THE MEDICAL STARTER PLAN PRIVATE MEDICAL COVER FOR OVERNIGHT & LONGER STAYS IN HOSPITAL
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R C A This brochure includes promotional and contractual information N Promotional 1 HATHAT THETHE ASSOCIATIONSASSOCIATIONS SAYSAY You were introduced to the Medical Starter Plan through your membership of your sponsoring association or group. The Hospital and Medical Care Association has worked with over 1,000 W well known associations to offer its plans. This is what some of them say about us… W GEM Motoring Assist has been arranging a wide range of top quality services for its members since 1932. For the past nine years we have been delighted to add HMCA to our list of chosen service providers and have always found working with them to be a pleasant and efficient process. Many GEM members have benefited from this long-standing partnership which I hope will continue for many years to come. Paula Williams Chief Executive, GEM Motoring Assist
Our members have been able to take advantage of HMCA medical insurance facilities for over ten years, the longest running benefit that we have offered, which is much appreciated by them! Gordon Rainsford Chief Executive, English Bridge Union
HMCA has provided us with an excellent service, and has tailored several products to suit the needs of our organisation. We have found all products to be of a high quality and represent excellent value as a membership benefit. We find the entire HMCA team extremely professional, knowledgeable and helpful in their approach to business enquiries. I would not hesitate in recommending HMCA products and services to other professional bodies and organisations. Sharon Bruty Head of Communications, CILEx Journal
HMCA is a valued membership benefit for ROSL members here in the UK. Our members have commented positively on the quality of product and professionalism of the team. We are delighted to work closely with the HMCA team, and have developed promotional opportunities for the products via our communications and we are always pleased to see them at our regular New Member Receptions. Gemma Matthews Director of Marketing, Royal Over-Seas League
As a long established club for Saab Owners, we know the worth of added value benefits for our members and are pleased with the response from our membership and the service provided by HMCA. David Garnett Club Secretary, SAAB Owners Club
HMCA have provided a wide ranging service including medical cover to our members since 2014 at competitive prices. They are consistently both professional and friendly, we have received much positive feedback. Penny Cotton Head of Membership, Royal Academy of Dance 2
What the Associations Say...... 1 Why are we Competitive?...... 2 Private Health Care is Peace of Mind...... 3 Summary of Benefits...... 4 Questions and Answers...... 5 & 6 Hospital Accommodation List...... 7, 8 & 9 Checklist...... 10 Description of Benefits...... 13 to 17 Medical Starter Plan Contractual Information...... 12 to 18 What Our Members Say...... Back cover
WHY IS HMCA SO COMPETITIVE?
HMCA Members was established over 40 years ago and has grown to be one of the most successful membership benefit providers in the UK. HMCA membership is also one of the most exclusive as ‘‘ our plans are only available to the members of trade, professional and membership groups and subscribers of select publications. Our many years of experience ensures we have a plan to suit your needs at the best possible price. Healthcare cannot be marketed like other products; it requires thoughtful planning and expert skills. Our goal is to provide the best service possible. When you call HMCA you can be assured that your call is answered in person by a member of our staff who will always be happy to help you. Whether you are making an enquiry, joining HMCA or submitting a claim, we are there for you. These are the simple reasons why the Medical Starter Plan is competitive and leads the way.
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✪ J M Blackmore PROVIDING SERVICES TO MEMBERSHIP GROUPS ASSOCIATION SECRETARY
167169©2020 HMCA. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic or mechanical or photocopied, recorded or otherwise, without prior permission of HMCA. All HMCA paper products are from a sustainable source and are recyclable. Promotional 3 Private Healthcare Is Peace Of Mind No matter how fit and healthy we are, it is hospitals throughout the UK; if they WHY CHOOSE THE inevitable that at some point in our lives need to be admitted, they will have their MEDICAL STARTER we will fall ill and need medical care. And own private room equipped with TV and PLAN? when illness does strike it is to the NHS telephone, and visiting is arranged to suit ● All the benefits of that most people will turn in seeking a patient and family. A quick, private and private medical diagnosis, treatment convenient service treatment in-hospital and recovery. “4.2 million people waiting that removes many for you and your family. for an appointment with a of the anxieties ● VIP treatment with The NHS has for some associated with the specialist of your years been showing hospital consultant*” NHS hospital stays. choice, at the time of signs that it, too, is now not in the best of Furthermore, some providers have no your choice, at the health. A growing and ageing population upper age limit attached to their policies hospital of your choice. is putting an ever-increasing strain on and cover can even be extended to include ● Any hospital on our list staff and services. family members. may be used and others with prior agreement. Reports of underfunding, a shortage of Taking control of your healthcare ● Excellent benefits with medical staff, noisy and overcrowded However, those interested in taking out substantial savings over wards, cancelled operations and long health insurance should not leave it too other major plans. waiting times will be familiar to everyone. late. As we get older our healthcare needs These are just some of the increase. Therefore, as only some of the reasons why you should According to official figures there are 4.2 health insurance companies provide cover consider the Medical million people waiting for an appointment for pre-existing conditions, the best time Starter Plan as your first with a hospital consultant*. NHS England to invest in getting private treatment choice for your private says the maximum for illnesses you may health cover. When waiting time for All this can be avoided suffer tomorrow – is you are ill you do not this type of hospital by taking out today. want any uncertainty or referral should be 18 inconvenience, your weeks, but a growing private health insurance By acting now you worries can be substantial number of health authorities are failing can ensure your future healthcare will not enough without added to meet this target. be dictated by NHS bureaucracy and, just pressures. Whilst the as importantly, you will be able to benefit National Health Service Quick, private and convenient from the widest possible cover. has a very good system for Understandably, these lengthy delays dealing with emergencies are causing additional stress for patients, Private health insurance cannot guarantee and chronic situations, the waiting list nationwide undermining their health and quality of good health, but it can ensure that when for less urgent operations life even further. How many people do you are feeling unwell continues to grow. you know whose physical health and you will quickly receive Having to wait months, mental well-being has deteriorated from the best possible care, or even years, suffering the anxiety of having to wait months for when and where you discomfort and pain a hospital appointment? want it. The peace of could have disastrous mind that comes with effects on your work and All this can be avoided by taking out that knowledge cannot family life. By joining private health insurance. Seeing a doctor be underestimated the Medical Starter Plan, in private practice used to be only for the and is often the these problems will be wealthy, but not anymore as the cost of most important overcome. private medical cover is becoming more factor for affordable. people deciding to A private medical plan delivers prompt take control of *The King’s Fund - How is the NHS Performing? June 2018 access to hospital consultants, thus their healthcare Quarterly Report. avoiding lengthy waiting lists. Patients provision and can choose from an extensive list of “go private”. Promotional 4 Summary of Benefits The maximum benefit payable for each person covered on the plan is M £250,000 per year. For full details, please refer to the Description of Benefits in the contractual information at the back of this brochure. E
IN-HOSPITAL TREATMENT FOR OVERNIGHT OR LONGER STAYS D ● Accommodation Charges FULL REFUND I ● Ward Nursing Charges FULL REFUND C ● Ward Drugs FULL REFUND A ● A £100 a night tax-free cash benefit is available, for up to 30 nights, when all treatment is carried out as a National Health patient in a public ward of an L NHS Hospital.
