Your guide to our services
Personal healthcare
7th edition - July 2016
5 MOST TRUSTED HEALTHCARE PROVIDER
FOR THE FIFTH YEAR 2011 - 2015
Contents
Your guide to our services
Your guide to our services
2
How to contact us
3
How to qualify for our services
4
What does discretionary mean?
6
Advice and helplines
7
Diagnostic consultations and tests
8
Treatment services
10
Physiotherapy
12
Psychological Wellbeing
13
Tuberculosis support and treatment
14
Financial assistance for cancer
15
and tuberculosis
2
Our standards of service
16
How we use your data
17
Have your say
18
Benenden Charitable Trust
19
Member’s stories
20
Be Healthy magazine
21
Other products and services
22
Glossary
24
Notes
26
As a mutual community we’re committed to treating every member fairly. We aim to provide a range of discretionary services that will help our members and to deliver them with care, compassion and understanding. This guide has been created to help outline who’s eligible to request our help, the range of services you can currently request and those services we’re unable to help with. Inside you’ll find information on each of our healthcare services and the simple process of requesting them. Keep this guide handy and if you need to call upon our services in the future you’ll find everything you need to know in one place. We review our services annually ensuring they can be delivered for an affordable contribution. Services may vary depending on the funds available or over time, but we’ll always endeavour to give the best value possible.
It’s easy to get in touch To make everything as smooth and easy as possible for you when you contact us:
1
Have your membership number ready – to help us find your records.
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Make sure you have seen and discussed your concerns with your GP and that you have an active referral on the NHS waiting list - so that we know that we are helping appropriately.
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Tell us about the NHS waiting times for the services you’re requesting support for and how that affects your life – to help us apply discretion.
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Be aware that we must speak with the person that the request for help relates to unless they are under 16 years of age or someone who is authorised in writing to speak on their behalf.
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We will ask a series of necessary questions to validate a person’s identity.
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We may record your call for training and quality purposes.
‘Members’, ‘nominees’, ‘you’ and ‘we’ This guide is for members and nominees. To avoid repetition, we usually say ‘members’ or ‘you’. Both mean members and nominees. References to ‘we’ mean Benenden.
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How to ensure you qualify for our services Please read this carefully • You can request help from our Information Services as soon as you join. All other diagnostic and treatment services can be requested after you have been a Benenden member for six months.
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• You can only request services if you are named on a current membership record. • You must keep your contributions and personal details up to date. If your contributions are not up to date, you are not entitled to request services.
• You must receive written authorisation from Benenden before arranging any diagnostic or treatment service that you would like us to support. We do not fund services that have not been authorised by us in writing.
• If you are not resident in the UK, you are entitled to request Information Services only. If you return to live in the UK, you must register with a GP and explore NHS support before requesting any other services.
• When a nominee becomes a member in their own right, any time they spent as a nominee on someone else’s membership counts towards their six month qualifying period, providing their contributions have been kept up to date.
• You can only request assistance for one set of symptoms at any one time. We may ask you to decide which health concern you wish Benenden to support.
Misuse and abuse
Costs we cannot help you with
• In some cases, we expect you to pay the cost of certain services we authorise and reclaim the cost from us. This will normally be paid within 7 working days directly into your bank account. If this would create financial hardship for you, please discuss it with us first and, in exceptional circumstances, we may be able to pay the costs directly to the provider delivering those services. We may contact hospitals or consultants to ensure that the information supplied on the invoice is correct.
As every service we provide is funded entirely by our members’ contributions, there are some costs and services that we cannot help you with in any circumstances. We’ve listed some of these below. When there are additional exclusions relating to a specific service, we will let you know about these in our letter of authorisation.
• If you fail to attend a medical appointment authorised or arranged by us, you will not be entitled to ask for further services for the same healthcare issue. We work to complement the NHS and make our services available as promptly as we can. We are unable to defer appointments. • If you verbally or physically abuse or threaten one of our employees, representatives or providers, you may be refused further services. • If you are discharged from hospital or another medical establishment for breach of regulations or against medical advice, you will not be entitled to further services for that healthcare issue and you may be expelled from Benenden. • If you misapply the funds of Benenden or wilfully supply false information when requesting a service, you may be required to repay sums due to Benenden. You may also be expelled from Benenden
We’re unable to reimburse you for services: • Obtained before we have given our written authorisation • Carried out after any specified timeframe • That cost more than the financial limit we agreed with you • Monitoring of an ongoing condition, including consultations or treatment for the same reoccurring symptoms, as we would expect you to obtain this support through the NHS • Procedures not recognised by the National Institute of Clinical Excellence • Private patient facilities in an NHS hospital whilst you are receiving NHS care • Any services provided outside the UK • Any services if you are not a UK resident other than Information Services described on page 7. • Personal expenses when in hospital.
