HMCA MEDICAL CARE PLANPrivate medical cover for you and your family

2

Why you need private medical coverThe NHS is good at what it does, however, no state funded scheme can offer the benefits of Private Medical Cover. All of us want the peace of mind offered by one or all of the following:

• Bypass lengthy NHS waiting lists and quickly receive medical attention

• Your own hospital room with en-suite facilities and your own TV

• You choose the specialist at a location that is convenient for you

• You see the Consultant, not their registrar or trainee

• Private medical care can speed up the recovery process

• Your family and loved ones can visit any time

• Private Hospitals strive to ensure that the risk of infection for their patients is kept as low as possible and focus on hygiene and infection control as a top priority

WHY ARE HMCA SO COMPETITIVE? With 40 years of intimate experience of the insurance and underwriting profession HMCA are able to produce value for money products within the health care market.

• HMCA have minimal advertising costs. Dealing with membership groups and associations they do not use the normal media outlets for advertising, for example national newspapers and television.

• HMCA deal directly with group and association members through existing channels of communication.

• HMCA have a low overall cost base which is reflected in the subscriptions they charge.

WHY CHOOSE THE HMCAMEDICAL CARE PLAN?WHO ARE HMCA? • All the benefits of private medical

treatment for you and your family.

• VIP treatment with the specialist of your choice, at the time of your choice, at the hospital of your choice.

• Any hospital on our list may be used and others with prior agreement.

• Excellent benefits with substantial savings over other major plans.

These are just some of the reasons why you should consider the HMCA Medical Care Plan as your first choice for your private health cover. When you are ill you do not want

any uncertainty or inconvenience, your worries can be substantial enough without added pressures.

Whilst the National Health Service has a very good system for dealing with emergencies and chronic situations, the waiting list nationwide for less urgent operations continues to grow.

Having to wait months, or even years, suffering discomfort and pain could have disastrous effects on your work and family life. By joining the HMCA Medical Care Plan, these problems will be overcome.

WE ARE HERE TO HELPIf you wish to discuss your health care requirements or the HMCA Medical Care Plan, please telephone our helpline on (01423) 799949 or fax on (01423) 866586 or write to:HMCA, Beech Hall, Knaresborough, Yorkshire, HG5 0EA. Email: hmca@hmca.co.uk • Website: www.hmca.co.uk

312/60897 ©2017

With members in the United Kingdom and Republic of Ireland plus those countries in the European Economic Area (EEA) our dedicated team of experienced employees service plans for tens of thousands of discerning individuals who have taken out membership over the years. They provide a high level of response to policy claims, evidenced by regular feedback from our customers and the associations using HMCA.

HMCA is authorised and regulated by the Financial Conduct Authority. They have plans underwritten by Lloyd’s of London, Axiom Underwriting Agency Limited, The Care Insurance Company Limited, Autohome Limited and Das Legal Expenses Insurance Company Limited to name a few who are governed by English Law and covered by the Financial Services Compensation Scheme.

� � � �

� �

� �

� �

� �

� � � � � � � �

� �

� �

� �

� � � � � �

YEARS

PROVIDING SERVICES TO MEMBERSHIP GROUPS

IN-HOSPITAL TREATMENT FOR OVERNIGHT OR LONGER STAYS• Accommodation Charges FULL REFUND • Ward Nursing Charges FULL REFUND• Ward Drugs FULL REFUND

• A £200 a night tax-free cash benefit is available, for up to 30 nights, when all treatment is carried out as a National Health patient in a public ward of an NHS Hospital.

• Surgical Charges for surgeons’ and anaesthetists’ combined fees, including aftercare, are refunded as described in the Description of Benefits and Levels of Cover.

• Theatre fees, consumables, drugs and surgical dressings are refunded as described in the Description of Benefits and Levels of Cover.

• Benefit is also payable for in-hospital treatment such as: • Medical charges for consultant physician fees, pathology and

investigations whilst in hospital. • Intensive care. • Dental care for specialist in-hospital or day-case treatment.

OUT-PATIENT AND ADDITIONAL BENEFITS• Specialists services for consultations, investigations, day-case surgery,

pathology, physiotherapy, x-rays and scans.

• Alternative treatments of chiropractic, osteopathy, homeopathy and acupuncture.

• Radiotherapy and chemotherapy.

• A £800 maternity grant when both parents are members.

• Parent accompanying child.

• Home-nursing following private treatments.

• Private ambulance.

• Personal accidental death benefit of £5,000.

• Personal accident disability cover of £1,000.

OVERSEAS COVER• Continuation of cover when travelling abroad on holiday or business.

SuMMARy Of bENEfItSThe maximum benefit payable for each person named on the Membership Certificate for acute surgical or acute medical conditions, in each subscription year, is £250,000. For full details, please refer to the Description of Benefits and Levels of Cover on page 14 and 15 and the definitions, exclusions and conditions on page 18 and 19.

4

DEMANDS AND NEEDSthis Plan meets the demands and needs of individuals who wish to have benefits towards the cost of their private medical treatment, now and in the future.

SPECIAL GUARANTEED TRANSFER FACILITYCover can be transferred from an existing medical plan and future claims made for acute conditions originating at the time the member was participating in a previous plan will be honoured. No health questions are asked or medical examination required and there will be no break in protection when you transfer to the Medical Care Plan.

LONG-TERM ILLNESSAll private health plans cover short-term medical conditions which are curable. Long-term conditions which are not covered are those which are recurrent, persistent or incurable. When a condition is first diagnosed as being long-term (and did not exist prior to enrolment) benefit will be provided for such diagnosis and any necessary treatment, under the terms of the contract, for one initial episode.

As private health cover was never intended to replace the NHS, but meant to complement the service, all subsequent treatment will be given by the NHS. HMCA does provide, however, a £1,000 LONG-TERM ILLNESS GRANT that can be used at the discretion of HMCA to help in the transition to NHS care.

MONEY-BACK GUARANTEEIf not satisfied you may return the HMCA Medical Care Plan within fourteen days for a full refund. You will be subject to the Rules of Membership which are incorporated in the Membership Certificate which will be sent to you immediately upon your election. The subscription payable is based upon the age of the oldest person included in the enrolment.

FREE MEDICAL INFORMATION AND COUNSELLING HELPLINE

This service is provided free of charge to HMCA Medical Care Plan members. It is operated by qualified medical staff and provides a wealth of support and information irrespective of whether the member is making a claim for medical treatment.

This also includes a counselling service which is available 24 hours a day, 365 days a year, allowing our members to discuss their problems confidentially with a qualified counsellor at a time convenient to them.

REFER TO KEY FACTS ON PAGE 16-17

5

thanks, too, for looking after my invoices during my Heart operation period last Summer and for settling the Accounts without any fuss or bother. Luckily, I’ve been no trouble to you or myself since then so, fingers crossed, there will be no more serious problems in the foreseeable future.

Equity Reader

Q. Does the Medical Care Plan have an excess or deductible, such as the first £500 of a claim being paid by the member?

A. No. We believe that our members should have cover from the commencement of any treatment covered under the Medical Care Plan.

Q. Is the offer to join the Medical Care Plan dependent upon my remaining a member of my sponsoring association?

A. You must be a member of your sponsoring association when joining the Medical Care Plan. After enrolment you become a member of the Medical Care Plan.

