Family

Welcome to AXA Health

Welcome to your AXA Health Education Healthcare Scheme online resource centre. Whether you are an existing member or you are considering healthcare cover, this site provides access to important information, guidance and documentation.

You’ll also be able to discover the health and wellbeing services we offer and find out how to make a claim.

You can find the policy literature for the Education healthcare plans here.

For policy year starting 1 October 2024 to 31 March 2025:

For members covered between 1 April 2024 to 30 September 2024, please refer to the plans ICL below. This details the significant changes that have been made to the benefits available under the plan, with effect from 1 April 2024.

For policy year starting 1 April 2024 to 30 September 2024:

For members covered between 1 October 2023 - 31 March 2024, please refer to the plans Important Changes Leaflets below. This details the significant changes that have been made to the benefits available under the plan, with effect from 1 October 2023.

Welcome and thank you for considering the AXA Health Education Healthcare scheme cover for your employees.

Amidst the whirl of life, there are few better feelings than providing healthcare cover and support for your employees. The comfort from knowing that they’re supported by PMI in case they fall ill cannot be understated.

Here you’ll find valuable information to help you understand and decide whether the healthcare cover is right for you and your employees. This includes useful information about the cover, how to make a claim, your rights under the cover, how to make a complaint and your important policy literature.

What’s covered and who’s involved in it?

FAQs

The policy is underwritten by AXA PPP healthcare Limited, trading as AXA Health. Your policy is a group contract of insurance between you and AXA Health. AXA Health will be the insurer and provider of this group plan. The members or their dependants on your group plan should contact AXA Health directly when making a claim, on 0800 068 6256.

AXA Health has appointed its wholly owned subsidiary The Permanent Health Company Limited (PHC) to assist in the administration of these group plans. If you have any queries regarding your membership, please call PHC’s Member Services on 01923 770 000.

For more information, read the Roles and Responsibilities here.

We give all members full access to the complaint resolution process.

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

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 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 0800 364 524.

Or write to:

AXA Health, International House, Forest Road, Tunbridge Wells, Kent, TN2 5FE

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.

Gold Plan

Member documents

You can find the policy literature for the Gold Education healthcare plan here.

For policy year starting 1 October 2024 to 31 March 2025:

For members covered between 1 April 2024 - 30 September 2024, please refer to the plans Important Changes Leaflets below. This details the significant changes that have been made to the benefits available under the plan, with effect from 1 April 2024.

For policy year starting 1 April 2024 to 30 September 2024:

For members covered between 1 October 2023 - 31 March 2024, please refer to the plans Important Changes Leaflets below. This details the significant changes that have been made to the benefits available under the plan, with effect from 1 October 2023.

Platinum Plan

Member documents

You can find the policy literature for the Platinum Education healthcare plan here.

For policy year starting 1 October 2024 to 31 March 2025:

For members covered between 1 April 2024 - 30 September 2024, please refer to the plans Important Changes Leaflets below. This details the significant changes that have been made to the benefits available under the plan, with effect from 1 April 2024.

For policy year starting 1 April 2024 to 30 September 2024:

For members covered between 1 October 2023 - 31 March 2024, please refer to the plans Important Changes Leaflets below. This details the significant changes that have been made to the benefits available under the plan, with effect from 1 October 2023.

FAQs

Should you wish to take out healthcare cover or to know more about the cover available, please contact your scheme administrator who will be able to provide you with more detail.

The policy is underwritten by AXA PPP healthcare Limited, trading as AXA Health. Your policy is a group contract of insurance between your employer and AXA Health. AXA Health will be the insurer and provider of this group plan. As a member of this group plan you should contact AXA Health directly when making a claim, on 0800 068 6256.

AXA Health has appointed its wholly owned subsidiary The Permanent Health Company Limited (PHC) to assist in the administration of these group plans.

If you have any queries regarding your membership, please call PHC’s Member Services on 01923 770 000. 

For more information, please read our Roles and Responsibilities here.

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. For further information on how your excess is applied, please refer to your Membership Handbook.

To make a claim follow the steps below:

  1. Ask your GP for an open referral
    We will accept referrals from the AXA Doctor at Hand service or a GP at your GP practice. If your GP says you need specialist treatment, tell them you want to go private and ask for an ‘open referral’. With an open referral your GP doesn’t name a particular specialist, but instead gives you the type of specialist you need to see, for example a cardiologist. This means we can help you find a suitable specialist and make a convenient appointment for you. Occasionally the NHS will be best placed to provide care locally (for example specialist paediatric (children’s) care at an NHS centre of excellence). When this is the case, we will talk to you about your NHS options as well.
  2. Contact us on 0800 068 6256 before you see the specialist
    Contact us as soon as you’ve seen your GP. It’s important you contact us before you see the specialist or have any treatment so that we can tell you what you’re covered for. This will mean you don’t end up having an unexpected bill for treatment that you’re not covered for.
  3. We’ll check your cover and let you know what happens next
    We may ask you to provide more information, for example from your GP or specialist. You, your GP, or your specialist must provide us with the information we ask for by the date that we ask for it or you may not be covered for your claim.

