Healthier Solutions

Private health insurance that fits around you

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 Flexible cover that fits
around you
Everyone’s different. At Aviva, we recognise that what you
want from your healthcare cover could be very different
to what somebody else wants. That’s why our Healthier
Solutions policy provides flexible and affordable cover
options to suit your budget and needs.

Contents
3 What Healthier Solutions gives you
4 Healthier Solutions explained
Policy summary
5 What‘s covered?
7 A summary of cancer cover
8 Cancer benefits and FAQs
10 Ways to enhance your cover
11 Ways to reduce your premium
12 What isn’t covered?
13 Underwriting
14 How to make a claim
15 Your questions answered
17 Further information
What else does Healthier Solutions offer?
18 MyHealthCounts
18 MyAviva
19 24-hour telephone helplines
19 Health and fitness club discounts
20 Providing the help and support you expect
21 Choose Healthier Solutions today

This product is underwritten by Aviva Insurance

Limited and administered by Aviva Health UK Limited

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 What Healthier Solutions
gives you
Healthier Solutions is flexible, giving you the ability to choose Family cover
which benefits are important to you from a range of options.
You, your spouse/civil partner/partner and your children can all be
This means you can tailor your private health insurance to suit
covered by Healthier Solutions if you permanently live in the UK.
your own requirements.
l Pay for the eldest child under 20 years of age and all other
Healthier Solutions provides: children under 20 will be covered for free
l 24 hour GP helpline
l prompt access to private medical treatment at private facilities
convenient to you l Childrencan even be included if they’re temporarily away from
home – for example, if they’re away at university in term time
l extensive core cover
l Ifthere’s a new addition to your family, your baby will
l options to enhance your cover or decrease your premiums get up to three months’ free cover, from their date of birth. If
l the option to protect your no claim discount you already have a child covered on the policy then your new
child will be covered for free as stated above.
l access to a range of NHS and private hospitals across the UK.
This includes large networks such as BMI, Nuffield and Spire No claim discount
l access to a range of added value benefits including 24-hour Each member on the policy has their own no claim discount (NCD).
GP and stress counselling helplines and discounts of up to With 15 levels each member’s discount increases by one level each
25% on membership at a selection of UK health and fitness year they don’t claim, up to a maximum discount of 75%.
clubs
If a member needs to make any new claims, their NCD will not
l MyHealthCounts – helping you manage your health with be affected if the total we pay in a year is £250 or less.
the potential to receive a discount at your next renewal If a member makes any new claims that total more than £250 in
the year, their NCD will reduce by three levels. However, the NCD
l MyAviva – manage your Aviva policies at the touch of a
will never reduce by more than three levels in any one year. Plus
button.
if you don’t make any claims during your next policy year, it will
start to build up again.

aviva.co.uk/health 3

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 Healthier Solutions
explained
Healthier Solutions gives you the flexibility to choose the cover
containing the benefits you want – no more, no less. This is important
not only for your peace of mind but also for your pocket.

You can choose the options you want from Healthier Solutions to enhance your cover or reduce your premiums. By choosing
to enhance your cover your premiums will increase.

Healthier Solutions - your options

Other
Ways to treatment
enhance and therapies
your cover Mental Dental including Protected Choice of
health and osteopathy, no claim hospital lists
treatment optical physiotherapy, discount
chiropractic

Core cover
Choice of
Reduced excesses
out-patient £100 Choice of
Six week
cover £200 reduced
Ways to reduce option
£0, £500 or £500 hospital lists
your premiums £1,000 limit £1,000
£3,000
£5,000

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 Healthier Solutions
– what’s covered?
This is a summary of the Healthier Solutions policy.
It’s important that you read this section.

Healthier Solutions is an individual private medical insurance product, provided by Aviva. This is a summary of the benefits
available for this product. Full terms and conditions are available on request. You’ll be required to complete an application to
determine the final terms of your policy.
The table below is designed to show at-a-glance what’s in Healthier Solutions’ core cover. Remember, you can also choose
options to upgrade or downgrade your cover. Details of those options are included on the following pages.

Benefits Notes
In-patient or day-patient treatment of acute conditions at a facility recognised by us as part of a network, a hospital on the Key hospital list or an NHS
hospital recognised by us.
Including accommodation, meals, nursing care, drugs and
Hospital charges 4
dressings
Specialists’ fees 4 Up to the limits in our specialist fee schedule

Diagnostic tests 4 Including blood tests, X-rays, scans, ECGs

Radiotherapy/chemotherapy 4

NHS cash benefit £100 each night Up to 30 nights each person every policy year

Additional benefits
Immediately following treatment as an in-patient or day-patient
Home nursing 4
that is covered by the policy; on specialist recommendation
Private ambulance 4
Parent accommodation when staying with a child covered by the Child of 15 or under receiving treatment that is covered by the
4
policy policy; one parent only
£70 each day,
Hospice donation Donation to the hospice
up to 10 days

