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Pupils Healthcare Scheme

With everything in life, expertise and experience really count. When it comes to your
child's health,  they’re everything.

Family matters

Amidst the whirl of family life, there are few better feelings than knowing you've done what's best for your loved ones.

We'll support your child at an important stage of life. The knowledge that they are supported by healthcare cover in case they fall ill cannot be understated.

The Marsh and AXA Health relationship

AXA Health are delighted to be supporting Marsh. AXA Health provides you with expertise, innovative products and service you can trust. With nearly 80 years’ experience of providing healthcare cover, we have been helping people with their health and wellbeing for longer than the NHS.

Support you and your child can rely on

The feeling your child is in a safe pair of hands is reassuring in a difficult time. If your child is unwell and their GP recommends further treatment, their Pupils' Healthcare Scheme membership will aim to make the experience easier and less stressful through:

transparent-tick-40x35.pngCover for an adult to stay with your child in hospital when they are receiving in-patient treatment, even though the parent is not an AXA Health member.

transparent-tick-40x35.pngHotel accommodation benefit of up to £100 a night, up to £500 a year in addition to the parent accommodation benefit.

transparent-tick-40x35.pngProviding award winning customer service and an impressive range of healthcare support services.

transparent-tick-40x35.pngTreatment by experts in their field, so you can be confident your child will receive appropriate treatment and care.

transparent-tick-40x35.pngConditions that were present before the membership started are covered.

transparent-tick-40x35.pngCover outside of school hours and term times, providing treatment is in the UK.

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Find out more

For further information on the Pupils' Healthcare Scheme please call the Marsh Limited Education Practice on
01444 335 174. Lines are open Monday to Friday 9am to 5pm 



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Useful resources for Pupils healthcare scheme

We want to make it as easy as possible for your child to access their healthcare scheme, you may find the resources below helpful:

 Marsh Pupils handbook

Common questions

The Pupils’ Healthcare Scheme gives you the peace of mind that should your child become ill, which is an already stressful time, they have fast access to treatment and care for eligible conditions. Cover is available for only £126 per child for each term (£378 per school year) during the membership year 1 September 2021 to 31 August 2022. This includes Insurance Premium Tax (IPT), however AXA Health reserve the right to amend the charge if IPT increases. 

Once cover has commenced it will continue as long as your child remains at the school, the premium continues to be paid and the school continues in the Scheme. 

This section gives a summary of the cover.

IF YOUR CHILD IS AN IN-PATIENT OR DAY-PATIENT
Private hospital and day-patient fees Paid in full At a hospital or day-patient unit in our Directory of Hospitals.
Hospital accomodation for one adult while your child is in hospital Paid in full Covers the cost of one adult staying in the hospital with your child.
Hotel accomodation for one adult while your child is in hospital Up to £100 a night up to £500 a year Covers towards the costs for one adult to stay near to the private hospital where your child is having treatment.
Specialist fees No yearly limit Includes fees for: surgeons | anaesthetists | physicians
IF YOUR CHILD IS AN OUT-PATIENT
Surgery No yearly limit
CT, MRI or PET scans Paid in full At a facility listed in our Directory of Hospitals.
Specialist consultations, diagnostic tests and practitioner fees when your child's specialist refers them No yearly limit Practitioners are nurses, dieticians, orthoptists, speech therapists, psychotherapists or psychologists.
Fees for out-patient treatment by physiotherapists, acupuncturists, homeopaths, osteopaths or chiropractors No yearly limit on fees up to a combined overall maximum of 10 sessions in a year when your child's GP refers them We refer to physiotherapists, osteopaths and chiropractors as 'therapists'.
MENTAL HEALTH - IF YOUR CHILD IS AN IN-PATIENT OR DAY-PATIENT
Private hospital and day-patient unit fees for mental health treatment Paid in full up to 45 days a year So long as your child uses a hospital or day-patient unit in our Directory of Hospitals. Including fees for; accomodation | diagnostic tests | drugs.
Specialist fees for mental health treatment No yearly limit
MENTAL HEALTH - IF YOUR CHILD IS AN OUT-PATIENT
Specialist consultations No yearly limit
Mental health treatment by psychologists and psychotherapists when a recognised specialist refers them No yearly limit
ADDITIONAL BENEFITS
Cash payment when your child has free NHS In-patient treatment that would have been covered by their scheme £50 a night up to £1,000 each year

Cancer cover and care

The scheme includes cover for cancer including chemotherapy, radiotherapy, diagnostic tests and surgery.

The main things we don’t cover

Like all health insurance schemes, there are a few things that are not covered. 

We’ve listed the most significant things here, but please also see the details in the scheme handbook.

  • Chronic conditions.
  • Treatment received outside the UK.
  • Private GP fees.
  • Treatment for normal ageing, for example puberty.
  • Health checks and dental treatment.
  • Learning and development disorders.
  • Fees for specialists who aren’t recognised or charge above our agreed rates.
  • All costs incurred once your child’s cover has ended, even if they were pre-authorised, or the condition began when your child was included.

The details given are a summary of the scheme. Full details of the cover available, including what is and isn’t covered, are given in the membership handbook.

Once your child is a Pupils’ Healthcare Scheme member, there are a few things you need to know. Firstly, any treatment your child is looking to have needs to be medically necessary. We recommend you inform us before any treatment to confirm your child’s cover. 

Imagine having a medical expert in the family - someone you could call anytime you have a health worry, big or small.