Whether you can add family members, including babies, to your cover will depend on the agreement we have with your group/employer who has taken out this cover under a group insurance contract. Depending on the agreement with your group, there may be restrictions on when you can add family members. Please discuss this with your scheme administrator. 

You can normally add:

a. Your partner. You must be either married, in a civil partnership, or living together permanently in a similar relationship.

b. Any of your children or your partner’s children. Children cannot stay on the plan after the renewal date following their 25th birthday.

You may not need a GP referral for certain conditions*.

For musculoskeletal conditions, call AXA Health as soon as you develop a problem. We’ll check you’re covered and refer you to our muscles, bones and joints service who will arrange an initial clinical needs assessment with a physiotherapist. During the needs assessment the physiotherapist will listen to your concerns, take you through an initial assessment of the issues you're experiencing and then advise the most appropriate treatment for you.

In addition, you can get access to support and treatment for mental health conditions through our mental health assessments and support service, by speaking to a counsellor or psychologist who will assess your condition and recommend a treatment plan, without the need for a GP referral*.

You also have access to our skin, prostate and breast cancer pathways.

For all other conditions, you will need a referral from our AXA Doctor at Hand services or a GP at your GP practice.

Please note: members under the age of 18 will need to see their GP for a referral for all conditions as these services are not available to them.

*Subject to the terms, conditions and underwriting terms applied to your cover. For example, if you are covered on moratorium, we may require some further information from your registered GP in order to assess whether your claim is eligible.

To register and activate your access to the AXA Doctor at Hand service, you’ll need:

  1. Your membership number or activation code, found in your membership communications.
  2. Photo ID – you can use a passport, driver’s licence, identity card or residence permit card.
  3. Camera access – you’ll need to be able to take a selfie on the phone or computer you’re using.

Access using the link below to get started.

https://member.doctorcareanywhere.com/SignUp/axa/

We give all members full access to the complaint resolution process.

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

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 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 0800 364 524.

Or write to:

AXA Health, International House, Forest Road, Tunbridge Wells, Kent, TN2 5FE

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.

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).

Generic FAQs

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.

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 required.

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 PMI 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 benefits or underwriting.

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

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

A lead member can cover up to 8 dependants. Children may be covered up to the renewal following their 25th birthday.

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.

Yes, you can insure dependants as a single parent cover, even though your partner has cover in place already. The criteria is that all correspondence for all members on cover will go to the lead members address as long as they are UK residents with a UK GP. As the lead member, the premiums would be based on your age with family member upgrades calculated at the appropriate multiple on that premium.

Yes you can insure:

  • Dependants on single parent cover even though your children may live at a different address.

Or

  • Your partner and your children as family cover.

Please be aware, you can only have one partner on cover. The handbook states that you 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.

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).
  • You lose a child through death or the child is no longer eligible (e.g. overage).

Should you leave the company then your private medical insurance will cease on the day your current employer advises us to finish 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.

PMI terms explained

Private medical insurance has some confusing terminology within in. To help you understand what we mean for of these, have created short videos.

We call conditions you were aware of when you joined pre-existing conditions. A pre-existing condition is any disease, illness or injury that:

  • you have received medication, advice or treatment in the five years before the start of your cover, or
  • you have experienced symptoms of in the five years before the start of your cover: whether or not the condition was diagnosed.

This video is designed to help you understand more about what we mean by chronic conditions and provide practical examples of when we will or will not cover treatment of those conditions.

This video is designed to help you understand more about what we mean by moratorium underwriting and provide practical examples of what we will or will not cover, and when this will be covered.

Contact us options

In the event you need to make or discuss a claim, or would like to make a complaint, please contact us by:



Phone

For general queries about the policy, please contact PHC Member services on 01923 770 000

Claims helpline on 0800 068 6256

E-mail

Alternatively you can email directly to mmbeducation@thephc.co.uk 

Making a complaint

If you want to make a compaint, 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 name and membership number
  • a contact phone number
  • the details of your complaint
  • any relevant information that we may not have already seen.

Please call us on 0800 364 524. Or write to AXA Health, International House, Forest Road, Tunbridge Wells, Kent, TN2 5FE.