Q. May I transfer from my plan to your Medical Care Plan?

A. Yes. If you are in a medical plan you can transfer to the Medical Care Plan with no break in protection.

Q. I have no existing private medical cover, can I join?

A. Yes, you can join and after one full year’s membership providing you have been treatment and symptom free for 12 consecutive months, HMCA will cover any pre-existing medical condition that occurred prior to joining us.

Q. Can you explain the benefit levels in the Description of Benefits and Levels of Cover?

A. Charges for in-patient accommodation, ward drugs and nursing charges are covered in full. Other benefits are based on the type of treatment received and the complexity of any operations carried out. The complexity of all operations is advised by the specialist carrying out your treatment. Our benefits are based on our experience of the likely costs involved and we apply limits to protect against overcharging which would have the effect of increasing claims costs and our members’ subscriptions.

Q. Are your terms similar to those in my present plan?

A. The benefits are summarised on pages 4 and 5 entitled ‘Summary of benefits’, and the Description of Benefits and Levels of Cover are on pages 14 and 15 and these may differ from your current plan.

Q. Is the scope of the HMCA Medical Care Plan wider than many others?

A. As well as providing comprehensive benefits for treatment of acute medical conditions the Plan has a number of very important extra features which extend the scope:

• We include treatment for injuries sustained whilst playing sport.

• Cover continues whilst you are abroad on holiday or business for up to six months, at no extra cost.

• A free helpline is provided to give information on treatment, costs or any other general medical-related questions. This includes a confidential counselling service.

QuEStIONS AND ANSWERSHere is a list of the questions most frequently asked by members of trade and professional groups on the subject of private medical cover provided by our Medical Care Plan. If you have any additional questions please telephone our Helpline as shown on back cover.

6

Q. Who do I speak to when I want to make a claim?

A. Our UK based claims team who offer a personal service and provide prompt settlement.

Q. What happens if I am admitted to an NHS hospital?

A. If you choose to have all your treatment solely through the NHS you will receive £200 a night spent in hospital, for up to 30 nights. Of course, this is tax-free cash which you keep to spend as you wish.

Q. May I choose the hospital which treats me?

A. Yes. There are no restrictions, you can use any of the hospitals detailed on our comprehensive list. If your preferred hospital is not listed please contact our Helpline.

Q. Do you pay my specialist or hospital directly if I claim?

A. Yes. We are happy to pay your specialist or hospital on your behalf or we can reimburse you.

Q. Can you pay the hospital direct?A. Yes. We have arrangements with leading

hospital groups and they will bill us direct for any admissions to hospital. Please contact our Helpline for more information.

Q. Is day-case surgery covered?A. Yes. The plan provides payment towards day-

case surgery.

Q. Am I covered for alternative medical treatment?

A. Yes. Under our Specialist Services section you are covered for chiropractic, osteopathy, homeopathy and acupuncture given by qualified practitioners.

Q. Do you have restrictive clauses relating to the NHS waiting lists?

A. No. We do not have restrictive clauses relating to the NHS waiting lists.

Q. Am I covered when travelling overseas?A. Yes. Cover continues when you travel abroad

on holiday or business at no extra cost.

Q. Am I covered for sporting injuries?A. Yes. There is no restriction on any sport.

Q. What is the maximum age at which I may join the HMCA Medical Care Plan or transfer from another plan?

A. There is no age limit when joining HMCA.

Q. What is Insurance Premium Tax (IPT)?A. IPT is a tax on general insurance, for example

motor, household and medical cover, levied by the government.

7

I would like to take this opportunity to thank the HMCA staff who were so understanding and efficient in dealing with my telephone call at a time which was extremely distressing as the specialist was at the time convinced that it was a recurrence. I felt I received a very personal service and if this comment can be used in any way to encourage more people to join HMCA I would be quite happy for it to be used.

National Trust Reader, Kent

Royal Overseas League member

tHE HMCA MEDICALCARE PLAN CHECKLISt

8

You should compare the HMCA plan with other plans by using this checklist.

NO MORATORIUM OR WAITING PERIOD FOR TRANSFERS

SPECIALISTFreedom of Choice.

PROMPT CLAIMS SERVICEOur UK based claims team offer a personal service and provide prompt settlement.

NO MEDICAL EXAMINATIONNo medical examination is required when you join.

CHOICE OF COUNTRYWIDE HOSPITALSYou have the choice of over 550 hospitals on our list and others with prior arrangement.

SPORTS ACTIVITIESThere are no exclusions.

OVERSEAS COVERCover continues when you travel abroad on holiday or business and is included at no extra cost, whereas most other plans may reduce benefits or ask for increased subscriptions, or indeed offer no cover at all.

NO REDUCTION IN BENEFITSHMCA has consistently improved the benefits of its Medical Plans.

PROSTHESESHMCA includes these.

DENTAL TREATMENTIn-hospital or day-case surgical treatment is included.

PREGNANCY AND CHILDBIRTHComplications and miscarriages are covered.

HOME-NURSINGHMCA allows up to £3,600 each year.

LONG-TERM ILLNESS GRANTAfter enrolment, a member receiving treatment that ceases to be short-term qualifies for a grant of up to £1,000. This benefit can be given at the discretion of HMCA.

9

SPECIAL GUARANTEED TRANSFER FACILITYCover can be transferred from an existing plan and future claims made for acute conditions originating at the time you were participating in a previous plan will be honoured. No health questions are asked or medical examination is required and there is no break in protection when you transfer to the Medical Care Plan.

NHS HOSPITAL CASH BENEFITA £200 a night tax-free cash benefit is available, for up to 30 nights, if treatment is wholly in an NHS Hospital.

FREE MEDICAL INFORMATION AND COUNSELLING HELPLINEThis service is provided free of charge to all HMCA Medical Care Plan members. It is operated by qualified medical staff and offers a wealth of information and help regardless of whether the member is making a claim. Information can be given on medical conditions, changing your doctor, social services, self-help groups and much more. This also includes a counselling service which is available 24 hours a day, 365 days a year, allowing our members to discuss their problems confidentially with a qualified counsellor at a time convenient to them.

I am writing to thank you and the Association staff for the fine service I have received since I joined your scheme several years ago. In particular I would thank Mr Andrew baker for his support during the past three years which have been difficult for me, involving treatment for my late wife and operations to my shoulder and just five weeks ago an operation to replace my left knee. your prompt payments have also helped reduce the stress.