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What does discretionary mean? With the exception of treatment for Tuberculosis, all our services are discretionary. This means we’ll carefully consider every aspect of your request and the relevant funds available, then we’ll use our discretion to decide whether we can help or suggest an alternative option. As a responsible member who shares our values and ethos, we trust you to use your judgement to decide if your problem can be resolved in an appropriate way through the NHS or by other means without causing you unnecessary worry. If you do need additional support, it’s vital you discuss your case with us so we can authorise help.
We offered our diagnostic, physio, psychology and counselling services 50,789 times. We said ‘yes’ 96,058 times thanks to our members’ monthly contributions.
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Please don’t arrange any services until you receive our authorisation in writing because we will be unable to reimburse these costs. Visit our website and watch a video explaining how using our discretion to consider each member’s individual needs works to ensure we can provide help when you need it most. Simply visit www.benenden.co.uk/discretionary
Our membership community of almost 900,000 are able to access our exceptional discretionary healthcare services, including 24/7 GP Advice, Physiotherapy, Psychological Wellbeing, diagnosis and treatment.
42,868 members joined our personal healthcare community in 2015.
15,842 users registered online to service their account and joint the online community.
Information and helplines available as soon as you join Our advice and helpline services are available from the minute you join Benenden and you can access them throughout the life of your membership. Whenever you or your family need these support services they’re just a phone call away. 24/7 GP Advice Line Our 24-hour GP Advice Line gives you the round-the-clock reassurance of knowing you can speak to a qualified, UK-based GP day or night, from anywhere in the world. You can talk to the GP about a wide range of things such as an ache or pain that won’t go away, sensitive or confidential concerns that you have, a diagnosis or treatment you’ve been given, or the side-effects of any medication you’re taking. Please note: As the GP is not your own GP, they cannot make referrals or write a prescription for you, but they can suggest a diagnosis and recommend the best course of action. How to use this service
• To use the service call 0800 414 8247* from the UK or +44 800 414 8247* from abroad. • This is a call back service so you can specify a convenient 15-minute time slot and a doctor will call you back.
24/7 Psychological Wellbeing Helpline
How to use this service
• To use the service call 0800 414 8247* from the UK or +44 800 414 8247* from abroad. • Qualified therapists are on hand day and night to offer advice and put your mind at rest.
Independent Care Advice Service It can be a very difficult decision when you or a family member requires long-term, short-term convalescence, residential or respite care. Our Independent Care Advice Service assesses your circumstances and gives you the information you need to make an informed decision – from basic advice to detailed reports on UK care providers, respite care and much more. How to use this service • You can use this service for yourself or on behalf of a family member. • Call 0800 414 8100* to arrange to speak to an expert (Lines are open 8am - 8pm, Monday – Friday excluding bank holidays).
If you’re feeling anxious our qualified therapists can offer information about local UK services that can help with a range of topics including relationship problems, money worries, employment anxiety and bereavement.
When you call any of these helplines, you will be asked to provide essential information, such as your membership number and name. The service provider will be required to treat this information with respect and keep it confidential.
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Diagnostic consultations and tests When you’re ill, waiting for a diagnosis can be very distressing. If you have a long wait for your NHS consultations and tests, we may be able to help you get a quicker diagnosis. Please note: we do not fund services that have not been authorised by us in writing. As a UK resident, you can request this service any time after you have been a Benenden member for six months. How to request this service 1. Visit your GP. 2. If they recommend a consultation or tests, ask them to refer you through the NHS.
You may be asked to send to us a letter from your GP called a ‘referral’. If we can help, we will authorise the service in writing. Following a diagnosis, you will be referred back to your GP for any treatment, ongoing management and monitoring of your condition. You should discuss your treatment needs with your GP, check the NHS waiting time and, if necessary, ask us to support your treatment by calling our Member Services team on 0800 414 8100*.
3. As our services are funded by member contributions, we ask you to remain on the NHS waiting list and utilise this where possible. You will be asked to confirm your NHS wait time if you contact us to request services.
Payment
4. If you feel the waiting time for a diagnosis is causing you concern, please contact our Member Services team on 0800 414 8100* (see page 3 for the information you need to give them).
