How to Make a Claim | Saga Health Insurance

Making a claim with Saga Health Insurance

Step one

Being referred for treatment

Your consultation or treatment must follow an initial referral by a GP (including via a digital GP service) or dentist or another healthcare practitioner. The situations in which we will accept such a referral are set out on Bupa's website.

For muscle, bone or joint pain, see the ‘MSK Direct Access’ explanation on this page.

Step two

You need to call us on 0330 018 0778 or you can contact us digitally by visiting Bupa's website or downloading the Bupa Touch App.

To help us make the claims process as simple and swift as possible, please have the following information close to hand when you call us:

your policy number

details of the condition you are suffering from

details of when your symptoms first began

details of when you first consulted a GP about your condition

details of the treatment that has been recommended.

Step three

We will explain which nearby specialists, facilities and healthcare professionals are available under your benefits and provide you with a pre-authorisation number so your healthcare provider can send the bill directly to us.

If your specialist recommends further tests or treatment, it is important you check back with us to obtain further pre-authorisation.

We strongly advise you to call us before arranging or receiving any treatment to pre-authorise it, as you will be responsible for paying any fees or charges that are not covered under your benefits.

Step four

Usually, we will pay the providers of your treatment directly

Please send any correspondence to: Bupa Claims, Bupa Place, 102 The Quays, Salford M50 3SP.

What's an excess?

This is the amount you’ve chosen to contribute towards your treatments. You’ll only pay this once a year for each person who claims. Having an excess lowers your premium.

What is a ‘4-week’ or a ‘6-week’ rule?

If the procedure or invasive diagnostic test is not available for you through the NHS within four or six weeks of when you need it, depending on the option you've selected, we’ll get you seen privately.

You’ll have chosen this to lower your premium when you signed up to your Saga plan.

What is a No Claim Discount (NCD)?

This is a discount added to your policy each year based on your claims history. The No Claim Discount rises annually by 5% to a maximum of 60% if no claims are made. (Please see your Policy Book for more information on NCD).

How is the No Claim Discount (NCD) calculated?

Your current NCD level is shown on your Policy Schedule. This is how the NCD level is calculated:

Where nobody covered on the policy makes a claim - The NCD for the policy is increased by one level at the following policy renewal date until level 10 is reached
For each claim made on the policy - The NCD for the policy is reduced by two levels at the following policy renewal date for each claim made until level 0 is reached.

These are the NCD levels and their discount percentage on a basic premium rate:

Level 0 = 0%
Level 1 = 10%
Level 2 = 20%
Level 3 = 25%
Level 4 = 30%
Level 5 = 35%
Level 6 = 40%
Level 7 = 45%
Level 8 = 50%
Level 9 = 55%
Level 10 = 60%

Can I make a claim online?

You can create an account online by visiting Bupa online or download the Bupa Touch App. From here you can call or use Webchat to get in touch, pre-authorise treatment and view your claims history.

Do I have to pay for my treatment?

Not if you see one of our fee-assured specialists and your treatment is covered by your policy. If you choose a specialist that is not approved by us, or one that charges more than our approved fee limits, you may have to pay some or all of your treatment costs yourself.

Check your Policy Book for more details on treatments and what is and isn’t covered by your policy.