Company Plan

How does it work?

This page contains answers to a variety of common questions about our Company plan.

If you have a question that you don't see answered here, please contact us

How does this plan work?

Where can I be treated?

You can receive treatment from any recognised hospital, clinic, or legally qualified medical practitioner.

To help you find a facility quickly and easy, visit bupaglobal.com/en/facilities/finder. We can normally arrange direct settlement with these facilities too.

Our Healthline service will help you find a suitable medical professional.

How do I arrange treatment?

When you know that you need to seek medical advice and/or treatment, we ask that you contact us first. This allows us to check your cover, confirm that your proposed treatment is eligible for payment, and in many cases, contact your medical provider to arrange direct settlement.

How does the claims process work?

There are two ways that your medical treatment can be paid:


Direct settlement

  • You contact us to advise what treatment you intend to receive.
  • We confirm that treatment is eligible and that we can ‘pre-authorise’ (guarantee payment) of it.
  • We send pre-authorisation to you and the provider of your treatment.
  • You complete and sign the pre-authorisation form.
  • Your medical provider attaches the invoice(s) for your treatment and returns with the pre-authorisation documents to us.
  • We process the claim and pay your medical provider directly.
  • We send you a ‘payment statement’ advising when and how it was paid, and who received the payment.
  • You settle any shortfall with your medical provider.
Pay and claim
  • You contact us to advise what treatment you intend to receive.
  • We confirm your cover and benefit limits.
  • You receive treatment and pay your medical provider (usually at time of treatment).
  • You and your medical provider fully complete a claim form and return the claim form to us.
  • We process the claim and pay you*.
  • We send you a ‘payment statement’ advising when and how it was paid, and who received the payment.

How does Bupa Global make claim payments?

Wherever possible, we will follow the instructions given to us in the payment section of the claim form.
  • We can pay you, the principle member (applicant) or your medical provider.
  • We can pay by cheque or by electronic bank transfer.
  • We can pay in more than 80 currencies.

How do deductibles work?

A deductible is the amount you must pay towards covered medical expenses before we will start paying for your treatment.

Once your deductible amount has been reached, all covered expenses will be paid in line with your policy’s benefit limits.

For example, if you have an annual deductible of £Sterling 500, the total value of your eligible claims must reach £Sterling 500 before we will pay any benefit.

The annual deductible applies separately to each person on your membership, and is not cumulative.

What treatment and conditions are not covered?

There are certain conditions and treatments that we do not pay for on any level of coverage.

We always ask that you contact us before arranging or receiving any treatment so we can confirm coverage./p>

Excluded conditions and treatments:

  • artificial life maintenance
  • birth control
  • conflict and disaster
  • congenital conditions
  • convalescence and admission for general care
  • cosmetic treatment
  • deafness
  • dental treatment/gum disease
  • desensitisation and neurtralisation
  • developmental problems
  • donor organs
  • drugs and dressing (out-patient)***
  • epidemics and pandemics
  • experimental treatment
  • eyesight
  • family doctor treatment***
  • footcare
  • genetic testing
  • harmful or hazardous use of alcohol, drugs and/or medicines
  • health hydros, nature cure clinics and related treatments
  • hereditary conditions
  • HIV/AIDS
  • infertility treatment
  • maternity
  • obesity
  • persistent vegetative state (PVS) and neurological damage
  • personality disorders
  • physical aids and devices
  • pre-existing conditions
  • preventive and wellness treatment
  • reconstructive or remedial surgery
  • self-inflicted injuries
  • sexual problems/gender issues
  • sleep disorders
  • speech disorders
  • stem cells
  • surrogate parenting
  • travel costs for treatment
  • unrecognised medical practitioner, hospital or healthcare facility
  • USA treatment (unless USA cover is purchased separately)

Do you have a limit for the cost of treatment I may receive?

When you are in need of a treatment provider, our dedicated team can help you find a recognised medical practitioner, hospital or healthcare facility within network. Alternatively, you can view a summary of benefits providers on Facilities Finder at bupaglobal.com/en/facilities/finder. Where you choose to have your treatment and services with a treatment provider in network, we will cover all eligible costs of any covered benefits, once any applicable co-insurance or deductible amount which you are responsible to pay has been deducted from the total claimed amount.

