The Essential Hospital Treatment Plan covers over a thousand medical procedures, which in general terms are defined as:
All covered medical procedures and their respective bands are listed in the Schedule of Procedures. The operations listed in the Schedule of Procedures are covered providing they are carried out in a way which meets the criteria for a procedure shown above.
Please refer to the Policy Terms and Conditions for other general exclusions, which may also affect whether a procedure shown is covered.
The procedures that the Essential Hospital Treatment Plan covers are divided into 12 separate bands, each with their own budget. The table below gives an overview of the kind of procedures covered in the different bands and the budget of money you would receive should you need a procedure covered by your policy.
If you decide to receive treatment in a private hospital then you can spend up to the budget in the Private Hospital Benefits and any amount left over will be returned to you as cash. Please note that whilst Private Hospital Benefits are designed to cover the cost of packages of care at most private hospitals, should you decide to exceed this budget then the additional amount will need to be met by yourself.
If you choose to receive your medical treatment from the NHS, we will pay you a cash benefit appropriate for that procedure according to the NHS Benefits shown in the table below.
|Classification and description of medical procedures||Example||Private Hospital Benefits||NHS Benefits|
|Band 1||These are the most straightforward procedures, generally undertaken as a day case.||Removal of a skin lesion||£850.00||£200.00|
|Band 2||Again, these are day cases and are commonly endoscopic procedures.||Fibre-optic examinations of the digestive system||£1,500.00||£350.00|
|Band 3||These procedures are mainly day cases but have a higher degree of invasiveness.||Examination of the knee using key hole surgery||£2,500.00||£650.00|
|Band 4||These procedures may also be day cases but they generally have an additional feature that can mean patients spend one night in hospital.||Removal of a cataract in the eye||£3,500.00||£850.00|
|Band 5||These procedures are reasonably complicated and require a short stay in hospital.||Removal of varicose veins in both legs||£4,500.00||£1,200.00|
|Band 6||These procedures are often technically complicated, and require a short stay in hospital.||Key hole surgery removal of the gall-bladder||£6,000.00||£1,500.00|
|Band 7||Included in this category are in-patient procedures for which you would expect to stay several nights in hospital.||Various treatments of the intestine||£7,500.00||£2,000.00|
|Band 8||These are significant procedures requiring an extended recovery.||Removal of the stomach or large intestine||£10,000.00||£2,500.00|
|Band 9||These are significant and complex procedures requiring intense post-operative recovery.||Major blood vessel operations||£12,500.00||£3,000.00|
|Band 10||These procedures are significant and require expensive technology.||Angioplasty operations to improve blood supply to the heart||£15,000.00||£3,500.00|
|Band 11||Any procedure in this category requires very high levels of care.||Most heart valve replacements||£20,000.00||£4,000.00|
|Band 12||These procedures are the most complex.||Quadruple heart bypass operation||£25,000.00||£5,000.00|
PatientChoice is able to keep health insurance premiums very low by not trying to duplicate the NHS in areas where the NHS already provides an excellent service. Therefore the Hospital Treatment Plan does not cover: