Aviva Flex

What is it?

Private medical benefit pays for the cost of private medical care. There are two levels of medical benefit to choose from – Comprehensive and Comprehensive Plus – please see the table below for the benefits included in each level and decide which one is best for you. You can also choose to add your partner and your children.

• Read all of the information available including the terms and conditions below before selecting this benefit.
• Take a look at the information about the two levels of benefit carefully and consider which is best for you and your family.
• The Comprehensive scheme does not allow cover for any pre-existing conditions. You will also be responsible for the first £100 of treatment costs.
• The Comprehensive Plus scheme will cover pre-existing conditions. You will be responsible for the first £100 of treatment costs.
• When you enrol you must select your your chosen level of benefit and which dependants you wish to include.
• If you’ve previously selected this benefit through my Aviva flex and you’re happy with the level of cover you don’t need to do anything at annual enrolment, the benefit will simply continue as before.

The table below outlines the key differences between the two levels of benefit available, but please make sure you read the detailed terms and conditions before you choose which level of cover is best for you:

All benefit limits apply per member per scheme year.

Benefits	Comprehensive	Comprehensive Plus	Notes
Hospital treatment as an in-patient or day-patient
Hospital charges			Including accommodation and meals, nursing care, drugs and surgical dressings, theatre fees
Specialists' fees			Up to the limits in our specialist fee schedule
Diagnostic tests			For example endoscopy, removal of tissue for biopsy, blood tests, X-rays, scans and ECGs
Radiotherapy / chemotherapy
NHS cash benefit	£150 per night, up to 25 nights	£150 per night, up to 25 nights	For in-patient treatment only
Psychiatric treatment			Up to 28 days
Treatment for back pain and neck pain
Treatment as an out-patient
Consultations with a specialist
Treatment as an out-patient			Specialists fees are paid up to the limits in the fee schedule
Diagnostic tests			For example - blood tests, X-rays, ECGs; CT, MRI and PET scans as an out-patient are only paid for at a diagnostic centre
Primary care consisting of: Specialists' fees for consultations and diagnostic tests GP referred X-rays, scans and blood tests GP referred treatment as an out-patient by an orthopaedic physician		Up to £500 in combined total	Out-patient CT, MRI and PET scans must take place at a diagnostic centre for chronic conditions and previously acute conditions
Radiotherapy / chemotherapy
Psychiatric treatment		Up to £500	On GP referral to a psychiatric therapist or to a specialist
GP referred treatment by: a physiotherapist a chiropractor or an osteopath			For any condition other than back pain or neck pain, up to 10 sessions in combined total per member per condition per scheme year
Treatment for back pain and neck pain
Other benefits
Home nursing			Immediately following treatment as an in-patient or day-patient that is paid for by the scheme
Private ambulance
Parent accommodation when staying with a child			Child of 11 or under receiving treatment that is paid for by the scheme; one parent only
Minor surgery by a GP	Up to £70 per procedure	Up to £70 per procedure	For procedures appearing on our GP minor surgery list
Hospice donation	£70 per day, up to 10 days	£70 per day, up to 10 days
Treatment for complications of pregnancy and childbirth
Surgical procedures on the teeth performed in a hospital
GP Helpline			Unlimited number of calls
Stress Counselling Helpline			Unlimited number of calls
Personal Health Manager			Unlimited use
Claims excess, payable by the member	£100	£100	Per member per scheme year

There are a number of general exclusions which the scheme will not pay for. Please check the scheme rules for full details.

Please take your time to read the information about these benefits before making your choices.

• Details of monthly charges for each benefit are available when you log in.
• For general questions about this benefit, you can call the my Aviva flex helpline on 0800 917 2310.

Saves on Tax?

Saves on NI?

Member guide

Click here to download the Comprehensive plus scheme member guide.

Member guide

Click here to download the Comprehensive member guide.

Scheme rules

Click here to download the Comprehensive Plus scheme rules.

Scheme rules

Click here to download the Comprehensive scheme rules

Payments for this benefit are taxable using the P11D process

• It’s worth comparing prices and levels of cover even if you currently have private medical benefit
• If you already have Aviva-funded private medical cover and choose to take a lower level of Private Medical Benefit (PMB) or to opt out of this benefit, you will receive 75% of the remaining cash value (PMB Adjustment Allowance)
• Do you have any pre-existing conditions that might not be covered under the Comprehensive scheme?
• If you select Private Medical benefit you will only be able to upgrade or downgrade your level of cover at annual enrolment.
• If you choose to leave the scheme, you will only be able to rejoin at annual enrolment.

In the month after enrolment a confirmation pack explaining what you need to do if you require treatment will be sent to your home address.