Should you choose to have covered benefits with a treatment provider who is not part of network, we will only cover costs that are Reasonable and Customary. This means that the costs charged by the treatment provider must be no more than they would normally charge, and be similar to other benefits providers providing comparable health outcomes in the same geographical region. These may be determined by our experience of usual, and most common, charges in that region. Government or official medical bodies will sometimes publish guidelines for fees and medical practice (including established treatment plans, which outline the most appropriate course of care for a specific condition, operation or procedure). In such cases, or where published insurance industry standards exist, we may refer to these global guidelines when assessing and paying claims. Charges in excess of published guidelines or Reasonable and Customary made by an ‘out-of-network’ treatment provider will not be paid.

This means that, should you choose to receive covered benefits from an ‘out-of-network’ treatment provider:

  • you will be responsible for paying any amount over and above the amount which we reasonably determine to be Reasonable and Customary – this will be payable by you directly to your chosen ‘out-of-network’ treatment provider;
  • we cannot control what amount your chosen ‘out-of-network’ treatment provider will seek to charge you directly.

There may be times when it is not possible for you to be treated at a treatment provider in network, for example, if you are taken to an ‘out-of-network’ treatment provider in an emergency. If this happens, we will cover eligible costs of any covered benefits (after any applicable co-insurance or deductible has been deducted).

If you are taken to an ‘out-of-network’ treatment provider in an emergency, it is important that you, or the treatment provider, contact us within 48 hours of your admission, or as soon as reasonably possible in the circumstances. If it is the best thing for you, we may arrange for you to be moved to a treatment provider in network to continue your treatment once you are stable. Should you decline to transfer to a treatment provider in network only the Reasonable and Customary costs of any covered benefits received following the date of the transfer being offered will be paid (after any applicable co-insurance or deductible has been deducted).***

Additional rules may apply in respect of covered benefits received from an ‘out-of-network’ benefits provider in certain countries.

Services available to you

How can I track the progress of my claim?

We will process your claim as quickly as possible. You can check the progress of claims** you have made via our MembersWorld website or by contacting General Enquiries on +44 (0) 1273 323 563.

How can I contact Bupa Global?

As a Bupa Global member, you can call our Medical Centre at any time of the day or night, and day of the year, and speak to medically trained people who understand your situation and can give you the healthcare advice, support and assistance you need.

We also have a team of expertly trained people ready to help with any general enquiries you may have.

Medical Centre: +44 (0)1273 333 911
General Enquiries: +44 (0)1273 323 563
Email us via our MembersWorld website


What is your complaints process?

We are always pleased to hear about aspects of your membership that you have particularly appreciated, or that you have had problems with. If something does go wrong, here is our simple procedure to ensure your concerns are dealt with as quickly and effectively as possible.

Getting in touch


If you have any comments or complaints, you can call the Bupa Global customer helpline on +44 (0) 1273 323563, 24 hours a day, 365 days a year. Alternatively, you can email via MembersWorld, or write to us at:

Bupa Global
Victory House
Brighton
BN1 4FY
UK

Easier to read information

We want to make sure that members with special needs are not excluded in any way. For hearing and speech impaired members who have a textphone, please call +44 (0) 1273 866557.

We also offer a choice of Braille, large print, or audio for our letters and literature. Please let us know which you would prefer.

Taking it further

If we have not been able to resolve the problem and you wish to take your complaint further, please call the Bupa Global customer helpline on +44 (0) 1273 323 563 or write to the Head of Customer Relations at:

Bupa Global
Russell Mews
Brighton
BN1 2NR
UK

It’s very rare that we can’t settle a complaint, but if this does happen, you may refer your complaint to the Financial Ombudsman Service.
You can write to them at:

The Financial Ombudsman Service
Exchange Tower
London
E14 9SR

Call them on:
0845 023 4567 or 0300 123 9123 (from inside the UK only)
+44 (0) 20 7964 0500 (from outside the UK)

Find details at their website:
www.financial-ombudsman.org.uk

Please let us know if you want a full copy of our complaints procedure. (None of these procedures affect your legal rights).

