Specialist consultation fees, electrocardiogram (ECG), X-ray, and pathology fees
Please check your specific membership plan to make sure that this benefit is included in your level of cover. These terms are not specific to Essentials and Tailored membership plans.
We will pay benefit, at the appropriate rate and up to the appropriate maximum in any one calendar year, when a person entitled to benefit has a specialist consultation or treatment from a medically qualified person who specializes in a field of medicine. The specialist does not have to hold a consultant position in a hospital, but must be a member, fellow or licentiate (licence holder) of one of the Royal Colleges (or their international equivalent) or be included on the register of specialists maintained by the General Medical Council. This benefit also refunds costs you would have to pay for an ECG or X-ray, and pathology fees charged to you at the appropriate department of a hospital or as part of a consultation.
You must send us an original receipt showing your name, dates of the consultation or treatment, the physician’s or surgeon’s qualifications and their official stamp.
On the claim form, you must fill in the reason for the consultation, treatment or tests.
What is covered
- Hearing aids and audiology tests provided by a registered hearing-aid supplier
- Investigative procedures (for example, colonoscopy, laparoscopy, colposcopy and sigmoidoscopy)
- Medical tests, including ECG, EEC and lung function tests
- Pathology and biopsy fees
- Physicians’ or surgeons’ operation fees
- Speech therapy, dyslexia and dyspraxia treatment provided by a registered medical practitioner
- X-ray, including mammograms, CT scans, ultrasounds, MRI scans and screenings
- If a claim has been settled by a provider of private medical insurance, we can only pay benefit (up to the appropriate maximum) for any remaining excess if you send us your statement from the provider of private medical insurance.
What is not covered
- Anaesthetists’ fees
- Counselling fees (we cover these fees under the health and wellbeing benefit)
- Private antenatal scans
- Private hospital charges (for example, theatre and room fees)
- Pre-existing conditions
- Worldwide cover during business visits and holidays abroad