Institute of Cast Metals Engineers

ENGLAND BEDFORDSHIRE Bedford Bedford General HospitalBedford BMI Manor HospitalLuton Luton & Dunstable Hospital NHS Trust BERKSHIRE Ascot Heatherwood HospitalReading Circle Reading HospitalReading Spire Dunedin HospitalReading Royal Berkshire HospitalReading Berkshire Independent HospitalSlough Wexham Park HospitalSlough Spire Thames Valley HospitalThatcham West Berkshire Community HospitalWindsor King Edward VII HospitalWindsor BMI Princess Margaret HospitalWindsor Circle Windsor Clinic BRISTOL Bristol Spire Bristol ‘Glen’ HospitalBristol Nuffield Hospital BristolBristol Bristol Eye HospitalBristol Frenchay HospitalBristol Bristol Royal InfirmaryBristol St Michaels HospitalBristol Southmead Hospital BUCKINGHAMSHIRE Amersham Amersham HospitalAylesbury Stoke Mandeville HospitalGerrards Cross Chalfont & Gerrards Cross HospitalGreat Missenden BMI The Chiltern HospitalHigh Wycombe BMI Shelburne HospitalHigh Wycombe Wycombe HospitalMilton Keynes BMI Saxon ClinicMilton Keynes Milton Keynes General HospitalPrinces Risborough The Paddocks Clinic

CAMBRIDGESHIRE Cambridge Addenbrookes HospitalCambridge Spire Cambridge Lea HospitalCambridge Nuffield Hospital CambridgeCambridge Papworth HospitalHuntingdon Hinchingbrooke HospitalPeterborough Peterborough City HospitalPeterborough Fitzwilliam HospitalWisbech North Cambridgeshire Hospital CHESHIRE Altrincham Altrincham General HospitalCheadle BMI Alexandra HospitalChester Countess of Chester HospitalChester Nuffield Hospital GrosvenorCrewe Leighton HospitalCrewe BMI South Cheshire HospitalMacclesfield Macclesfield District General HospitalMacclesfield Spire Regency HospitalRuncorn Halton General HospitalWarrington Warrington HospitalWarrington Spire Cheshire Hospital CLEVELAND Hartlepool University Hospital of HartlepoolMiddlesbrough James Cook University HospitalStockton-on-Tees Nuffield Hospital TeesStockton-on-Tees University Hospital of North Tees CORNWALL Falmouth Falmouth HospitalHayle St Michaels HospitalPenzance West Cornwall HospitalRedruth Camborne Redruth Community HospitalTruro Duchy HospitalTruro Royal Cornwall Hospital

CUMBRIA Barrow-in-Furness Furness HospitalCarlisle Cumberland InfirmaryKendal Westmorland General HospitalWhitehaven West Cumberland HospitalWorkington Workington Community Hospital DERBYSHIRE Buxton Buxton HospitalChesterfield Chatsworth ClinicDerby Nuffield Hospital DerbyDerby Royal Derby Hospital DEVON Barnstaple North Devon District HospitalBideford Bideford & District HospitalExeter Nuffield Hospital ExeterExeter Royal Devon & Exeter HospitalExmouth Exmouth HospitalIlfracombe Ilfracombe & District Tyrrell HospitalNewton Abbott Newton Abbott HospitalPlymouth Derriford HospitalPlymouth Mount Gould HospitalPlymouth Nuffield Hospital PlymouthPlymouth Royal Eye InfirmarySidmouth Victoria HospitalTavistock Tavistock HospitalTeignmouth Teignmouth HospitalTiverton Tiverton & District HospitalTorquay Mount Stuart HospitalTorquay Torbay Hospital DORSET Bournemouth Christchurch HospitalBournemouth Nuffield Hospital BournemouthBournemouth Royal Bournemouth HospitalDorchester BMI Winterbourne HospitalDorchester Dorset County Hospital

Poole BMI Harbour HospitalSherborne Yeatman HospitalWeymouth Weymouth Community Hospital DURHAM Bishop Auckland Bishop Auckland HospitalChester-le-Street Chester-le-Street HospitalDarlington Darlington Memorial HospitalDarlington BMI WoodlandsDurham University Hospital of North DurhamShotley Bridge Shotley Bridge Hospital ESSEX Basildon Basildon University HospitalBrentwood Nuffield Hospital BrentwoodBrentwood Spire Hartswood HospitalBuckhurst Hill Holly House HospitalChelmsford Broomfield HospitalChelmsford Springfield HospitalClacton-on-Sea Clacton & District HospitalColchester Oaks HospitalColchester Essex County HospitalColchester Colchester General HospitalEpping St Margarets HospitalGrays Orsett HospitalHarlow Princess Alexandra HospitalHavering Queens HospitalIlford King George HospitalMaldon St Peters HospitalRedbridge Spire Roding HospitalSouthend-on-Sea Southend HospitalSouthend-on-Sea Spire Wellesley HospitalSouthend BMI Southend Private Hospital GLOUCESTERSHIRE Cheltenham Cheltenham General HospitalCheltenham Nuffield Hospital CheltenhamGloucester Gloucester Royal HospitalGloucester Winfield HospitalStroud Stroud General Hospital

HOSPItAL ACCOMMODAtION LISt

10

You can use any hospital on this list, over 550 are available.

I would like to thank you for the smooth and efficient way HMCA have dealt with the claim to date and justifies our confidence in switching from Aviva to HMCA to date. Clearly we hope not to require making more claims for a long time.

WI Life reader

HAMPSHIRE Basingstoke North Hampshire HospitalBasingstoke BMI Hampshire ClinicEastleigh Nuffield Health Wessex Hospital Havant Spire Portsmouth HospitalLymington New Forest HospitalPortsmouth Queen Alexandra HospitalPortsmouth St Marys HospitalSouthampton Spire Southampton HospitalSouthampton Southampton General HospitalSouthampton Princess Anne HospitalSouthampton Royal South Hants HospitalWinchester Royal Hampshire County HospitalWinchester BMI Sarum Road Hospital

HEREFORDSHIREHereford Hereford County HospitalHereford Nuffield Hospital Hereford

HERTFORDSHIRE Bishops Stortford Herts & Essex General HospitalHarpenden Spire Harpenden HospitalHemel Hempstead Hemel Hempstead HospitalHertford Hertford County HospitalHitchin Pinehill HospitalSawbridgeworth Rivers HospitalSt Albans St Albans City HospitalStevenage Lister HospitalWatford Spire Bushey HospitalWatford Watford General HospitalWelwyn Garden City Queen Elizabeth II Hospital ISLE OF WIGHT Newport St Marys Hospital KENT Ashford William Harvey HospitalBeckenham BMI Sloane HospitalBeneden Beneden Hospital Canterbury BMI Chaucer Hospital

Canterbury Kent & Canterbury HospitalChatham Spire Alexandra HospitalDartford Darent Valley HospitalDeal Victoria HospitalDover Buckland HospitalFolkestone Royal Victoria HospitalGillingham Medway Maritime HospitalHerne Bay Queen Victoria Memorial HospitalLongfield BMI Fawkham Manor HospitalMaidstone Maidstone HospitalMaidstone BMI Somerfield HospitalMaidstone Maidstone KIMSMargate Queen Elizabeth the Queen Mother HospitalOrpington BMI Chelsfield Park HospitalSevenoaks Sevenoaks HospitalSidcup Queen Marys HospitalTunbridge Wells Tunbridge Wells HospitalTunbridge Wells Nuffield Hospital Tunbridge WellsTunbridge Wells Spire Hospital, Tunbridge WellsWillesborough One Ashford Hospital LANCASHIRE Blackburn BMI Beardwood HospitalBlackburn Royal Blackburn HospitalBlackpool Spire Fylde Coast HospitalBlackpool Victoria HospitalBolton BMI Beaumont HospitalBolton Royal Bolton HospitalBurnley Burnley General HospitalChorley Euxton Hall HospitalClitheroe Abbey Gisburne Park HospitalLancaster BMI Lancaster HospitalOrmskirk Ormskirk & District General HospitalOrmskirk Renacres HospitalPreston Fulwood Hall HospitalPreston Royal Preston Hospital

