What is covered? Lifeline Membership Guide International health insurance BUPA Group

This section contains your table of benefits and the accompanying notes. Before you look at these please read the important information below about the kind of costs that we cover.

2.1 Treatment that we cover

For us to cover any treatment that you receive, it must satisfy all of the following requirements:

- it is at least consistent with generally accepted standards of medical practice in the country in which treatment is being received

- it is clinically appropriate in terms of type, duration, location and frequency, and

- it is covered under the terms and conditions of the plan.

2.2 Conditions that we cover

Acute conditions

This plan covers you for treatment of acute conditions. Acute conditions are diseases, illnesses or injuries that respond to medical care without the need for long-term or prolonged treatment. The treatment that you receive should be likely to lead to a complete recovery, or restore you as closely as possible to your previous state of health.

Please note that this definition above means that you do not have cover for treatment for chronic conditions (please see Section 3 for more information about chronic conditions).

Acute and chronic conditions - how it works in practice

1. We will cover an acute condition until we become aware that it is chronic.

2. If you develop a condition which is known to be chronic, we will pay for treatment to

- diagnose your condition

- stabilise your condition

but, we will not pay for ongoing treatment or drugs to maintain your health or control the condition.

3. If you suffer from an acute flare-up of a chronic condition we will pay for treatment you receive during this period.

Example: a chronic condition such as angina is usually controlled by medication. We will not pay for drugs, consultations or other treatment to control this condition. However, angina could lead to severe chest pains and the need for a heart bypass; this is an acute flare-up of a chronic condition. In this situation we would pay costs associated with the heart by-pass according to the table of benefits (section 2.4) and the notes (section 2.5)

Please contact the customer services helpline if you have any questions about acute and chronic conditions.

2.3 Reasonable and customary charges

We only pay costs when the charges made by the provider of services are reasonable and customary. By this we mean that the charges are the same as those made to our members by the majority of other service providers in the same country: and also that they are not more than the provider would normally charge.

2.4 Table of benefits

The table of benefits shows the benefits and limits that apply to your plan. The notes that follow it in section 2.5 contain the detailed rules for each benefit. You also need to read 3. What is not covered? so that you understand the exclusions on your plan. A copy of the Table of benefits can be found on the fold-out cover of the guide.

How to read the Table of benefits

There are three levels of cover: Essential, Classic and Gold. You need to read the column in the table of benefits that applies to your level of cover, as shown on your Membership Certificate.

Benefit limits

There are two kinds of benefit shown in this table. The 'overall annual maximum' is the maximum we will pay for all benefits in total for each person, each membership year. Some benefits also have a limit applied to them separately: for example Home Nursing.

All benefit limits apply per member and per membership year; This means that once a benefit limit has been reached, that benefit will no longer be available until you renew your plan and start a new membership year.

Currencies

All the benefit limits in this table of benefits and notes are set out in three currencies: £ sterling, $ US dollars and € euros.

The currency in which you pay us your subscriptions is the currency that applies to your membership for the purpose of the benefit limits.

For example, if you pay your subscriptions in £ sterling then the benefit limits given in £ sterling apply to your membership and $ US dollar and € euro limits do not apply to you.

If you are unsure which level of cover you have, the currency that applies to your membership, or whether you have an annual deductible, you can check on our Membersworld website or contact the customer services helpline.

Table of benefits

Index

Lifeline:

* provides international private medical insurance for people living or working abroad for at least six months of the year

* for individuals and their families

* three different levels of cover to meet any client's needs:

	Product description (and limits)
Essential	Essential
Classic	Classic
Gold	Gold

Company Scheme ( Castellano Deutsch Français Português )

For more information please contact me:
email	davidharris@wanadoo.es / *saniprof@mail.ddnet.es*
Fax:	(+ 34) 91 8032484
'phone:	(+ 34) 609 522 300
Also more information on..	www.e-healthinsuranceservices.com

BUPA insurance products

1. How to use your Lifeline plan	2. What is covered? / Table of benefits
3. What is not covered?	4. Assistance Cover (optional if purchased)
5. Pre-authorisation	6. Making a claim
7. Annual deductibles	8. Paying subscriptions and other charges
9. Your membership	10. Making a complaint
11. Glossary	12. Medical words and phrases
Lifeline Essential	Lifeline Classic
Lifeline Gold

main index / índice principal

Disclaimer / Aviso

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