Option 2 – Benenden Hospital
If we can help, you may be given two options to obtain a diagnosis Option 1 – Local diagnostic service If authorised, we will help you receive prompt diagnosis by providing access to a local network of consultants and hospitals. The financial limit is £1500 per condition. Diagnostic consultations and tests may include: • Outpatient consultations with a specialist consultant. • Outpatient diagnostic tests or investigations recommended by your GP or consultant. • A selection of minor treatments. This is detailed in our letter of authorisation. 8
Next steps after we agree to help
You do not need to worry about the payment of the diagnostic consultations or tests. All bills will be settled directly by Benenden up to the £1,500 limit.
If you live within a two-hour car journey time of Benenden Hospital Kent your consultation or tests will take place there. Wherever you live in the UK, you can request to be seen at Benenden Hospital, and relatives who live far away can find affordable overnight accommodation at Peek Lodge within the hospital grounds. Next steps after we agree to help After you have spoken to one of our advisers and they have outlined our possible services, you will be asked to send to us a letter from your GP called a ‘referral’. If we can help you, we will authorise the service in writing and liaise with Benenden Hospital. The hospital will contact you to arrange a prompt appointment.
If you need treatment after your diagnosis we may be able to continue to fund your treatment at Benenden Hospital. After diagnosis or treatment you will then be referred back to your GP for on-going management and monitoring of your condition. Payment You do not need to worry about the payment of diagnosis. All bills will be settled directly by Benenden.
Where we’re unable to help
We have listed the general exclusions on pages 4-5 and there are some additional exclusions specifically for this service, which include: • Any form of treatment, where a bed is needed on a hospital ward, even if just for a short period • Pre and post-operative consultations • Physiotherapy
Second opinion consultations
• Laser Eye Treatment
If you have already seen a consultant through the NHS and would like a ‘second opinion’ from a different consultant we require a referral letter from your GP. This letter supports your request for a second opinion and enables us to fully consider your request. We will always consider using the consultation services at Benenden Hospital Kent in the first instance.
• Cosmetic consultations
Next steps after we agree to help
• Speech therapy
We will guide you through seeking a second opinion and if appropriate the payment process
• Second opinion consultations where the condition was diagnosed at Benenden Hospital or at one of our other approved hospitals
• Medical aids, appliances or prescription costs • Complementary therapy consultations • Consultations or tests that are not for diagnostic purposes • Pain management
Please be aware that the above list of exclusions is not exhaustive and we ask that you always contact our Member Services team before arranging any healthcare services to find out whether Benenden can help you.
Real members, real stories. See more members’ experiences at www.benenden.co.uk/ memberstories 9
Treatment Service If you’re waiting for treatment or surgery, we may be able to help you by funding your admission at one of our approved hospitals or clinics nationwide or at Benenden Hospital in Kent. As a UK resident you can request this service any time after you have been a Benenden member for six months. Please note: you must get our authorisation in writing in advance. Benenden Hospital and other Benenden approved hospitals or clinics can offer treatment for a wide range of conditions. If you live within a two-hour car journey time of Benenden Hospital Kent your treatments will take place there. Wherever you live in the UK, you can request to be seen at Benenden Hospital, and relatives who live far away can find affordable accommodation at Peek Lodge in the hospital grounds. If you live more than 2 hours away from Benenden Hospital, we will normally ask you to go to the nearest Benenden approved hospital to your home, but you can request to be treated at another Benenden approved hospital or clinic if it is more convenient. Please note, only Benenden can authorise treatment and say where and when it will be provided.
How to request this service 1. Visit your GP. 2. If they recommend treatment, ask them to refer you through the NHS. 3. Find out what the waiting time would be. As our services are funded by member contributions we ask you to use the NHS where possible. 4. If you feel the waiting time is causing you concern, please contact our Member Services team on 0800 414 8100* (see page 3 for the information you need to give them). 5. We may request a referral letter from your GP so that we can see if we can help you. The letter should include the results of any appointments or tests you have had. 6. We may also ask for a copy of the consultant’s report. When we receive the consultant’s report, we may need to refer you to Benenden Hospital or your nearest approved hospital or clinic for further tests, or we will authorise a consultation to confirm your treatment needs. Next steps after we agree to help If treatment can be provided at Benenden Hospital we will write to you to confirm our support. Benenden Hospital will also contact you to arrange an admission date.