GP referred speech therapy Two sessions For each child covered by the policy

For each baby born or adopted by a m

 ember, subject to a
Baby bonus £100 each baby
10 month qualifying period
For the conditions specified in the terms and conditions, subject
Treatment for complications of pregnancy and childbirth 4
to a 10 month qualifying period

Surgical procedures on the teeth performed in a hospital 4 Specialists’ fees are covered up to the limits in our fee schedule

Limited emergency treatment when temporarily abroad for a

Limited emergency overseas cover 4
period of up to 90 days. This is not travel insurance

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 Policy summary

Benefits Notes
Additional benefits
Psychiatric treatment as an out-patient Up to £2,000 On GP referral to a psychiatric therapist or psychiatric specialist

GP helpline 4 Unlimited number of calls

Unlimited number of calls. This benefit is available for
Stress counselling helpline 4
members aged 16 and over.
Out-patient treatment of acute conditions
If you have a consultation with a specialist who is not fee
Consultations with a fee approved specialist 4 approved we will only pay up to the limits we pay our fee
approved providers
Treatment by a specialist as an out-patient 4 Specialists’ fees are covered up to the limits in our fee schedule

Out-patient CT, MRI or PET scans will only be covered at a

Diagnostic tests 4
diagnostic centre recognised by us

Pre-admission tests 4

Radiotherapy/chemotherapy 4

Networks NHS amenity beds

To help manage costs and drive consistent quality of care, we’re If you receive treatment as an NHS in-patient or day-patient
developing a number of networks of facilities, specialists and whilst occupying an NHS amenity bed (a bed paid for by you in
other practitioners for specific conditions. If we have a network a single room or side ward in an NHS hospital where you receive
for your condition or suspected condition, we’ll tell you where NHS in-patient or day-patient treatment), and that treatment
you can have treatment which may not be at a hospital on your would have been paid for by the policy if you had chosen to
hospital list. We will only pay for that treatment if it is carried out receive it as a private patient, we’ll reimburse you for the cost of
within our networks. the amenity bed.

A list of the conditions or suspected conditions for which

we have networks in place can be found at
aviva.co.uk/health-network

Private Healthcare Information Network

You can find independent information about the quality and cost
of private treatment available from doctors and hospitals from the
Private Healthcare Information Network at phin.org.uk

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 A summary of cancer cover
with Healthier Solutions
The tables below provide a summary of the cancer cover available on Healthier Solutions. Full terms and conditions are available
on request.
If you choose the reduced out-patient cover, the monetary limit for out-patient treatment won’t apply to cancer treatment received
after you have been diagnosed with cancer.
If your treatment is for a condition or suspected condition for which we have a network, we’ll only pay for that treatment if it is
carried out at a facility and/or under the care of a specialist (or other practitioner) recognised by us as part of that network. If we don’t
have a network for the condition or suspected condition for which you need treatment, your in-patient and day-patient treatment is
covered at a hospital on your hospital list.
If you have the six week option, we don’t pay for treatment as an in-patient or day-patient if it’s available on the NHS within six weeks
from the date your specialist recommends it. If you’re diagnosed with cancer, this may mean that your treatment will be available on
the NHS and we won’t pay for most of the treatment that you need.

Benefits Notes

Hospital charges for surgery and At a facility recognised by us as part of a network, a hospital on your hospital list or an
4
medical admissions NHS hospital recognised by us

Specialists’ fees 4 Up to the limits in our specialist fee schedule

We pay £100 a day for treatment received as an in-patient or day-patient, £100 for each
day you receive out-patient radiotherapy, chemotherapy or blood transfusions or
NHS cancer cash benefit £100 each day out-patient surgical procedures. £100 for each day you receive intravenous (IV)
chemotherapy at home and £100 for each week you are taking oral chemotherapy at
home. You won’t be able to claim more than £100 in any one day

Includes specialist services immediately following surgery, such as consultations with a

Post surgery services 4
dietician or stoma nurse

Radiotherapy and chemotherapy 4

Bone strengthening drugs (such as We pay for bone strengthening drugs when they are being used to treat metastatic
4
bisphosphonates) bone disease

Treatment prescribed by your specialist

for side effects while you are receiving 4
chemotherapy or radiotherapy

We will pay towards the cost of a wig if you need one due to hair loss caused by cancer
Wigs Up to £100
treatment. This is payable once each member, not every policy year

External prostheses Up to £5,000 We will pay towards the cost of the first external prosthesis following surgery for cancer

Stem cell and bone marrow transplants 4 Includes collection, storage and implantation

Monitoring Up to ten years

On-going needs, such as regular

Up to five years
replacement of tubes or drains
Only if you have already had treatment for cancer that we have paid for. For example,
Preventative treatment for cancer we’ll pay for a mastectomy to a healthy breast in the event that you’ve been diagnosed
with cancer in the other breast