LEICESTERSHIRE Hinckley Hinckley & District HospitalLeicester Glenfield HospitalLeicester Leicester General HospitalLeicester Nuffield Hospital LeicesterLeicester Leicester Royal InfirmaryOadby Spire Leicester Hospital LINCOLNSHIRE Boston Pilgrim HospitalGrantham Grantham & District HospitalGrimsby St Hughs Hospital Grimsby Diana, Princess of Wales HospitalLincoln BMI Lincoln HospitalLincoln Lincoln County HospitalLouth County HospitalStamford Stamford & Rutland Hospital GREATER LONDON Ashford Ashford HospitalBarnet Barnet HospitalCarshalton St Helier HospitalEnfield Chase Farm HospitalEnfield BMI Kings Oaks HospitalHarefield Harefield HospitalHarrow Northwick Park HospitalHarrow BMI Clementine Churchill HospitalHarrow St Marks HospitalIsleworth West Middlesex University HospitalKingston upon Thames Kingston HospitalKingston upon Thames New Victoria HospitalNorthwood BMI Bishops Wood HospitalNorthwood Mount Vernon HospitalSouthall Ealing HospitalStanmore Royal National Orthopaedic HospitalUxbridge Hillingdon HospitalMiddlesex BMI The Cavell Clinic

LONDON (Postal Area) E2 London Chest HospitalSE3 BMI Blackheath HospitalSW3 Royal Brompton HospitalSW10 Chelsea & Westminster HospitalW6 Charing Cross HospitalNW4 Hendon HospitalWC1N Royal London Hospital for Integrated MedicineWC1 Great Ormond Street HospitalSE1 Guys HospitalW12 Hammersmith HospitalW12 Queen Charlottes & Chelsea HospitalN6 Highgate HospitalWC1E Hospital for Tropical DiseasesNW8 Hospital of St John & St ElizabethNW8 British Hernia CentreW1G King Edward VII HospitalW1G Weymouth Street HospitalSE5 Kings College HospitalSE13 University Hospital Lewisham E1 Royal London Hospital WhitechapelE1 BMI London Independent HospitalEC1 Moorfields Eye HospitalWC1 National Hospital for Neurology & NeurosurgeryN18 North Middlesex University HospitalSW19 Parkside Hospital WimbledonW1 The Portland Hospital for Women & Children SW15 Queen Marys Hospital RoehamptonNW3 Royal Free HospitalSW3 Royal Marsden HospitalW1 Royal National Ear, Nose & Throat HospitalEC1 St Bartholemews Hospital

11CONTINUED

Photo courtesy of BMI The Duchy hospital

SW17 St Georges HospitalW2 St Marys HospitalSE1 St Thomas’ HospitalNW1 University College HospitalNW1 Western Eye HospitalE11 Whipps Cross HospitalN19 Whittington HospitalSW5 Bupa Cromwell Hospital GREATER MANCHESTER Ashton-under-Lyne Tameside General HospitalBury Fairfield General HospitalLeigh Leigh InfirmaryManchester Spire Manchester HospitalManchester Christie HospitalManchester North Manchester General HospitalManchester Royal Manchester Childrens HospitalManchester Royal Eye HospitalManchester Royal InfirmaryManchester St Marys HospitalOldham Royal Oldham HospitalRochdale Birch Hill HospitalRochdale BMI Highfield HospitalRochdale Rochdale InfirmarySalford Oaklands HospitalSalford Salford Royal HospitalStockport Stepping Hill HospitalWigan Royal Albert Edward InfirmaryWigan Wrightington HospitalWythenshawe Wythenshawe Hospital MERSEYSIDE Liverpool Broadgreen HospitalLiverpool Spire Liverpool HospitalLiverpool Royal Liverpool University HospitalLiverpool Liverpool Womens HospitalLiverpool University Hospital AintreeLiverpool Liverpool Heart & Chest HospitalOrmskirk Ormskirk & District General HospitalPrescot Whiston HospitalSt Helens Fairfield General HospitalSt Helens St Helens HospitalSouthport Southport & Formby District General HospitalWirral Clatterbridge HospitalWirral Spire Murrayfield HospitalWirral Arrowe Park Hospital NORFOLK Cromer Cromer HospitalGreat Yarmouth James Paget University Hospital

Kings Lynn BMI Sandringham HospitalNorwich Spire Norwich HospitalNorwich Norfolk & Norwich Uni Hosp NORTHAMPTONSHIRE Kettering Kettering General HospitalKettering Woodland HospitalNorthampton Northampton General HospitalNorthampton BMI Three Shires Hospital NORTHUMBERLAND Alnwick Alnwick InfirmaryHexham Hexham General Hospital NOTTINGHAMSHIRE Nottingham Nottingham City HospitalNottingham BMI The Park HospitalNottingham Queens Medical CentreNottingham Circle Nottingham ClinicNottingham Nottingham Woodthorpe HospitalSutton in Ashfield Kings Mill HospitalWorksop Bassetlaw District General Hospital OXFORDSHIRE Banbury Foscote HospitalBanbury Horton General HospitalOxford Churchill HospitalOxford Nuffield Orthopaedic CentreOxford Nuffield Hospital Oxford (The Manor)Oxford Oxford Eye HospitalOxford John Radcliffe Hospital SHROPSHIRE Oswestry Robert Jones & Agnes Hunt Orthopaedic HospitalShrewsbury Nuffield Hospital ShrewsburyShrewsbury Royal Shrewsbury HospitalTelford Princess Royal Hospital

SOMERSET Bath BMI Bath ClinicBath Circle Bath HospitalBath Royal National Hospital for Rheumatic DiseasesBath Royal United HospitalBridgwater Bridgwater Community HospitalMinehead Minehead & West Somerset HospitalTaunton Musgrove Park HospitalTaunton Nuffield Hospital TauntonWeston Super Mare Weston General HospitalYeovil Yeovil District Hospital

STAFFORDSHIRE Burton-on-Trent Queens HospitalNewcastle-under-Lyme Nuffield Hospital North StaffordshireStafford Staffordshire General HospitalStafford Rowley Hall HospitalStoke-on-Trent Royal Stoke University Hospital SUFFOLK Bury-St-Edmunds BMI St Edmunds HospitalBury-St-Edmunds West Suffolk HospitalIpswich Ipswich HospitalIpswich Nuffield Hospital Ipswich SURREY Ashtead Ashtead HospitalCamberley Frimley Park HospitalCaterham North Downs HospitalCheam Spire St Anthony’sChertsey BMI Runnymede HospitalChertsey St Peters HospitalCroydon BMI Shirley Oaks HospitalEpsom Epsom General HospitaLFarnham Spire Clare Park HospitalGuildford Nuffield Hospital GuildfordGuildford BMI Mount Alvernia HospitalGuildford Royal Surrey County HospitalHorley Spire Gatwick Park HospitalKingston-upon-Thames BMI Coombe WingLeatherhead Leatherhead HospitalRedhill East Surrey HospitalSutton Royal Marsden HospitalWeybridge Weybridge HospitalWoking Nuffield Hospital Woking SUSSEX - EAST Brighton Royal Alexandra Childrens HospitalBrighton Royal Sussex County HospitalBrighton Sussex Eye HospitalBrighton Nuffield Hospital BrightonCrowborough Horder Centre Eastbourne Eastbourne District General HospitalEastbourne BMI Esperance HospitalHove Spire Montifiore HospitalLewes Victoria HospitalSt Leonards-on-Sea Conquest HospitalSt Leonards-on-Sea Spire Sussex HospitalUckfield Uckfield Community Hospital SUSSEX - WEST Chichester Nuffield Hospital ChichesterChichester St Richards Hospital

