Access Surgery & Access Surgery Premier: Cover for private treatment that s surprisingly affordable.

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1 Access Surgery & Access Surgery Premier: Cover for private treatment that s surprisingly affordable. Health cover for working life and beyond Access Surgery makes non-urgent private surgery and medical treatment more affordable and accessible, so people can be treated quicker and be back to their healthy best far sooner. Taking patients from consultation and diagnosis, on to surgery and treatment and through to post-operative physiotherapy, this cover offers end to end care with the personal touch. Key features Affordable private treatment for a fraction of the cost of Private Medical Insurance, and premiums don t increase with claims Accessible quick, easy access to private consultation, diagnosis, treatment and rehabilitation for non-urgent procedures Personal all cases are managed by a small dedicated team Simple setting up a policy and accessing treatment is straightforward; no medical is required. Immediate cover for all new eligible conditions Choice choose from a wide range of consultants, hospitals and treatment centres private or NHS

2 Access Surgery and Access Surgery Premier Access Surgery and Access Surgery Premier are part of Westfield Health s Hospital Treatment Insurance (HTI) range, so they help policyholders to access private treatment for medical conditions that the NHS defines as non-urgent, rather than wait for treatment on the NHS or pay for their own private care. There are two levels of cover available with Access Surgery Premier providing a broader range of medical and surgical procedures, and a greater value of maximum lifetime benefit that Access Surgery. Both levels of cover offer, as standard, a 1,000 Outpatient benefit in each 12 month period to pay for consultation, diagnostic tests and scans. A 100 excess can be applied to this Outpatient benefit. Patients are also able to access post-operative physiotherapy on top of the 1,000 benefit. The Outpatient benefit and post-operative physiotherapy can be removed if the applicant wants to reduce their premium. Procedures covered Typical Procedures Access Surgery Premier More than 1,350 procedures, defined as: Medical procedures requiring a general anaesthetic Medical procedures requiring a regional or local anaesthetic in conjunction with an incision involving a surgical knife Endoscopic fibre optic procedures Appendicectomy In growing toenails Haemorrhoids Glaucoma surgery Thyroidectomy Intestinal problems Skin grafts Brain surgery Glandular problems Plus all procedures covered by Access Surgery Access Surgery More than 60 common non-urgent surgical procedures Slipped discs Knee replacement Cataracts Gynaecological problems Hip replacement Sinus problems Prostate problems Carpal tunnel release What is excluded? Maximum number of procedures Maximum benefit during lifetime of cover Maximum value of single private treatment package Surgical procedures for cancer, heart conditions, emergency treatment, chronic conditions, fertility treatment or cosmetic treatment 3 in a consecutive 12 month period 250, ,000 25,000 12,500 1,000 Outpatient Cover Optional Optional

3 How much does Access Surgery cost? Premiums for both Access Surgery Premier and Access Surgery are based on age only. They will not increase with claims and don t require a medical for cover to be approved. Applicants are able to tailor their cover to reduce the premium they pay by: Including a 100 excess, which would be applied to the first Outpatient claim in each policy year; Choosing Access Surgery instead of Access Surgery Premier; Excluding the Outpatient benefit, so they are just covered for private surgery. Outpatient treatment may be covered by a health cash plan. To keep the insurance plan affordable and significantly less expensive than comprehensive private medical insurance, it has been developed to cover procedures for new eligible conditions that the NHS classifies as non-urgent. As such, it does not cover surgical procedures for cancer, heart conditions or emergency treatment areas that the NHS prioritises. Although cancer related surgical procedures are excluded, we will cover procedures when cancer is suspected but not confirmed, e.g. biopsies. Other treatments are excluded, such as those for chronic conditions (such as a disease, illness or injury that needs regular or periodic treatment, medication or advice, e.g. diabetes and asthma) and treatments typically excluded on PMI policies (fertility treatment, cosmetic treatment, etc). Please refer to the Definitions section in the Plan Guide terms and conditions for details. Cover is provided on a moratorium basis. Policyholders will not be covered for any medical condition (or related medical condition) that they knew about, or had symptoms, received advice or treatment for in the 3-year period prior to their commencement date. They can only have an eligible medical procedure for a pre-existing condition once they have been free of symptoms, treatment or advice for 2 continuous years from the policy commencement date. It s important to note that policy premiums will not increase with claims. For example, if a 43 year old applies for Access Surgery Premier with Outpatient benefit and no excess, their premium would be 31.40* per month. Reducing the level of cover to Access Surgery with Outpatient and no excess would reduce the premium to 20.99*. Hip and knee replacements can typically involve a wait of more than 100 days on NHS waiting lists, and cataract surgery, more than 90 days. The cost of accessing private treatment for hip replacements can exceed 10,000, and 2,400 for cataracts.