End of life care:

l 
in a hospital if it’s medically necessary 4
£100 each
l 
donation to a hospice night, up to Each night you’re admitted
£10,000
£50 each day,
l 
donation to a registered charity Each day that you’re visited at home by one of their nurses.
up to £10,000

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 Policy summary

Cancer benefits
and FAQs
Our cancer pledge
sive cove
We understand the importance of providing extensive cover and support at every stage of your en

r
t
Ex
cancer treatment. Our cancer pledge means we’ll cover the cancer treatment and palliative care ge
nce r pled
Our ca
you need, as recommended by your specialist.
We also want to make things as comfortable as possible for you following your cancer treatment,

rt
so we’ll provide extensive cover for your aftercare, including consultations with a dietician, as well and uppo
s
as money towards prostheses and wigs.

At a hospital or other facility from our networks, or if we don’t have a network for your
Where will I be covered
condition or suspected condition:
to have treatment?
l 
at a hospital on your list that we recognise for your treatment and condition
l 
out-patient CT, MRI and PET scans will only be covered at a diagnostic centre
recognised by us
l 
at home if your specialist agrees that this is possible – this will depend on the treatment
that you need.

Are diagnostic tests covered? Yes. The policy won’t pay for genetic tests to see whether you’re likely to get cancer or not.
However we’ll pay for genomic tests that are needed to see if a particular treatment is suitable
for you.

Will I be covered for surgery? Yes.

Will I be covered for preventative We’ll pay for surgery to prevent further cancer if you have already had treatment for cancer
treatment? that we have paid for – for example, we’ll pay for a mastectomy to a healthy breast in the
event that you have been diagnosed with cancer in the other breast, if it’s recommended
by your specialist. We won’t pay for treatment where you have no symptoms of cancer, for
example where you have a strong family history of cancer.

What drug treatment is covered? We cover in full:

l 
chemotherapy – drugs used to destroy cancer cells
l 
targeted therapy and biological therapy
l bone strengthening drugs - such as bisphosphonates.
We’ll also pay for treatment that you need to deal with side effects while you’re having
chemotherapy or radiotherapy, such as anti-sickness drugs and antibiotics.
We’ll pay for hormone therapy only if you need it to shrink a tumour before you have surgery
or radiotherapy. Hormone treatment isn’t covered by the policy at any other time.
Your GP will be able to prescribe this or administer it.

Is radiotherapy covered? Yes.

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 Will I be covered for palliative care? Yes, there’s no time limit on our cancer cover so we’ll continue to provide cover at every stage
of the disease.

Will I be covered for end of life care? Yes. We’ll pay for end of life care in hospital if it’s medically necessary. If you’re admitted to
a hospice we’ll make a donation to the hospice. We’ll also make a donation to a registered
charity if you stay at home and are visited by a nurse from that charity.

Will I be covered for routine monitoring Yes, for up to ten years after your treatment has finished. We don’t pay for monitoring after
when treatment has finished? treatment for non-melanoma skin cancer.
If you have any ongoing medical needs, such as regular replacement of tubes or drains, we’ll pay
for up to five years after your treatment for cancer has finished.

Are there any other limits on cover? If you have experimental treatment, we’ll pay the equivalent cost of the established treatment
that would usually be given for your condition. If there’s no equivalent treatment, we won’t
cover any of the costs of the experimental treatment. If a drug is licensed, but not for the
type of cancer that you have, we’ll assess your case and if there’s clinical evidence to show it’s
appropriate for your condition, we’ll pay in full.

What other benefits and services are l 

Following surgery, we’ll cover a number of different specialist services that you may need,
available? such as consultations with a dietician or a stoma nurse.
l We’ll contribute up to £5,000 towards the cost of an external prosthesis following surgery
for cancer.
l We’ll pay up to £100 towards the cost of a wig if you need one due to hair loss caused by
cancer treatment.
l We’ll pay for stem cell and bone marrow transplants, including the collection, storage and
implantation.
l 
NHS cancer cash benefit – for treatment that would have been covered by the policy we’ll
pay £100 for in-patient or day-patient treatment for cancer; out-patient radiotherapy,
chemotherapy, blood transfusions or surgical procedures; £100 each day for intravenous
chemotherapy at home and £100 each week if you’re taking oral chemotherapy drugs at
home. You can’t claim more than £100 each day.

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 Policy summary

Ways to enhance your cover

For an additional cost you can add any of these options to your core
cover and enhance the benefits available from Healthier Solutions.

Dental and optical Other treatment and therapies

Our core cover already includes surgical procedures on your If you suffer an injury such as whiplash or a sports injury, your
teeth. This option gives you additional cover for routine dental GP may refer you to an osteopath, acupuncturist, physiotherapist
treatment. It also includes cover for optical expenses. or a chiropractor.