Crawley Crawley HospitalEast Grinstead Queen Victoria HospitalHaywards Heath Nuffield Hospital Haywards HeathHaywards Heath Princess Royal HospitalHorsham Horsham HospitalWorthing Worthing HospitalWorthing BMI Goring Hall Hospital TYNE & WEAR Gateshead Queen Elizabeth HospitalNewcastle Freeman HospitalNewcastle Newcastle General HospitalNewcastle Nuffield Hospital Newcastle-upon-TyneNewcastle Royal Victoria InfirmaryNewcastle Walkergate HospitalNorth Shields North Tyneside General HospitalSouth Shields South Tyneside District HospitalSunderland Eye InfirmarySunderland Sunderland Royal HospitalWashington Spire Washington Hospital WARWICKSHIRE Leamington Spa Nuffield Warwickshire HospitalNuneaton George Eliot HospitalRugby Hospital of St CrossStratford Circle Stratford ClinicWarwick Warwick Hospital WEST MIDLANDS Birmingham City HospitalBirmingham Childrens HospitalBirmingham Heartlands HospitalBirmingham BMI The Edgbaston HospitalBirmingham BMI Priory HospitalBirmingham Queen Elizabeth HospitalBirmingham Royal Orthopaedic HospitalBirmingham Womens HospitalCoventry University Hospital CoventryDudley Corbett HospitalDudley Russells Hall HospitalHalesowen West Midlands HospitalSolihull Birmingham Midland Eye CentreSolihull Spire Parkway HospitalSolihull Solihull HospitalSutton Coldfield Good Hope HospitalSutton Coldfield Spire Little Aston HospitalWalsall Manor HospitalWest Bromwich Sandwell General HospitalWolverhampton New Cross HospitalWolverhampton Nuffield Hospital Wolverhampton

12

WILTSHIRE Marlborough Savernake HospitalSalisbury New Hall HospitalSalisbury Salisbury District HospitalSwindon Great Western HospitalSwindon BMI Ridgeway Hospital WORCESTERSHIRE Droitwich BMI Droitwich Spa HospitalKidderminster Kidderminster HospitalRedditch Alexandra HospitalWorcester Worcester Royal HospitalWorcester Spire South Bank Hospital YORKSHIRE - NORTH Bridlington Bridlington & District HospitalHarrogate BMI The Duchy HospitalHarrogate Harrogate District HospitalMalton Malton Norton & District HospitalNorthallerton Friarage HospitalScarborough Scarborough General HospitalYork York District HospitalYork Nuffield Hospital York YORKSHIRE - SOUTH Barnsley Barnsley HospitalDoncaster Park Hill HospitalDoncaster Royal InfirmaryRotherham Rotherham HospitalSheffield BMI Thornbury HospitalSheffield Sheffield Childrens HospitalSheffield Claremont HospitalSheffield Northern General HospitalSheffield Royal Hallamshire HospitalSheffield Weston Park Hospital YORKSHIRE - WEST Bingley Yorkshire ClinicBradford Royal InfirmaryDewsbury Dewsbury & District HospitalElland Spire Elland HospitalHuddersfield BMI Huddersfield HospitalHuddersfield Royal InfirmaryKeighley Airedale General HospitalLeeds Leeds General InfirmaryLeeds Spire Leeds HospitalLeeds Spire Methley ParkLeeds Nuffield Hospital LeedsLeeds St James University HospitalPontefract Pontefract General InfirmarySalterhebble Calderdale Royal HospitalWakefield Pinderfields General Hospital

HULL & EAST YORKSHIRE Cottingham Castle Hill Hospital

Goole Goole & District HospitalHull Spire Hull & East Riding HospitalHull Royal InfirmaryScunthorpe Scunthorpe General Hospital WALES CLWYD Abergele Abergele HospitalRhyl Glan Clwyd HospitalWrexham Maelor HospitalWrexham Spire Yale Hospital DYFED Aberystwyth Bronglais General HospitalCamarthen BMI Werndale HospitalCamarthen West Wales General HospitalHaverfordwest Withybush General Hospital GLAMORGAN - MID Bridgend Diana, Princess of Wales HospitalLlantrisant Royal Glamorgan HospitalMerthyr Tydfil Prince Charles Hospital GLAMORGAN - SOUTH Cardiff Cardiff Bay HospitalCardiff Spire Cardiff HospitalCardiff The Vale Hospital, HensolCardiff University Hospital of Wales GLAMORGAN - WEST Neath Neath Port Talbot HospitalSwansea Morriston HospitalSwansea Sancta Maria HospitalSwansea Singleton Hospital GWENT Abergavenny Nevill Hall HospitalNewport St Josephs Hospital GWYNEDD Bangor Gwynedd HospitalLlandudno Llandudno General Hospital SCOTLAND CENTRALFalkirk Falkirk Royal InfirmaryStirling BMI Kings Park HospitalStirling Stirling Royal Infirmary GRAMPIAN Aberdeen BMI Albyn HospitalAberdeen Royal Aberdeen Children’s HospitalAberdeen Aberdeen Royal InfirmaryAberdeen Woodend Hospital

HIGHLAND Fort William Belford HospitalInverness Raigmore HospitalWick Caithness General Hospital LOTHIAN Edinburgh Royal Hospital for Sick ChildrenEdinburgh Royal Infirmary of EdinburghEdinburgh Western General HospitalLivingston St Johns HospitalLivingston Spire Livingston Physio Clinic

STRATHCLYDE Alexandria Vale of Leven HospitalAyr BMI Carrick Glen HospitalAyr Ayr HospitalGlasgow Nuffield Hospital GlasgowGlasgow BMI Ross Hall HospitalGlasgow Southern General HospitalGlasgow Victoria InfirmaryGreenock Inverclyde Royal HospitalKilmarnock Crosshouse Hospital TAYSIDE Arbroath Arbroath InfirmaryBrechin Stracathro HospitalDundee BMI Fernbrae ClinicPerth Perth Royal Infirmary NORTHERN IRELAND COUNTY ANTRIM Belfast Belfast City HospitalBelfast Kingsbridge Private HospitalBelfast Mater HospitalBelfast Musgrave Park HospitalBelfast Royal Victoria HospitalBelfast Ulster Independent ClinicBelfast Ulster HospitalLisburn Lagan Valley HospitalNewtownabbey Whiteabbey Hospital COUNTY ARMAGHCraigavon Craigavon Area Hospital COUNTY DOWN Bangor Bangor Community HospitalDownpatrick Downe HospitalNewry Daisy Hill HospitalNewtownards Ards Community Hospital COUNTY FERMANAGH Enniskillen South Western Acute Hospital

LONDONDERRY Ballykelly North West Ind HospitalColeraine Causeway HospitalLondonderry Altnagelvin Area HospitalMagherafelt Mid Ulster Hospital TYRONE Dungannon South Tyrone HospitalOmagh Tyrone County Hospital CHANNEL ISLANDS Alderney Mignot Memorial HospitalGuernsey Princess Elizabeth HospitalJersey Jersey General Hospital ISLE OF MAN Douglas Nobles HospitalRamsey Ramsey & District Cottage Hospital

13

THE ROYAL OVER-SEAS

LEAGUE

I must thank you wholeheartedly for the way

HMCA is looking after me and I will certainly spread the good news of your excellent service.

