Intermediaries

If your group policy started between 1 April 2024 and 31 March 2025 please find your policy documents below.

• HealthCover4life handbook
• HealthCover4life specified hospital list handbook
• HealthCover4life directory of hospitals
• HealthCover4life specified hospital directory of hospitals
• Plan 1 IPID
• Plan 2 IPID
• Plan 3 IPID
• Plan 4 IPID
• Application Forms:
  • Declaration of continued good health
  • Group HealthCover4life - Addition of dependant member FMU 
  • Group HealthCover4life - Experience rated
  • Group HealthCover4life - Switch plan
  • Group HealthCover4life - Virgin plan
  • Group HealthCover4life - Member FMU
  • Group HealthCover4life - Member simplified declaration
  • Group HealthCover4life - Group Payroll Deduct
  • Group HealthCover4life - Plan transfer
• Combined benefits table Plans 1 - 4
• Wellbeing Services flyer
• Moratorium underwriting explained
• PHC underwriting options explained

If you were a PHC member covered on HealthCover4life Plan 1, 2, 3 or 4 between 1 April 2023 and 31 March 2024 please refer to your plans Important Changes Leaflet below. This details the significant changes that have been made to the benefits available under the plan.

• Plans 1 - 3 Important Changes Leaflet
• Plan 4 Important Changes Leaflet

For group policies starting on or after 1 October 2023, please find your literature below.

• HealthCover4life Handbook
• Directory of Hospitals 
• HealthCover4life Specified Plan Handbook
• Specified Directory of Hospitals 
• Plan 1 IPID
• Plan 2 IPID
• Plan 3 IPID
• Plan 4 IPID
• Combined benefits table Plan 1 - 4
• Wellbeing services flyer
• Moratorium underwriting explained 
• PHC underwriting options explained 

For members covered on HealthCover4life Plans 1, 2, 3 or 4 between 1 October 2022 - 30 September 2023, please refer to the plans Important Changes Leaflets below. This details the significant changes that have been made to the benefits available under the plan, with effect from 1 October 2023.

• Important Changes Leaflet Plans 1 - 4

For group policies starting on or after 1 April 2023, please find your literature below.

• HealthCover4life Handbook
• Directory of Hospitals
• HealthCover4life Specified Plan Handbook
• Specified Directory of Hospitals 
• Plan 1 IPID
• Plan 2 IPID
• Plan 3 IPID
• Plan 4 IPID
• Combined benefit table Plans 1 - 4
• Wellbeing Services flyer
• Moratorium underwriting explained
• PHC underwriting options explained 

For members covered on HealthCover4life Plans 1, 2, 3 or 4 between 1 April 2022 - 31 March 2023, please refer to the plans Important Changes Leaflets below. This details the significant changes that have been made to the benefits available under the plan, with effect from 1 April 2023.

• Plan 1, 2 and 3 Important Chnages Leaflet
• Plan 4 Important Changes Leaflet

For group policies starting on or after 1 October 2022 please find update Directory of Hospital lists below. All other documents remain the same as 1 April 2022.

• Directory of Hospitals
• Specified Directory of Hospitals

If you would like alternative formats of these documents or should you have any queries, please do get in touch. 

The Financial Conduct Authority (FCA) requires AXA PPP healthcare, trading as AXA Health, to provide PHC with details of the target market of their plans. It also requires them to ensure the intended distribution strategy of the plans are consistent with the identified target market, so they are not offered to customers who do not share the common needs, characteristics and objectives of the identified target market. As such, they have created a HealthCover4life target market statement to help you better understand all of this. Laid out below is the HealthCover4life target market statement which covers the following information:

• the product type;
• product status (open or closed to new business);
• who the product is designed for and who the product is not designed for;
• the main product features;
• information on potential product complexity;
• details of any additional customer costs;
• the intended distribution strategy of the plan;
• information on which product literature should be read alongside the target market statements to provide more information on the plan e.g. the appropriate Insurance Product Information Document (IPID) and the plan handbook; and
• AXA Health’s approach to product governance.

This information will assist you in establishing the health insurance demands and needs for each plan’s target market. The Insurance Product Information Documents (IPID) and the Membership Handbooks will also help customers to make informed decisions about the suitability of our plans, and whether they offer fair value considering their health insurance demands and needs.

