Welcome to AXA Health

Private health insurance, or private medical insurance (PMI), covers the costs of eligible private medical treatment. AXA Health policies also include an array of health and wellbeing benefits to support you to live life well. From seeing a specialist for diagnosis, to having a comfortable private hospital stay.

Private health insurance is designed to complement the care provided by the NHS.

You will receive your Certificate of Cover, detailing your level of cover and membership number. This will be sent in the post to your home address. All other policy literature and information is available on this website axahealth.co.uk/edu-member.

An excess is the amount that needs to be paid each membership year towards the cost of treatment, if you make a claim. For example: if your treatment costs £1,000 and you have an excess of £250, we’ll pay £750 and you’ll pay £250.

If there’s more than one person on your policy (for example, your partner or child), each person will have their own excess. So, if there are two people on your policy and you both claim, you’ll have to pay two excesses - one for each person. Each person covered under your plan will have the same excess.

Your Certificate of Cover will tell you if you have an excess and how much it is. Excesses are applicable per person, per policy year.

Where there are multiple claims in one plan year, only one excess will be applied.

For full details regarding how the excess works, please see section 5 ‘Managing your membership’ of the membership handbook.

Our dedicated claims team is based in International House, Forest Road, Tunbridge Wells, Kent, TN2 5FE.

You cannot be a member of more than one PMI scheme at the same time. Therefore, if you already have an alternative PMI arrangement there will be no change. However, should you wish to leave your current arrangement and join the AXA Health MMB Education scheme, you may choose to do so. Before making any decisions to switch arrangements, please ensure you review the terms and conditions of each plan to fully understand any impacts on your plan benefits or underwriting terms.

Please refer to your current policy documents and the relevant membership handbook for full details.

It is extremely difficult to provide a like for like comparison against other providers due to the complexity of the product and the multiple product options, benefits and underwriting styles. You can however compare the Platinum and Gold plans in the “Benefits Comparison Table.“

Whether you can add family members, including babies, to your cover depends on the contract of insurance we have with your employer, as there may be restrictions on when you can add family members. Members who are joining the group plan may be required to complete an application form.

We are unable to add a new eligible member until we’ve received and accepted the application form or received formal instruction to add, and there are restrictions on the length of time cover will be back-dated dependent upon the underwriting terms that apply.

Who can members add?

Members can normally add:

• your partner. You must be either married, in a civil partnership, or living together permanently in a similar relationship
• Any of your children or your partner’s children

If you would like to add a new baby to your cover, you can normally do this from their date of birth, so long as we are notified within 13 weeks of their birth.

Please note: Children cannot stay on a group member or eligible family members plan after the renewal date following their 25th birthday.

A lead member can cover up to 8 dependants.

Newborn babies can be added to the policy from their date of birth (when added within 13 weeks) and are covered free of charge up to the first renewal. If your baby requires treatment in a Special Care Baby Unit or paediatric intensive care following birth, you may not be covered for the costs. Please contact us to confirm any cover available to you in this case.

As the lead member, the premiums would be based on your age with family member upgrades calculated at the appropriate multiple on that premium.

We do not cover any costs for treatment you receive outside the UK or if you live outside the UK. If you move abroad, you won’t be able to keep your current membership and you will not be able to make any claims for treatment.

If you change your mind after opting into the scheme, changes will be subject to a life event criteria during the scheme year. Any other changes can only be made at renewal.

The qualifying life events include: 

• You get married or enter a civil partnership.
• You have a divorce, legal separation, bereavement or need to remove your partner as they are no longer eligible.
• You have a new child through birth, adoption or marriage (stepchild).

Should you leave the company then your private medical insurance will cease on the day your current employer advises us to end your cover. If you are leaving your employment there is the option to continue your PMI by transferring to a personal plan.

For the vast majority of existing members, AXA Health can cover you for existing medical conditions with no additional medical underwriting, when transferring to a plan with comparable benefits and restrictions.

No. Your insurance is not designed to cover every situation. It is designed to add to, not replace, the NHS. There are some conditions and treatments that the NHS is best at handling – emergencies are a good example.

Rest assured that AXA Health always aims to keep pricing competitive and being part of a group scheme like this can help offset large increases.

To support providing value to our customers, AXA Health has customer value procedures in place. These procedures include regular assessments to test the products provide fair value to those using it.

The products are monitored on an ongoing basis throughout the product lifecycle and assessed against a set of Management Information (MI) metrics to analyse performance and ensure that they continue to meet the needs, characteristics and objectives of the customer and deliver fair outcomes.

Premiums are fixed for the policy year. Price increases at renewal can occur based on three factors; medical inflation, policy usage and age.

The standard hospital list has been carefully selected to offer extensive UK geographical coverage and includes in excess of 85 hospitals in the ‘Greater London’ area. Please refer to the Directory of Hospitals for the full list.

Private hospitals are not set up to deal with life-threating illnesses or injuries and as such they do not have Accident & Emergency facilities. In an emergency, you should call an NHS ambulance or go to an NHS A&E department.

Yes, all our GPs can write a prescription, however, these will be private prescriptions and will incur a cost as we are not part of the NHS. The cost of private prescription medication is different to the standard NHS prescription charges, and we have no control over what your pharmacy charges. Our doctors always try to prescribe the most cost-effective medicine and will let you know if it's going to be expensive.

As part of your healthcare cover, you are entitled to 25% off a range of Nuffield Health or Circle Health Group Health Assessments (terms and conditions apply). For more information about the health assessments available to you including prices, please visit Health assessment (axahealth.co.uk).

As part of the Mental Health Assessments and Support service available to you through your healthcare cover, we can arrange an assessment with a counsellor or psychologist. Where appropriate, they may refer you to a psychiatrist for further assessment and treatment.

Routine hearing tests are not covered by the policy. You will need to contact the claims team on 0800 068 6256 to discuss specific circumstances.

We do not cover any treatment, investigations, assessment or grading to do with learning and developmental disorders. This includes conditions such as dyslexia, dyspraxia, autism spectrum disorder and attention deficit hyperactive disorder (ADHD).

Scheme admin
This group insurance contract can be cancelled by writing to or calling us within the first 14 days after the start or renewal date. If this is done, the group will receive a refund of the premium that has been paid provided that no claims have been paid in that time. If the group insurance contract is not cancelled within this time, it will continue so long as the group premium continues to be paid.

Member
As your membership is part of a group policy that has been arranged by the group you are not able to cancel it. If you want to stop your membership to the plan, please contact your group administrator.

Whilst we currently don’t have a mobile app, you do have access to this dedicated online platform. You can access all you need to know about your AXA Health cover, from membership literature, including your Membership Handbook and Directory of Hospitals. You will also discover the value-added health and wellbeing services available to you and how to access them.

The plans do not include cover for treating emergency dental problems or any routine dental care. This includes any fees for dental specialists, such as orthodontists, periodontists, endodontists or prosthodontists.

We will cover the costs of oral surgery when you are referred for treatment by a dentist, such as:

• reinserting your own teeth after an injury; or
• removing impacted teeth, buried teeth and complicated buried roots; or
• removal of cysts of the jaw (sometimes called enucleation).