Royal Over-seas League member

tHE HMCA MEDICAL CARE PLANDescription of benefits and levels of coverThe maximum benefit payable for each person named on the Membership Certificate for acute surgical or acute medical conditions, in each subscription year, is £250,000.

ACCOMMODATION CHARGES IN A HOSPITAL ON OUR HOSPITAL LIST

WARD NURSING CHARGES FOR EACH STAY IN HOSPITAL

NHS TREATMENTFor the duration of medical treatment carried out solely as a National Health patient in a public ward of an NHS hospital.

SURGICAL CHARGES FOR EACH STAY IN HOSPITALSurgeons’ and Anaesthetists’ Combined Fees including aftercare.Major Plus OperationMajor OperationIntermediate OperationMinor OperationAdditional Benefit for an operation requiring specialised operative techniques

THEATRE FEES, CONSUMABLES, DRUGS AND SURGICAL DRESSINGS FOR EACH STAY IN HOSPITALMajor Plus OperationMajor OperationIntermediate OperationMinor OperationAdditional Benefit for an operation requiring specialised operative techniques

PATHOLOGY, INVESTIGATIONS & PHYSIOTHERAPYWhen charged individually by the hospitalWhen charged as part of a package price

PROSTHESES FOR EACH STAY IN HOSPITALProstheses payable in accordance with the operation.Major Plus OperationMajor OperationIntermediate OperationMinor OperationAdditional Benefit for an operation requiring specialised operative techniques.

WARD DRUGS & CONSUMABLES FOR EACH STAY IN HOSPITALWhen charged separately for in-hospital treatment.

PHYSICIAN FEES FOR NON SURGICAL STAYS IN HOSPITALFirst 3 days

After 3 days

INTENSIVE CARE / HIGH DEPENDENCYBenefit is payable for medical treatment in an intensive care or high dependency unit.

£

Full refund

Full refund

200 a night for up to 30 nights a year

up to 1525up to 1100up to 735up to 420up to 2100

up to 2280up to 1515up to 990up to 715up to 2725

£

up to 1000up to 500

up to 2700up to 1210up to 715up to 440up to 1350

Full refund

up to 120 foreach dayup to 60 foreach day

each yearup to 2100

14

IN-HOSPITAL TREATMENT - FOR OVERNIGHT OR LONGER STAYS

15

OTHER ADDITIONAL BENEFITSPERSONAL ACCIDENT BENEFITS

DAY CASE & OUTPATIENT BENEFITS

OVERSEAS BENEFITS

DENTAL BENEFITS

PERSONAL ACCIDENTAL DEATH BENEFIT

PERSONAL ACCIDENT DISABILITY COVER

SPECIALIST SERVICES COMBINED OVERALL ANNUAL LIMIT

Consultations/Physiotherapy or Complementary Medicine

Investigations, Pathology, X-Rays, Scans

Day Case Surgery

Within this benefit the annual overall maximum cannot exceed £2350

DENTAL TREATMENTBenefit is payable only where specialist in-hospital and day-case treatment is necessary.

OVERSEAS COVERCover continues when you travel abroad on holiday or business for a period not exceeding 6 months. Excluded are general practitioners’ services and hotel expenses. Before travelling obtain form EHIC from the Post Office or telephone 0845 606 2030 for reciprocal arrangements in EEA countries.

RADIOTHERAPY/CHEMOTHERAPYA grant is given towards treatment

PARENT/GUARDIAN ACCOMPANYING A CHILDFor a child under 16 years of age, HMCA will pay the accommodation charge for one parent for a period not exceeding 20 days a year.

HOME-NURSINGFollowing treatment at a private hospital, or treatment arranged on a private basis at an NHS hospital for a qualified nurse for medical reasons.

PRIVATE AMBULANCEFor transport by a private ambulance to or from a hospital for medical reasons.

MATERNITY GRANTWhen both parents have been members for a year.

LONG-TERM ILLNESS GRANTLong-Term conditions which are not covered are those that are recurrent, persistent or incurable. After enrolment, a member receiving treatment that ceases to be short-term qualifies for a grant. This benefit can be given at the discretion of HMCA.

£

5000

1000

£

£2350

Benefits as for the U.K.

£

each yearup to 800

each dayup to 300

each yearup to 3600

each yearup to 350

for eachbirth 800

up to 1000

£

up to 450

up to 1250

up to 2350

NEW

NEW

FREE MEDICAL INFORMATION HELPLINE SERVICE

This service is provided free of charge to all HMCA Medical Care Plan members. It is operated by qualified medical staff, counsellors and health advisers and provides non-diagnostic advice on medical matters irrespective of whether you are making a claim for medical treatment. Advice can be sought by members on behalf of themselves and their immediate family even if the latter are not members.

The plan is underwritten by The Care Insurance Company Limited, 33/2 Cannon Lane, Gibraltar, GX11 1AA. It is governed by English law and all documents will be provided in English.

The Medical Care Plan provides a range of benefits for the private treatment of acute surgical and medical conditions which are listed on the Description of Benefits.

The term of the contract is 12 months and your subscription is quoted on the enclosed correspondence. If you wish to change your mind you have the right to cancel within 14 days of receipt of your certificate and any subscriptions paid will be refunded. After the first 14 days you may cancel your cover at any payment date thereafter by writing to HMCA, Beech Hall, Knaresborough, Yorkshire HG5 0EA.

To make a claim telephone 01423 866985 or write to the Claims Department, HMCA, Beech Hall, Knaresborough, Yorkshire, HG5 0EA.

HMCA operates a three-stage complaints procedureIf you have a complaint please write to The Directors of HMCA, Beech Hall, Knaresborough, Yorkshire, HG5 0EA. If you are dissatisfied with the response you should write to The Care Insurance Company Limited, 33/2 Cannon Lane, Gibraltar, GX11 1AA. If after their review you are still dissatisfied, your complaint can be referred to the Financial Ombudsman Service at Exchange Tower, Harbour Exchange Square, London E14 9SR.

SIGNIFICANT FEATURES AND EXCLUSIONSThe Medical Care Plan provides benefits for in-hospital and out-patient treatment. • An NHS benefit of £200 a night is paid if treatment is carried out in an NHS

hospital• An NHS grant is payable when treatment is received free as an NHS

patient, as accident or emergency admissions are not covered (exclusion 2.28 refers).

• A Personal Accident and disability benefit is provided.• A free Medical Information Helpline is provided.• When you transfer to the HMCA Medical Care Plan from an existing plan,

conditions that originated whilst you had cover with your previous provider will be covered by HMCA. This is called the HMCA Transfer Facility (see condition 3.3 for a full description).

• There is no age limit for enrolment in the HMCA Medical Care Plan.• Long-term conditions which are recurrent, persistent or incurable are not

covered. These are commonly known as chronic conditions. (See condition 3.3.2 for a full description).

• There are some restrictions in the first year for claims for joint and back conditions (see exclusion 2.24). This does not apply to those enrolling under the transfer facility.

KEy fACtS

16

These key facts are a summary of this plan: for full details please refer to the Description of Benefits and Levels of Cover on page 14 and 15 and the definitions, exclusions and conditions on page 18 and 19.

