Do I need to keep the Bluline administration team informed as treatment progresses?
The Scheme relies on its Members to update Bluline Administration at each stage of the claim. If we are unaware of treatment or appointments then the Member or Associate Members may be liable for any costs.
What does Discretionary Scheme mean?
All of our claims are individually assessed and claims decisions are made at board level to ensure a fair and sympathetic outcome. We are on your side and will always have your best interests at heart. Being a discretionary scheme means we are able to approve claims that other standard insurance providers cannot.
Can I add my family to my membership?
Yes, you are able to add your immediate family to your membership. This can include your partner/spouse and any children (until 21st birthday or 24th birthday if in full time education). Immediate family must reside at the same address as your membership, unless in full time education.
What is a pre-existing condition and am I covered?
A pre-existing condition is any injury/illness or related injury/illness that is known by the Member to exist within 5 years prior to the Member or joining the scheme. You will need to be 5 years symptom free from the date of joining the scheme and we will need to see your medical records dating back 5 years from the date of joining before we can look into covering it.
Can I make numerous claims within a year?
You can make numerous claims however there are limitations to how many claims you can make for one part of the body. A member’s claim limit is £17500 per claim and a maximum of £30000 per year. You also have limitations within these. Please refer to your benefits schedule for full details.
What are my claim limitations?
A member’s claim limit is £17500 per claim and a maximum of £30000 per year. You also have claim limitations within these. Please refer to your benefits schedule for full details.
Does Bluline cover chronic illnesses?
A chronic illness is a disease or illness of long duration involving very slow changes and often of gradual onset. The term does not imply anything about the severity of an illness or condition.The scheme does not cover any conditions that require continuous, recurrent or on-going treatment, for example asthma, diabetes or arthritis.
Does Bluline provide emergency cover?
Bluline does NOT cover any emergencies. If you are admitted/treated as an emergency then Bluline will not step in. Please revert to the NHS if you need emergency medical attention.
What do the directors of the scheme do?
Bluline is overseen by a board of directors which is made up of members of the police federation. The Directors are non-partisan and receive no remuneration for their role. They are able to assess claims that fall outside the scheme rules to achieve a fair outcome on the wider membership. They also ensure that’s the schemes funds are being used in an equitable fashion.
What if I do not feel well enough to communicate?
You may nominate a spouse, relative or friend to have authorisation to speak on your behalf on your new claim.
Do I need to tell the consultant or hospital that I am a member of the Scheme?
It is essential that you identify yourself as a member of the Scheme prior to receiving treatment.
I am having treatment within an NHS hospital; can I move to a private hospital?
If you are receiving medical care within an NHS hospital, then it is not possible to transfer to a private hospital. If you are discharged from NHS care or there is a significant delay with investigation or treatment, we may consider referring you for private care at that stage.
I have already started treatment within the NHS, if I incur a delay can I become a private patient?
If there is a significant delay with investigation or treatment, we may consider referring you for private care at that stage.
How do I gain authorisation for a consultation?
To gain authorisation for a consultation you will need to speak to a member of Bluline administration team and update them on your claim.
How do I gain authorisation for a treatment/procedure?
You will need to provide the Bluline administration team with the clinic letter from your consultation, the OPCS procedure code and date of proposed treatment/surgery. The Bluline administration team will then look at the costs & scheme rules and be able to inform you if it is authorised.
I have a scheduled NHS procedure/treatment booked; however I would prefer to go private, is this possible?
We are unable to assist members if you have declined/refused NHS treatment.
Can I have annual follow up appointments?
Bluline does not cover annual follow ups as the scheme does not cover long term monitoring. You will need to revert to the NHS in this instance.
How many follow up appointments are covered on my claim?
Each claim is assessed individually. Please contact the Bluline administration team to discuss what is covered on your claim. There are set limitations for consultations. Please see the benefit schedule for full details.
What happens if I get a need more treatment at a later date for the same injury?
Claims, where a period of six months has elapsed since the last treatment or notification by the Member will be deemed to be closed. Further treatment undertaken after this period will be regarded as a new claim if applicable within the Scheme rules.
What is required to get authorisation for a surgical procedure?
Please be aware that in most cases for a procedure or surgery to be authorised, we will need to see the clinic letter and have the procedure code and costs from the hospital.
You may need to contact the consultant or their secretary for this information and inform Bluline Administration.
Where should I send correspondence or invoices?
All invoices and correspondence must be sent to the Bluline Administration Office.
How do I contact Bluline to make a claim?
Please contact the Bluline administration team and we will be able to help you. You can either telephone us on 01905 796682 or email us at email@example.com. The office is open Monday to Friday 9.30am – 3.30pm (excluding bank holidays).
If my claim is rejected or falls outside the scheme rules, what options do I have?
Bluline administration team are able to refer your claim anonymously to the Directors of the scheme in some instances. The Directors will then make a decision as to whether we can open a claim/provide treatment.
How long does it take to have a decision made by the directors if my claim is refused?
Once the Directors have received the anonymous application, you will receive a response within 24 working days. The decision of the Directors will be final and binding.
When do I pay my administration fee for my claim?
The Bluline administration team will send you a Claim Form once you have opened your claim to sign and return to us. It will also state the bank details for an online transfer or you can send us a cheque. We will not pay for any invoices received until your administration fee has been paid.
Where do I send all correspondence/invoices too?
Bluline Discretionary Health Scheme, Administration Ltd, Unit 1 de Salis Drive, Hampton Lovett, Droitwich,
WR9 0QE, firstname.lastname@example.org