Please see the communication issued to our intermediary partners in March 2022 about this.

Consumer Duty and Fair Value Assessments

On 28 May 2021 the FCA published Policy Statement 21/5 which set out their new pricing practices rules. These rules set out requirements which apply to both insurers and their distribution partners and have been introduced as a result of the FCA's concerns about how insurance pricing could lead to poor product value and potential customer harm following a series of thematic reviews.

In line with Consumer Duty requirements regarding product value, we have identified opportunities to enhance our customer outcomes and have taken the appropriate action.

Our products and services have been reviewed to assess whether they remain consistent with the needs of the target market, the distribution strategy remains appropriate, and the product provides fair value for the customer including vulnerable customers. The results of these are available here and will be updated at least annually.

Under this new regulation, The Permanent Health Company Limited (PHC) is classed as a distributor. 

AXA PPP healthcare Limited (AXA Health) is our sole underwriting agent and product manufacturer, and therefore is responsible for providing sufficient information for product distributors to understand the intended target market and the value these products provide to our customers. 

Accordingly, AXA Health has provided information on:

• The characteristics of our products or services.
• The identified target market.
• The needs, characteristics and objectives of customers.
• The distribution strategy
• Product Governance 

PHC is responsible for ensuring that our distribution partners are provided this information.

In order to fulfil this obligation, we are pleased to provide the PHC Corporate HealthCover4Life Fair Value Assessment, in addition to the Target Market Statement, conducted by the product manufacturer AXA Health.

The below target market statement is not intended for customer use.

Fair value for our customers (PDF)

Target market for HealthCover4life (PDF)

Private health insurance, or private medical insurance (PMI) covers the costs of eligible private medical care. PHC policies include an array of health and wellbeing benefits to support members to live life well. From seeing a specialist for diagnosis, to having a comfortable private hospital stay, PHC offers a range of cover that aims to meet a member's specific needs. Private health insurance complements the care provided by the NHS.

With moratorium underwriting, a member won’t have cover for treatment of medical problems they had in the five years before they joined PHC, until:

• They’ve been a member for two years in a row, and

• They’ve had a period of 24 consecutive months since they joined that have been trouble-free from that condition.

The member's Certificate of Cover will tell them if they have an excess and how much it is. If they have an excess, we will take the excess off the amount covered by the plan for the first claim for each person in each membership year. For example, if the claim was covered for £800, and the excess was £100, we would pay £700.

The member can contact PHC on 0800 068 7111 (or 01923 726 212 if calling from a mobile). 

To make a claim follow the steps below:

1. Ask their GP for an open referral.

We will accept referrals from the AXA Doctor at Hand service or a GP at their GP practice. If their GP says they need specialist treatment, tell the GP the member wants to go private and ask for an ‘open referral’. With an open referral their GP doesn’t name a particular specialist, but instead gives them the type of specialist they need to see, for example a cardiologist. This means we can help the member find a suitable specialist and make a convenient appointment for them. Occasionally the NHS will be best placed to provide care locally (for example specialist paediatric (children’s) care at an NHS centre of excellence). When this is the case, we will talk to the member about their NHS options as well.

2. The member must contact us on 0800 068 7111 before they see the specialist.

The member must contact us as soon as they’ve seen their GP. It’s important they contact us before they see the specialist or have any treatment so that we can tell them what they’re covered for. This will mean they don’t end up having an unexpected bill for treatment that they’re not covered for.

3. We’ll check the member's cover and let them know what happens next.

We may ask them to provide more information, for example from their GP or specialist. The member, their GP, or their specialist must provide us with the information we ask for by the date that we ask for it or the member may not be covered for their claim.

Our dedicated claims team is based in Rickmansworth, Hertfordshire. We also have an out of hours/overflow service through AXA Health, based in Tunbridge Wells, Kent.

Whether members can add family members, including babies, to their cover will depend on the agreement we have with their group/employer who has taken out this cover under a group insurance contract. Depending on the agreement with their group, there may be restrictions on when they can add family members. Please discuss this with their scheme administrator. 

A member can normally add:

a. Their partner. They must be either married, in a civil partnership, or living together permanently in a similar relationship.

b. Any of their children or their partner’s children.

Children cannot stay on the plan after the renewal date following their 25th birthday.

