A Guide to Using BUPA
Planned Treatment
Full details are provided in the BUPACare membership guide but these can be summarised as follows:
1. The Jockey should first see their GP or the PJA Medical Advisor, Dr. Anna Louise Mackinnon, who will refer them to a consultant, therapist or complementary practitioner. When the Jockey sees their GP, they need to tell them that they are a BUPA member and needs to be referred to a BUPA partnership consultant using a BUPA participating hospital.
2. Call BUPA on 0845 60 90 111. BUPA will confirm that the person the Jockey has been referred to is acceptable to them and that the proposed treatment is covered. BUPA will also advise the Jockey if they need a claim form.
3. See the consultant, therapist or complementary practitioner. The Jockey needs to take their BUPA membership pack and certificate with them and find out the exact treatment they need to undergo.
4. If it is recommended to have further treatment or tests, the Jockey must call BUPA on 0845 60 90 111. BUPA will confirm if the additional treatment is covered and the benefits available. They will help the Jockey to choose a participating hospital in their area that their consultant has admitting rights to.
5. When going to hospital. The Jockey needs to take their membership pack with them.
6. When leaving hospital. The Jockey needs to pay any personal expenses such as newspapers or phone calls. BUPA will pay the medical and hospital bills covered by membership.
7. If the consultant has recommended home nursing or out-patient care, the Jockey needs to call BUPA on 0845 60 90 111. BUPA will confirm if they are covered for this and the benefits available.
Key Points
To ensure full cover, the Jockey must remember:
- Treatment must be for an acute condition.
- Referral must be by his GP or Dr. Anna Louise Mackinnon the PJA’s Medical Adviser.
- Out-patient surgical operations, day-patient and in-patient treatment must be provided by a BUPA approved partnership consultant or a non-partnership consultant who charges within BUPA benefit limits. Treatment must be received in a participating hospital.
- The Jockey must occupy a room at his scale of cover when receiving day-patient or in-patient treatment.
How to Transfer to Private treatment from the NHS
When treatment has started under the NHS - through the Accident & Emergency (A&E) department - and a Jockey wishes to transfer to private treatment.
1. Initial assessment has been made and any emergency treatment has been administered, by the A&E doctor.
2. Advise the A&E doctor that the Jockey has private medical insurance with BUPA and wants to be referred for private treatment. BUPA will accept the referral of an A&E doctor instead of the usual GP.
OR
If there is a long initial waiting period for assessment or x-rays for example, it may be possible to bypass this by calling the GP or Dr Anna-Louise Mackinnon and asking for an urgent referral to a private consultant. If contacting a GP, the Jockey will need to advise them that they are a BUPA member and needs a BUPA partnership consultant using a BUPA participating hospital.
NEXT STEPS
1. Get the name of the consultant the Jockey has been referred to from the A&E doctor or his GP.
2. Call BUPA member services on 0845 609 0111 for authorisation. The Jockey wont need a claim form as BUPA will provide an authorisation number.
3. When seeing the consultant for private treatment, the Jockey needs to give them, or the hospital administrator, the authorisation number. The consultant/hospital will then bill BUPA direct.