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If the treatment can be provided at one of our approved hospitals or clinics we will write to you to confirm authorisation. You can then contact the hospital to arrange your appointment using the authorisation details we provide. After your treatment, we fund one postoperative consultation and you will be discharged back to your GP for any ongoing monitoring and management of your symptoms and condition. Payment You do not need to worry about the payment of treatment. All bills will be settled directly by Benenden In certain circumstances you may be offered additional services by the hospital, which fall outside of the service provided by your Benenden membership. Should you choose to take up this offer, we will not reimburse the additional cost; the hospital will bill you and you will be required to settle this directly with the hospital. Deferring treatment We work to complement the NHS and provide authorised services as promptly as we can. We are unable to defer appointments to suit your personal circumstances
• Inpatient or complex orthopaedic surgery such as joint replacements, spinal, neck or back surgery • Complex ear surgery • Cosmetic surgery • Emergency treatment • Fertility treatment i.e. IVF • Complementary therapies • Breast surgery • Pain management • Dental treatment or oral surgery • Inpatient mental health treatment • Surgery for transplants • Surgery for obesity • Cancer care Please be aware that the above list of exclusions is not exhaustive and we ask that you always contact our Member Services team before arranging any treatment to find out whether Benenden can help you.
Where we’re unable to help you We have listed the general exclusions on pages 4-5 and there are some additional exclusions specifically for this service, which include: • Treatment outside Benenden Hospital or one of our approved hospitals or clinics
• Heart/arterial surgery • Head/neurological surgery • Some specific eye treatments
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Physiotherapy This service allows you to be assessed by a qualified Physiotherapist who will determine if you will benefit from face-to-face physiotherapy or from a course of self-managed at-home exercises. As a UK resident you can request this service any time you have been a Benenden member for six months. Please note: you must get our authorisation in writing before arranging any appointments. Self-management treatment
Next steps after we agree to help
If self-management is the best option for you, the physiotherapist will provide you with specific advice and exercises designed to assist your body’s natural healing processes for the fastest possible recovery. A qualified physiotherapist will be assigned as your personal case manager to arrange regular contact to provide support and advice over the telephone.
Once we have confirmed we can help, we will authorise the service in writing and arrange for one of our Physiotherapists to call you at a mutually convenient time. Payment You do not need to worry about the payment of your treatment sessions, as we will pay the Physiotherapist directly.
Face-to-face treatment If the physiotherapist recommends face-toface treatment we will arrange for you to attend one of over 700 local Rehabworks accredited clinics. How to request this service 1. Visit your GP. 2. If they recommend physiotherapy, ask them to refer you through the NHS. 3. Find out what the waiting time would be. As our services are funded by member contributions we ask you to use the NHS where possible. 4. If you feel the waiting time for a diagnosis is causing you concern, please contact our Member Services team on 0800 414 8100* (see page 3 for the information you need to give them). 5.
The qualified physiotherapist will suggest a course of self-managed at home exercises or recommend face to face physiotherapy sessions.
You must stay on the NHS waiting list as this service is designed to be used as an interim solution, until your NHS appointment becomes available. 12
Where we’re unable to help you
We have listed the general exclusions on pages 4-5 and there are some additional exclusions specifically for this service, which include: • Physiotherapy treatments in a centre that is not within the accredited Benenden network
• Treatment by chiropractors, osteopaths, muscular-skeletal practitioners, complementary or sports therapists • Tests, for example x-rays • Pain management treatment including injections • Treatment for a recurring or ongoing condition Please be aware that the above list of exclusions is not exhaustive and we ask that you always contact our Member Services team before arranging any healthcare services to find out whether Benenden can help you.
Psychological Wellbeing If you are suffering with work or personal problems, our Psychological Wellbeing service can offer positive support and a personalised service to get you back on track. Psychological Wellbeing Helpline – accessible as soon as you join Benenden • 24 hour helpline where you will speak immediately to a qualified therapist •
Following support from the helpline, or should the support required not be available, you will be signposted back to the NHS via your own GP.
Psychological Wellbeing Treatment – accessible upon completing 6 month qualifying period If it is clinically appropriate following discussion with the Psychological Wellbeing Helpline and upon an NHS referral from your GP you will be triaged and assessed by a qualified therapist who will identify if further support is required. The therapist will provide information on a range of interventions which will be based on your individual clinical need. The range of interventions include:
How to request this service 1. Visit your GP. 2. If they recommend you would benefit from psychological support, ask them to refer you through the NHS. 3. Find out what the waiting time would be for a therapist appointment. As our services are funded by member contributions we ask you to use the NHS where possible. 4.
If you feel the waiting time for support is causing you concern, please contact our Member Services team on 0800 414 8100* (see page 3 for the information you need to give them).
This is a confidential, 24hr service that you can call from anywhere in the world. When you contact us we will put you in touch with a qualified therapist who will discuss ways in which Benenden can help you.
