Answering your questions

You’ll find the answers to your questions about a number of subjects here

Can I access hospitals for treatment? 

Yes, private hospitals are now accepting new referrals but there still might be some disruption to when and where private services are delivered. Private hospitals are treating private patients in line with the current NHS England guidelines. These guidelines are changing regularly, however, the latest guidelines enable private providers to carry out non-urgent routine work.

Are all private facilities available now?

We expect there will continue to be some disruption to when and where private services are delivered. Availability may vary by location, and by specialism. And if the NHS needs further support in the future, those that are available may become unavailable again.  

We’re working closely with private healthcare providers and our national networks to understand where you can access your diagnostics and treatments.

Can I still visit my specialist?  

In the majority of cases first consultations are still virtual (either by telephone or a video platform). Following an initial consultation, the specialist will direct you towards the most appropriate pathway of care.

How do I get treatment?

Just contact your GP or our online private GP service Doctor@Hand and ask for an open referral: then phone our Claim Consultants on 0800 068 7111.

What is an ‘open’ referral?

An open referral is where your GP states that treatment is necessary and which type of specialist you require that treatment from, but doesn’t specify the specialist’s name. This means we’ll be able to support you by finding a provider who is available to treat you and we can help you in arranging private treatment with them. 

Will my usual policy limits apply if I need to see a specialist or have treatment?

Until further notice, there’s no excess to pay and no outpatient limits on consultations and diagnostic tests for PHC members when you use our Clinical Support Centre. If treatment is needed, then normal policy limits will apply. Any out-patient services that aren’t accessed through the Clinical Support Centre (e.g. out-patient mental health treatment) will continue to be subject to the out-patient limits and excess for your plan.

What happens if there are no facilities available near me?

The availability of private facilities will vary, so you may need to travel further than normal. In cases where they’re not available yet, you’ll have access to our Clinical Support Centre. We’ll help you access the health services and clinical support you need, remotely – by video, telephone or online.

Where can I find out more about the Clinical Support Centre?

You can find out all about it here including how it works, how to get the most out of remote consultations and how we’ve been able to help members so far. And of course you can give us a call.

What happens if there are no facilities available and I can’t be treated remotely?

Remote support won’t be suitable or effective for every condition. Where the service or treatment can’t be provided remotely, the clinical experts will be able to advise the best course of action and can help to manage your condition until treatment does become available.

Call us so we can check your cover and then you can have your private treatment as soon as it becomes available, provided you maintain your cover.

What do I do if I can’t get an appointment with my GP?

For some conditions you won’t need a GP referral as you’ll have direct access to treatment through the Clinical Support Centre. We’ll let you know if you need a GP referral. Then you can access our remote private GP service – Doctor@Hand – by telephone and video, free of charge within Doctor Care Anywhere's fair usage policy. Our Doctor@Hand service is provided by Doctor Care Anywhere.

Any concerns regarding the coronavirus should be referred to NHS 111, rather than the Doctor@Hand service. 

How do I access Doctor@Hand?
  1. Visit https://member.doctorcareanywhere.com/SignUp/doctorathand and enter your PHC membership number. You can find this on your membership documents.
  2. When prompted, enter the details for everyone on your plan. Please enter the information exactly as it appears on your membership certificate - don’t shorten names and use the same address.
  3. Follow the instructions to set up your account with Doctor Care Anywhere, who deliver the service. You’re ready to book your first appointment.
Can I use Doctor@Hand for my child?

Yes, when the child is covered on one of our Individual or SME private healthcare insurance plans, you can access the service on their behalf.

Will you keep me updated as things progress or change? 

Yes, please visit our dedicated COVID-19 hub for the latest information and if you have any queries contact us.

What if I’d rather wait a couple of months to start my treatment?

With continued uncertainty about the virus it might mean private facilities will be needed to support the NHS again if the infection rate increases during the winter months. We want to make sure you can access treatment while it is available.  

If you have a niggling health concern and you’ve put off diagnosis or treatment, please don’t delay any longer. Contact us to explore how you can access services safely and with confidence.

I’m currently pregnant; will you cover me to go privately so that I am not at risk within an NHS hospital?

