All employees are eligible to join the scheme within three months of joining Nuffield Health. Joining the Healthcare Scheme provides you with access to treatment at Nuffield Health Hospitals, and reassurance of knowing you’ll be cared for and treated the Nuffield Health way.
COVID-19 (Coronavirus) Update
The Healthcare Scheme will remain open and running for the duration of COVID-19; however, service availability may be reduced or delayed. Call our scheme administrators on 0800 028 7687 for information on specific claims.
How to join or make changes
You can join the scheme within three months of first becoming eligible to join. If you are a new employee, you will receive a prompt to join the Healthcare scheme as part of your on-boarding tasks within Workday. You will have 90 days to join from your start date.
Changes can be made within 3 months of qualifying lifestyle events, a full list of which can be found here. When making changes due to a lifestyle event you will need to upload evidence of this event and provide a comment. This will then be reviewed for eligibility and approved if it meets criteria. If you are adding or changing dependents on your Healthcare scheme, you will be required to submit the Medical Declaration Form. It will be sent to your Workday inbox once you submit your application. Further details on how to apply for the Healthcare Scheme can be found in the Workday Quick Reference Guide.
Applications are processed on a monthly basis, and they will be effective from the 1st of the following month. You will receive a letter from the scheme administrator confirming details of your membership once your application has been approved and processed, typically within the first 3-4 weeks of the following month. Please call the scheme administrator on 0800 028 7687 if you have any queries regarding claims you have made or looking to make or queries regarding your policy.
About this benefit
Your Healthcare Scheme is provided through a healthcare trust. This scheme is administered on behalf of the Trustees by Bupa, who specialise in the management of corporate healthcare schemes.
All employees are immediately eligible to join the scheme from the date of hire and Nuffield Health will pay for single membership (unless noted differently in your contract of employment). You can join the scheme, or make changes to your membership, within three months of first becoming eligible to join or prior to the scheme renewal date each year which is usually 1 January. To join the scheme, refer to the How to Join section above.
Summary of benefits
Your Healthcare Scheme is designed to pay for treatment of curable, short term disease, illness or injury.
Subject to the rules of the scheme the following medical services are normally available under the scheme:
- Consultation fees
- Hospital accommodation fees
- Surgeon, anaesthetist and physician fees
- Charges for diagnostic tests (X-rays, MRI, PET, CT scans, ECGs etc.) on GP or Consultant's referral
- Prescribed drugs, medicines and dressings when a patient is in hospital
- Psychiatric treatment Day care treatment
- Physiotherapy and acupuncture
- Reasonable cost of accommodation in the hospital for a parent when a child under 16 is receiving treatment eligible under the scheme
- Full details of the benefit provided including any limits and exclusions for certain benefits is detailed in the Healthcare Scheme Handbook.
Who can apply to join the scheme?
All employees on a Nuffield Health contract of employment are eligible to join the scheme. Bank staff, Hospital Consultants and Self-Employed staff are not eligible to join.
How much does it cost to join the scheme and is the benefit taxable?
From January 1 2021, the cost of single membership is £42.08 per month and is paid for by the company (unless noted differently in your contract of employment). However, you are liable for income tax on the amount the company pays, known as a taxable benefit. Nuffield Health will process this taxable benefit for you through the monthly payroll. This means that all tax reporting is done through payroll and so there will be no need to declare your medical cover on a P11d at the end of the tax year.
Can I add family members to the scheme?
You can choose to add your partner and/or child(ren) to your scheme at your own cost - i.e. you pay the membership contributions yourself via payroll deduction - the company will not pay these for you (unless noted differently in your contract of employment). From 1 January 2021 monthly costs for dependants are £42,08 for a partner, £21.04 for child(ren) (for any number of children) or £63.12 for a partner and child(ren). You can view a more detailed summary of costs here.
