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Member help and claims

Start a claim for medical treatment

Occupational health

1. Visit your GP

Ask your GP for an ‘open referral’

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Talk to an expert

2. Contact us

Contact us and we’ll explain your cover and our Fast Track Appointment service can find you an appointment with an appropriate specialist. 

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Quality care

3. Have your treatment

If you want someone to help you understand your diagnosis and treatment, our Health at Hand experts are on hand to support you, day and night.

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Next steps

4. Next steps

Once you’ve had your treatment, we’ll settle the bill for what's covered. And if you need more treatment or support with your recovery, contact us.

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Visit your GP


Make a GP appointment

If you’re feeling unwell, book an appointment to see your GP. Your private healthcare insurance kicks in once a GP has referred you on for specialist care after they’ve evaluated your symptoms, carried out any diagnostic tests and you've finished any treatment they’ve prescribed.

This initial stage of your treatment is referred to as ‘Primary Care’ and it isn’t usually covered by our plans. If you want to know more, have a read of this factsheet

If you’re experiencing muscle or joint pain, you don’t need a GP referral first. You can call our Working Body service right away and we’ll arrange for a physiotherapist to give you a call back. They’ll assess your symptoms, talk to you about what they could mean, and help you plan what to do next.

GP running tests

Get an open referral

If your GP has assessed your condition and wants to refer you to see a specialist – that’s when your private medical insurance steps in.

Ask your GP for an ‘open referral’. This is when your GP refers you for specialist care, but doesn’t name a specific person for you to see.

Call us when you have an open referral - we’ll check your cover and can find you a specialist using our Fast Track Appointments service. As long as you have out-patient cover on your plan, we'll pay for your consultation. 

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Check that we cover your specialist

If your GP has named a particular specialist for you to see, give us a call before booking an appointment so we can check you’re covered to see that person. If you use a specialist that isn't recognised under your plan, you'll need to pay for all of their costs yourself.

If you've selected the guided option we will not cover treatment or consultations by a specialist we didn't help you choose using our Fast Track Appointments service. 

That's why it’s important to call us before you go ahead with any private consultations, tests or treatment, so we can let you know in advance if the costs are covered. Have a look at this GP referral factsheet to learn more about the referral process.

Struggling to get an appointment with your GP?

With AXA Doctor at Hand, powered by Doctor Care Anywhere, you can see a GP safely from home by video or phone call, whenever you need to 24/7*. 

Right now, we’re giving you unlimited access* to AXA Doctor at Hand as part of your AXA Health membership.

*Subject to appointment availability and the Doctor Care Anywhere fair-usage policy.

Give us a call


We can find you a specialist

Once you have a specialist referral from your GP, give us a call. Before we find you a specialist, we need a few details from you in order to assess your claim. It helps us out if you have your GP referral letter to hand when you call and we may ask to see a copy of this. You can also register a new claim and upload documents to your online account via Member Online if you'd prefer. 

We may ask for more information from your GP before we can confirm you’re covered, we’ll let you know what information we need as it can vary depending on your condition.

As long it's covered by your plan, you'll be good to go. Our Fast Track Appointment service can find a suitable appointment for you and make sure you get seen as soon as possible.

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Specialist tests and treatment

If your specialist wants to carry out more tests or has recommended a procedure to treat your condition, give us a call before you go ahead. We’ll need to check if tests or procedures are covered under your plan. If they are we'll give you an authorisation number to give to your specialist.

If you go ahead with the treatment or test without calling us first to check your cover, we might not be able to pay for it.

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Using the NHS

Private healthcare insurance doesn’t cover everything, so there may be times we can’t authorise your claim. Take a look at some of the most common reasons why we can’t authorise a claim.  

If that’s the case, you may need to use the NHS to carry out your treatment. Give us a call and we can see how we may be able to support you when using the NHS for treatment. 

You may be able to claim a cash payment if you need to stay in hospital overnight, depending on your cover. 

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Member Online

Need to update your permissions?

Your medical data is yours. So, if you become unwell, we can’t talk to your family members about your condition or treatment – unless you tell us we can.

It works the other way too. If you want to speak to us about another member’s claims or health concerns, then we need their permission first.

You can manage these ‘permissions’ in your online account. Just log in and go to your profile. Or you can give our membership team a call on the number provided in your membership documents. 

Have your treatment


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We're here to support you

When you go to your specialist appointment, give your specialist your AXA Health membership number and the authorisation number we’ve given you. 

If you’d like help understanding your diagnosis or the treatment you’re getting, our Health at Hand experts are on hand to support you. 

Give them a call day or night on 0800 003 004.

Health at Hand

Next steps

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Paying your claim

We normally settle any bills directly with the specialist or hospital where you’ve had your treatment. If your treatment is not covered for any reason, we’ll let you know. 

Depending on your level or cover and your course of treatment, we may need to request some more information from your specialist before we pay your claim. 

Take a look at some of the most common reasons why we can’t pay a claim.  

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Member Online

If you've chosen to deal with us online, you can log in to your member account to find details of your claims. 

We'll email you whenever you need to do anything, or if there's an update for you to look at. You can also manage your membership, view your documents or start a new claim online. 

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Paying your excess

Whenever you call us to make a claim, we’ll let you know whether there’s an excess to pay on your plan. 

Once we’ve received the invoice for your treatment we’ll reduce the amount we pay the hospital or specialist by the amount of your excess. 

We’ll let you know how to pay your excess when we send you a statement following your consultation or treatment.

Your recovery

If you need some support with your recovery, our Health at Hand experts are on hand day and night to support you. Call Health at Hand on 0800 003 004.

If you need further treatment, let us know and we’ll check your cover.