Benefit Amount of cover Benefit Amount of cover

Optical benefit Up to £200  P referred treatment by a physiotherapist,

G  p to 10 sessions in
U
chiropractor, osteopath or acupuncturist. combined total
Accidental dental injury Up to £600

Routine dental treatment Up to £300 GP minor surgery Up to £100 each procedure

A £50 excess applies separately to both the optical benefit and

routine dental treatment. The £50 excess applies to each person
Protect your no claim discount (NCD)
every policy year. For a small additional premium you can protect your no claim
discount.
Mental health treatment
The NCD protection takes effect if you make claims that would
With this option, we give you cover for both in-patient and have caused you to drop three levels down the NCD scale.
day-patient treatment if you’re diagnosed with acute psychiatric Instead of your NCD reducing, it will stay at the same level, but
conditions such as schizophrenia or clinical depression. your protection will be lost. That means the NCD will apply in the
usual way at the following renewal.
Benefit Amount of cover
Once you have been claim-free for a year you can ask us to
protect your NCD again.
In-patient and day-patient accommodation
In full up to 28 days
and nursing
If you are switching to us from another insurer, or want to add
the protection at a future renewal, you can only take this option
Specialists’ fees for in-patient treatment Up to £210 each week
as long as you:

l have not had any form of cancer, heart disease or stroke in

Upgrade your hospital list the last five years
We offer you the choice of hospital list so you can choose one l have not had any consultations, diagnostic tests or treatment
that suits you. Healthier Solutions core cover includes the Key in the last 12 months
hospital list. You can then choose to upgrade to the Extended
hospital list to increase the number of hospitals you can use. l have no consultations, treatment or diagnostic tests pending
with a GP, specialist or hospital, and
Remember if we have a network for your condition or suspected
condition you’ll still need to use our network facility for your l are not aware of any conditions for which you may need
treatment rather than a hospital on your list. diagnostic tests or treatment in the next six months, whether
or not you have consulted a medical practitioner.

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 Ways to reduce your premiums
If reducing your premiums would help meet your budget, Healthier
Solutions gives you the opportunity to add these cost reducing options
to your policy.
Six week option Reduce your hospital list
If you choose this option, we will not pay for in-patient or You can choose the hospital list that suits you best. In its core
day-patient treatment, or NHS cash benefit, if the treatment cover, Healthier Solutions includes the Key hospital list. But you
is available to you on the NHS within six weeks. can choose to downgrade to one of the following lists:
l 
the Signature hospital list offers private hospitals in
Should you just need out-patient treatment e.g. consultations, tests
or an out-patient procedure, this is unaffected by the six week rule, Scotland and Northern Ireland only.
so we will pay for you to go privately regardless of the NHS wait. l the Trust hospital list includes mostly private patient units
If your out-patient treatment leads to an in-patient or day-patient of NHS Trust and Partnership hospitals. Please note that you
procedure, then the six week rule will apply to that procedure. must live within the catchment area of a Trust hospital to
If there is an NHS wait of six weeks or more, there is cover for qualify for this list.
prompt treatment at private facilities. If it’s found that you require Remember if we have a network for your condition or suspected
emergency treatment, you’ll be admitted on the NHS within six weeks condition you’ll still need to use our network facility for your
therefore treatment will not be covered by your policy. treatment rather than a hospital on your list.

Policy excess Reduced out-patient cover

You can choose to reduce your out-patient cover to a limit of
Another way to reduce your premiums is to add an excess to your £0, £500 or £1,000 to lower your premium. All of these options
policy. An excess is an amount, agreed in advance, that you or each provide cover in full for CT, MRI and PET scans at a diagnostic
person on your policy pays towards the cost of your claims bill. You centre that we recognise, pre-admission tests carried out within
can choose from £100, £200, £500, £1,000, £3,000 or £5,000, and 14 days of an eligible admission to ensure that you are fit to
the excess only applies once each person, every policy year. undergo surgery and anaesthesia, and out-patient radiotherapy
For example, if you choose a £5,000 excess and your treatment in and chemotherapy treatment.
a policy year costs £10,000, you’ll pay the first £5,000 and we’ll If you choose the £0 option, these will be the only out-patient
pay the rest. If the treatment carries on into the next policy year, benefits available on your policy.
another excess will apply, so you’ll again pay the first £5,000 If you choose either a £500 or £1,000 limit, the following benefits
of treatment received in that policy year. are covered up to your chosen limit each person every policy year:
l consultations with a fee approved specialist
If you claim for a benefit that has a limit, and you haven’t
already paid your excess for that policy year, the excess will count l 
diagnostic tests
towards the benefit limit. l s pecialist referred treatment by a physiotherapist,
chiropractor, osteopath
So if, for example, your excess is £200 and the treatment you’re
l p
 sychiatric treatment as an out-patient.
claiming for has a benefit limit of £500, you would have to pay
the first £200 and we would only pay up to a further £300 for The reduced out-patient limits don’t apply to treatment for
that benefit in that policy year. cancer. If you choose to reduce your out-patient cover to a limit
of either £0, £500 or £1,000, we won’t apply the limits to cancer
If the treatment you’re claiming for cost £1,000 and your excess
treatment received after you have been diagnosed with cancer.
was also £1,000, you’d have to meet the full cost of that treatment
Whichever reduced out-patient cover option you choose, the
yourself. However, your excess would be paid and would not apply
following benefits will be removed from your policy:
to other claims in that policy year.
l s urgical procedures on the teeth, and
l 
treatment for complications of pregnancy and childbirth, and
l e mergency overseas cover.
aviva.co.uk/health 11