Few health insurance plans cover pregnancy and childbirth because they are not illnesses. Despite the current situation the NHS is still set up to deal with this. If you have any concerns, speak to your midwife, go to NHS 111, or call one of the midwives on our Health at Hand helpline 0800 027 1393 (Monday to Friday 8am to 8pm, Saturday 8am to 4pm and Sundays 8am to 12pm).

How do I contact your Health at Hand telephone helpline? 

Call Health at Hand on 0800 027 1393 - 24 hours a day, 365 days a year.

If you specifically need midwife or pharmacist services, these are available Monday to Friday 8am to 8pm, Saturday 8am to 4pm and Sundays 8am to 12pm.

How long will the new Clinical Support Centre be available?

The Clinical Support Centre is now available as part of your standard cover, to provide you continued access to support from the safety of your home.  Private medical facilities for face-to-face care are widely available again in many areas, so our advisers can help guide you to the right support.

I only have limited out-patient cover on my plan; does this mean I’ll now be covered for remote consultations and diagnostics arranged through the Clinical Support Centre?

Yes. You can still contact the Clinical Support Centre who will help direct you to the right health services included in your plan.  However, your usual outpatient limitations will apply again for remote consultations and diagnostic testing from 1 December.

What if the Clinical Support Centre can’t help with my condition?

Remote support won’t be suitable or effective for every condition. Where the service or treatment can’t be provided remotely, our clinical experts will be able to advise the best course of action.

Are these services available to my children who are also covered on my plan?

Yes. Our specialists and practitioners include those who are expert in paediatrics.

What are you doing for members who struggle with technology or don’t have access to the internet?

Some of our providers are able to deal with our members over the telephone and treat them in their centres or clinics. However, we are continuing to look at how we can make sure access to care is available to as many of our members as possible.

 

What are the symptoms of COVID-19?

The commonest symptoms are a high temperature and a new, continuous cough. In addition, the sense of smell can be lost (anosmia) or changed, which can also lead to changes in the sense of taste. If you are concerned that you may have coronavirus visit the NHS 111 online coronavirus service.

How can I help stop the infection spreading? 
  • wash your hands with soap and water often – do this for at least 20 seconds
  • use hand sanitiser gel if soap and water are not available
  • wash your hands as soon as you get back home
  • cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
  • put used tissues in the bin immediately and wash your hands afterwards

Anyone who is concerned about COVID-19 should visit the NHS’ Coronavirus (COVID-19) resource for information and guidance.

How is coronavirus (SARS-Cov-2), which causes the illness COVID-19, tested?

There are several possible ways to test for infection with SARS-Cov-2:

Testing for the virus itself to determine if you have a current infection: In the UK this is most commonly a PCR test, which detects small amounts of RNA (genetic material) from the virus. This is done in a lab using a polymerase chain reaction (PCR) technique and can take several days to provide the result, although it is hoped that newer technologies will make this process more rapid. Antigen tests are also in development. They detect small amounts of protein molecules (‘antigens’) from the virus. They can be performed quickly, on site, and don’t need to be sent to a lab. They are not as sensitive as PCR tests, which can be viewed as both an advantage and a disadvantage. They are not yet widely available and their role in testing during the pandemic has not been clearly established.

Antibody tests: There are also tests that are based on the detection of antibodies – proteins the body produces in response to an infection. These tests can be laboratory tests (such as the ELISA technique) or alternatively they can be rapid-tests using a finger-prick blood sample. Antibodies are not detectable for the first few days and weeks of the infection and their role in diagnosing a current infection is still being evaluated. These tests are generally used to detect previous infection. Importantly, despite their increasing reliability at correctly detecting antibodies to coronavirus (SARS-CoV-2), it is not yet proven that having antibodies means that someone is immune or is safe from passing infection on to others. It is important that people do not use tests that have not been validated in their situation because the results could be misleading and harmful. This is especially true for infectious diseases such as COVID-19 because there is a risk of serious harm to other people through harmful behaviours after incorrect use of tests.