• Signposting to other agencies, such as support groups • Access to websites, skype, printable programmes, workbooks and computerised programmes • Telephone counselling • Face to face therapy
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Tuberculosis (TB) treatment As we were founded over a century ago to treat Tuberculosis, unlike our other services, we offer TB treatment on a non-discretionary basis. As a UK resident you can request this service any time after you have been a member for six months. Please note: you must get our authorisation in writing before you incur any costs. How to request this service
Payment
1. Visit your GP.
You do not need to worry about the cost of your treatment, as we will pay the hospital directly.
2. If they diagnose you with TB, ask them about the help available through the NHS and the waiting time involved. 3. We will liaise with your GP to agree the best treatment for you. If this is in-patient treatment it may last for up to two weeks and is usually arranged at a hospital near to your home. 4. We recommend that you use the NHS to give you the clinical care and ongoing support you need. We may also be able to offer you financial help with the added expenses of living with TB. Please turn to page 15 for details.
Real members, real stories. See more members’ experiences at www.benenden.co.uk/ memberstories 14
Financial assistance for cancer and tuberculosis If you find yourself with a diagnosis of an active cancer or TB condition it can be stressful enough without the worry of added costs relating to your illness. If you are suffering from financial hardship as a result of your condition we may be able provide some assistance to add to the medical help given by the NHS, Social Services and other organisations. How to request this service
You can request this service any time after you have been a Benenden member for six months and are a UK resident. First, please find out about the help that is available to you through the NHS, Social Services, and other organisations such as Macmillan Cancer Support, then call our Member Services team on 0800 414 8100. One of our team will guide you through the support that may be available and signpost you to any useful contacts. If we can help, we will write to you to confirm the type and level of financial assistance we can provide. In line with our organisational values and ethos please let us know if your situation changes or if you no longer need our support.
You may also not be deemed eligible for support if you are being monitored or receiving maintenance treatment. Where we’re unable to help We have listed the general exclusions on pages 4-5 and there are some specific additional exclusions for this service which include: • Any condition apart from a cancer or tuberculosis diagnosis • Daily living costs not related to your condition • Costs outside the authorised period of help • Long-term ongoing support • Cancer surgery or treatment
This benefit is designed to help us to support members of the Benenden Community who are facing financial hardship at a time of need. We therefore will assess each case on an individual basis and in the context of community funds.
• Prescriptions
It is essential that you receive our authorisation in writing before you incur any costs
• Support when your condition is in remission or when you are receiving maintenance treatment (including endocrine therapy and biological therapy (Herceptin)) or your care is moved into a monitoring phase
Our support is reviewed on a regular basis and we may ask you for a written medical report from your GP or consultant. An outcome of the review may be that you are no longer deemed eligible to continue to receive support which we would communicate directly with you.
• Complementary therapies • Modifications to your home, such as the installation of a stair lift • Loss of income
Please be aware that the above list of exclusions is not exhaustive and we ask that you always contact our Member Services team before incurring costs to find out whether we can help. 15
Our standards of service As a mutual organisation everything we do is completely focused on giving our members the very best care and excellent service every time you contact us. We aim to:
When things go wrong
• Where applicable we will repay your authorised healthcare costs within seven working days of receiving an original invoice
We do our best to offer a caring and effective service. If there is a problem with your membership or any of the services we provide or signpost you to, we want to hear about it. We welcome your comments and complaints as they help us to improve our services.
• Respond to routine correspondence within three working days, either by letter or email • Give our names in all correspondence and on the phone • Be welcoming, courteous, respectful and responsive • Treat you and other members fairly • Advise you clearly about the services that we can or cannot assist you with and to confirm these details verbally and in writing each time you contact us to request our help • Keep you informed and communicate with you clearly • Provide good quality information suited to your individual needs
If you have cause to make a complaint, please contact us. You can call us on 0800 414 8100 or send us a message via our website at www. benenden.co.uk/contact-us If you remain unhappy after we have investigated your complaint through our internal complaints procedure (available on our website) you may be able to refer your complaint to the Financial Ombudsman Service. You can contact them at:
To help us achieve these standards, we ask you to:
Financial Ombudsman Service, Exchange Tower, London, E14 9SR
• Be courteous and respectful to our staff
0300 123 9 123 (calls a free on mobile and landlines)
• Have your membership number ready when you contact us • Help us by providing any information we need • Give us feedback on our performance through our website www.benenden.co.uk/contact-us
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We will deal with your concerns as quickly and effectively as possible and, if we have made a mistake, we will do everything we can to put things right.
www.financial-ombudsman.org.uk Membership contributions
We may have an occasion when it is necessary to provide you with a refund of your membership contributions or to collect an additional contribution from you. Due to the cost of administering these payments a minimum payment amount of £4 or such other amount as we notify to members through the members’ magazine Be healthy, will be applied in these circumstances.