Can I access my plan online?

Yes, as a Bupa Global member you will have access to our MembersWorld website where you can:
  • view your policy
  • update your personal details
  • track the progress of your claims*
  • make payments online
  • search our international hospital directory
  • download claim forms and other useful documents
  • talk to us online using our free Webchat service

As a group secretary, can I manage the group plan online?

Yes, as a group secretary of a Company policy, you will have access to our CorporateWorld website where you can:
  • manage employee details
  • manage payment details
  • access useful documents such as membership guides and claim forms

Managing your plan

How are subscriptions paid?

Your sponsor (your organisation) has to pay any and all subscriptions due to Bupa Global, together with any other charges (such as insurance premium tax) that may be payable.

How can I renew my plan?

The renewal of your membership is subject to your sponsor renewing your membership.


Can I add other people to my plan?

If your sponsor agrees, you, the principal member may apply to include additional dependants on your membership by filling in a Company application form. You can download this easily from MembersWorld at bupa-intl.com/membersworld. Or you can contact us and we will send one to you.

The medical history for all additional dependants, you apply to include on your membership including any newborn children, will be reviewed by our medical underwriters. This may result in special restrictions or exclusions, which are personal to them and which will be shown on your membership certificate or we may decline to offer cover. For newborn children any exclusions or restrictions will be applied from their 91st day of birth if they are eligible for newborn care, or we may decline to offer cover after 90 days of birth.

Newborn children are eligible for newborn care and can be included on your membership from their date of birth when:

  • the child has not been born as a result of assisted reproduction technologies, ovulation induction treatment, adopted or born to a surrogate
  • you have completed an application form and we have received it before your child is 30 days old

Newborn children who are not eligible for newborn care can be included from their 91st day once you have completed a Company application form and the process for adding additional dependants will be followed.

Newborn care is not available in the USA if cover for pregnancy has been excluded in the USA as shown on your certificate of cover.

Please read ‘Newborn care’ benefits in your ‘Table of benefits’.

Adding USA cover to your plan

You the principal member can apply to include coverage in the USA at any time following your original date of joining. To apply you will need to complete a Company application form which can be downloaded easily from membersworld at bupaglobal.com/membersworld. Your application will be reviewed by our medical underwriters and may result in exclusions or restrictions specific to coverage in the USA.

What is a group insurance plan?

The Bupa Global Company plan is a group insurance plan. You are therefore one of a group of members, which has a sponsor (normally the company you work for). The person who runs the membership within your organisation is usually referred to as the group secretary.

The plan is governed by an agreement between your sponsor and Bupa Global, which covers the terms and conditions of your membership. This means that there is no legal contract between you and Bupa Global. Only the sponsor and Bupa Global have legal rights under the agreement relating to your cover, and only they can enforce the agreement.

As a member of the plan, you do have access to our complaints process. This includes the use of any dispute resolution scheme we have for our members.

How is the plan cancelled?

Your sponsor (organisation) can end your membership, or that of any of your dependents, from the first day of a given month by writing to us. We cannot backdate the cancellation of your membership.

Can I transfer to a personal plan if my group plan ends?

Yes, if for whatever reason your group policy ends, you can apply to transfer to a personal Bupa Global plan. You can also apply for your dependents to transfer with you.

I haven't been able to find the answer to my question

We are continuously adding information to this website and are sorry that you haven’t found the information you were looking for on this occasion.

Please contact us where an adviser will be ready to help

*Via cheque or electronic bank transfer, as applicable. **MembersWorld may not track claims in the USA as we use a third party here. ***Guidelines for fees and medical practice (including established treatment plans, which outline the most appropriate course of care for a specific condition, operation or procedure) may be published by a government or official medical body. In such cases, or where published insurance industry standards exist, Bupa Global may refer to these when assessing and paying claims. Charges in excess of published guidelines or reasonable and customary costs may not be paid.

The Bupa Global difference

Over 40 years of medical expertise and dedication to health. A global team of advisers and health experts who, between them, speak multiple languages – and a service that exceeds expectations. These are just a few of the things that make Bupa Global different. Explore how we provide you with world-class cover and stand apart from the rest.