Importantly, Public Health England (PHE) has not yet endorsed any return to normal activities based on antibody testing and people should continue to follow the online NHS’ Coronavirus (COVID-19)  resource for information and guidance. People should not rely on potentially misleading results from unvalidated tests as this will do more harm than good.

Will you pay for my COVID-19 test?

The eligibility of testing for the new coronavirus (SARS-CoV-2) is subject to the normal terms and conditions in our plans.

We will cover the cost of a PCR (Polymerase Chain Reaction) COVID-19 test when:

  • requested by a specialist we recognise after you have been referred to them by a GP, and, the test is for the purpose of diagnosing symptoms
  • requested by a private hospital / facility we recognise for the purpose of eligible admission, eligible out-patient surgical procedures or eligible chemotherapy/radiotherapy. 

We will not cover the following: 

  • Antibody testing
  • PCR (Polymerase Chain Reaction) COVID-19 tests when it is for screening purposes prior to out-patient consultations, scans, tests, therapy or practitioner treatment
  • PCR (Polymerase Chain Reaction) COVID-19 tests at the request of a GP, prior to seeing a recognised specialist.  For example, test needed due to any delays/problems in the NHS testing system.

Most plans do not provide cover for screening or testing of symptom-free individuals, preventative treatments or treatment that would normally be carried out in a primary care setting, including fees for services that could be provided by a GP.

Additionally, we will not pay for tests that have not been proven effective. At the current time, the only tests proven to be effective for use in individuals are PCR tests (polymerase chain reaction tests), which are available on the NHS (external link) for anyone in England, Wales, Scotland and Northern Ireland who has symptoms of coronavirus, whatever their age.

Will I need to be tested for COVID -19 in order to have treatment? 

It is possible that some form of testing will be needed, depending on the type of treatment and where you are treated. The private facility will be able to tell you whether you need a test, how it will be administered and what to do when you receive the results.

Do you cover the treatment of COVID-19?

COVID-19 treatment is subject to the normal terms and conditions of your plan. However, all cases are managed by the NHS and Public Health England and in practice it is unlikely you will need to use your plan.

Most plans do not cover treatment normally carried out in a primary care setting, including fees for services that could be provided by a GP.

If admission is required, there are currently no private facilities within the United Kingdom offering services to patients who have been diagnosed with, or who are suspected of having COVID-19.

Until 31 March 2021, we’re increasing NHS cash benefits by £100 per night (or adding a benefit of £100 per night if this isn’t currently in your plan). This is for NHS in-patient treatment or NHS cancer radiotherapy or chemotherapy that would have been covered privately on your plan. This will also apply if you are hospitalised as a result of Covid-19.

If you have a health concern and you’ve put off diagnosis or treatment, please don’t delay any longer. Please contact us so we can help you keep your health on track.

If I develop a secondary problem related to COVID-19, would this be covered? 

If the treatment needed was eligible, it would be covered in line with the terms and conditions of your plan.

I’m thinking of cancelling my plan, can I have a premium holiday?

If you are experiencing financial difficulty that is impacting your ability to pay your premium and is as a result of circumstances related to the current COVID-19 crisis, please contact your broker to discuss your options.

If my treatment has been authorised, but I have to wait till after the pandemic to have treatment, and I renew during this time, will I be charged an excess again?

Excesses apply for each membership year. This means that if you incur costs during this membership year, we will take the excess off what we pay for your claim. If you then incur more costs in the next membership year, even if it’s for the same condition, we will take the excess off that claim.

What is happening to the PureGym discount, given all their UK gyms are currently closed?

We are still offering our members up to 50% off an annual PureGym membership on ActivePlus. We are working closely with PureGym to inform members if and when locations close because of changes in government guidelines. If you're gym location is closed, we will automatically freeze your annual membership. Once the gyms reopen, PureGym will add the time the gym was closed to the end of the current PureGym membership. So, for example, if the gym remains shut for 3 months, PureGym will add an additional 3 months on to the members term, so they will receive the full 12 months of membership. This will happen automatically, so you do not need to do anything. If you have any questions about this, please contact our dedicated ActivePlus Customer Service Team at customer.services@myactiveplus.com

 

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