How we use your data Benenden adhere to the requirements of the UK Data Protection Act 1998 and we are also registered on the public register of data controllers which is looked after by the Information Commissioner. We keep you fully informed about how we use your information and have a Privacy Notice that explains what these uses are. The Privacy Notice is available at www.benenden.co.uk/privacy-policy Changes to this privacy notice are made occasionally, so please revisit our website to read it through from time to time. A printed copy is also available on request. Please be aware that we will not enter into discussions regarding membership or personal health records with any third party, or any individual other than the member or nominee to which they relate. In situations where this is not possible, due to personal circumstances, we can accept written authority to speak to an authorised representative. Examples include a GP letter confirming that it is appropriate to speak to an authorised representative, power of attorney or court of protection order.
We will be happy to discuss with you what type of written authorisation would be appropriate. We do however, share information with carefully selected third party suppliers in order to give you the best experience when you use our services. For members or nominees under the age of 16, we are able to discuss matters with their parents or guardians.
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Have Your Say When you become a Benenden member you are automatically allocated to one of our branches. Benenden’s Democracy
Branches have three main responsibilities:
The Society’s branches form the democratic basis by which members are able to have their say in how the Society is run.
• Enabling members to get together at branch meetings and put forward their views on Benenden
Each Branch is run by a group of volunteer members who give their time generously to support the Society. These volunteers stand for election and where successful form a committee which consists of a Chairman, Treasurer and Secretary plus Committee Members
• Communicating the views of branch members by sending delegates to represent them at the annual Conference
Each Branch Committee organises several meetings every year that all members, such as yourself, are encouraged to attend. These meetings provide a great opportunity to meet fellow members and to make your views about Benenden known. They are also the way by which the Branch can put proposals to the Society’s Conference, how members discuss their views on all Conference business and agree how to instruct their delegates on how to vote at Conference.
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• Nominating members for election to Society positions such as the Committee of Management, Society Secretary or other posts. If you wish to learn more or to attend a Branch meeting please let us know. Nominees are welcome to attend branch meetings, but only members are entitled to vote. If you have been a nominee for six months or more and are over 16 years of age, why not join as a member in your own right? Find Out More You can find out more about having your say at www.benenden.co.uk/about-benenden/ branches or by emailing the Society Secretary at thesecretary@benenden.co.uk
Benenden Charitable Trust Benenden Charitable Trust was formed at the Society’s centenary conference in 2005 to help in situations where a member’s personal healthcare plan cannot. Benenden Charitable Trust exists to assist people who find themselves in financial difficulty due to sickness, disability, infirmity or any other medical condition. What help is available?
Who can apply?
The majority of grants are under £1,000, but requests for up to £5,000 can be considered to help with a variety of needs including:
Benenden Charitable Trust can help members and former members of Benenden, as well as friends and family named on another person’s membership. The charity does not accept applications from non-members directly but occasionally receives non-member referrals from selected partner charities.
• treatment not available on the NHS or through Benenden membership • treatment where there are long NHS delays • specialist equipment and disability aids such as a stair lift or wheelchair • breathing space grants if your circumstances mean you struggle with everyday living costs Requests are considered on a case-by-case basis, taking your individual requirements and financial circumstances into account to ensure the charity is providing help where it is most needed.
How to apply You can download a printable application form from www.benenden.co.uk/charitable-trust, or you can request one by calling 0800 414 8450* (Tues-Fri 8am-4pm). If you would like to discuss your individual situation, or need help in completing your application, the trust’s friendly team is happy to advise you.
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What our members have to say Sharing examples of real members’ experiences is one of the best ways to demonstrate how we help people in times of need. You can see more members’ experiences at www.benenden.co.uk/ memberstories or by visiting our YouTube channel.
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Benenden saved me from being stuck on a 1-year waiting list for surgery. My problem was getting worse every month and my pain levels were increasing. Not having to wait for surgery has had such a positive impact on my life. Benenden have helped and supported me so much. Fiona McLean
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We’d be delighted to hear from you if you have a Benenden experience that you’d like to share. You can get in touch by emailing casestudies@benenden.co.uk
Kevin Thorpe
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Having had my surgery cancelled twice during the previous 3 months via the NHS Benenden was a life saver and saved me months of discomfort.
