Mainly Health Plans SL
4. Assistance cover ( Guide ) Optional if purchased.
This section contains the rules and information for Assistance Cover, am optional benefit which helps you if you need to travel to get the treatment that you need.
Note: There are two levels of Assistance Cover for Evacuation and Repatriation. Your certificate will show if you have Evacuation or Repatriation but you can visit the Membersworld website or contact the Customer Services helpline if you are unsure.
What is Assistance Cover?
The Evacuation and Repatriation options both cover you for reasonable transport costs to the nearest medical facility where the treatment that you need is available if it is not available locally. Repatriation also gives you the option of returning to your specified country of nationality.
We may not be able to arrange evacuation or repatriation in cases where the local situation makes it impossible, unreasonably dangerous or impractical to enter the area, for example from an oil rig or within a war zone.
4.1 Assistance Cover - general rules
The following rules apply to both the Evacuation and Repatriation levels of cover:
1. You must contact our appointed representatives for confirmation before you travel on...
2. Our appointed representatives must agree the arrangements with you.
3. Assistance Cover is applicable for in-patient and day-case treatment only.
4. The treatment must be recommended by your consultant or family doctor and for medical reasons, not available locally.
5. The treatment must be eligible under your plan.
6. You must have cover for the country you are being treated in, for example the USA
7. You must have the appropriate level of Assistance Cover in place before you need the treatment
8. Evacuation or Repatriation will not be eligible if you were aware of the symptoms of your condition before applying for Assistant Cover.
Doctors from BUPA International's appointed representatives will discuss all relevant factors with your own consultant or family doctor before authorising travel. Evacuation or Repatriation will not be authorised if this would be against medical advice
4.2 How to arrange your Evacuation or Repatriation
Arrangements for evacuation will be made by our appointed representatives and must be confirmed in advance by calling .... You must provide us with any information or proof that we may reasonably ask you for to support your request. We will only pay if all arrangements are agreed in advance by BUPA International's appointed representatives.
4.3 Evacuation cover: what we will pay for
If you have Evacuation cover it will be shown on your Membership Certificate. If you are still unsure you can visit our Membersworld website or contact the customer services helpline.
* We will pay in full for your reasonable transport costs for day-case or in-patient treatment
* We will only pay for evacuation to the nearest place where the required treatment is available. This could be to another part of the country that you are in, and may not be your home country
* We will pay for the reasonable travel costs for another BUPA International member to accompany you, but only if it is medically necessary.
* We will pay for the reasonable costs of your, and the accompanying member's return journey to the place your were evacuated from. All arrangements for your return should be approved in advance by BUPA International or our appointed representatives and the journey must be made within fourteen days of the end of the treatment. We will pay for either.
* the reasonable cost of the return journey by the most direct route available by land or sea, or
* the cost of an economy class air ticket by the most direct route available, whichever is the lesser amount.
* We will pay reasonable costs for the transportation only of your body, subject to airline requirements and restrictions, to your home country, in the event of your death while you are away from home. We do not pay for burial or cremation, the cost of burial caskets etc or the transport costs for someone to collect or accompany your remains. April 2009 updates
Note: we do not pay for any other costs related to the evacuation such as hotel accommodation or taxis. Costs of any treatment you receive are not payable under Evacuation cover, but are payable from your medical cover as described in your table of benefits and the 2. What is covered? section of this guide.
Please also note that for medical reasons the member receiving treatment may travel in a different class from their companion.
4.4 Repatriation cover and what we will pay for
If you have Repatriation cover it will be shown on your Membership Certificate. If you are still unsure you can visit our Membersworld website or contact the customer services helpline. Repatriation cover also includes Evacuation cover - see 4.3 above.
* We will pay in full for your reasonable transport costs for day-case or in-patient treatment
* We will pay for repatriation to your specified country of nationality
* We will pay for one repatriation for each illness or injury per lifetime
* We will pay the reasonable travel costs for a relative or your partner to accompany you to your specified country of nationality if we have authorised this in advance of the repatriation.
* We will also pay an allowance of up to £Sterling25, US$50 or €37 per day for up to 10 days to cover the living expenses of the person accompanying you
* We will pay for you and the person accompanying you to return to where you were repatriated from. All arrangements for your return must be approved in advance by BUPA International or our appointed representatives and you must make the return journey within fourteen days of the end of the treatment you were repatriated for. We will pay either.
* the reasonable cost of the return journey by the most direct route available by land or sea, or
* the cost of a scheduled return economy class air ticket by the most direct route available, whichever is the lesser amount.
* We will pay reasonable costs for the transportation only of your body, subject to airline requirements and restrictions, to your home country, in the event of your death while you are away from home. We do not pay for burial or cremation, the cost of burial caskets etc or the transport costs for someone to collect or accompany your remains. April 2009 updates
Note: we do not pay for any other costs related to the repatriation such as hotel accommodation or taxis. Costs of any treatment you receive are not payable under Repatriation cover, but are payable from your medical cover as described in your table of benefits and the 2. What is covered? section of this guide.
Please also note that for medical reasons the member receiving treatment may travel in a different class from their companion.