Edge – Table of benefits

The Edge plan is the ideal solution for anyone looking to take the first step into affordable private healthcare and gives you access to the UK’s top consultants, diagnosis using the most advanced medical technology available and treatment at the UK’s leading private hospitals and clinics.

With the Edge plan you are covered for any treatment related to a pre-existing conditions, there is no waiting period, so you can start claiming for any new eligible conditions immediately. You will receive up to £1000/year for outpatient treatment, and there is NO excess to pay. The Edge plan does not include cover for dental, optical, and a maternity cash benefit).

Click on the titles below to view the Edge table of Benefits details

Out-patient

If you’re an out-patient
For muscle, bone and joint pain – No GP referral needed – Call us on 03000 70 70 70 and select option 1.
For any treatment in an HCA hospital you will be responsible for 40% of the costs. This means we will pay 60%
of eligible treatment costs in all HCA hospitals or facilities should you decide to use these services.
DetailsLimit per Person per Benefit YearNotes on Benefits
CT, MRI or PET scans.
For more information see Section 3.7, page 28 – Paying the specialists and practitioners that treat you.
Paid up to your £1,000 overall limit for each person per scheme year.

Except as outlined for HCA.

Diagnostic tests when your GP or specialist refers you.Paid up to your £1,000 overall limit for each person per scheme year.

Except as outlined for HCA.

Specialist consultations.

Practitioner fees when your specialist refers you.

For more information see Section 3.7, page 28 – Paying the specialists and practitioners that treat you.

Paid up to your £1,000 overall limit for each person per scheme year.Practitioners are nurses, dieticians, orthoptists or speech therapists.
Fees for out-patient treatment by physiotherapists, acupuncturists, homeopaths, osteopaths or chiropractors.Self refer for up to 6 sessions of treatment. If further sessions are required then a GP referral would be needed.We call physiotherapists, osteopaths and chiropractors therapists. We call physiotherapists, osteopaths and chiropractors therapists.
Complementary therapy, acupuncturists or homeopaths
Paid up to £250 per scheme year.
Doctor On-call consultations.
Unlimited video or telephone consultations with a private GP in a scheme year.Doctor On-call is powered by
Doctor Care Anywhere.
Out-patient drugs, dressings and appliances.
(whilst under the care of a specialist).
£250 per person, per scheme yearThis includes out-patient prescription charges and appliances required to aid your recovery such as crutches or wheelchairs.

Mental Health

If you’re an out-patient

Mental Health
If you’re an out-patient.
DetailsLimit per Person per Benefit YearNotes on Benefits
Specialist consultations for mental health treatment.
Paid up to your £1,000 overall limit for each person per scheme year.
Mental health treatment by psychologists and psychotherapists.

For more information see Section 4.22, page 44 – Mental Health.

Paid up to your £1,000 overall limit for each person per scheme year.

Your healthcare scheme does not pay for

As you would expect, there are a few things that are not paid for. We’ve listed the most significant things here, but please also see the detail in your handbook.

Your healthcare scheme does NOT pay for:
DetailsFor more informationNotes
In-patient or day-patient treatment.
This healthcare scheme is designed to only pay for out-patient treatment as set out in the benefit table.
Routine pregnancy and childbirth.For details, see Section 4.26, page 46 – Pregnancy and childbirth, or call us on 03000 70 70 70.
Treatment of ongoing, recurrent and long-term conditions (chronic conditions) except as allowed for in the benefits table.
For details, see Section 3.6, page 25 – How your membership works with conditions that last a long time or come back.
Treatment received outside the UK.Your healthcare scheme does not include any benefit for treatment overseas.

Your healthcare scheme is not designed to cover every situation. It is designed to add to, not replace, the NHS. There are some conditions and treatments that the NHS is best at handling – emergencies are a good example.

NOTE: *Total benefit allowance across all benefits is £1,000 per scheme year. Read the Edge plan handbook.

Doctor On-call

Private online GP Service,Free to all members.

For Business

Private Healthcare for
your Employees.