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Marion Callan
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Benenden has helped me see people promptly. If I hadn’t had the operation I wouldn’t have known about the cancer. Having their support and help has taken away a lot of stress and anxiety.
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Myself, my husband and members of our family have been Benenden members for many, many years. It’s very reassuring to know that with many health problems Benenden is there to help if we can’t get help from the NHS within a reasonable time.
Roger Rees
Be Healthy magazine At Benenden we know it’s important to look after our members, even when you’re fit and healthy. So our quarterly Be Healthy magazine is packed with news stories, healthy living advice, delicious recipes and much more. IAL SPEC RT REPO
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| Summer 2016
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12 health myths NKED DEBU
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How to access Be Healthy magazine Members can choose to receive the magazine by post or e-mail – when you join, you will be automatically registered for a postal version. Please contact the Member Services team on 0800 414 8100* if you would prefer to read it online via email.
If you are visually impaired, you can contact Member Services to arrange for Be Healthy to be sent to you in large print, audio or braille format. Opting out of Be Healthy If you no longer wish to receive Be Healthy by post or email, please contact Member Services to opt-out of both.
You can also log in to the Member Website at www.benenden.co.uk/memberwebsite to read the latest issue or download it as a pdf. We have a limited number of Be Healthy back issues available for members. Please contact Member Services if you have missed the most recent issue; we will check to ensure your mailing options and address details are correct then arrange for a replacement to be sent – subject to availability.
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Other products and services To help us support the Benenden Community beyond our traditional healthcare offering, we also offer a range of products and services that complement and support your Benenden membership. These complementary services are designed to support the needs of our members and we are able to reinvest the returns to support the Benenden core discretionary fund. You’ll find more information on new products and services on our website.
Travel insurance Whether you’re looking for a single trip policy for your annual holiday or require the flexibility of an annual multi-trip insurance, we can provide comprehensive cover.
www.benenden.co.uk/travel
Health assessments Offering excellent value our range of health assessments are simple to arrange and easy to access with our network of nationwide healthcare locations.
www.benenden.co.uk/healthassessments
Home insurance Our flexible home insurance is built to suit your home and the lifestyle you lead. Whether you wish to cover buildings or contents only or both combined our two levels of cover, Essential and Premier, give you the option to tailor your cover to your specific needs. Plus you can choose optional add-ons like bicycle or garden cover and whichever cover you choose, our 24 hour Home Emergency Assistance comes as standard.
www.benenden.co.uk/benendenhome
These products are offered by Benenden Wellbeing Limited, which is authorised and regulated by the Financial Conduct Authority (FS Register No 593286). Benenden Wellbeing Limited is registered in England and Wales, Company No 08271017 and is a wholly owned subsidiary of The Benenden Healthcare Society Limited. Registered Office: Holgate Park Drive, York, YO26 4GG.
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Independent living We understand that maintaining personal independence is important and that’s why we’ve partnered with healthcare.co.uk to offer members a suitable range of products created to help regain and preserve mobility and freedom.
www.benenden.co.uk/independent-living
Care fees funding Ongoing care can make a significant difference to someone’s life when they are struggling to look after themselves. However, finding the money for care in later life can be difficult. This is where an experienced, qualified adviser can talk you through the your available options and help you find the best possible care.
www.benenden.co.uk/carefees
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Glossary Local Rehabworks A physiotherapy provider that we have included in our approved network accredited list of recognised providers based on location, clinical compliance and value, clinics and to which we send members for physiotherapy treatments, which are arranged and funded by us.
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Authorised (service)
We will send written confirmation of approval for a service to you but we will not reimburse the cost of any service that has not been authorised in writing by us.
Authorised (representative)
A person authorised by you in writing to represent you when dealing with us. We cannot deal with anyone other than a member or nominee if we have not received an instruction naming an authorised representative from that member or nominee, unless it is for a nominee under 16.
Availability (services)
Access to our services may vary according to the resources available and other relevant factors. Services are provided on a discretionary or non-discretionary basis (see below), depending on the current rules and guidelines.
Availability (NHS)
We use this to describe whether medical consultations, tests, or treatment can be easily obtained through the NHS or not. We often use ‘availability’ in connection with the NHS waiting time.
Benenden approved hospital or clinic
A hospital that we have selected for its range of services, quality and value, and to which we send members for consultations, tests and/or treatment, which are arranged and funded by us.
Chronic condition
A disease that is long-lasting or recurrent.
Complementary treatment
This includes: Dietitian, speech therapy, homeopathy, pain clinics, acupuncture (unless carried out by a Physiotherapist). This is not a comprehensive list.