● Surgical charges for surgeons and anaesthetists combined fees are refunded based on the Description of Benefits. S ● Theatre fees, consumables, drugs and surgical dressings are refunded based on T the Description of Benefits. A ● Benefit is also payable for in-hospital treatment based on the Description of Benefits for medical charges for consultant physician fees, pathology and R investigations whilst in hospital.
● SPECIAL GUARANTEED Transfer Facility T Cover can be transferred from an existing medical plan, and future claims made for acute conditions originating at the time the Member was participating in a E previous plan, will be honoured. R ● Money-Back Guarantee If not satisfied you may return the Medical Starter Plan within fourteen days for a full refund. P
HMCA GP ADVICE LINE L UPGRADE AVAILABLE A HMCA can now offer a 24/7 unlimited use GP Advice Line that can be accessed worldwide for telephone or video consultations. N Plus, should the doctor feel you would benefit from prescription medication, you can have this delivered to you at any UK address, whether you are at home, work or on holiday. If you wish to upgrade to include this, telephone 01423 799949. PRIVATE ROOM Promotional 5
UESTIONS &
Here is a list of the Q. Do you pay my surgeon or Q. Am I covered for sporting injuries? questions most hospital directly if I claim? A. Yes. Some hazardous pursuits are excluded only from the Personal frequently asked A. Yes. We are happy to pay your Accident Benefit as listed on surgeon or hospital on your behalf by members page 17. of trade and or we can reimburse you. professional Q. Do you have restrictive clauses groups on the Q. May I choose the hospital which relating to the NHS waiting lists? subject of private treats me? A. No. We do not have restrictive clauses relating to the NHS waiting medical cover A. Yes. There are no restrictions, lists. provided by the you can use any of the hospitals Medical Starter detailed on our comprehensive Q. Is the offer to join the Medical Plan. If you have list. If your preferred hospital Starter Plan dependent upon any additional is not listed please contact our my remaining a member of my questions please Helpline. sponsoring association? telephone our A. You must be a member of your Helpline on 01423 sponsoring association when joining Q. Can you explain the benefit the Medical Starter Plan. After 799949. levels in the Description of enrolment you become a Member Benefits. of HMCA. A. Charges for in-patient accommodation, ward drugs and Q. Is the scope of the Medical Starter Plan wider than many others? nursing charges are covered in A. As well as providing comprehensive full. Other benefits are based on in-hospital benefits for treatment the type of treatment received and of acute medical conditions, the the complexity of any operations Plan has a number of very important carried out. The complexity of extra features which extend the scope: all operations is advised by ● We include treatment for injuries the specialist carrying out your sustained whilst playing sport. treatment. Our benefits are based ● A Personal Accident benefit is on our experience of the likely provided. costs involved and we apply limits to protect against over-charging Q. May I transfer from my plan to your Medical Starter Plan? which would have the effect of GUARANTEED A. Yes. If you are in a medical plan you increasing claims costs and our can transfer to the Medical Starter ACCEPTANCE Members’ subscriptions. Plan. 6
NSWERS
Q. Are your terms similar to those in my present plan? A. The benefits are summarised on page 4 entitled “Summary of Benefits”, and the “Description of Benefits” is in the contractual information on pages 13 to 16. These may differ from your current plan.
Q. I have no existing private medical cover, can I join? A. Yes, you can join and after one full year's membership providing you have been treatment and symptom free for 12 consecutive months, any pre-existing medical condition that occurred prior to joining us will Q. Does the Medical Starter Plan be covered. have an excess or deductible, such as the first £500 of a claim Q. What is the maximum age at being paid by the Member? which I may join the Medical A. No. We believe that our Members Starter Plan or transfer from should have cover from the another plan? commencement of any treatment A. There is no age limit when joining covered under the Medical Starter HMCA. Plan. However, excesses are available if you want to reduce Q. Who do I speak to when I want to your subscription. Please ring make a claim? A. Our UK based claims team who 01423 799949 for more details. offer a personal service and provide prompt settlement. Q. What happens if I am admitted to an NHS hospital? Q. What is Insurance Premium Tax A. If you choose to have all your (IPT)? treatment solely through the NHS A. IPT is a tax on general insurance, you will receive £100 a night spent for example motor, household in hospital, for up to 30 nights. Of PEACE OF MIND and medical cover, levied by the course, this is tax-free cash which government. you keep to spend as you wish. WITH HMCA Promotional 7 You can use any hospital on this list, over 500 are available.
