Docstoc

Get fit_ keep fit

Document Sample
Get fit_ keep fit Powered By Docstoc
					Membership Guide
from 1 January 2005




   Get fit,
   keep fit




   BUPA Heartbeat
   additional cover option
    Contacting us
     If you have any questions about your membership or your cover please call the helpline and

     we will be happy to help you.


     Call the helpline on         0845 60 68 000*†
                                            (lines open 8am to 8pm, Monday to Friday and
                                            8am to 6pm Saturday).



     For those with hearing or speech difficulties who use a textphone, call our dedicated line on
     0845 60 66 863* (lines open 9am to 5pm, Monday to Friday).


     Or write to us at: BUPA, Staines, TW18 4XF
     Or fax us on: 01784 465 232



     BUPA HealthLine
     As a BUPA Heartbeat member if you have any queries or questions about your health call our
     confidential 24 hour BUPA HealthLine where our qualified nursing team have the time to listen
     and the skills to help whatever your health question or concern.


     The BUPA HealthLine number is      0845 60 13 216*†
     * Calls are charged at local rates
     † Calls will be recorded and may be monitored




2
1

Introduction
This membership guide must be read together with your health care select option
membership guide.

Words in bold and italic in this guide are defined terms which have a specific meaning. Some of these words and
phrases may be the same as in other additional cover options or health care select options membership guides,
however, their definition may not be the same. You should check their meaning in the Glossary in section 4 of this
membership guide.

BUPA Heartbeat offers cover under different additional cover options. These are the rules and benefits of the get
fit, keep fit additional cover option and form part of our agreement for members whose cover under the plan
includes this scheme. They apply to each member covered under the scheme whose cover starts or renews on or
after the ‘effective from’ date.

•   For anyone joining the scheme they apply from their scheme start date.

•   For any member whose cover under the scheme is renewed, they apply for the period from their first renewal
    date on or after the ‘effective from’ date.

The membership certificate will show if you are covered under this scheme under the plan.




                                                                                                                     3
    2

    What is and isn’t covered and
    how to claim
    This section sets out what is covered under the scheme. There are also some things that are
    not covered; these are set out in the ‘what is not covered’ sections of the benefit notes and
    in section 3: general exclusions.

    Summary of benefits
    This table only shows the headings for the type of benefits covered under this scheme. Each heading refers to a
    benefit note. We only pay the benefits we say we pay for in the benefit notes and only up to the limits set out in
    them, subject to the rules and benefits of the plan including this scheme and the exclusions.

    We do not pay any benefits for treatment or services not covered under this scheme, including any that take place
    after the date your cover ends. Any costs you incur that are not covered under this scheme are your responsibility.




    Type of benefit
    Your qualifying period                                                            benefit note 1: this benefit note applies
                                                                                      equally to benefit notes 2 to 5
    Fitness assessment                                                                benefit note 2
    Complementary medicine cash benefit                                               benefit note 3
    Dietary cash benefit                                                              benefit note 4
    Foot care cash benefit                                                            benefit note 5
    BUPA HealthLine named nurse access                                                benefit note 6




    Benefit note 1 your qualifying period
    This benefit note 1 applies equally to benefit notes 2 to 5 and should be read together with those benefit notes. It
    does not apply to benefit note 6.

    A qualifying period applies to your cover under this scheme. We do not pay benefits under benefit notes 2 to 5
    for any treatment, goods or services that you receive during your qualifying period.




4
Benefit note 2 get fit, keep fit fitness assessment
We pay for you to have one get fit, keep fit fitness assessment each year carried out in a health assessment
centre. The centres will be happy to explain precisely what tests will be carried out as part of a get fit, keep fit
health assessment. For medical reasons, occasionally some tests may be omitted from a fitness assessment and this
will be explained on the day.

You must be covered under the scheme at the time of your get fit, keep fit fitness assessment or we will not pay
for it. If you have a fitness assessment in a centre that is not a health assessment centre we will not pay for it.