Consultant
A doctor who holds the title of consultant and has one of the following recognised qualifications: FRCP, MRCP, FRCS, MRCS, FRCOG, MRCOG, FRCPOphth, MRCPOphth, FRCPsych, MRCPsych, FDS RCS, MFDS RSC, F.Ch.S, M.Ch.S or FCPods.
Consultant’s report
A document produced by the diagnosing consultant to confirm the patient’s state of health, the clinical diagnosis and any recommendations for treatment and NHS wait.
Consultation service
The provision of diagnostic consultations through the consultants at Benenden Hospital or a Benenden approved hospital or clinic. Also, any necessary follow-up consultations that are authorised by Benenden, and tests and investigations needed as part of the diagnostic consultation as described in our letter of authorisation.
Diagnosis
Finding out what is causing your symptoms.
Discretionary
We are not a medical insurer and do not provide guaranteed services. We use our discretion to administer our services depending on your needs and the NHS waiting time.
Eligibility
The term we use to describe whether someone has met all the rules which apply to qualification for Benenden Personal Healthcare services. For most services, you must have served a six-month qualifying period. Contributions must be paid up to date. You must be able to provide your membership number and/or other personal identifying details if asked by a member of staff.
Expulsion
Benenden can expel a member who misapplies our funds or breaches our rules. See Benenden rules 5.1, 5.2, 5.3 and 10.4. (See page 4).
GP referral letter
A letter from the patient’s General Practitioner that outlines the clinical symptoms and requests the patient to be seen by a specialist.
Local diagnostic service
Authorisation of up to ÂŁ1,500 for you to receive diagnosis through one of our approved hospitals or by providing access to our local diagnostic network of consultants and hospitals.
Limitations, exclusions and restrictions
The range of services which members and nominees may request is currently limited to those described in this guide and other Benenden literature. They are in line with Rule 9 of the Rules of the Society and approved by the Committee of Management.
Medical report
A detailed report produced by a consultant or a General Practitioner that provides specific clinical information about the patient’s current and ongoing state of health, with details of any medication or treatment provided and any recommendations for future medical care.
Member
A member or nominee of Benenden.
Nominee
A person who is named on the membership of a member and is nominated by the member to receive our services.
Non-discretionary
If an eligible member with Tuberculosis living in the UK asks for our help, we will authorise guaranteed treatment for Tuberculosis provided Benenden has the resources to meet the costs of treatment.
Provider
A person or organisation in the UK, such as a named hospital, approved by Benenden to provide a service to a member.
Reimbursement
The agreed amount we will pay back to you for authorised medical and related expenses on production of a valid invoice. You must provide original, valid invoices within three months.
Retrospective
We cannot provide funding after the event for any service which has not been authorised in writing by us in advance.
Services
This includes information, consultation, medical, surgical and financial services, provided by us within the current guidelines, on a discretionary or non-discretionary basis.
Treatment service
A selected range of surgical procedures, which can only be funded if undertaken at Benenden Hospital or one of our approved hospitals or clinics.
We
Benenden.
You
A member or nominee of Benenden.
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Notes
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Notes
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Useful phone numbers
0800 414 8100* Membership and medical service enquiries Lines are open 8am – 8pm, Monday to Friday (except Bank Holidays)
0800 414 8247* 24/7 GP Advice Line and Psychological Wellbeing Helpline
Lines open 8am – 8pm Monday to Friday (except Bank Holidays). 24/7 lines open 24 hours a day, seven days a week. Please note that your call may be recorded for our mutual security and also for training and quality purposes. Membership is available to anyone over the age of 16 who is normally resident in the UK. Members can add family and friends to their membership regardless of their age. Some services have a six-month qualifying period. Benenden is a trading name of The Benenden Healthcare Society Limited and its subsidiaries. Benenden Personal Healthcare is offered by The Benenden Healthcare Society Limited, which is an incorporated friendly society, registered under the Friendly Societies Act 1992, registered number 480F. The Society’s contractual business (the provision of tuberculosis benefit) is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. The remainder of the Society’s business is undertaken on a discretionary basis. The Society is subject to Prudential Regulation Authority requirements for prudential management. No advice has been given. If in doubt as to the suitability of this product, you should seek independent advice. Registered Office: The Benenden Healthcare Society Limited, Holgate Park Drive, York, YO26 4GG.
This booklet is available on request in large print or braille. LFT/GTSS/JW/07.16
5 MOST TRUSTED HEALTHCARE PROVIDER
FOR THE FIFTH YEAR 2011 - 2015