ENGLAND CORNWALL Chelmsford Broomfield Hospital BEDFORDSHIRE Falmouth Falmouth Hospital Chelmsford Springfield Hospital H Bedford BMI Manor Hospital Hayle St Michael’s Hospital Clacton-on-Sea Clacton & District Bedford Bedford General Penzance West Cornwall Hospital Hospital Hospital Truro Duchy Hospital Colchester Oaks Hospital O Luton Luton & Dunstable University Truro Royal Cornwall Hospital Colchester Essex County Hospital Hospital Colchester Colchester General S CUMBRIA Hospital BERKSHIRE Barrow-in-Furness Furness Hospital Epping St Margaret’s Hospital Ascot Heatherwood Hospital Carlisle Cumberland Infirmary Grays Orsett Hospital P Reading Circle Reading Hospital Kendal Westmorland General Harlow Princess Alexandra Reading Spire Dunedin Hospital Hospital Hospital Reading Royal Berkshire Whitehaven West Cumberland Havering Queens’ Hospital I Hospital Hospital Illford King George Hospital Reading Berkshire Independent Maldon St Peter’s Hospital Hospital DERBYSHIRE Redbridge Spire London East T Slough Wexham Park Hospital Buxton Buxton Hospital Hospital Slough Spire Thames Valley Derby Nuffield Hospital Derby Southend-on-Sea Southend Hospital Hospital Chesterfield Royal Derby Hospital Southend-on-Sea Spire Wellesley Hospital A Windsor King Edward VII Southend-on-Sea BMI Southend Private Hospital DEVON Hospital Windsor BMI Princess Margaret Barnstaple North Devon District L Hospital Hospital GLOUCESTERSHIRE Exeter Nuffield Hospital Exeter Cheltenham Cheltenham General BRISTOL Exeter Royal Devon & Exeter Hospital Bristol Spire Bristol ‘Glen’ Hospital Cheltenham Nuffield Hospital Hospital Exmouth Exmouth Hospital Cheltenham A Bristol Nuffield Hospital Bristol Ilfracombe Ilfracombe Tyrrell Gloucester Gloucester Royal Bristol Bristol Eye Hospital Hospital Hospital Bristol Frenchay Hospital Newton Abbott Newton Abbott Hospital Gloucester Winfield Hospital C Bristol Bristol Royal Infirmary Plymouth Derriford Hospital Stroud Stroud General Hospital Bristol St Michael’s Hospital Plymouth Mount Gould Hospital Bristol Southmead Hospital Plymouth Nuffield Hospital HAMPSHIRE C Plymouth Basingstoke Basingstoke & North BUCKINGHAMSHIRE Plymouth Royal Eye Infirmary Hampshire Hospital Amersham Amersham Hospital Sidmouth Victoria Hospital Basingstoke BMI Hampshire Clinic O Aylesbury Stoke Mandeville Tavistock Tavistock Hospital Eastleigh Nuffield Health Wessex Hospital Teignmouth Teighnmouth Hospital Hospital Gerrards Cross Chalfont & Gerrards Cross Tiverton Tiverton & District Havant Spire Portsmouth M Hospital Hospital Hospital Great Missenden BMI The Chiltern Torquay Mount Stuart Hospital Lymington New Forest Hospital Hospital Torquay Torbay Hospital Portsmouth Queen Alexandra M High Wycombe BMI Shelburne Hospital Hospital High Wycombe Wycombe Hospital DORSET Portsmouth St Mary’s NHS Treatment O Milton Keynes BMI Saxon Clinic Bournemouth Christchurch Hospital Centre Milton Keynes Milton Keynes General Bournemouth Nuffield Hospital Southampton Spire Southampton Hospital Bournemouth Hospital D Princes Risborough BMI The Paddocks Bournemouth Royal Bournemouth Southampton Southampton General Clinic Hospital Hospital Dorchester BMI Winterbourne Southampton Princess Anne Hospital A CAMBRIDGESHIRE Hospital Southampton Royal South Hants Cambridge Addenbrookes Hospital Dorchester Dorset County Hospital Hospital Cambridge Spire Cambridge Lea Poole BMI Harbour Hospital Winchester Royal Hampshire County T Hospital Sherborne Yeatman Hospital Hospital Cambridge Nuffield Hospital Winchester BMI Sarum Road Cambridge DURHAM Hospital I Cambridge Royal Papworth Bishop Auckland Bishop Auckland Hospital Hospital HEREFORDSHIRE Cambridge Cambridge Heart Clinic Chester Le Street Chester Le Street Hereford Hereford County O Huntingdon Hinchingbrooke Hospital Hospital Hospital Huntingdon Cromwell Clinic Darlington Darlington Memorial Hereford Nuffield Hospital Peterborough Peterborough City Hospital Hereford N Hospital Darlington BMI Woodlands Peterborough Fitzwilliam Hospital Durham University Hospital of North HERTFORDSHIRE Wisbech North Cambridgeshire Durham Bishops Stortford Herts & Essex General Hospital Hartlepool University Hospital of Hospital Hartlepool Harpenden Spire Harpenden L CHESHIRE Shotley Bridge Shotley Bridge Hospital Hospital Altrincham Althrincham General Stockton-on-Tees Nuffield Hospital Tees Hatfield One Hatfield Hospital Hospital Stockton-on-Tees University Hospital of North Hemel Hempstead Hemel Hempstead I Cheadle BMI Alexandra Hospital Tees Hospital Chester Countess of Chester Hertford Hertford County Hospital ESSEX Hospital S Chester Nuffield Hospital Basildon Basildon University Hitchin Pinehill Hospital Grosvenor Hospital Sawbridgeworth Rivers Hospital Crewe Leighton Hospital Basildon Orwell Private St Albans St Albans City Hospital T Macclesfield Macclesfield District General Cardiothoracic Unit Stevenage Lister Hospital Hospital Brentwood Nuffield Hospital Watford Spire Bushey Hospital Macclesfield Spire Regency Hospital Brentwood Watford Watford General Runcorn Halton General Hospital Brentwood Spire Hartswood Hospital TAX FREE NHS Warrington Warrington Hospital Hospital Welwyn Garden City Queen Elizabeth II Warrington Spire Cheshire Hospital Buckhurst Hill Holly House Hospital Hospital CASH BENEFIT Chelmsford Baddow Hospital When we issue a claim form, we will send you an up to date list 8
ISLE OF WIGHT Stamford Stamford & Rutland E11 Whipps Cross Hospital Nottingham BMI The Park Hospital Newport St Mary’s Hospital Hospital N19 Whittington Hospital Nottingham Queens Medical Centre SW5 BUPA Cromwell Hospital Nottingham Circle Nottingham Clinic KENT GREATER LONDON Nottingham Nottingham Woodthorpe Ashford One Ashford Hospital Ashford Ashford Hospital GREATER MANCHESTER Hospital Ashford William Harvey Hospital Barnet Barnet Hospital Ashton-under-Lyne Tameside General Nottingham Spire Hospital Beckenham BMI Sloane Hospital Carshalton St Helier Hospital Hospital Sutton in Ashfield Kings Mill Hospital Benenden Benenden Hospital Enfield Chase Farm Hospital Bolton BMI The Beaumont Worksop Bassetlaw District General Canterbury BMI Chaucer Hospital Enfield BMI Kings Oak Hospital Hospital Hospital Canterbury Kent & Canterbury Enfield BMI The Cavell Hospital Bury Fairfield General Hospital Harefield Harefield Hospital Hospital OXFORDSHIRE Chatham Spire Alexandra Harrow Northwick Park Hospital Leigh Leigh Infirmary Banbury Foscote Hospital Hospital Harrow BMI Clementine Churchill Manchester Spire Manchester Banbury Horton General Hospital Dartford Darent Valley Hospital Hospital Hospital Oxford Churchill Hospital Deal Victoria Hospital Harrow St Mark’s Hospital Manchester Christie Hospital Oxford Nuffield Orthopaedic Dover Buckland Hospital Isleworth West Middlesex University Manchester North Manchester General Centre Folkestone Royal Victoria Hospital Hospital Hospital Oxford Nuffield Hospital Oxford (The Gillingham Medway Maritime Kingston upon Thames Kingston Hospital Manchester