Members do not need a GP referral for certain conditions. For musculoskeletal conditions, as soon as they develop a problem, call PHC. We’ll check they’re covered and refer them to the muscles, bones and joints service who will arrange an initial clinical needs assessment with a physiotherapist. During the needs assessment the physiotherapist will listen to their concerns, take them through an initial assessment and then advise the most appropriate treatment for them.

Please note: Members under the age of 18 will need to see their GP for a referral for these conditions as the muscles, bones and joints service is not available to them.

In addition, they can get faster access to support and treatment for mental health conditions through a Mental health assessments and support service, by speaking to a counsellor or psychologist who will triage them without a GP referral.

These two services are only available to members aged 18 and over.

The member will also have access to the skin, prostate and breast cancer pathways (only available if aged over 18) without the need of a GP referral.

For all other conditions, they will need a GP referral.

Like all insurance plans, there are some things which are not covered. The main exclusions are:

• Pregnancy and childbirth

• Treatment of medical conditions a member had, or had symptoms of, before they joined

• Treatment of ongoing, recurrent and long-term conditions (chronic conditions)

• Dental treatment

• Neurodiversity assessments, treatment and medication

For more information and full details on what's excluded on their policy, please refer to their Membership Handbook. 

To register and activate a member's access to the AXA Doctor at Hand service, they’ll need:

1. Their membership number or activation code, found in their membership communications.

2. Photo ID – they can use a passport, driver’s licence, identity card or residence permit card.

3. Camera access – they’ll need to be able to take a selfie on the phone or computer they’re using.

Access using the link below to get started.

https://member.doctorcareanywhere.com/SignUp/axa/

Our Counselling and Support Service is available 24 hours a day, 365 days a year, to help members and their family members covered on their plan deal with life’s ups and downs. To speak to somebody, Call PHC’s dedicated Counselling and Support Service on 0800 316 1213. Please state that they are a PHC member when they call. To access the online portal, please visit axabesupported.co.uk and input the username and password found in their Membership Handbook.

The Counselling and Support service is available to PHC members aged 16 and over only.

HealthCover4life plans do not provide cover for any dental problems or routine dental care including oral surgery or treatment of cysts in the jaw that are tooth related or are of dental origin. This also means we will not pay any fees for dental specialists, such as orthodontists, periodontists, endodontists or prosthodontists.

We will cover the following types of oral surgery when the member is referred for treatment by a dentist:

• reinserting their own teeth after an injury; or

• removing impacted teeth, buried teeth and complicated buried roots; or

• removal of cysts of the jaw (sometimes called enucleation).

We do not cover any costs for treatment a member receives outside the UK or if they live outside the UK. If they move abroad, they won’t be able to keep their current membership and they will not be able to make any claims for treatment.

New-born babies can be added to the policy from their date of birth and are covered free of charge up to the first renewal and when added within 3 months of their birth. If a member's baby requires treatment in a Special Care Baby Unit or paediatric intensive care following birth, they may not be covered for the costs. Please contact us to confirm any cover available to the member in this case.

As part of a member's healthcare cover, they are entitled to 25% off on a range of Nuffield Health or Circle Health Group Health Assessments. (Terms and conditions apply). For more details about the health assessments available to them including prices, please visit Health assessment (axahealth.co.uk).

Unfortunately, we do not cover the costs of any external devices, which includes hearing aids.

We do not cover any treatment, investigations, assessment or grading to do with learning and development disorders. This includes conditions such as attention deficit hyperactive disorder (ADHD).

As part of the Mental Health Assessments and Support service, available to members through their healthcare cover, we will arrange an assessment with a counsellor or psychologist. Where appropriate, they may refer the member through to a psychiatrist for further assessment and treatment.

Private hospitals are not set up to deal with life-threating illnesses or injuries. They do not have Accident & Emergency facilities. In an emergency, a member should still rely on the NHS to support them.

Whilst we currently don’t have a mobile app, a member will have access to a dedicated online platform, Your PHC. Your PHC is the dedicated area of our website where members can access all they need to know about their PHC cover, from membership literature, including their Membership Handbook and Directory of Hospitals, as well as discovering the value-added health and wellbeing services available and how to access them. Details of how to access this can be found on their membership communications.