A get fit, keep fit fitness assessment includes:
    • physical examination and consultation

    • medical history and lifestyle questionnaire

    • report and personal health action plan

    • blood pressure and pulse rate measurement

    • resting ECG

    • lung function

    • cardiovascular risk score

    • height and weight measurements

    • body mass index calculation

    • white blood cell count

    • blood tests

    • unrine tests

in addition for women

    • breast check

    • breast awareness instruction


How to arrange a get fit, keep fit fitness assessment
Step 1: Call the helpline to confirm your get fit, keep fit cover. We will:

         • confirm whether your chosen centre is a health assessment centre, or

         • be able to give you details of health assessment centres in your area.

         You can call us up to 45 days before the date you wish your fitness assessment to take place.

Step 2: We will send you a confirmation letter. The letter will be valid for 45 days. You can then go ahead and
         book your fitness assessment.

Step 3: Take your confirmation letter with you to your fitness assessment and hand it in on your arrival.

Step 4: The health assessment centre will bill us direct for your fitness assessment. You will not need to fill in a
         claim form.




                                                                                                                       5
    Benefit note 3 complementary medicine cash benefit

    What is covered

    •     Acupuncture and homoeopathy

    We pay a cash benefit for eligible treatment provided to you by a complementary medicine practitioner who is
    an acupuncturist or homoeopath. You must be referred to the complementary medicine practitioner by your GP.


        We pay 50% of the amount that you are charged for such eligible treatment up to an overall maximum of £150 each
        year. This is the overall amount we pay for all such treatment and not for each type of treatment individually.



    •     Chiropractic and osteopathy

    We pay a cash benefit for eligible treatment provided to you by a complementary medicine practitioner who is a
    chiropractor or osteopath. You must be referred to the complementary medicine practitioner by your GP.


        We pay 50% of the amount that you are charged for such eligible treatment up to an overall maximum of £150 each
        year. This is the overall amount we pay for all such treatment and not for each type of treatment individually.



    What is not covered
    In addition to the exclusions set out in section 3 of this membership guide we also do not pay for any treatment,
    services or charges that are excluded from your cover under your health care select option. Please refer to your
    health care select option membership guide for further details of what you are not covered for.


    How to claim
    Step 1: Before you see your complementary medicine practitioner call the helpline to check your get fit, keep fit
               cover and to ask us for a claim submission form.

    Step 2: Take your claim submission form with you when you go for your treatment and ask your complementary
               medicine practitioner to complete the form

    Step 3: Send your completed form to us together with your original invoices and receipts.


    Benefit note 4 dietary cash benefit

    What is covered
    We pay a cash benefit for treatment provided to you by a dietician, for example consultations and services to
    assess your diet.


        We pay a cash benefit of 50% of the amount you are charged for such consultations and services up to a maximum of
        £150 each year. This is the overall amount we pay for all such consultations and services and not for each type of
        consultation or service individually.




6
How to claim
Step 1: Before you see your dietician call the helpline to check your get fit, keep fit cover and to ask for a claim
         submission form.

Step 2: Complete the claim submission form and send it to us together with your original invoices and receipts.


Benefit note 5 foot care cash benefit

What is covered
We pay a cash benefit for treatment provided to you by a chiropodist.


  We pay a cash benefit of 50% of the amount you are charged for such treatment up to a maximum of £150 each
  year. This is the overall amount we pay for all such treatment and not for each type of treatment individually.



How to claim
Step 1: Before you see your chiropodist call the helpline to check your get fit, keep fit cover and to ask for a claim
         submission form.

Step 2: Complete the claim submission form and send it to us together with your original invoices and receipts.


Benefit note 6 BUPA HealthLine named nurse access
When you have get fit, keep fit cover you have access to a more personal BUPA HealthLine service. This includes
access to a named nurse as your point of contact and who will offer you information and on-going support on
health issues and concerns.




                                                                                                                         7
    3

    General exclusions
    This section explains the additional treatment, services and charges that are not covered under benefit notes
    2 to 5. These exclusions are in addition to the other treatment, goods or services excluded under benefit notes
    2 to 5 as set out in the ’what is not covered section’ of each of those benefit notes.
    These exclusions are grouped under headings. The headings are just signposts, they are not part of the exclusion. If
    there is an exception to an exclusion this is shown. Where we refer to specific treatments or medical conditions in
    the exceptions these are examples only and not evidence of cover.