Royal Manchester Children’s Manor) Hospital Kingston upon Thames New Victoria Hospital Hospital Oxford John Radcliffe Hospital Herne Bay Queen Victoria Memorial Northwood BMI Bishops Wood Manchester Royal Eye Hospital Hospital Hospital Manchester Royal Infirmary SHROPSHIRE Longfield BMI Fawkham Manor Northwood Mount Vernon Hospital Manchester St Mary’s Hospital Oswestry Robert Jones & Agnes Hunt Hospital Southall Ealing Hospital Oldham Royal Oldham Hospital Orthopaedic Hospital Maidstone Maidstone Hospital Stanmore Royal National Orthopaedic Rochdale Birch Hill Hospital Shrewsbury Nuffield Hospital Maidstone Maidstone KIMS Hospital Rochdale BMI Highfield Hospital Shrewsbury Margate Queen Elizabeth the Queen Uxbridge Hillingdon Hospital Rochdale Rochdale Infirmary Shrewsbury Royal Shrewsbury Mother Hospital Salford Oaklands Hospital Hospital Margate Spencer Private LONDON (Postal Area) Salford Salford Royal Hospital Telford Princess Royal Hospital Hospital SE3 BMI Blackheath Stockport Stepping Hill Hospital Orpington BMI Chelsfield Park Hospital Wigan Royal Albert Edward SOMERSET Hospital SW3 Royal Brompton Infirmary Bath BMI Bath Clinic Sevenoaks Sevenoaks Hospital Hospital Wigan Wrightington Hospital Bath Circle Bath Hospital Sidcup Queen Mary’s Hospital SW10 Chelsea & Westminster Wythenshawe Wythenshawe Hospital Bath Royal National Hospital for Tunbridge Wells Tunbridge Wells Hospital Rheumatic Diseases Hospital W6 Charing Cross Hospital MERSEYSIDE Bath Royal United Hospital Tunbridge Wells Nuffield Hospital Tunbridge NW4 BMI Hendon Hospital Liverpool Broadgreen Hospital Taunton Musgrove Park Hospital Wells WC1N Royal London Hospital for Liverpool Spire Liverpool Hospital Taunton Nuffield Hospital Tunbridge Wells Spire Tunbridge Wells Integrated Medicine Liverpool Royal Liverpool University Taunton Hospital WC1 Great Ormond Street Hospital Weston Super Mare Weston General Hospital Liverpool Liverpool Women’s Hospital LANCASHIRE SE1 Guy’s Hospital Hospital Yeovil Yeovil District Hospital Blackburn BMI Beardwood W12 Hammersmith Hospital Liverpool University Hospital Hospital W12 Queen Charlotte’s & Chelsea Aintree STAFFORDSHIRE Blackburn Royal Blackburn Hospital Liverpool Liverpool Heart & Chest Burton-on-Trent Queen’s Hospital Hospital N6 Highgate Hospital Hospital Newcastle-under-Lyne Nuffield Hospital North Blackpool Spire Fylde Coast WC1E Hospital for Tropical Ormskirk Ormskirk & District General Staffordshire Hospital Diseases Hospital Stafford Staffordshire General Blackpool Victoria Hospital NW8 Hospital of St John & St Prescot Whiston Hospital Hospital Bolton BMI Beaumont Hospital Elizabeth St Helens Fairfield Independent Stafford Rowley Hall Hospital Bolton Royal Bolton Hospital NW8 British Hernia Centre Hospital Stoke-on-Trent Royal Stoke University Burnley Burnley General W1G King Edward VII St Helens St Helens Hospital Hospital Hospital Hospital Southport Southport & Formby District Chorley Euxton Hall Hospital SE5 King’s College Hospital General Hospital SUFFOLK Gisburne BMI Gisburne Park SE13 University Hospital Wirral Clatterbridge Hospital Bury-St-Edmunds BMI St Edmunds Hospital Lewisham Wirral Spire Murrayfield Hospital Lancaster BMI Lancaster Hospital E1 Royal London Hospital Hospital Bury-St-Edmunds West Suffolk Hospital Ormskirk Ormskirk & District General Whitechapel Wirral Arrowe Park Hospital Ipswich Ipswich Hospital Hospital E1 BMI London Independent Ipswich Nuffield Hospital Ormskirk Renacres Hospital Hospital NORFOLK Ipswich Preston Fulwood Hall Hospital EC1 Moorfields Eye Hospital Cromer Cromer Hospital Preston Royal Preston Hospital WC1 National Hospital Great Yarmouth James Paget University SURREY for Neurology & Hospital Ashtead Ashtead Hospital LEICESTERSHIRE Neurosurgery Kings Lynn BMI Sandringham Camberley Frimley Park Hospital Hinckley Hinckley & District N18 North Middlesex University Hospital Caterham North Downs Hospital Hospital Hospital Norwich Spire Norwich Hospital Cheam Spire St Anthony’s Leicester Glenfield Hospital SW19 Parkside Hospital Norwich Nolfolk & Norwich University Chertsey BMI Runnymede Leicester Leicester General Wimbledon Hospital Hospital Hospital W1 The Portland Hospital for Chertsey St Peter’s Hospital Leicester Nuffield Hospital Women & Children NORTHAMPTONSHIRE Croydon BMI Shirley Oaks Leicester SW15 Queen Mary’s Hospital Kettering Kettering General Hospital Leicester Leicester Royal Roehampton Hospital Epsom Epsom General Infirmary NW3 Royal Free Hospital Kettering Woodland Hospital Hospital Oadby Spire Leicester Hospital SW3 Royal Marsden Hospital Northampton Northampton General Farnham Spire Clare Park W1 “Royal National Throat, Nose Hospital Hospital LINCOLNSHIRE & Ear Hospital” Northampton BMI Three Shires Guildford Nuffield Hospital Boston Boston West Hospital EC1 St Bartholemews Hospital Guildford Boston Pilgrim Hospital Hospital Guildford BMI Mount Alvernia Grantham Grantham & District SW17 St Georges Hospital NORTHUMBERLAND Hospital Hospital W2 St Marys Hospital Alnwick Alnwick Infirmary Guildford Royal Surrey County Grimsby St Hugh’s Hospital SE1 St Thomas’ Hospital Hexham Hexham General Hospital Grimsby Diana Princess of Wales NW1 University College Hospital Horley Spire Gatwick Park Hospital Hospital Hospital Lincoln BMI Lincoln Hospital NW1 Western Eye Hospital NOTTINGHAMSHIRE Kingston-upon-Thames BMI Coombe Wing Lincoln Lincoln County Hospital W1G Weymouth Street Nottingham Nottingham City Leatherhead Leatherhead Hospital Louth County Hospital Hospital Hospital Redhill East Surrey Hospital Promotional 9