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 Policy summary

Healthier Solutions
– what isn’t covered?
Healthier Solutions has a number of exclusions, although these may
vary slightly depending on the options that you choose.

Whichever options you choose, Healthier Solutions doesn’t cover you for:
l pre-existing conditions (unless we have expressly l kidney dialysis
included treatment relating to them)
l cosmetic treatment (except following an accident or
l long term or chronic conditions. This exclusion doesn’t surgery for cancer)
apply to treatment for cancer
l take home drugs and dressings
l HIV/AIDS and related conditions
l professional sports injuries
l treatment for pregnancy and childbirth (although
l experimental treatment (limited benefit may be available
depending on your chosen policy options some cover
for complications is available subject to a 10 month – please contact us)
qualifying period) l treatment required as a result of war, terrorism,
l
contamination by radioactivity, biological or chemical
treatment directly or indirectly related to birth control
agents
l diagnostic tests and treatment for infertility
l self inflicted injury
l surgical or medical appliances such as neurostimulators
l sexual dysfunction
(for example cochlear implants) and crutches
l sleep disorders and sleep problems such as snoring and
l charges by a GP, medical practitioner or specialist for
completion of a claim form unless the claim is sleep apnoea
confirmed by us l treatment for warts, verrucas and skin tags
l alcoholism, alcohol abuse, drug abuse, solvent abuse l varicose veins of the leg, unless they meet the
and other addictive conditions criteria detailed in the policy wording
l treatment undertaken by a specialist without GP referral l weight loss surgery
l psycho-geriatric conditions l treatment outside of network (for any condition or
l diagnostic
suspected condition for which we have a network).
tests requested by a GP, such as x-rays,
blood tests and scans

This is a summary of the exclusions on this policy. Full terms and conditions are available on request. You’ll be required
to complete an application to determine the final terms of your policy.

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 Healthier Solutions
underwriting
Health insurance is designed to cover new and unexpected medical
conditions. Healthier Solutions offers a choice of underwriting options.

Full Medical Underwriting Continued Medical Exclusions

This means we ask you questions about your past health and any You can apply for Healthier Solutions on this basis if you are
pre-existing conditions and related conditions will be excluded transferring from an existing fully medically underwritten medical
unless we agree to accept them. insurance plan.

We’ll apply the same personal medical exclusions to your

Moratorium Healthier Solutions policy that were applied to your previous plan
(if any). No new personal medical exclusions will be added.
Instead of filling out a health questionnaire, an automatic
exclusion applies.

We do not cover treatment of any pre-existing condition,

Continued Moratorium
or any related conditions, if you have had: You can apply for Healthier Solutions on this basis if you
l symptoms are transferring from an existing plan which is written on a
l medication moratorium basis. We apply our moratorium wording with effect
l treatment from the commencement date of your existing policy.
l diagnostic tests

l advice

relating to that condition in the five years before you

Switch Criteria
join the policy. If you’re switching on continued underwriting terms from another
provider you’ll need to sign a declaration stating that:
However, we’ll cover a pre-existing condition if you
l you haven’t had any treatment, tests or consultations in the
do not have:
l medication
last 12 months, and
l diagnostic tests l there are no treatments, tests or consultations pending.
l treatment You’ll also need to tell us whether in the past 5 years you’ve had
l advice any treatment or advice relating to any:
relating to that condition during a continuous two year
l cancers
period after you join the policy.
l heart or circulatory problems
and, if you’re looking to include the enhanced psychiatric cover
option:

l psychiatric condition or mental illness.

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 Policy summary

How to make a claim –

three simple steps
When you feel unwell, the last thing you want to face is a difficult claims journey.
So we’ve made ours as easy and as hassle free as possible.
If you have any questions, please call the customer service helpline on 0800 158 3333.
Calls may be monitored and/or recorded.