    Special conditions
    We do not pay benefits for or relating to any treatment, goods or services for, or arising from, a special condition.

    Psychiatric conditions
    We do not pay benefits for treatment, goods or services that are for or related to a psychiatric condition.
    Exception: Subject to your qualifying period we pay benefits for treatment, goods or services for or related to a
    psychiatric condition that you receive if:
        • you are covered under a health care select option that has cover for psychiatric conditions, and
        • you have been a member of that health care select option or any other health care select option or BUPA
           scheme that included cover for psychiatric conditions for the whole of the two years leading up to your
           receiving such treatment, goods or services.

    Infertility treatment
    We do not pay benefits for treatment, goods or services that are for or related to infertility treatment.
    Exception: Subject to your qualifying period we pay benefits for treatment, goods or services for reasonable
    investigations into the cause of infertility if:
        • you and your partner are both members of a health care select option that has cover for such treatment,
           and
        • you have both been members of that health care select option or any other health care select option or
           BUPA scheme that included cover for this type of treatment for the whole of the two years leading up to
           your receiving the treatment, goods or services, and
        • neither you nor your partner had been aware of any problems before joining that health care select option
           or BUPA scheme.

    Treatment for AIDS/HIV
    We do not pay benefits for treatment, goods or services that are for or related to treatment for AIDS or HIV
    including any condition that is related to or results from AIDS or HIV.
    Exception: Subject to your qualifying period we pay benefits for treatment, goods or services for or arising from
    AIDS or HIV if:
        • you have been covered under a health care select option or BUPA scheme that included cover for this type
           of treatment for the whole of the five years before the date that you became infected with AIDS or HIV
           without a break in your cover, or
        • you have been a member of any health care select option or BUPA scheme that included cover for this type
           of treatment since at least July 1987 without a break in your cover.


8
4

Glossary
Words and phrases printed in bold and italic in this get fit, keep fit membership guide have the meanings set out
below.


 Word / Phrase            Meaning

Acute condition           a disease, illness or injury that is likely to respond quickly to treatment which aims to return you
                          to the state of health you were in immediately before suffering the disease, illness or injury, or
                          which leads to your full recovery.

Additional cover option one of five different options under which cover can be provided for a member aged 18 years or
                          over under the plan as set out in the membership guide for that option. The additional cover
                          options are: healthy man; healthy woman; get fit, keep fit; health check; convalescence care.

                          The additional cover option(s) that applies to a member’s cover is/are shown on the membership
                          certificate.

Agreement                 the agreement between the main member and us to provide cover for members under the
                          terms and conditions set out in the documents referred to in rule 1.1, ‘The agreement between
                          the main member and us’ in section 1 of each member’s health care select option membership
                          guide.

BUPA                      BUPA Insurance Limited. Registered in England and Wales No 3956433. Registered office: BUPA
                          House, 15-19 Bloomsbury Way, London WC1A 2BA. BUPA provides your cover.

Chiropodist               a state registered chiropodist (SRCh) who at the time you receive your treatment:

                              • holds current full membership of the Society of Chiropodists and Podiatrists

                              • is registered with the Health Professions Council, and

                              • is under age 70.

Complementary             an acupuncturist, chiropractor, homoeopath or osteopath who at the time you receive your
medicine practitioner     treatment is:

                              • under age 70 and recognised by us as a complementary medicine practitioner for the
                                   purpose of the scheme, and

                              • is recognised by us for providing the type of treatment you need.

                          You can contact us to find out if a practitioner is recognised by us as a complementary medicine
                          practitioner and the type of complementary medicine we recognise them for.

Diagnostic tests          investigations, such as X-rays or blood tests, to find or to help to find the cause of your
                          symptoms.




                                                                                                                                 9
     Dietician            a practitioner who, at the time you receive your treatment is:

                              • under age 70

                              • registered as a member of the British Dietetic Association

                              • registered with the Health Professions Council, and

                              • recognised by us as a dietician for the purpose of the scheme and for providing the type of
                                   treatment you need.

                          You can contact us to find out if a practitioner is recognised by us as a dietician and the type of
                          treatment we recognise them for.

     Dependant            your partner and any child of yours who is a member of the scheme and named on your
                          membership certificate.