Sutton Royal Marsden Hospital Solihull Spire Parkway Hospital HULL & EAST YORKSHIRE Edinburgh Royal Infirmary of Woking Nuffield Hospital Solihull Solihull Hospital Cottingham Castle Hill Hospital Edinburgh Woking Sutton Coldfield Good Hope Hospital Goole Goole & District Edinburgh Western General Sutton Coldfield Spire Little Aston Hospital Hospital SUSSEX - EAST Hospital Hull Spire Hull & East Riding Edinburgh The Edinburgh Clinic Brighton Royal Alexandra Children’s Walsall Manor Hospital Hospital Livingston St John’s Hospital Hospital West Bromwich Sandwell General Hull Royal Infirmary Brighton Royal Sussex County Hospital Scunthorpe Scunthorpe General STRATHCLYDE Hospital Wolverhampton New Cross Hospital Hospital Alexandria Vale of Leven Hospital Brighton Sussex Eye Hospital Wolverhampton Nuffield Hospital Ayr BMI Carrick Glen Brighton Nuffield Hospital Wolverhampton WALES Hospital Brighton CLWYD Ayr Ayr Hospital Crowborough Horder Centre WILTSHIRE Abergele Abergele Hospital Glasgow Nuffield Hospital Eastbourne Eastbourne District General Malborough Savernake Hospital Rhyl Glan Clwyd Hospital Glasgow Hospital Salisbury New Hall Hospital Wrexham Maelor Hospital Glasgow BMI Ross Hall Hospital Hove Spire Montefiore Salisbury Salisbury District Wrexham Spire Yale Hospital Glasgow Queen Elizabeth University Hospital Hospital Hospital Lewes Victoria Hospital Swindon Great Western Hospital DYFED Greenock Inverclyde Royal St Leonards-on-Sea Conquest Hospital Swindon BMI Ridgeway Hospital Aberystwyth Bronglais General Hospital St Leonards-on-Sea Spire Sussex Hospital Hospital Kilmarnock Crosshouse Hospital WORCESTER Camarthen BMI Werndale Hospital SUSSEX - WEST Droitwich BMI Droitwich Spa Camarthen Glangwili General TAYSIDE Chichester Nuffield Hospital Hospital Hospital Arbroth Arbroth Infirmary Chichester Kidderminster Kidderminster Hospital Haverfordwest Withybush General Brechin Stracathro Hospital Chichester St Richards Hospital Redditch Alexandra Hospital Hospital Dundee BMI Fernbrae Hospital Crawley Crawley Hospital Worcester Worcester Royal Perth Perth Royal Infirmary East Grinstead Queen Victoria Hospital Hospital GLAMORGAN - MID East Grinstead McIndoe Surgical Worcester Spire South Bank Bridgend Princess of Wales NORTHERN IRELAND Centre Hospital Hospital COUNTY ANTRIM Haywards Heath Nuffield Hospital Haywards Llantrisant Royal Glamorgan Belfast Belfast City Hospital Heath YORKSHIRE - NORTH Hospital Belfast Kingsbridge Private Haywards Heath Princess Royal Hospital Bridlington Bridlington & District Merthyr Tydfil Prince Charles Hospital Hospital Horsham Horsham Hospital Hospital Belfast Mater Hospital Worthing Worthing Hospital Harrogate BMI The Duchy Hospital GLAMORGAN - SOUTH Belfast Musgrave Park Hospital Worthing BMI Goring Hall Harrogate Harrogate District Cardiff Cardiff Bay Hospital Belfast Royal Victoria Hospital Hospital Hospital Cardiff Spire Cardiff Hospital Belfast Ulster Independent Malton Malton Norton & District Cardiff The Vale Hospital, Clinic TYNE & WEAR Hospital Hensol Belfast Ulster Hospital Gateshead Queen Elizabeth Middlesborough James Cook University Cardiff University Hospital of Lisburn Lagan Valley Hospital Hospital Hospital Wales Newtownabbey Whiteabbey Hospital Newcastle Freeman Hospital Northallerton Friarage Hospital Newcastle Nuffield Hospital Newcastle- Scarborough Scarborough General GLAMORGAN - WEST COUNTY ARMAGH upon-Tyne Hospital Neath Neath Port Talbot Craigavon Craigavon Area Hospital Newcastle Royal Victoria Infirmary York Clifton Park Hospital Hospital Newcastle Walkergate Hospital York York District Hospital Swansea Morriston Hospital COUNTY DOWN North Shields North Tyneside General York Nuffield Hospital York Swansea Sancta Maria Hospital Downpatrick Downe Hospital Hospital Swansea Singleton Hospital Newry Daisy Hill Hospital South Shields South Tyneside District YORKSHIRE - SOUTH Hospital Barnsley Barnsley Hospital GWENT COUNTY FERMANAGH Sunderland Sunderland Eye Doncaster Park Hill Hospital Abergavenny Nevill Hall Hospital Enniskillen South Western Acute Infirmary Doncaster Royal Infirmary Newport St Joseph’s Hospital Hospital Sunderland Sunderland Royal Rotherham Rotherham Hospital Hospital Sheffield BMI Thornbury Hospital GWYNEDD LONDONDERRY Washington Spire Washington Sheffield Sheffield Children’s Bangor Gwynedd Hospital Ballykelly North West Independent Hospital Hospital Llandudno Llandudno General Hospital Sheffield Claremont Hospital Hospital Coleraine Causeway Hospital WARWICKSHIRE Sheffield Northern General Londonderry Altnagelvin Area Leamington Spa Nuffield Warwickshire Hospital SCOTLAND Hospital Hospital Sheffield Royal Hallamshire CENTRAL Magherafelt Mid Ulster Hospital Nuneaton George Eliot Hospital Hospital Stirling BMI Kings Park Hospital Rugby Hospital of St Cross Sheffield Weston Park Hospital Larbert Forth Valley Royal TYRONE Stratford Circle Stratford Clinic Hospital Dungannon South Tyrone Hospital Warwick Warwick Hospital YORKSHIRE - WEST Omagh Tyrone County Hospital Bingley Yorkshire Clinic GRAMPIAN WEST MIDLANDS Bradford Royal Infirmary Aberdeen BMI Albyn Hospital CHANNEL ISLANDS Birmingham City Hospital Dewsbury Dewsbury & District Aberdeen Royal Aberdeen Children’s Alderney Mignot Memorial Birmingham Children’s Hospital Hospital Hospital Hospital Birmingham Heartlands Hospital Elland Spire Elland Hospital Aberdeen Aberdeen Royal Guernsey Princess Elizabeth Birmingham BMI The Edgbaston Huddersfield BMI Huddersfield Infirmary Hospital Hospital Hospital Aberdeen Woodend Hospital Jersey Jersey General Hospital Birmingham BMI Priory Hospital Huddersfield Royal Infirmary Birmingham Queen Elizabeth Keighley Airedale General HIGHLAND ISLE OF MAN Hospital Hospital Fort William Belford Hospital Douglas Noble’s Hospital Birmingham Royal Orthopaedic Leeds Leeds General Infirmary Inverness Raigmore Hospital Hospital Leeds Spire Leeds Hospital Wick Caithness General Birmingham Women’s Hospital Leeds Spire Methley Park Hospital Coventry BMI Meriden Hospital Leeds Nuffield Hospital Leeds Coventry University Hospital Leeds St James’s University LOTHIAN Coventry Hospital Edinburgh Spire Murrayfield Dudley Corbett Hospital Pontefract Pontefract Hospital Hospital Dudley Russells Hall Hospital Salterhebble Calderdale Royal Edinburgh Spire Shawfair Park Halesowen West Midlands Hospital Hospital Hospital Solihull Birmingham Midland Eye Wakefield Pinderfields General Edinburgh Royal Hospital for Sick Centre Hospital Children
Promotional 10 THE MEDICAL STARTER PLAN CHECKLIST You could compare the HMCA plan with other plans by C using this checklist.
