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The BUPA International Company Maritime
scheme
(Maritime employees only)
Cost /
Subscriptions
Notes to the table of
benefits
These Notes are very important. Please read them carefully along with the
table of benefits, as
they explain more fully the benefits that are available to you and apply to each
person covered under your membership.
Note 2 - Day-case and in-patient treatment
Day-case treatment is
treatment
which for medical reasons normally means you have to stay in a bed in
hospital
during the day, but not overnight. And
in-patient treatment
is
treatment
which for medical reasons normally means you have to stay overnight or longer in
hospital.
We pay for the
day-case
and
in-patient treatment
charges as explained in these
Notes. Please remember that we will only pay for the
treatment
if it is provided by a
consultant.
Hospitals
We pay
hospital
charges for
day-case
and
in-patient treatment
for:
* accommodation - see Note 2a
* nursing care, surgical dressings and drugs - see Note 2b
* theatre charges and
intensive care
- see Note 2d
* pathology, X-rays, diagnostic tests and physiotherapy - see Note 2e
* parent accommodation (accompanying a child under 18) - see Note 2h
The
hospital
charges we will pay for are explained more fully in Note 2a.
To ensure you are paid in full for these
hospital
charges, it is important that the
day-case
or
in-patient treatment
is provided by a
consultant
in a recognised
hospital
and that:
* it is medically essential for you to occupy a
hospital
bed to receive the
treatment
* you occupy a
hospital
room which is no more expensive than the
hospital's
single room with en suite bathroom, and
* your room is used only for you to receive
day-case
or
in-patient treatment
covered under your membership
Staying in hospital for longer than 10 days
If you need to stay in
hospital
for longer than 10 days you must send us a medical report if this is reasonably
practical for you to do so. The report must reach us before your eighth night in
hospital.
The
consultant
must tell us in the report:
* the exact diagnosis
* what
treatment
you have received so far
* what
treatment
you are going to have in future, and
* what date you are expected to leave
hospital.
Note 2a: Hospital accommodation
We pay for your
hospital
accommodation provided as part of your
day-case
or
in-patient treatment,
including all your own meals and refreshments. We do not pay for personal items
such as telephone calls, newspapers, guest meals or cosmetics.
We do not pay
hospital
accommodation if:
* it relates to an overnight stay for
treatment
which would normally be provided as
out-patient
or
day-case treatment
or
* if you stay in a bed in
hospital
for
treatment
that would normally be provided as
out-patient treatment.
Note 2b: Nursing care, drugs and dressings
We pay for nursing services, drugs and surgical dressings you need as part of
your
day-case
or
in-patient treatment.
We do not pay the cost of drugs and surgical dressings you receive for
out-patient treatment.
We do pay for the costs of drugs and dressings prescribed for you by your for to
the extent set out in
Note 3.
We do not pay for extra nurses, hired in addition to the
hospital's
own staff. In the rare case where the
hospital
does not provide nursing staff we will pay for the reasonable cost of hiring a
qualified nurse
for your
treatment.
Note 2c: Consultants' fees
We pay surgeons' and anaethetists' fees for
surgical operation
a forming part of
day-case
or
in-patient treatment.
We pay physicians' fees for
day-case
or
in-patient treatment
if the
day-case
or
in-patient treatment
does not include a
surgical operation.
If your
day-case
or
in-patient treatment
includes a
surgical operation
we will only pay physicians' fees if the attendance of a physician is medically
necessary, for example, in the rare event of a heart attack following a
surgical operation.
Note 2d: Theatre charges and intensive care
We pay
hospital
charges for using an operating theatre for
day-case
or
in-patient treatment
covered by your membership.
We pay
hospital
charges for
intensive care
in an intensive care unit, intensive therapy unit, high dependency unit or
cardiac care unit if the
hospital
in which you receive your
day-case
or
in-patient treatment
is equipped with such a unit and if:
*
intensive care
is routinely required after the
treatment,
such as after heart or brain surgery, or
*
intensive care
is medically essential due to unexpected circumstances arising from
treatment
that does not routinely require
intensive care,
in which case your
consultant
should contact us at the earliest opportunity.
Note 2e: Pathology, X-rays, MRI and CT scans, diganostic tests and
physiotherapy
We pay
hospital
charges for pathology (such as checking blood and urine samples for specific
problems), radiology (such as X-rays), magnetic resonance imaging (MRI) and
computed tomography (CT) (head and body scanning) and diagnostic tests (such as
electrocardiograms), when recommended by your
consultant
to help determine or assess your condition when carried out in a
hospital
as part of
day-case
or
in-patient treatment.
We also pay for
treatment
provided by
therapists
(such as physiotherapy) if it is needed as part of your
day-case
or
in-patient treatment
in a
hospital.
Note 2f: Prostheses (artificial body parts) and appliances
We pay in full for a
prosthesis
charged by a
hospital
or
consultant
for
day-case
or
in-patient treatment.
By this, we mean an artificial body part which is designed to form a permanent
part of your body and is surgically implanted for one or more of the following
reasons:
* to replace a joint or ligament
* to replace one or more heart valves
* to replace the aorta or an arterial blood vessel
* to replace a sphincter muscle
* to replace the lens or cornea of the eye
* to control urinary incontinence (bladder control)
* to act as a heart pacemaker
* to remove excess fluid from the brain
* to reconstruct a breast following surgery for cancer when the
reconstruction is carried out within two years of you having received the
treatment
for cancer.
We also pay in full, for the following
appliances
when charged by a
hospital
or
consultant:
* a knee brace which is an essential part of a
surgical operation
for the repair to a cruciate (knee) ligament
* a spinal support which is an essential part of a
surgical operation
to the spine.
Note 2g: Cancer tests, drugs and consultants' fees for oncology
We pay in full for
consultants'
fees that are related specifically to planning and carrying out
day-case
or
in-patient treatment
for cancer.
We also pay
hospital
charges in full for tests and drugs (such as cytotoxic drugs) that are related
specifically to planning and carrying out
day-case
or
in-patient treatment
for cancer.
Note 2h: Parent accommodation (staying with a child under 18)
We pay the cost of
hospital
accommodation for each night you need to stay with your child in
hospital.
This is limited to only one parent each night. Your child must be:
* aged under 18, and
* either a member in his or her own right, or included in a family membership,
and
* receiving
hospital
in-patient treatment
for which the child is covered under their membership.
Note 2i: Psychiatric treatment (after two years' membership)
We pay for
psychiatric treatment
after you have been a member of the scheme (or any BUPA scheme which includes
cover for
psychiatric treatment)
for the whole of the two years leading up to the
treatment.
We pay in full for
consultants'
fees for
psychiatric treatment
you receive as
day-case
or
in-patient treatment
in a
hospital.
We only pay for up to a collective total of 90 days day-case and in-patient
psychiatric treatment
during your membership of this scheme and any other BUPA scheme whether your
membership is continuous or not. This means that, for example, if BUPA have paid
for a collective total of 45 days day-case and in-patient
psychiatric treatment
under another BUPA scheme then we will only pay for up to a collective total of
45 days day-case and in-patient
psychiatric treatment
under this scheme. This is the total number of days we pay up to for day-case
and in-patient
psychiatric treatment
collectively and not individually.
Note 3
Glossary
Hoteles
- ¡chollos! / discounted last-minute hotel bargains!
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