Below, we've aimed to answer all your claiming questions. We want you to have a policy that meets your needs, so we recommend that you review your cover on a regular basis to make sure that it does.
If you can't find the answer you're looking for and it's not in the product terms and conditions, as a business customer you can call us on 0800 980 7517 (Monday - Friday 9am - 5pm) or email us.
The first thing you need to do is pay for the costs of the treatment or service to the person providing them (for example, your optician). You then claim those costs back from us. It’s really easy to claim online. Please visit simplyhealth.co.uk/register and follow the simple registration process. If you’re unsure about how to claim online then please contact us.
Before we’re able to pay your claim, we need to be sure that the policy covers it. For example, we need to be sure that the person who receives the treatment or service is a member, and that there is not an exclusion that applies.
You’ll need to send a receipt that shows:
We don’t accept receipts that have been altered, or invoices, credit or debit card receipts, or bank statements. We are unable to return receipts. We won’t be able to pay a claim if you don’t send us everything that we need to assess it.
We may need to ask the person who provided the service or treatment for more details.
We won’t pay if there’s a charge for this. We may ask for a second opinion but we’ll pay the cost for this.
Submitted claims will appear on your online account (and the SimplyPlan app) once they are processed, which can take up to 3 working days.
We have a range of services and health-related information available to you. You can access these services through your online account. If you haven’t already registered please visit simplyhealth.co.uk/ register and follow our simple registration process. The information and services available on the myWellbeing website can change without notice from time to time.
The service is available 24 hours a day, 365 days a year by calling 0330 102 5443. Webcam appointments are also available from 8.30am to 6.30pm, Monday to Friday.
If the GP privately prescribes you some medication, they can arrange for the medication to be delivered to you at home or at work. The cost of the medication and delivery is not covered under this policy.
The policyholder or their partner will need to call on behalf of any children covered under this policy.
The service is available 24 hours a day, 7 days a week by calling 0800 975 3345. This service has some age restrictions, please see the myWellbeing website for more information.
This service is available 24 hours a day, 7 days a week by calling 0800 975 3345. This service has some age restrictions, please see the myWellbeing website for more information.
Some of the myWellbeing services are only available in the UK. The website will tell you which of the services this applies to.
This benefit is to help towards the costs when you see a qualified dental professional (for example a dentist or hygienist) in a dental surgery.
This benefit is to help towards the costs when you see a qualified optical professional (for example an optometrist or optician).
Important: In order to be able to practise in the UK:
We will not pay for treatment by someone who is not registered with the HCPC, GOsC or GCC (as appropriate).
Important: In order to be able to practise in the UK chiropodists / podiatrists must be registered with the Health and Care Professions Council (HCPC). We will not pay for treatment by someone who is not registered with the HCPC.
A diagnostic consultation is to find or to help to find the cause of your symptoms.
This benefit can help towards costs such as meals for visitors, telephone calls, travel costs or even hospital parking fees, if you are admitted to hospital.
To make an online claim for hospital cover you’ll need a copy of your discharge letter as evidence of your admission. If you do not have your discharge letter, you’ll need to get written confirmation of your hospital stay (for example a headed letter from the hospital).
This benefit has a qualifying period of 12 months.
If, after the qualifying period, you have a baby or adopt a child we will pay new child payment for that baby or child. We only make one payment for each child no matter how many policies you or your partner are covered on. If you have more than one policy you will have to choose which one to claim the new child payment under.
We will also make a payment following a stillbirth of your child after 24 weeks of pregnancy.
To claim under this benefit we may ask you for supporting documents, for example a birth or stillbirth certificate, or adoption papers.
This policy will not pay for:
Anyone who we have accepted for cover under this policy.
Anyone in a relationship with, and who lives with, the policyholder. This could be their husband, wife, civil partner or unmarried partner.
If an employer chooses family cover this means employees can include their partner and any number of unmarried dependant children under the age of 21, or 24 if they are in full time education. Any family members included on the employee's policy must be resident in the UK, Channel Islands or Isle of Man.
If you are due to leave your group policy you may want to apply for a personal cash plan policy.