✓ no medical examination No medical examination is required when you join. ✓ H no AGE RESTRICTIONS You can join at any age. ✓ a PROMPT AND personal claims servicE is provided Our goal is to pay claims on the day we receive your hospital and specialist's bills. E ✓ NHS Hospital Cash Benefit A £100 a night tax-free cash benefit is available, for up to 30 nights, if treatment is wholly in an NHS Hospital. ✓ choice of countrywide hospitals C You have the choice of over 500 hospitals on our list and others with prior arrangement. ✓ EXCESS OR DEDUCTIBLE This is available, for more details ring 01423 799949. K ✓ SPECIALIST Freedom of choice. ✓ PROSTHESES HMCA includes these. L ✓ Special GUARANTEED transfer fACility Cover can be transferred from an existing plan, and future claims made for acute conditions originating at the time you were participating in a previous plan, will be honoured. I ✓ INITIAL CONSULTATION You will be covered for an initial specialist's consultation which results in treatment requiring an overnight or longer stay in hospital. S HMCA GP ADVICE LINE UPGRADE AVAILABLE HMCA can now offer a 24/7 unlimited use GP Advice Line that can be accessed worldwide for telephone or video consultations. T Plus, should the doctor feel you would benefit from prescription medication, you can have this delivered to you at any UK address, CHOOSE YOUR whether you are at home, work or on holiday. OWN SPECIALIST If you wish to upgrade to include this, telephone 01423 799949. AND HOSPITAL Promotional 11
If you wish to discuss your healthcare requirements or the Medical Starter Plan, please call our helpline on 01423 799949
THIRD AGE MATTERS READER Dear Sirs
I recently joined HMCA’s Private Healthcare scheme, and chose the top band of cover. Unfortunately, within weeks, I became extremely unwell. HMCA were incredibly helpful. Not only were they charming pre-my joining them, answering my endless questions with great patience, they were prompt and courteous about dealing with the claims that I submitted to them regarding my illness. Because I suddenly became unwell over a weekend, the easiest way for me to go forward was to self-pay as I went along, and to submit all my receipts to HMCA. My claim was dealt with extremely quickly. I unfortunately had a relapse, resulting in having to submit a further claim - again, payment was extremely prompt. Having personally paid out a large amount of money for my medical fees, I was so grateful to be remunerated so rapidly, and with such courtesy. I cannot recommend (and praise) HMCA highly enough. It is bad enough being unwell and vulnerable, let personal alone having to cover such high costs, so it was extremely reassuring to find that my case was dealt with so quickly. accident cover Thank you to all the team at HMCA! included Third Age Matters Member, North London, December 2018 12
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IMPORTANT INFORMATION SECTION Contractual 13 MEDICAL STARTER PLAN M dESCRIPTION OF BENEFITS The maximum benefit payable for each person named on the E Membership Certificate for acute surgical or acute medical D conditions, in each subscription year, is £250,000 I IN-HOSPITAL TREATMENT FOR OVERNIGHT OR LONGER STAYS ONLY £
C ACCOMMODATION CHARGES IN A HOSPITAL ON OUR Full refund HOSPITAL LIST A WARD NURSING CHARGES FOR EACH STAY IN Full refund HOSPITAL
NHS TREATMENT 100 a night L For the duration of medical treatment carried out solely as a for up to 30 National Health patient in a public ward of an NHS hospital. nights’ a year
SURGICAL CHARGES FOR EACH STAY IN HOSPITAL Surgeons and Anaesthetists Combined Fees including aftercare. Major Plus Operation up to 1625 S Major Operation up to 1145 Intermediate Operation up to 765 Minor Operation up to 435 T Additional Benefit for an operation requiring specialised up to 2100 operative techniques A THEATRE FEES, CONSUMABLES, DRUGS AND SURGICAL DRESSINGS FOR EACH STAY IN HOSPITAL Major Plus Operation up to 2500 Major Operation up to 1575 R Intermediate Operation up to 1030 Minor Operation up to 745 Additional Benefit for an operation requiring specialised up to 2725 T operative techniques pathology, investigations & Physiotherapy When charged individually by the hospital up to 1100 E When charged as part of a package price up to 500
WARD DRUGS & CONSUMABLES FOR EACH STAY IN R HOSPITAL When charged separately for in-hospital treatment. Full refund
PROSTHESES FOR EACH STAY IN HOSPITAL Prostheses payable in accordance with the operation. Major Plus Operation up to 3000 Major Operation up to 1260 P Intermediate Operation up to 745 Minor Operation up to 455 Additional Benefit for an operation requiring up to 1350 L specialised operative techniques PHYSICIAN FEES FOR NON SURGICAL STAYS IN HOSPITAL up to 120 for A First three days each day up to 60 for N After three days each day 14
PERSONAL ACCIDENT BENEFITS £ PERSONAL ACCIDENT DEATH BENEFIT 1000500 M PERSONAL ACCIDENT DISABILITY COVER 5000250 E OUTPATIENT & ADDITIONAL BENEFITS £ D each year RADIOTHERAPY/CHEMOTHERAPY up to 800 A grant is given towards treatment. I INITIAL CONSULTATION up to 250 You will be covered for an initial specialist’s consultation which results in treatment requiring an overnight or longer C stay in hospital. A L
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P L A N Contractual 15 THE MEDICAL STARTER PLAN Description of Benefits
1 DEFINITIONS 1.19 Chemotherapy The treatment of cancer using The following expressions have the following meanings:- specific chemical agents or drugs that are 1.1 Association HMCA Members. selectively destructive to malignant cells and 1.2 Scheme A Scheme, managed by HMCA Members, tissues. for providing benefits in respect of treatment for 1.20 Ward Drugs Medication which is administered acute surgical or acute medical conditions for any whilst the patient is an in-patient on the ward. This disease, injury or illness on a short term basis by does not include Chemotherapy drugs. Specialists at any hospital on the list. 1.21 Day Case An admission to a hospital that does 1.3 Insurer HMCA Insurance Limited. not involve an overnight stay. 1.4 Year Any twelve calendar months commencing 1.22 EEA Includes all member states of the EEA, as well at the date of enrolment or annual renewal of a as the Isle of Man and Channel Islands. subscription. 2 EXCLUSIONS 1.5 Member A person who is either an individual or Benefits shall not be payable for:- group and applies for enrolment under Condition 2.1 Treatment of a Long-term Illness (refer to condition 3.1 and is accepted. 3.3.2 to see how this exclusion is applied); 1.6 Dependants monitoring of any condition; routine follow-up 1.6.1 The Member’s Spouse or partner if living at the consultations; treatment which does not address same address. the underlying medical condition and only offers 1.6.2 A child, or grandchild, of the Member, or the temporary relief of symptoms (i.e. palliative care). Member’s partner, up to the age of 26, single and 2.2.1 Pre-existing injury or disease contracted prior to living at home. your enrolment date (or the Member’s previous 1.6.3 A child, or grandchild, of the Member, or the plan under the terms of the transfer facility). After Member’s partner, in full-time education. one full year’s membership such pre-existing injury 1.7 Patient “The Patient” means the Member or one or disease and conditions arising or resulting of his Dependants receiving benefits under the therefrom of which no symptoms (indication of a scheme. disease or disorder) have manifested themselves 1.8.1 NHS Hospital A hospital operated under the or treatment, or medication, or advice, including National Health Service with facilities for medical check-ups, has been rendered in the preceding 12 and surgical treatment. consecutive calendar months, will be covered. 1.8.2 Private Hospital A hospital or nursing home with 2.2.2 At the time of joining, if the Member is undergoing facilities for medical and surgical treatment which treatment or investigations (including with your charges fees for its services and in the United General Practitioner) these are excluded unless fully Kingdom is registered under the Nursing Homes disclosed and accepted by the Insurer in writing. Act 1975 (or is excluded from the definition of a 2.3 Pregnancy or childbirth, except in cases of nursing home in the Act by Section 1 (2)(a) thereof complications of childbirth when the NHS benefit but is not an NHS Hospital) or overseas is operated will be payable subject to both parents having or recognised by the appropriate authority where been enrolled for at least twelve months. it is situated. 2.4 The investigation or treatment of Infertility. 1.9 Acute Medical Condition Any disease, illness or 2.5 Treatment for alcohol and drug abuse. injury of rapid onset, severe symptoms and brief 2.6 Treatment for sexually transmissible diseases duration. including Acquired Immune Deficiency Syndrome 1.10 Long-term Illness A medical condition that has (AIDS) or AIDS Related Complex (ARC) howsoever become either recurrent, persistent or incurable. this Syndrome has been acquired or may be 1.11 Treatment Surgical or medical procedures named. undertaken by Specialists needed to diagnose 2.7 Treatment for injury or illness directly or and/or cure an acute medical condition. indirectly occasioned by, happening through or 1.12 In-Hospital Treatment An overnight stay by a in consequence of war, invasion, acts of foreign Member or his Dependant for private treatment in enemies, hostilities (whether war be declared or a Private Hospital in connection with the treatment not), civil war, riot, terrorism, rebellion, revolution, of an acute medical condition. insurrection, military or usurped power. 1.13 Specialist A medical or dental practitioner who is 2.8 Treatment or advice given by a General Practitioner registered under the Medical Acts and holds or has or Dentist. held a consultant appointment in an NHS Hospital 2.9 Self inflicted injuries or disabilities. or otherwise holds a certificate of specialist 2.10 Sight testing, routine medical examinations and accreditation recognised by a competent authority. any dental condition not involving an oro-surgical 1.14 General Practitioner A registered medical operation. practitioner in general practice. 2.11 Spectacles or other optical aids, hearing aids, 1.16 Interpretation Where appropriate, reference to surgical medical appliances or equipment, denture the masculine gender shall be deemed to include or dental appliances. the feminine. 2.12 Rehabilitation, convalescence, or time spent in a 1.18 Accident or Emergency Admissions community or cottage hospital, a nursing home or 1.18.1 by ambulance to either an NHS or Private Hospital similar establishment. as a direct result of or immediately following an 2.13 Cosmetic surgery, whether or not for psychological accident reasons. 1.18.2 to either an NHS or Private Hospital directly from 2.14 Dialysis in Chronic Renal Failure. the Accident & Emergency or Casualty department 2.15 Treatment received outside the country of for urgent or unplanned treatment residence when the purpose of being abroad is 1.18.3 to either an NHS or Private Hospital on the same wholly or in part to obtain such treatment, unless day as a referral for treatment is made by either a agreed in advance with HMCA. General Practitioner or Specialist, when immediate 2.17 Treatment not being undertaken by a Specialist. Treatment or Diagnostic Tests are a medical 2.18 Treatment when received as a public ward patient necessity in an NHS hospital. 16
2.19 (i) the completion of claim forms (ii) medical 3.11 The subscription is payable in advance and . reports which may be required at any time in eligibility to benefit ends when the period covered E INSU NC RA respect of Members or Dependants. by the subscription has expired or any instalment A N R C 2.20 Drugs and dressings prescribed on an out-patient of subscription has not been paid on the due date. U E S . N basis. 3.12 Where the annual subscription is paid by I I N .
