Benefit Schedule


This schedule is intended as a guide to the level of benefit normally considered by the Management Committee.

There is an overall maximum of £17,500 per claim and an overall maximum of £30,000 per person in any scheme year which runs from 1st October

  1. In-patient and Day Care Benefit for Treatment at Preferred Provider Hospital
    Benefit in connection with a specified medical procedure or procedures for authorised treatment

    1. Hospital Accommodation & Nursing FULL COVER
      Operating Theatre & Recovery Room FULL COVER
      Prescribed Drugs & Dressings FULL COVER
    2. Surgeons & Anaesthetists Fees FULL COVER
    3. Pathology, Radiology, Consultations & Physiotherapy FULL COVER
    4. Parent accompanying child under 12 – Max 10 days FULL COVER
    5. Specialist Physician Fees – for regular attendance in a hospital for up to 14 days FULL COVER
  2. In-patient and Day Care Benefit for Treatment NOT at a preferred provider hospital
    Members may be asked to obtain self-pay patient costs and obtain cash benefit from the scheme
  3. Hi-tech investigations
    Hi-tech diagnostic procedures including (but not limited to) Endoscopy, MRI & CT scans, angiography £2,000
  4. Out-patient
    1. Consultations, Pathology, Radiology & Physiotherapy £1,500*
    2. Complementary Medical Treatment (including Chiropractic treatment, Osteopathy, Acupuncture and Homeopathy) not including medicines. £500*
    3. Radiotherapy, Chemotherapy and Oncology only at the discretion of the Directors
  5. Private Ambulance
    Charges for transport by a registered ambulance service to or from a hospital or nursing home when required for medical reasons £150*
  6. Home Nursing by a registered Nurse recommended by a Specialist for medical (not domestic) reasons £1,000
  7. NHS Cash Benefit (not available for WHAT IS NOT COVERED BY THE SCHEME) Up to an overall limit of £2000* (not payable if other benefit limits have been reached)
    For each night of a planned admission, spent as a patient in an NHS bed without charge £200 per Night

    For each treatment undertaken on a planned Day Care basis in the NHS without charge £200 per Treatment Emergency admissions to the NHS are not eligible for benefit
  8. Second Opinions
    In certain circumstances and only at the discretion of the Directors FULL COVER
  9. Claims Helpline
    The Claims Helpline is available Monday to Friday 9.30 – 3.30 excluding Public Holidays add telephone number 01905 796682.


  1. * Benefit payable in each Fund Year
  2. Cash Limits will apply to any treatment undergone at a Non-Preferred Provider. These will be advised when approval is given to use such facilities. Members may be asked to act as Self-pay patients and claim reimbursement from the fund when using such facilities.
  3. All treatment undertaken at Preferred Providers is invoiced direct to our Managers at special prices that have been pre-negotiated. It is essential that you identify yourself as a member of the Fund prior to receiving treatment.
  4. Failure to comply with the claims procedure will result in the member being responsible for all treatment costs incurred.