staying overnight, or that you have at home. You could also receive £100 every three weeks if you need to take oral cancer treatments.
What’s not covered on any policy?
- Life events like pregnancy, menopause or ageing.
- Allergies and food intolerances.
- Life events like pregnancy, menopause or ageing.
- Conditions you had before your policy started.
We also call these pre-existing conditions. Your policy usually won’t cover injuries or conditions you had before your cover started.
For example, if you had a knee injury in March, and then took out health cover in June, your new policy wouldn’t cover this injury. You also couldn’t claim for any tests or treatment related to the knee injury. This is because your symptoms began before you had cover. - Ongoing health issues with no known cure,
We also call these chronic conditions. Diabetes and asthma are examples of ongoing health issues with no known cure. Your policy usually won’t cover treatment related to ongoing or chronic issues.
There are some exceptions. Bupa may cover ongoing care for mental health or cancer. Even if there is no cure.
There are other exceptions to the rules that might apply to you. So, if you have a question, it’s worth getting in touch.
What’s not covered on our Treatment and Care policy?
Our Treatment and Care policy also has these three exclusions. These are as well as the exclusions that apply to all policies.
- Out-patient appointments before treatment
These are appointments that a GP or specialist might recommend that you have before you’re diagnosed. You might have these at a hospital, but you wouldn’t need to be admitted for the day or stay overnight. These appointments would help to diagnose what’s wrong with you. - Tests before treatment
These are tests that a GP or specialist might recommend before you’re diagnosed. The tests would help to diagnose what’s wrong with you. - Scans before treatment
These are scans that a GP or specialist might recommend before you’re diagnosed. The scans would help to diagnose what’s wrong with you.
Our Treatment and Care policy is designed for those who are happy to be diagnosed by the NHS. It doesn’t cover appointments, scans or tests that you may need before you are diagnosed. If you’d like to include these, see our Comprehensive health insurance.
Important documents
Check our Treatment and Care cover summary for a quick overview of what’s covered. Or see Policy benefits and terms for full details. Our booklet, Important points about your cover, has examples showing how our cover works.
Choose the right cover for you
Take a look through our Comprehensive and Treatment and Care cover options side by side and see which one is best for you.
Benefits of our health insurance
With private health insurance, we’re there for you when you need us most. Take a close look at some of the benefits you’ll get with Bupa.
Learn more about private health insurance
Get a better understanding of our health insurance cover. We also cover topics such as looking after yourself as a parent and looking after your children’s health.
Private health insurance exclusions
Before you take out health insurance, check what is and isn’t covered.
In-patient and out-patient cover
Find out what terms like in-patient and out-patient cover mean.
Getting insurance when you’re self-employed
We’ve put together some FAQs about health insurance when you’re self-employed.
Will I need an excess on my health insurance policy?
Health insurance policies often include an excess. See our guide to understanding how excess works.
You can ask the NHS to refer you to a private hospital for healthcare services if:
- You have a private health insurance policy and would like to use your policy to claim for your treatment.
- You don’t have private health insurance, but you’d like to pay for your own treatment at a private hospital. Private treatment can also be paid for on a pay-as-you-go basis in our nationwide health centres and in London’s Cromwell Hospital. We have a wide range of pay as you go treatments available, from physiotherapy appointments to hip surgery and access to private GPs.
- You’ve had an NHS appointment and would like a second opinion on your treatment plan or diagnosis from a private healthcare expert.
- You’d like to make improvements to your health and lifestyle and feel you’d benefit from a health assessment.
If you have a Bupa health insurance policy, you may be able to get referred for treatment with a private specialist within an NHS hospital or health centre.
For most medical treatment to be covered, you normally need to see a GP to obtain a referral to a specialist or consultant. A referral letter is usually provided, as consultants and specialists need to understand why a patient is being referred to best treat, diagnose, and guide them through a treatment plan. We do understand that there are some circumstances when a GP appointment may not be clinically necessary, and you may be referred by another Healthcare Practitioner. However, if you have health insurance with Direct Access cover and are worried about symptoms concerning cancer, mental health or muscles, bones and joints, you can call us directly for advice and treatment usually without the need for a GP referral†.
Most of our health insurance customers are eligible to use Bupa Blua Health, our digital GP service.†† With a simple click, you could be talking to a GP within 24 hours – day or night. If needed, the doctor could provide you with an open referral letter.‡‡
A doctor cannot refuse to treat a patient based on their personal views when it comes to a patient’s lifestyle. However, if a doctor has a legitimate objection or concern about a procedure, they can refuse to carry out a treatment. Should this happen, all patients have the right to see another doctor, if they wish to.
Get a health insurance quote now
Our health insurance is designed to suit you. You can get a personalised quote by chatting to us and answering questions about your health and lifestyle.
Call us for a quote on
We may record or monitor our calls. Lines are open Monday to Friday 8am to 8pm.
†Customers who live on the Isle of Man, or have a Bupa Standard, Bupa Premium or Bupa Your Choice policy, do not have access to Bupa Blua Health, but can access GP24 provided by HealthHero. Some corporate schemes don't include access to Bupa Blua Health or GP24, so please check your scheme documents or give us a call.
Anytime HealthLine is not regulated by the Financial Conduct Authority or the Prudential Regulation Authority.
Bupa Blua Health is provided by Bupa Insurance Services Limited, registered in England and Wales with number 3829851. Digital GP services are powered by eMed Healthcare UK Limited, registered in England and Wales with number 15086104, Registered Office: 184-192 Drummond Street, London, England, NW1 3HP.
Bupa health insurance is provided by Bupa Insurance Limited. Registered in England and Wales No. 3956433. Bupa Insurance Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Arranged and administered by Bupa Insurance Services Limited, which is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales No. 3829851. Registered office: 1 Angel Court, London, EC2R 7HJ.
Page last reviewed: 10/05/23
