Discretionary healthcare for you and your loved ones
The Healthcare Scheme is a discretionary scheme set up for members of the Military family. All the members pay into the scheme to provide cover when it’s needed for each other.
It’s discretionary because each case is looked at on an individual basis to see what help is right for that member. To make sure decisions are fair, the scheme has rules that guide which treatments are covered and which are not. Unlike private medical insurance, there are no ‘hidden’ extras or payments for ‘extra’ cover. Just one simple price for each member.
24/7 Service
Around the clock GP telephone consultation service, available wherever you may be stationed
Expert Care
Receive expert care from top medical professionals with no waiting times
Family Cover
All children up to 18 years old included under a Family policy
-What's covered
- Up to £30,000 in-patient treatment per year
- No waiting times
- First-class medical facilities
- Access to Chartered Physiotherapists
- Access to Mental Health support
- Private rooms with en-suite facilities
- 24 hour 7 days a week GP telephone consultation service
- Expert care from top specialists
- No medical examination needed before joining
- Family cover available for all children up to 18 years old
-What isn't covered
- Pre-existing conditions up to five years prior to joining the scheme
- Cancer treatments
- Dental treatments
- Emergency treatments
- Cosmetic surgery
- For a full list of what is not covered please refer to the Health Scheme rules
-Monthly costs
| Age | Individual Only | Individual & Partner | Family | Single Parent |
|---|---|---|---|---|
| 18-24 | £22 | £42 | £52 | £32 |
| 25-29 | £25 | £48 | £58 | £35 |
| 30-34 | £32 | £60 | £80 | £50 |
| 35-39 | £37 | £70 | £90 | £57 |
| 40-44 | £50 | £95 | £115 | £70 |
| 45-49 | £60 | £115 | £140 | £85 |
| 50-54 | £68 | £130 | £155 | £93 |
| 55-59 | £78 | £150 | £175 | £100 |
| 60-64 | £90 | £175 | £200 | £115 |
| 65-69 | £105 | £205 | £230 | £130 |
| 70-74 | £115 | £225 | N/A | N/A |
| 75+ | £125 | £245 | N/A | N/A |
+How do I claim?
> You will need an open referral from your GP to attend a consultation. If you are in your first 2 years of membership you will also need a GP report to confirm your claim isn’t for a pre-existing condition*.
> It is important you contact the Forces Mutual Claims Service, which is run by Healix Health, to request authorisation to attend a consultation by calling 0208 049 8387. Members requiring treatment in Northern Ireland please refer to your welcome letter for claims contact details.
> Once agreed, the Forces Mutual Claims Service will transfer you through to a booking line or arrange the appointment directly at one of the approved hospitals to arrange the appointment.
> Where treatment is required, you should contact the Forces Mutual Claims Service to request authorisation for the recommended treatments or tests on 0208 049 8387 or email forcesmutual@healix.com.
> Once a claim is authorised, you will be informed about paying a member contribution directly to the provider. The authorisation letter will be emailed or posted to you. Treatment can then be received at an approved Clinic or Hospital that the Forces Mutual Claims service propose.
> If no treatment is required at or following the appointment with the Specialist, or the procedure or operation suggested is not within the definition of treatment then no further action is necessary and no further Benefits will be payable.
> If you have a query relating to your membership details then please call 0151 363 5290.
*A pre-existing condition is any medical condition that you were aware of, or ought reasonably to be aware of prior to joining the scheme, even if medical advice has not yet been sought. For the pre-existing condition to be eligible for cover you will need to have had a period of five years without medical attention for it.
If you would like to make a complaint regarding your healthcare membership please call 0151 363 5290. If you have a complaint regarding the Forces Mutual Healthcare Claims Service please email forcesmutual@healix.com or call 0208 049 8387.