2.21 Treatment for mental illness or psychiatric instalments, such instalments are payable for the S
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2.22 Drugs not licensed in the U.K. for specific usage. any outstanding instalments on settlement of a N N A C
2.24 Treatment of joint and back problems will claim. R INSURANCE E U
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U E R C A membership. This does not apply to Members hospitals on the list provided. Other hospitals may N who enrol under the transfer condition or in be accepted subject to prior notification and the respect of treatment required where accident is Insurer’s written agreement. the sole cause. 3.15 Where discounts off the basic rates are allowed, 2.25 Correction of abnormalities or deformities which only one discount will be given. are congenital or which originate before the date 3.16 Benefits may be claimed for treatment by a of enrolment, and any treatment related to any specialist after referral from the patient’s GP. such abnormality or deformity. Where more than one surgical procedure is 2.26 Treatment which is experimental or has not been carried out whilst an in-patient then the benefit accepted as being effective. payable towards Surgical Charges and Theatre 2.27 Breast reductions for whatever reason. Fees shall be 100% of the highest rated procedure 2.28 Accident or Emergency Admissions, except when plus up to 50% of the appropriate benefit for the treatment is received free as an NHS patient, each subsequent procedure. For the purposes of when the NHS grant is payable. benefits, operations are classified as Complex, 2.29 Where previous treatment has been received Major Plus, Major, Intermediate or Minor. When by the Member for any joint, either before they a course of treatment is received solely as an became a Member of the scheme or since joining NHS patient, the cash benefit detailed in the it, no benefit will be payable under this policy in Description of Benefits shall be payable for each the case of any revision or repeat treatment to that eligible night spent in hospital. joint. 3.17 A claim form will be sent to the Member on request. Such a request should be made immediately the 3 CONDITIONS Member is advised to have Specialist treatment for 3.1 Anyone resident in the EEA shall be eligible to which a claim for benefit will be submitted. apply for enrolment of himself and his Dependants 3.19 A member shall not be entitled to ask for payment in the Scheme. in any foreign currency and claims in any such 3.2 The Insurer reserves the right to refuse any currency shall be paid in Pounds Sterling at the application or to restrict the range of benefits and rate of exchange prevailing on the day of the the Applicant shall not be entitled to know the cheque in settlement of the claim is drawn. reason for such decision. 3.20 Any claim for benefit must not exceed the actual 3.3 Cover may be transferred from an existing plan and expenses incurred and is payable up to the limit future claims made for acute conditions originating for the time being prescribed within the Member’s at the time the Member was participating in the chosen level. Such a claim must be in the Insurer’s previous plan, will be honoured subject to the prescribed form supported by accounts from Description of Benefits applicable at that time. whoever has provided the service. Any claim shall 3.3.1 The Member must provide evidence of the be made within three months’ of commencement existing plan and the commencement date of it to of treatment or giving of advice. It shall be HMCA for the transfer terms to apply. supported by such further evidence as the Insurer 3.3.2 When a condition is first diagnosed (and did not may reasonably require. In the event of treatment exist prior to enrolment) benefit will be provided or the giving of advice continuing further, accounts for such diagnosis and any necessary treatment for shall be submitted within one month of them one initial episode only. Subsequent treatment is being rendered and the requirement as to further not covered. When these circumstances occur the evidence shall apply. Insurer will issue an appropriate endorsement to 3.21 If expenses are covered by an insurance on the the certificate. Member or by any Provident Association, the 3.6 On the death of a Member, a spouse who is Insurer reserves the right not to pay more than its registered as a Dependant may without formality rateable proportion thereof. become a Member in his or her own right at the 3.22 For the purposes of calculating daily payments, appropriate rate, according to whether the spouse the days of admission and discharge together was the only Dependant or whether there were count as one day. one or more child Dependants. 3.23 Accommodation charges are payable only when 3.7 The contract is an annual one renewable from year directly related to the In-Hospital treatment to year at the option of the Member, subject to the received in Private Hospitals or the private wing of Description of Benefits and Subscriptions in force NHS Hospitals. at the date of renewal. 3.25 Where the treatment required results from the 3.9 Members who take up residence outside the fault of another, the Member must; EEA shall cease from the next renewal date to be (i) Take all reasonable steps that the Insurer Members of the Scheme. requires to recover from the party at fault the cost 3.10 The Insurer shall be entitled at any time in relation of the benefits paid by the Insurer and interest to a Member or Dependant to terminate the thereon. contract, or to subject the contract to different (ii) If recoverable, repay to the Insurer the cost of terms, if the benefits paid to the Member with interest. (a) The Member, or an enrolled Dependant, has at 3.26 The benefits payable towards a claim are those any time applicable to your certificate at the time the (i) misled the Insurer by mis-statement or claim form is issued. Therefore benefits from two concealment. separate membership years cannot be applied to (ii) otherwise failed to act with the utmost good the same claim. faith. 3.29 Each In-Hospital stay must be pre-authorised (b) the Member is a member of a group which at least the day before, with HMCA Members is wound up, or whose special arrangements are being in receipt of the completed claim form, a amended. consultant’s report and details of the hospital’s (c) The Insurer decides to discontinue the Scheme charges, before any agreement can be given as to or any part thereof. the eligibility and benefits payable. Contractual 17 THE PERSONAL ACCIDENT CASH PLAN Description of Benefits