17

COMPENSATIONThe Care Insurance Company Limited is covered by the Financial Services Compensation Scheme (FSCS). You may be entitled to compensation from the scheme in the unlikely event that The Care Insurance Company Limited cannot meet its obligations. This depends on the type of business and circumstances of the claim and would provide cover for 100% of the first £2,000 and 90% of the remainder of the claim without any upper limit. Further information about compensation scheme arrangements is available from the FSCS. (www.fscs.org.uk - telephone 020 7741 4100.)

HMCA/S PLC, trading as the Hospital & Medical Care Association (HMCA) of Beech Hall, Knaresborough, Yorkshire, HG5 0EA is an intermediary and is authorised and regulated by Financial Conduct Authority, reference no. 307587. This can be verified by visiting the FCA’s website https://register.fca.org.uk or by contacting the FCA on 0800 111 6768.

HMCA only offers Private Health Plans underwritten by The Care Insurance Company Limited. We do not offer advice and the information sent will allow you to make a choice of how to proceed.

THE DIRECT DEBIT GUARANTEE • This Guarantee is offered by all banks and building societies that accept

instructions to pay Direct Debits.

• If there are any changes to the amount, date or frequency of your Direct Debit HMCA/S PLC will notify you 3 working days in advance of your account being debited or as otherwise agreed. If you request HMCA/S PLC to collect a payment, confirmation of the amount and date will be given to you at the time of the request.

• If an error is made in the payment of your Direct Debit by HMCA/S PLC

or your bank or building society you are entitled to a full and immediate refund of the amount paid from your bank or building society.

• If you receive a refund you are not entitled to, you must pay it back when HMCA/S PLC asks you to. You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

Who regulates and monitors HMCA?HMCA/S PLC, trading as the Hospital & Medical Care Association (HMCA) is authorised and regulated by the financial Conduct Authority. We are also fully compliant with the Data Protection Act and regularly monitored by our auditors. All underwriters provide cover under the financial Services Compensation Scheme (fSCS) which provide compensation in the unlikely event the underwriter cannot meet is obligations.

tHE HMCA MEDICAL CARE PLANterms and conditionsThis Description (including the Definitions, Exclusions and Conditions hereunder) shall comprise the Agreement with HOSPITAL AND MEDICAL CARE ASSOCIATION of Beech Hall, Knaresborough, Yorkshire HG5 0EA and shall include the Application Form and Membership Certificate, and it shall be construed according to the Laws of England and Wales. The documents shall be read as a whole and no variations shall be admitted except those acknowledged by the issue of an endorsement by the Association.

1 DEFINITIONS The following expressions have the following meanings1.1 Association Hospital and Medical Care Association.1.2 Scheme A Scheme, operated by the Association comprising the Rules of Membership and Endorsements,

the Description of Benefits together with the table of Levels of Cover and Subscriptions current at the Date of Enrolment or at any subsequent anniversary thereof, and based on the information declared in the Member’s Application, for providing benefits in respect of treatment for acute surgical or acute medical conditions for any disease, injury or illness on a short term basis by Specialists at any hospital approved by the Association.

1.4 Year Any twelve calendar months commencing at the date of enrolment or annual renewal of a subscription.1.5 Member A person who is either an individual or group member of Hospital and Medical Care Association and

applies for enrolment under Condition 3.1 and is accepted.1.6 Dependants1.6.1 The Member’s Spouse or partner if living at the same address.1.6.2 A child, or grandchild, of the member, or the member’s partner, up to the age of 26, single and living at home.1.6.3 A child, or grandchild, of the member, or the member’s partner, in full time education.1.7 Patient “The Patient” means the Member or one of his Dependants receiving benefits under the scheme.1.8.1 NHS Hospital A hospital operated under the National Health Service with facilities for medical and surgical

treatment.1.8.2 Private Hospital A hospital or nursing home with facilities for medical and surgical treatment which charges

fees for its services and in the United Kingdom is registered under the Nursing Homes Act 1975 (or is excluded from the definition of a nursing home in the Act by Section 1 (2)(a) thereof but is not an NHS Hospital) or overseas is operated or recognised by the appropriate authority where it is situated.

1.9 Acute Medical Condition Any disease, illness or injury of rapid onset, severe symptoms and brief duration.1.10 Long-Term Illness A medical condition that has become either recurrent, persistent or incurable.1.11 Treatment Surgical or medical procedures undertaken by Specialists needed to diagnose and/or cure an acute

medical condition.1.12 In-Hospital Treatment An overnight stay by a Member or his dependant for private treatment in a Private

Hospital in connection with the treatment of an acute medical condition.1.13 Specialist A medical or dental practitioner who is registered under the Medical Acts and holds or has held

a consultant appointment in an NHS Hospital or otherwise holds a certificate of specialist accreditation

recognised by a competent authority.1.14 General Practitioner A registered medical practitioner in general practice.1.15 Home Nursing The full time services of qualified resident or daily nurses whilst a bed patient when prescribed

by a specialist for medical as distinct from domestic reasons.1.16 Interpretation Where appropriate, reference to the masculine gender shall be deemed to include the feminine.1.17 Complementary Medicine Treatment under the referral of your General Practitioner, where the medical

practitioner holds a certificate of specialist accreditation recognised by a competent authority (eg. Chiropractic, osteopathy, podiatry, homeopathy, acupuncture, etc.)

1.18 Accident or Emergency Admissions1.18.1 by ambulance to either an NHS or Private Hospital as a direct result of or immediately following an accident1.18.2 to either an NHS or Private Hospital directly from the Accident & Emergency or Casualty department for urgent

or unplanned treatment1.18.3 to either an NHS or Private Hospital on the same day as a referral for treatment is made by either a General

Practitioner or Specialist, when immediate Treatment or Diagnostic Tests are a medical necessity1.19 Chemotherapy The treatment of cancer using specific chemical agents or drugs that are selectively destructive

to malignant cells and tissues.1.20 Ward Drugs Medication which is administered whilst the patient is an in-patient on the ward. This does not

include Chemotherapy drugs.1.21 Day Case An admission to a hospital that does not involve an overnight stay.1.22 EE ncludes all member states of the EEA, as well as the Isle of Man and Channel Islands.

2 EXCLUSIONS Benefits shall not be payable for:-2.1 Treatment of a Long-Term Illness (refer to condition 3.3.2 to see how this exclusion is applied); monitoring of any

condition; routine follow-up consultations; treatment which does not address the underlying medical condition and only offers temporary relief of symptoms (i.e. palliative care).

2.2.1 Pre-existing injury or disease contracted prior to your enrolment date (or the member’s previous plan under the terms of the transfer facility). After one full year’s membership such pre-existing injury or disease and conditions arising or resulting therefrom of which no symptoms (indication of a disease or disorder) have manifested themselves or treatment, or medication, or advice, including check-ups, has been rendered in the preceding 12

18

consecutive calendar months, will be covered.2.2.2 At the time of joining, if the member is undergoing treatment or investigations these are excluded unless fully

disclosed and accepted by the Association in writing.2.3 Pregnancy or childbirth, except in cases of complications of childbirth when the NHS benefit will be payable

subject to both parents having been enrolled for at least twelve months.2.4 The investigation or treatment of Infertility.2.5 Treatment for alcohol and drug abuse.2.6 Treatment for sexually transmissible diseases including Acquired Immune Deficiency Syndrome (AIDS) or AIDS

Related Complex (ARC) howsoever this Syndrome has been acquired or may be named.2.7 Treatment for injury or illness directly or indirectly occasioned by, happening through or in consequence of war,

invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, riot, terrorism, rebellion, revolution, insurrection, military or usurped power.

