What your Bupa contract says

In short

This is a private medical insurance (PMI) policy from Bupa, the UK's best-known health insurer. It covers private hospital treatment, consultations, and diagnostic tests for acute conditions (things that are treatable and curable). It does not cover chronic or pre-existing conditions unless you pay extra. Bupa is not covered by the FSCS because it is not authorised by the PRA; however, it is regulated by the FCA for insurance mediation. You typically choose a level of cover (e.g., Treatment & Care, Comprehensive) and can add extras like dental, optical, or mental health.

What you agree to do

• You must pay your premium monthly or annually (your cover stops if you do not pay).
• You must tell Bupa about your full medical history when applying (medical underwriting).
• You must get a GP referral before seeing a specialist or making a claim in most cases.
• You must use Bupa-recognised hospitals and consultants to be covered, unless agreed otherwise.

What you can ask for

• You can cancel within 14 days of receiving your policy and get a full refund.
• You can choose which hospital or consultant you want, as long as they are on the Bupa network.
• You can claim for diagnostic tests, surgery, and post-operative care for covered conditions.
• You can add family members to your policy, including children up to a certain age.
• You can complain to the Financial Ombudsman Service if Bupa does not resolve your issue.

Points worth knowing

• Pre-existing conditions are excludedBupa will not cover any condition you already had symptoms of, or received treatment for, before you joined. This is called a moratorium or full medical underwriting. Some conditions may never be covered.
• Premium rises every year, often above inflationBupa typically raises premiums annually. As you get older, your premium increases more steeply. There is no cap on how much they can increase it.
• Chronic conditions are not covered on standard plansConditions like diabetes, asthma, or arthritis are ongoing (chronic) and are excluded. Bupa only covers acute conditions that can be treated and cured.
• Excess applies per claim or per yearYou may have to pay the first £100-£500 of each claim or each policy year, depending on the excess you chose. Higher excess means lower premiums but more out-of-pocket cost.
• Out-of-network treatment is not coveredIf you choose a consultant or hospital outside Bupa's recognised network without prior approval, you will have to pay the full bill yourself.

Dates and deadlines

Premium payment

Monthly by direct debit or annually in advance

Cooling-off period

14 days from receiving your membership certificate

Annual renewal

Bupa writes to you before your renewal date with updated premium and any changes to cover

Moratorium period for pre-existing conditions

Typically 2 years: if you have no symptoms or treatment for a condition during this period, it may become covered