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.
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 specialises 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). 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 the qualifications of the physician or surgeon. 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
• Any amount left after a claim has been settled by a provider of private medical insurance, as long as you send us your statement
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
See the ‘General exclusions’ section.