Included with your Medical Starter Plan are Personal d) any act of terrorism Accident benefits. Please read these Description of For the purpose of this exclusion, an act of Benefits and make sure that they meet your needs terrorism means an act or series of acts, including and that you are clear about the cover and the the use of force or violence, of any person or exclusions. These documents form the contract of group(s) of persons, whether acting alone or on insurance between you and the Insurer. behalf of or in connection with any organisation(s), committed for political, religious or ideological Certain words in this Plan have a specific meaning. purposes including the intention to influence any The definitions of such words are detailed under government and/or to put the public in fear for Definitions. Where a word has been defined, the such purposes definition will apply wherever that word appears e) the Insured being intoxicated by alcohol or drugs, in this Plan. except as prescribed by a registered qualified medical practitioner Definitions f) acquired immune deficiency syndrome (AIDS) Insurer: HMCA Insurance Limited or HIV Insured: the person stated on the Certificate g) hazardous pursuits Anniversary Date: 12 months’ after your enrolment date, stated on your membership certificate Accidental Death: death caused by an accident Fraud which is due to a sudden, unexpected, unusual Insurance fraud is a crime, and costs innocent specific event which occurs at an identifiable customers money every year because insurance time and place. companies have to charge higher premiums. You/your: the Insured Hazardous Pursuits: shall mean ballooning, caving, If you, or anyone acting on your behalf, supply the diving, hang-gliding, hydro-planing, riding on a Insurer with facts or information and/or make a motorcycle over 250cc (as a driver or passenger), claim which you know to be false or inaccurate and mountaineering, parachuting, pot-holing, racing of with the intent of seeking financial gain you may be any kind (other than on foot), rock or cliff climbing, committing a fraudulent act, which is a crime. If the white water rafting or canoeing, any sport carried Insurer obtains evidence which suggests that this is out as a professional the case, the Insurer may cancel the Plan and refuse Permanent Disablement/Disability: refers solely to settle your claim. The Insurer will also report the to loss of limb or loss of sight as separately defined. matter to the police. Loss of limb: means loss by physical separation of a hand at or above the wrist or of a foot at or above the ankle and includes total and irrecoverable loss of use of hand, arm, foot or leg. Loss of Sight: means total and permanent loss of sight in both eyes if the Insured Person has been added to the register of blind persons on the authority of a fully qualified ophthalmic specialist, or in one eye if the degree of sight remaining after correction is 3/60 or less on the Snellen Scale.
Exclusions This Plan does not cover death or disablement/ disability resulting directly or indirectly from; a) the Insured’s criminal activity, intentional actions or self-injury b) war, whether war be declared or not, hostilities or any act of war or civil war c) nuclear reaction, nuclear radiation or radioactive contamination 18
. E INSU IMPORTANT INFORMATION NC RA A N R C U E S . N I I N .
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HMCA Insurance Limited is the insurer that complaints procedure N underwrites the Medical Starter Plan and promotes If you have a complaint, please write to The its various plans through HMCA Members both in Directors of HMCA Members, Beech Hall, the UK and Republic of Ireland. It does not own, Knaresborough, Yorkshire, HG5 0EA. If you are nor is it owned by, any part of HMCA Members. dissatisfied with the response you should write to HMCA Insurance Limited, 33/2 Cannon Lane, HMCA Members is an insurance intermediary Gibraltar, GX11 1AA. If after their review you are still that works on behalf of the underwriters, HMCA dissatisfied, your complaint can be referred to the Insurance Limited. HMCA Members undertakes all Financial Ombudsman Service at Exchange Tower, aspects relating to administration, marketing and Harbour Exchange Square, London E14 9SR. management of claims. In return for this, HMCA Members is remunerated by HMCA Insurance Limited from the subscription the members pay.
HMCA Members only promotes Medical Plans THE DIRECT DEBIT GUARANTEE underwritten by HMCA Insurance Limited and its • This Guarantee is offered by all banks and experienced Telephone Helpline provides a non- building societies that accept instructions to advised sales service. The Telephone Helpline is pay Direct Debits. here for you to ask any questions regarding any aspect of the Plan. You can contact the Helpline on • If there are any changes to the amount, date 01423 799949. or frequency of your Direct Debit, HMCA/S PLC will notify you three working days in We do not offer advice and the information sent advance of your account being debited or will allow you to make a choice of how to proceed. as otherwise agreed. If you request HMCA/S PLC to collect a payment, confirmation of the DEMANDS AND NEEDS amount and date will be given to you at the This Plan meets the demands and needs of time of the request. individuals who wish to have benefits towards the cost of their private medical treatment in-hospital, • If an error is made in the payment of your now and in the future. Direct Debit by HMCA/S PLC or your bank or building society, you are entitled to a full and Compensation immediate refund of the amount paid from HMCA Insurance Limited is covered by the your bank or building society. Financial Services Compensation Scheme (FSCS). You may be entitled to compensation from the • If you receive a refund you are not entitled scheme in the unlikely event that HMCA Insurance to, you must pay it back when HMCA/S PLC Limited cannot meet its obligations. This depends asks you to. You can cancel a Direct Debit at on the type of business and circumstances of the any time by simply contacting your bank or claim and would provide cover for 100% of the building society. Written confirmation may be first £2,000 and 90% of the remainder of the claim required. Please also notify us. without any upper limit. Further information about compensation scheme arrangements is available from the FSCS. (www.fscs.org.uk - telephone 020 7741 4100.)
HMCA/S PLC, trading as Hospital & Medical Care Association, HMCA and HMCA Members is an intermediary and is authorised and regulated by the Financial Conduct Authority, reference no. 307587. This can be verified by visiting the FCA’s website https://register.fca.org.uk or by contacting the FCA on 0800 111 6768. I have nothing but praise for your Association. It is very reassuring for me to be able FIRST VOICE to use one of the leading eye surgeons in the world for my treatment for glaucoma. MAGAZINE In this modern world how nice to deal with people with old fashioned values, long READER may you continue. I cannot thank you enough. First Voice Magazine Reader, Derbyshire - March 2019
I would now like to say how happy and relieved I am to have become a member RCN of the association. Of course, the subscription paid a part but it was the care and BULLETIN understanding that made me want to be a member and I cannot praise you enough READER for that. RCN Bulletin Reader, Sussex - March 2019
I would like to thank all the HMCA staff that I have dealt with. Without exception, NATIONAL TRUST everyone is courteous, well informed and helpful; good customer service like this is MAGAZINE rare today, so HMCA should feel justifiably proud of their record. READER National Trust Magazine Reader, January 2020
I wish to thank you for the professional way my claim has been handled and the THIRD AGE courtesy your staff have shown on each occasion I have phoned with a query. MATTERS I have no hesitation in recommending your company to colleagues and friends. READER Well done! Third Age Matters Reader, London, January 2020
FREEMASONRY I write to say how impressed and appreciative I am regarding the staff of your Organisation. Whenever I make contact, every person I speak with is unfailingly polite, TODAY helpful and approachable. I always feel I am an individual client, not simply a number. READER Freemasonry Today Reader, Warwickshire - April 2019
We Are here to help If you wish to discuss your health care requirements or the Medical Starter Plan, please telephone our helpline on (01423) 799949 or fax on (01423) 866586 or write to: HMCA, Beech Telephone helpline Hall, Knaresborough, Yorkshire HG5 0EA. Email: (01423) 799949 Beech Hall Circa 1737 [email protected] Website: www.hmca.co.uk Beech Hall, Knaresborough