To add a dependant, you must request this via the Workday Benefits application. Changes can be made to your healthcare scheme within 3 months of qualifying lifestyle events, a full list of which can be found here. When making changes due to a lifestyle event you will need to upload evidence of this event. Once you submit your change request, you will receive a Medical Declaration Form in your Workday inbox that you will need to download, complete and send to Bupa. No claims for your dependant(s) can be processed, until we receive their medical declaration.
Any pre-existing medical conditions/symptoms that your dependants have will be excluded from treatment under the scheme for a period of two years. It is important to note, before you can make a claim, the questionnaire must be completed and returned to Bupa for them to review. Your dependants will still be covered and you will still pay for them, however any delay in completing the form could result in you paying for cover but unable to make a claim.
Until what age can my children remain in the scheme?
Child dependants registered on the scheme will be covered until the end of the scheme year in which they reach the age of 25.
Are pre-existing conditions covered in the scheme?
Pre-existing eligible conditions are covered on joining the scheme for employees and there is no medical history questionnaire to complete to join. However, if you add a dependant to the scheme, they will be required to complete a medical history questionnaire and any pre-existing medical conditions/symptoms that your dependants have will be excluded from treatment under the scheme for a period of two years. Remember to complete the Medical Declaration Form so that this can be reviewed by BUPA and once confirmed you will be able to make a claim. Please note you will still be covered for your dependants and will still pay for them from the date of application but you will be unable to make a claim until the medical declaration has been reviewed.
Do I need to pay anything towards any claims I make?
Every scheme member including dependants, pays the first £100 of any claims in any 12 month period that they receive treatment, this is called an excess.
The excess amount will need to be paid by you direct to the healthcare provider. Bupa will deduct this amount from the first invoice(s) paid and will write to you to confirm the amount you need to pay and to whom.
Covid-19 (Coronavirus) update: For main applicants only (Nuffield Health employees), the £100 excess will not apply to any claims for mental health treatment taken in a Nuffield facility. This does not apply to any dependants and any excess remains in place.
If my claim continues into another scheme year, will I have to pay two excesses?
The £100 excess is payable just once in a 12 month period from the start of the treatment. This means that you won't necessarily need to pay it at the beginning of the scheme year, but you may need to pay another excess if your treatment continues for more than a year.
Is the Healthcare Scheme a taxable benefit?
Yes, you pay tax on the amount Nuffield Health pays for your healthcare cover - this is known as a taxable benefit and is processed through the monthly payroll for you. It is shown on your payslip as "Healthcare”. You can view a summary of costs here.
Will I receive a P11d for my healthcare benefit?
No, because the benefit in kind tax is processed for you through the monthly payroll there is no need to report the amount separately to HMRC at tax year end and as such there will be no P11d form issued for healthcare benefits.
What happens in an emergency?
If you have an accident or are taken seriously ill, you should seek emergency treatment under the NHS. In these instances, the NHS provides the best treatment available.
Can I move from the NHS to a private room following an accident or emergency?
Following emergency admission to the NHS and at the appropriate time, arrangements may be made should you wish to transfer to a Nuffield network hospital, dependent on your suitability to transfer and the availability of a Nuffield network facility that can provide the treatment required. Bupa Healthcare requires approval from the specialist treating you and you should contact the Helpline to confirm if this benefit is available to you.
Which hospitals can be used?
You have access to the highest quality care at Nuffield Health hospitals. If you need treatment that cannot be provided at one of these hospitals, or you live more than 25 miles from one of them, you may be able to have treatment at another private hospital or NHS private ward. Bupa will confirm this with you when you call to authorise your claim.
Is this benefit available outside the UK?
No, the scheme does not pay for treatment overseas. We strongly recommend that you buy travel insurance before you go abroad.
Can I leave the scheme if I no longer wish to be a member?
You may voluntarily leave the scheme or remove dependants from your scheme ahead of the scheme renewal date each year (1 January) or within three months of a qualifying lifestyle event* via Workday - Benefits application.
Who should I contact for further information?
Should you have any further questions, please do not hesitate to email the Reward Team at email@example.com or alternatively contact the Nuffield Health Team at Bupa on 0800 028 7687.