4 Who can have cover? Access Surgery and Access Surgery Premier are available to UK residents between the ages of 18 and 79, so eligible friends and family can apply for cover too. Cover can continue beyond the age of 79, but no changes can be made to the policy after the 80th birthday. A typical Access Surgery patient journey The process detailed below is typical for a patient who has Access Surgery or Access Surgery Premier with Outpatient cover. The process may change for different cover options. Patient visits GP Second meeting between patient and Specialist to discuss results and treatment plan. If surgery is needed, part 2 of the claim form completed by the Specialist and returned to Westfield Health. GP refers patient to Specialist Patient is referred by the Specialist for a scan and tests. Scan arranged between the patient and the hospital, and Westfield Health settle invoice directly with the provider, if there are sufficient funds. We will assess the treatment plan and confirm whether it s eligible. The patient then arranges a date for their procedure. Patient calls Westfield Health to start the claims process. With our dedicated HTI Team, the patient completes and returns part 1 of the claim form. Westfield Health receive the consultation invoice to be settled directly. Any excess applicable is paid to the Specialist by the patient. Westfield Health contact the hospital to obtain the treatment package cost and pay the hospital invoice in advance. Patient receives surgery. The HTI Team assesses the symptoms to ensure that the condition is covered by the policy. If the claim is approved we give the go-ahead for the consultation. The patient visits the Specialist as a private patient. Following a referral, the patient arranges necessary post-operative physio to help with rehabilitation, which is paid for directly by Westfield Health. Outpatient options Private surgery If the Outpatient benefit is not selected when cover is taken out, outpatient consultations, scans and tests are not included and will need to be paid for by the patient, as will any recommended post-operative physiotherapy. Some of these benefits may be covered by a Westfield Health Cash Plan. From the first phone call, our case managers will guide policyholders through the process of accessing a treatment package appropriate to their needs. That might include initial consultation, access to a convenient medical scanning facility, treatment or surgery at either a private or NHS hospital, and post-surgery physiotherapy.

5 What s included in a fixed price-treatment package? Each fixed-price treatment package is tailored to the procedure required. All packages typically include: The consultant surgeon/physician fees The anaesthetist fees The private hospital charges relating to: the operating theatre accommodation either as an inpatient or day case personal meals inpatient drugs and dressings inpatient tests The cost of treating any surgical complications relating to the treatment that occur during the operation whilst in hospital or within 30 days of the original surgical procedure. (Surgical complications that arise more than 30 days after the operation will only be covered if they qualify as a separate surgical procedure, and will be treated as a separate claim). Some private treatment packages may also include a specified number of post-operative Outpatient physiotherapy sessions. The HTI Team will explain the details of the private treatment package, so the patient knows what s included. Some examples of items that are not covered in a fixed-price private treatment package are: Ambulance fees Travel costs Take-home drugs and dressings Car parking Newspapers and other sundry items Telephone calls Medical bands Each medical procedure is categorised into a band, depending on the complexity of the procedure ten bands for Access Surgery Premier and four bands for Access Surgery. Each of the bands has a benefit allowance for private treatment and a benefit for NHS treatment. You can view the full list of surgical and medical procedures covered, and which medical band they are classified as, on our website at

6 How it works with the NHS If the patient decides not to use the private package for their condition in favour of NHS treatment, or is assessed as being unsuitable for a private treatment package, they will be able to claim the NHS Benefit. This is the amount of money payable to the policyholder when they receive their treatment through the NHS. They can claim up to 5,000 on Access Surgery Premier or up to 3,000 on Access Surgery. In order to receive the NHS Benefit payment, the policyholder will need to submit a claim following their NHS procedure, along with a copy of their discharge summary. Details of the NHS Benefit amounts are available in the Plan Guide and online. For customers who already have a cash plan A number of the Outpatient benefits included in Access Surgery and Access Surgery Premier may be covered by a Health Cash Plan. People who already have a Health Cash Plan may consider excluding the Outpatient benefit from their cover. Having Westfield Health cover gave me huge peace of mind throughout the whole [treatment] process. It was fantastic to be able to get a quick diagnosis and know that I could access private treatment so I wouldn t have to wait a long time for surgery. Siobhan Hutchinson, Rope Assemblies How to apply The application process is all online, and full details of the plan are available at Speak to our Sales Consultants or call our Customer Care Team on for more information or help with the application process. Employer paid option also available If you like the sound of Hospital Treatment Insurance, there is a corporate paid version, where employers can pay for all, or a selection of their employees to have cover. Ask your Westfield Health Consultant for details of our corporate paid plans, available at competitive community rated premiums. Our friendly Customer Care Team is here to help Registered Office: Westfield Health, Westfield House, 60 Charter Row, Sheffield, South Yorkshire S1 3FZ CPS042v1 Product supplied by Westfield Contributory Health Scheme Ltd. Westfield Contributory Health Scheme Ltd (company number ) and Westfield Health & Wellbeing Ltd (company number ) are collectively referred to as Westfield Health and are registered in England & Wales. Additionally Westfield Contributory Health Scheme Ltd is authorised by the Prudential Regulation Authority (PRA) and regulated by the Financial Conduct Authority (FCA) and the PRA. Details of this registration can be found by accessing the Financial Services Register online at either the PRA or the FCA websites or by contacting the PRA on or the FCA on Our financial services registration number is Westfield Health 2017