1. Step 1 – Consult your GP 2. Step 2 – Call the Aviva customer

If you’re unwell you’ll need to see your service helpline on 0800 158 3333
GP, where you may be referred for further
After you’ve been referred by your GP you’ll
assessment or treatment.
need to call us to set up your claim.
This could be a named referral, where your GP
If we have a network for the treatment you
recommends a particular specialist, or an open
need, we‘ll let you know where you can have
referral, where your GP just states which type
your treatment. Our network facilities may
of specialist you need to see or the type of
be different to the hospitals on your chosen
treatment you need.
hospital list.
It’s really important that you get in touch with
If we don’t have a network for your condition
us before attending any appointments so we
or suspected condition:
can make sure your claim is covered under the
l if you’ve been given a named referral,
terms and conditions of the policy before you
incur any costs. we’ll check to make sure the specialist is
recognised by us.
l if it’s an open referral, we’ll use our specialist
finder database to select an appropriate
specialist and/or hospital.

3.
Step 3 – Diagnosis, treatment Payment of bills
or surgery All eligible bills will be settled by us directly with the
treatment provider. If you do receive a bill for your
After attending an appointment, your treatment, please send us a copy together with your policy
specialist may recommend hospital number, so that we can arrange payment.
treatment – this is where you need to ask
Please send this to:
for a procedure code.
Aviva Health UK Limited
Once you’ve called us with these details, we Bill Payment Team
can confirm whether or not your treatment Chilworth House
is covered and provide information about Hampshire Corporate Park
where you can receive treatment, whether Templars Way
this is through our networks, at a hospital Eastleigh
on your list or at other facilities recognised Hampshire
by us. SO53 5RY
We will contact you to advise if you need to pay any part of
the bills - for example if you have an excess.

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 Your questions answered

Q. C
 an the policy be cancelled? Q. Will the premiums go up?
After your application is received and accepted by us, you’ll We review premiums annually to reflect the overall cost of claims
receive policy documents and notice of the right to cancel. You and medical inflation. This can be influenced by factors such as
will then have 14 days (known as the ‘cooling-off’ period) in the availability of new treatments and medical technologies.
which to change your mind and cancel the policy. After your
policy has renewed you’ll have 14 days in which to change your In addition, Healthier Solutions policies are priced using age bands,
mind and cancel the policy, running from the first day of your reflecting the fact that people are more likely to claim as they get
new policy year. If you decide to cancel the policy, any money you older. The age bands are 0–16, then every year until 80+. This
have already paid during the 14 day ‘cooling off’ period will be means that you could see an age-related increase, in addition to
refunded, provided no claims have been made during this period. the general review.

For all other cancellation rights please refer to your policy Any claims you make will also affect the level of no claim
documents. discount (NCD) that you receive. You’ll be notified of any changes
prior to your annual renewal.
If you decide to cancel the policy, you must notify our Customer
Service Department at: Don’t forget that by registering for MyHealthCounts and
improving your Q score and ultimately your health, you could
Aviva Health UK Limited receive a discount of up to 15% on your renewal premium.
Chilworth House
Hampshire Corporate Park
Templars Way
Eastleigh
Q. C
 an I make changes to my cover
Hampshire
SO53 3RY.
once I’ve taken it out?
Depending on your policy and our available product range, you
Or by calling 0800 068 3827
may be able to increase or decrease your cover. We can do this
Calls to and from Aviva may be monitored and/or recorded during your 14-day ‘cooling-off’ period or at your next renewal,
subject to underwriter approval.
If you decide not to cancel the policy your cover for eligible
treatment will continue until the renewal date and we’ll continue
to collect any applicable premium. Q. W
 hat do I commit to doing when
I sign the application form?
Q. What is the duration of the policy? You agree to the declaration you have signed on the application
form and the information the application form contains. You
Your private health insurance policy is a one year contract. Prior to also agree to the policy terms and conditions, and to obtain
your policy continuing into another year you’ll be sent your renewal authorisation from us before incurring medical costs and other
documentation. You should review this information to make sure charges. All policies are for a one year period.
the cover/policy remains adequate for your needs.

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 Policy summary

Q. What are the fee guidelines for Q. I s there an overall maximum amount
specialists? that can be claimed in any one year?
Our guidelines are based on factors such as the complexity No. With Healthier Solutions there’s no limit to the number of
and duration of each medical procedure, and clearly state the times you can make eligible claims in any policy year, and there’s
maximum amount we’ll pay for specialists’ fees. If your specialist no maximum annual amount or ceiling to your claims for eligible
charges outside of these guidelines, your claim won’t be met private treatment. There are however limits to specific benefits.
in full. As this means you would be liable for any shortfall, we
Any claims you make will also affect the level of no claim
do advise you to contact us prior to incurring any costs with a
discount (NCD) that you receive. You’ll be notified of any changes
specialist.
prior to your annual renewal. However, don’t forget that some
claims do not affect your no claim discount. Full details are given
in the terms and conditions.
Q. What is a fee approved specialist?
A specialist or other practitioner who is recognised by us and has Q. How can I pay?
agreed to our guidelines for consultation fees.
You have a choice of payment method:

Q. What do you mean by network? l annually by Direct Debit or credit card

This is a specific group of facilities, specialists or other l monthly by Direct Debit which is an easy and convenient way
practitioners that we recognise to provide the treatment required to spread the cost over the year.
for particular conditions or suspected conditions. If we have a
network for your condition or suspected condition, we’ll tell Q. How is my premium calculated?
you where you can have your treatment which may not be at a
hospital on your chosen list. We will however only pay for that The premium you pay is based on the following variables; your
treatment if it is carried out within our networks. age, the postcode where you live, plus the benefit options you
have chosen.
A list of the conditions or suspected conditions for
which we have networks in place can be found at When switching from another provider, your claims history may
www.aviva.co.uk/health-network also affect the premium you pay.

Q. What could go wrong?

l If you don’t provide all the information which is likely to
influence the acceptance of your application, your policy may
be invalid.

l If you fail to pay your premiums when they are due, your
entitlement to benefits will end.

l If you don’t obtain authorisation from us before incurring

medical costs and other charges you’ll have to pay these yourself
if you later find out they are not a benefit on your policy.

16 Healthier Solutions

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 Further information

The Financial Services Compensation eight weeks, you may be able to take your case to the Financial
Ombudsman Service to investigate. Their contact details are:
Scheme (FSCS) The Financial Ombudsman Service
We’re covered by the FSCS. You may be entitled to compensation Exchange Tower
from the FSCS if we become insolvent and cannot meet our London
E14 9SR
obligations. This depends on the type of business and the
circumstances of the claim. Telephone: 0300 123 9123 or 0800 023 4567
E-mail: [email protected]
Where you’re entitled to claim, insurance advising and arranging is Website: financial-ombudsman.org.uk
covered for 90% of the claim, with no upper limit. Please note that the Financial Ombudsman Service will only
consider your complaint if you have given us the opportunity to
Further information about compensation scheme arrangements is
resolve the matter first. Making a complaint to the Ombudsman
available from:
won’t affect your legal rights.
Financial Services Compensation Scheme
10th Floor, Beaufort House
15 St Botolph Street Language
London
EC3A 7QU This document and all future documents and letters will be
Website: fscs.org.uk written in English.
Telephone: 020 7741 4100 or 0800 678 1100

About Aviva
If you have any cause for complaint
The Financial Conduct Authority is an independent watchdog that
Our aim is to provide a first class standard of service to our regulates financial services. It requires us to give you this document
customers, and to do everything we can to ensure you’re satisfied. so you can use the information to decide if our services are right
However, if you ever feel we have fallen short of this standard for you.
and you have cause to make a complaint, please let us know.
Our contact details are: Aviva Health UK Limited. Registered in England Number 2464270.
Registered Office 8 Surrey Street Norwich NR1 3NG. Authorised
Aviva Health UK Ltd
and regulated by the Financial Conduct Authority. Firm Reference
Complaints Department
PO Box 540 Number 308139. Our permitted business is advising on, arranging
Eastleigh and administering general insurance and pure protection contracts.
SO50 0ET
You may check this on the FCA’s website fca.org.uk/register or by
Telephone: 0800 051 7501
contacting the FCA on 0800 111 6768.
E-mail: [email protected]
Aviva Health UK Limited is a wholly owned subsidiary of Aviva
We have every reason to believe that you’ll be totally satisfied with
Insurance Limited. You may have your own financial adviser who
your Aviva policy, and with our service. It’s very rare that matters
will provide you with information about their permitted business
can’t be resolved amicably. However, if you’re still unhappy with
and the range of products they offer.
the outcome after we have investigated it for you and you feel that
there’s additional information that should be considered, you should You only need to pay the premium. Otherwise, you don’t have to
let us have that information as soon as possible so that we can review pay us for our services to you.
it. If you disagree with our response or if we have not replied within

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 What else does
Healthier Solutions offer?
As well as the peace of mind you’d expect from your private
health insurance policy, we offer you a number of extra benefits to
help you manage your health and your lifestyle.

