Initially started as a company providing affordable holidays for older individuals, Saga has developed into one of the UK’s most well-known providers for insurance and other services for individuals aged over 50.
Offering services such as cruises, holidays, insurance, and support with money, Saga offers support backed by over 70 years of experience (1).
This article will focus on health insurance plans that Saga provides and, although these treatment plans are only offered to individuals aged over 50 years, will describe the different forms of support that are available in these insurance plans for the individuals who fall into this demographic.
As an overview, Saga Health Insurance does cover both inpatient and outpatient addiction treatment, but only under certain plans.
This means that an individual can access addiction support and treatment for the recommended time frame of 28 days in a year.
It is recommended that individuals take part in these 28 days within one period of time, but it is possible to split this time up into different sessions if necessary and suitable.
The most comprehensive health insurance plans are found within the ‘Super Plan’, but the different options are outlined later in this article, including what is and what is not covered under each category of plan.
The specific rehabs accepting Saga Health insurance, rather frustratingly, keep changing, and so we’ve since decided not to list the specific rehabs that do, because this is subject to change.
Please contact our helpline on 0800 140 4690 for the full list of rehabs currently accepting payment via Saga Health insurance.
Under the general category of ‘mental health’, Saga Health Insurance can cover many different areas of care.
These are outlined below:
However, it is important to note that the areas of care covered above are only intended for general mental health claims, and not specifically for substance abuse/addiction struggles.
This is why it is important for individuals to gain a referral from a medical specialist so that their addiction is diagnosed as a mental health issue and can therefore be treated as one.
There are four main healthcare plans that an individual can access through Saga Health Insurance, and these are outlined briefly below:
There are several steps that an individual must take before they can begin to partake in addiction rehabilitation that is covered by a Saga Health Insurance plan.
For example, first an individual must receive a referral to rehabilitation through their GP.
The individual may be referred on to an addiction specialist or psychiatrist, but this is the first step before an individual can be considered for healthcare that is covered by Saga.
Then, this referral must be passed on to Saga who will pre-authorise the treatment based on their specific requirements or the needs of the individual.
In addition, Saga will only cover treatment that comes from one of their approved rehab providers, so individuals may be offered different treatment alternatives if they are looking at unapproved treatment providers.
From here, the individual must then submit a claim through Saga’s services, including all necessary medical and financial documentation – support is available throughout this process, so there will be guidance at all stages of the process.
An individual’s specific Saga Health Insurance plan will dictate exactly what types of care are covered or are not covered.
This can be seen as a brief overview earlier in the article, by taking a look at Saga’s different plans available (2), as well as by contacting Saga directly to find out specific details of their existing or potential future plan.
All details of these plans should be confirmed and fully understood before an individual agrees to a specific plan or policy.
As a specific feature of Saga Health Insurance, pre-existing conditions are generally excluded from care that is covered unless the individual has not received treatment or displayed any symptoms in a time period of three years.
Speak to Saga for specific examples or queries.
It is a rehabilitation standard that individuals spend 28 days in residential rehabilitation, though it is the case that this is not always suitable.
If an individual requires additional time, then this should be discussed with Saga directly in order to add additional days as part of specific care.
If an individual finds themselves in the position in which they are paying for rehabilitation out of their own pocket and then later require healthcare insurance, then there are several factors that they should keep in mind.
For example, reimbursement through Saga is only available if the treatment that the individual receives was pre-authorised (i.e., referred by a GP and awareness was brought to Saga before initiating).
In addition, the provider of this treatment must also be approved by Saga directly; any rehabilitation that was unapproved and has occurred retrospectively is unlikely to be reimbursed under Saga’s Health Insurance claims.
Any individual who finds themselves denied by Saga Health Insurance claims should ensure that their application is in accordance with Saga’s requirements and policy wordings, as well as that any supporting documentation is present.
If all of this is as it should be, then there are some alternatives that an individual can pursue.
There are other insurance providers that may have different requirements of care that may be more suited toward the individual, but all individuals in the UK are also eligible for potential National Health Service (NHS) treatments.
The NHS offers addiction treatment, but generally only on an outpatient basis and often wit ha long waiting list – something that is not suitable for cases of addiction due to the worsening of the condition over time.
To access further support and information about addiction, treatments, and financial support for these types of care, get in contact with Rehab 4 Addiction.
Our referral service offers free, confidential, and impartial advice, meaning that we are ready and willing to help any individual who needs support, no matter whether they hold health insurance or not.
To speak to a member of our friendly and professional team, call our addiction support line on 0800 140 4690 today and start your rehabilitation journey as soon as possible.
[1] Saga; About us; https://www.saga.co.uk/about-us
[2] Saga; Insurance; Health Insurance; https://www.saga.co.uk/health-insurance