2.8 Treatment or advice given by a General Practitioner or Dentist.2.9 Self inflicted injuries or disabilities.2.10 Sight testing, routine medical examinations and any dental condition not involving an oro-surgical operation.2.11 Spectacles or other optical aids, hearing aids, surgical medical appliances or equipment, denture or dental

appliances.2.12 Rehabilitation, convalescence, or time spent in a community or cottage hospital, a nursing home or similar

establishment.2.13 Cosmetic surgery, whether or not for psychological reasons.2.14 Dialysis in Chronic Renal Failure.2.15 Treatment received outside the country of residence when the purpose of being abroad is wholly or in part to

obtain such treatment, unless agreed in advance with HMCA.2.16 Home Nursing not falling within the definition hereinbefore contained.2.17 Treatment not being undertaken by a Specialist.2.18 Treatment when received as a public ward patient in an NHS hospital.2.19 (i) the completion of claim forms (ii) medical reports which may be required at any time in respect of Members

or Dependants.2.20 Drugs and dressings prescribed on an out-patient basis.2.21 Treatment for mental illness or psychiatric disorders or anxiety/stress related conditions.2.22 Drugs not licensed in the U.K. for specific usage.2.24 Treatment of joint and back problems will not be covered for the first twelve months of membership. This does

not apply to members who enrol under the transfer condition or in respect of treatment required where accident is the sole cause.

2.25 Correction of abnormalities or deformities which are congenital or which originate before the date of enrolment, and any treatment related to any such abnormality or deformity.

2.26 Treatment which is experimental or has not been accepted as being effective.2.27 Breast reductions for whatever reason.2.28 Accident or Emergency Admissions, except when the treatment is received free as an NHS patient, when the

NHS grant is payable.2.29 Where previous treatment has been received by the member for any joint, either before they became a member

of the HMCA scheme or since joining it, no benefit will be payable under this policy in the case of any revision or repeat treatment to that joint.

3 CONDITIONS3.1 Anyone resident in the EEA shall be eligible to apply for enrolment of himself and his Dependants in the

Scheme.3.2 The Association reserves the right to refuse any application or to restrict the range of benefits and the Applicant

shall not be entitled to know the reason for such decision.3.3 Cover may be transferred from an existing plan and future claims made for acute conditions originating at the

time the member was participating in the previous plan will be honoured subject to the Description of Benefits and Levels of Cover applicable at that time.

3.3.1 The member must provide evidence of the existing plan and the commencement date of it to HMCA for the transfer terms to apply.

3.3.2 When a condition is first diagnosed (and did not exist prior to enrolment) benefit will be provided for such diagnosis and any necessary treatment for one initial episode only. Subsequent treatment is not covered. When these circumstances occur the Association will issue an appropriate endorsement to the certificate. The Association provides a discretionary Long-Term Illness Grant which can be made available to those with a Long-

Term Illness to assist transition to NHS care.3.6 On the death of a Member, a spouse who is registered as a Dependant may without formality become a Member

in his or her own right at the appropriate rate, according to whether the spouse was the only dependant or whether there were one or more child dependants.

3.7 The contract is an annual one renewable from year to year at the option of the Member, subject to the Description of Benefits and the table of Levels of Cover and Subscriptions in force at the date of renewal.

3.9 Members who take up residence outside the EEA shall cease from the next renewal date to be members of the Scheme.

3.10 The Association shall be entitled at any time in relation to a Member or Dependant to terminate the contract, or to subject the contract to different terms, if

(a) The Member, or an enrolled Dependant, has at any time (i) misled the Association by mis-statement or concealment. (ii) otherwise failed to act with the utmost good faith. (b) the Member is a member of a group which is wound up, or whose special arrangements are amended. (c) The Association decides to discontinue the Scheme or any part thereof.3.11 The subscription is payable in advance and eligibility to benefit ends when the period covered by the

subscription has expired or any instalment of subscription has not been paid on the due date.3.12 Where the annual subscription is paid by instalments, such instalments are payable for the full year. The

Association reserve the right to deduct any outstanding instalments on settlement of a claim.3.14 The Association will consider claims for treatment at hospitals on the list provided. Other hospitals may be

accepted subject to prior notification and the Association’s written agreement.3.15 Where discounts off the basic rates are allowed, only one discount will be given.3.16 Benefits may be claimed for treatment by a specialist after referral from the patients GP. Where more than

one surgical procedure is carried out whilst an in-patient then the benefit payable towards Surgical Charges and Theatre Fees shall be 100% of the highest rated procedure plus up to 50% of the appropriate benefit for each subsequent procedure. For the purposes of benefits, operations are classified as Complex, Major Plus, Major, Intermediate or Minor. When a course of treatment is received solely as an NHS patient, the cash benefit detailed in the Levels of Cover shall be payable for each eligible night spent in hospital.

3.17 A claim form will be sent to the Member on request. Such a request should be made immediately the Member is advised to have Specialist treatment for which a claim for Benefit will be submitted.

3.19 A member shall not be entitled to ask for payment in any foreign currency and claims in any such currency shall be paid in Pounds Sterling at the rate of exchange prevailing on the day of the cheque in settlement of the claim is drawn.

3.20 Any claim for benefit must not exceed the actual expenses incurred and is payable up to the limit for the time being prescribed within the Member’s chosen level. Such a claim must be in the Association’s prescribed form supported by accounts from whoever has provided the service. Any claim shall be made within three months of commencement of treatment or giving of advice. It shall be supported by such further evidence as the Association may reasonably require. In the event of treatment or the giving of advice continuing further accounts shall be submitted within one month of them being rendered and the requirement as to further evidence shall apply.

3.21 If expenses are covered by an insurance on the Member or by any Provident Association, the Association reserves the right not to pay more than its rateable proportion thereof.

3.22 For the purposes of calculating daily payments, the days of admission and discharge together count as one day.3.23 Accommodation charges are payable only when directly related to the In-Hospital treatment received in Private

Hospitals or the private wing of NHS Hospitals.3.24 Upon giving Notice to the Association of their intention to make a claim therefore at the time of their entry into

hospital Members shall be entitled to the benefits under the scheme when temporarily abroad on holiday or on business.

3.25 Where the treatment required results from the fault of another, the member must; (i) Take all reasonable steps that the Association requires to recover from the party at fault the cost of the

benefits paid by the Association and interest thereon. (ii) If recoverable, repay to the Association the cost of the benefits paid to the member with interest.3.26 The benefits payable towards a claim are those applicable to your certificate at the time the claim form is issued.

Therefore benefits from 2 separate membership years cannot be applied to the same claim.3.28 The Maternity Grant is payable once both parents have been members for at least twelve months.3.29 Each In-Hospital stay must be pre-authorised at least the day before, with HMCA being in receipt of the

completed claim form, a consultant’s report and details of the hospital’s charges, before any agreement can be given as to the eligibility and benefits payable.

19

WE ARE HERE TO HELPIf you wish to discuss your health care requirements or the HMCA Medical Care Plan, please telephone our helpline on (01423) 799949 or fax on (01423) 866586 or write to: HMCA, Beech Hall Knaresborough, Yorkshire HG5 0EA. Email: hmca@hmca.co.uk Website: www.hmca.co.uk Beech hall, Knaresborough

Beech Hall Circa 1737all hmca paper products from a sustainable source and are recyclable.