     Eligible treatment   treatment of an acute condition together with the products and equipment used as part of the
                          treatment that:

                              • are consistent with generally accepted standards of medical practice and representative of
                                   best practices in the medical profession in the UK

                              • are clinically appropriate in terms of type, frequency, extent, duration and the facility or
                                   location where the services are provided

                              • are demonstrated through scientific evidence to be effective in improving health outcomes,
                                   and

                              • are not provided or used primarily for the expediency of you or your health care
                                   professional

                          and the treatment, services or charges are not excluded under the terms and conditions of your
                          option.

     Health assessment    any health assessment centre which is in our list of health assessment centres at the time you
     centre               receive your get fit, keep fit fitness assessment. The health assessment centres may change from
                          time to time. Details of these centres are available on request.

     Health care select   one of five different options under which cover can be provided for a member under the plan as
     option               set out in the membership guide for that option. The healthcare select options are: health care
                          select 1; health care select 2; health care select 3; health care select 4; health care select H&C.
                          The health care select option that applies to a member’s cover is shown on the membership
                          certificate.

     Main member          the person who has taken out the plan being the first person named on the membership
                          certificate.

     Member               the main member and any dependant.

     Membership           the most recent membership certificate that we issue to the main member for their current
     certificate          continuous period of membership of the plan.

     Partner              your husband or wife, or the person you live with in a relationship similar to that of a husband or
                          wife, whether the same sex or not.

     Plan                 the agreement between the main member and us to provide cover for the members under the
                          terms and conditions set out in the documents referred to in rule 1.1, ‘The agreement between
                          the main member and us’ in section 1 of each member’s health care select option membership
                          guide.

     Plan start date      the ‘Your membership starts’ date shown on the first membership certificate we sent the main
                          member for their current continuous period of membership under the plan.




10
Psychiatric condition   a mental or addictive condition, including alcoholism, drug addiction and eating disorders.

Qualifying period       the first six months following your scheme start date. If there is a break in your cover under this
                        scheme your qualifying period will start again from your new scheme start date.

Renewal date            •   each anniversary of the plan start date, or

                        •   if you are a member under a group plan arrangement with a common renewal date your
                            renewal date will be the common renewal date for the group and you will have been told
                            about this when you joined.

Scheme                  the BUPA Heartbeat, get fit, keep fit additional cover option.

Scheme start date       the ‘Your membership starts’ date shown on the first membership certificate we sent the main
                        member which lists the member as being covered for their current continuous period of cover
                        under this scheme.

Special condition       any exclusions or restrictions to cover that are personal to an individual based on the medical
                        history given to us for that individual. If special conditions apply to a person’s cover these are
                        shown on the special condition supplement attached to your membership certificate. You will
                        only receive a special condition supplement if special conditions apply to you and/or any of your
                        dependants.

Treatment               surgical or medical services (including diagnostic tests) that are needed to diagnose, relieve or
                        cure a disease, illness or injury.

We/our/us               BUPA.

Year                    •   when a member is first covered under this scheme this is the period beginning on their
                            scheme start date and ending on the day before the renewal date

                        •   for continuing members this is the period beginning on the renewal date and ending on the
                            day before the next renewal date.

Your                    this means the main member only.




                                                                                                                              11
                   Financial
                                         Travel        International
                    health
                                         cover         medical cover
                  protection



                   Health              Medical
                                                          Hospitals
                 assessment             Cover



                                                           Health
                 Care homes           Childcare           and care
                                                         assistance




                        THE WORLD OF BUPA
                                Call 0800 00 10 10
                                  www.bupa.com




PHP/3750/JAN05   BUPA and the heartbeat symbol are registered trademarks.   58464 UNI

				
DOCUMENT INFO
Shared By:
Tags: Keep
Stats:
views:23
posted:2/17/2011
language:English
pages:12
Description: Devil of several criteria: 1, Bust = height X 0.51 (example: the standard height 160cm chest = 160cm X 0.51 = 81.6cm), 2, waist circumference = height X 0.34 (example: the standard height 160cm Waist = 160cm X 0.34 = 54.4cm), 3, hip circumference = height X 0.542 (example: the standard hip height 160cm = 160cm X0.542 = 86.72cm).