That’s exactly what Health at Hand, our 24/7 helpline, is here for. You and your family can call our medical experts any time of the day or night. Our midwives, pharmacists and nurses have experience in child health issues. So you can get expert information on vaccinations, nutrition and childhood illnesses.

Our Health at Hand health information helpline provides ongoing support, including paediatric care.

Simply call 0800 003 004.

Nurses and counselors are available 24/7.

Midwives and pharmacists services:
Monday to Friday 8am to 8pm Saturday 8am to 4pm Sundays 8am to 12pm.

Making a claim 03301 025 503

1. Ask the child’s GP for an open referral
If the child’s GP says they need specialist treatment, tell them you want the child to go private and ask for an ‘open referral’.

With an open referral the GP advises the type of specialist the child needs treatment from but doesn’t name a particular specialist. This means our Fast Track Appointments service can help find a suitable specialist and make a convenient appointment for the child.

In some cases there will not be a private hospital with the necessary pediatrics facilities within a reasonable distance. In those cases we can pay for treatment that is covered to be provided privately at an NHS hospital.

2. Call us before the child sees the specialist
Call us as soon as the child has seen their GP.

It’s important you call us before the child sees the specialist or has any treatment so that we can tell you what they’re covered for. This will mean you don’t end up having to pay for costs that you’re not expecting.

Please help us by having the open referral information from the child’s GP to hand when you call. Occasionally, if we don’t have enough information to choose a specialist, we may ask for additional information from the GP and/or a copy of the open referral letter.

3. We’ll check the cover and let you know what happens next
We’ll check the treatment is covered by the plan, help you find a suitable specialist and offer to make the appointment.

To book the appointment, we’ll need to share some personal information with the specialist including medical information. In some circumstances, you may prefer to make the appointment yourself. We may ask you to provide more information, for example from the GP or specialist. You, the child, the GP or the specialist must provide us with the information we ask for by the date that we ask for it or we may not be able to cover the claim.

If the child needs further treatment, please call us first.

Fast Track Appointment service
We have a team who can help find a fee-approved specialist. Our service is available if the child’s GP has given an ‘open referral’, meaning they don’t give a specialist’s name, just the type of specialist the child needs to see.

What if the child’s GP refers them to a named specialist?

Simply give us a call and we’ll help from there.

Second opinion service
If you would like a second opinion from another specialist, please call us and we can discuss the options with you.

In all cases we may record and/or monitor calls for quality assurance, training and as a record of our conversation

For muscle, bone and joint pain, members can use Working Body – no GP referral needed.

With ‘Working Body’ the child can get access to treatment from a physiotherapist without the need for a GP referral. As soon as they develop a problem, just call us. We’ll check their cover and can make an appointment with a physiotherapist for you.

There will be cases where the NHS will be best placed to provide care locally as not all private hospitals in all areas of the country have suitable facilities for children. When this is the case we will talk to you about your child’s NHS options as well.

You can cancel your child’s cover before it begins by notifying your child’s school. You can cancel your child’s membership within 21 days of cover starting and receive a refund from the school if no claims have been paid. If a claim is made within the 21 day cancellation period and the parent / legal guardian still wishes to cancel, then the parent / legal guardian is liable for the premiums for that term. If at any time you wish to end your child’s cover you can do so from the end of any term and no refund will be made.

Cover is provided under our agreement with the school. However, we do give all members full access to the complaint resolution process.

Our aim is to make sure members are always happy with their membership. If things do go wrong, it’s important to us that we put things right as quickly as possible.

Making a complaint

If you want to make a complaint, you can call us or write to us using the contact details below.

To help us resolve your complaint, please give us the following details:

  • Your child’s name and membership number
  • a contact telephone number
  • the details of your complaint
  • any relevant information that we may not have already seen.

Please call us on 03301 025 503.

Or write to:
AXA PPP healthcare, Nightingale House, Redland Hill, Redland, Bristol BS6 6SH

Answering your complaint

We’ll respond to your complaint as quickly as we can.

If we can’t get back to you straight away, we’ll contact you within five working days to explain the next steps.

We always aim to resolve things within eight weeks from when you first told us about your concerns. If it looks like it will take us longer than this, we will let you know the reasons for the delay and regularly keep you up to date with our progress.

The Financial Ombudsman Service

You may be entitled to refer your complaint to the Financial Ombudsman Service. The ombudsman service can liaise with us directly about your complaint and if we can’t respond fully to a complaint within eight weeks, or if you’re unhappy with our final response, you can ask the Financial Ombudsman Service for an independent review.

The Financial Ombudsman Service
Exchange Tower
Harbour Exchange Square
London
E14 9SR

Phone: 0300 123 9123 or 0800 023 4567 (These numbers may not be available from outside the UK – so from abroad please call +44 20 7964 0500)

Email: complaint.info@financial-ombudsman.org.uk
Website: financial-ombudsman.org.uk

Your legal rights

None of the information in this section affects your legal rights.

AXA PPP healthcare is a participant in the Financial Services Compensation Scheme (FSCS). The Scheme may act if it decides that an insurance company is in such serious financial difficulties that it may not be able to honour its contracts of insurance. It may do this by:

  • providing financial assistance to the insurer
  • transferring policies to another insurer
  • paying compensation.

The Scheme was established under the Financial Services and Markets Act 2000 and is administered by the Financial Services Compensation Scheme Limited. You can find more information about the scheme on the FSCS website: fscs.org.uk.