MyHealthCounts l Byimproving your Q score and ultimately your health,

you could receive a discount of up to 15% on your renewal
Our online health and wellbeing tool – helping you to understand
premium.
your health and the lifestyle choices that impact it.
Terms and conditions apply. Please go to myhealthcounts.co.uk
With a Healthier Solutions policy, you’ll be entitled, free of
for more information.
charge, to join MyHealthCounts – designed to give you a better
understanding of your current state of health.
MyAviva
Here’s how it works: Because everything we do is full of good thinking for you, we
l Onceyou buy a Healthier Solutions policy, you can register created MyAviva. Our online portal will help you manage your
for MyHealthCounts by going to myhealthcounts.co.uk. Aviva policies in one secure and easy-to-use place, at a time
that suits you.
l After registering, you will be required to complete an online
There’s a whole host of other benefits at your fingertips:
health questionnaire telling us about your health and lifestyle
l manage your Aviva policies
choices. Based on this information we’ll calculate your Q score –
l update your personal details
showing how healthy you are compared to 100 people who are
all the same age, race and gender as you. l track your policy excess and out-patient limit (if applicable)
l view your cover and benefit details
l Sign up to a 12 week programme to improve your Q Score.
l arrange a call back to update your claim
There are 5 key areas to choose to get help with – smoking,
l get access to useful online tools
diet, exercise, weight loss and alcohol. We’ll send you weekly
l accessan existing customer 20% discount on selected new
emails with information and advice to keep you motivated
and on track to reach your goals. Aviva products
l download our smartphone app to view your policies on the go.

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 24-hour telephone helplines
We know that sometimes you or a member of your family just
can’t get to see your doctor, or you’re not sure whether or not
to bother them with your symptoms. When this is the case, don’t
spend your time worrying – just call the 24-hour GP helpline,
and you’ll be put through to a qualified GP. Or if you just want
some general healthcare information, like what sort of jabs you’ll
need before going on holiday, then you can always talk to one of
the trained nurses.

If you’re a little stressed and just want someone to talk to, whatever
the reason, you can call the 24-hour stress counselling helpline.
Experienced counsellors are there for you 24 hours a day, seven
days a week (available if you are aged 16 or over).

Health and fitness club discounts

Aviva has teamed up with some of the UK’s leading health and
fitness clubs, to offer you discounts to help keep you fit, happy
and healthy.

l Save
up to 25% on membership for a range of top
UK health clubs

l Choose from a nationwide network of health and

fitness clubs

l Top-notch membership comes with great facilities – many

of the clubs have a swimming pool.

Our network of national chain and independent chains are

continually expanding, so visit aviva.co.uk/getactive for further
information on our current offers.

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 Providing the help and
support you expect
Policy advice
We’re here to help. If you need more information on your policy
or want to make a claim, just pick up the phone and call the
customer service helpline.
You’ll find professional and friendly service available all week – even
during the evenings and at weekends. When you call, it would be
helpful if you could let us know your policy number – which you
can find on your policy schedule.

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 Choose
Healthier Solutions today
Buying a Healthier Solutions policy is easy, so you and your family can start
enjoying the peace of mind that private health insurance can bring.
Here’s what to do next: l administer your policy and handle any claims
l help detect and prevent fraudulent activity.
l i norder to obtain an illustration of your Healthier Solutions
premium speak to your insurance adviser or call us on Other companies from across the Aviva group, or third parties
0800 42 42 42. Information given on this number will only who provide services to us, in any country (including those outside
relate to Aviva Health UK Limited products.
the Economic European Area) could also use your information
l if you’re happy with the illustration provided you will then be in this way. If they do, we’ll make sure they agree to treat your
asked to complete an application form. information with the same level of protection as we would.
l a
 s soon as your application is accepted by us, you’ll be
covered and we’ll send you your welcome information and We may share your information with regulatory bodies, other
policy schedule. insurers (directly or using shared databases), your insurance
l p
 lease note you’ll have 14 days after your policy begins to intermediary, or third parties providing services to them.
change your mind and cancel the policy. To keep our products and services competitive and suitable for
customers’ needs, we may also use your information for research
Calls and emails to and from Aviva may be monitored and customer profiling.
and/or recorded.
From time to time, we may tell you about other products or
services which may be of interest. If you don’t want us to, please
Use of personal information write to us at: Aviva, Unit 5, Wanlip Road Industrial Estate,
We’ll use the information you give us to: Wanlip Road, Syston, Leicester, LE7 1PD.
l process and underwrite your application If you are deaf or hard of hearing and have a textphone, you may
l decide if we can offer cover and on what terms call us free of charge via BT Typetalk on 18001 0800 959 598.

aviva.co.uk/health 21

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 Notes

22 Healthier Solutions

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 Notes

aviva.co.uk/health 23

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 Aviva Health UK Limited. Registered in England Number 2464270. Registered Office: 8 Surrey Street Norwich NR1 3NG. Authorised and
regulated by the Financial Conduct Authority. Firm Reference Number 308139. A wholly owned subsidiary of Aviva Insurance Limited.
This insurance is underwritten by Aviva Insurance Limited. Registered in Scotland, No. 2116. Registered Office: Pitheavlis, Perth, PH2 0NH.
Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.
Firm reference number 202153.
Aviva Health UK Limited, Head Office: Chilworth House, Hampshire Corporate Park, Templars Way, Eastleigh, Hampshire, SO53 3RY.
aviva.co.uk/health

GEN4685 REG001 02/2017 © Aviva plc

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