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Frequently asked questions – for individuals

 

Here you'll find answers to some of the questions that are frequently asked by our customers. These are split out by the plan: Simply Cash Plan, Simply Dental Plan, Simply Cash Plan 70 Plus and Simply Personal Accident Plan. 

FAQs for all plans 

Joining online

How long does it take to join online?

Once you have read the policy information and chosen the level of cover which suits your needs, it will only take you a few minutes to enter:

  • name and date of birth of each person to be covered
  • address and contact telephone number
  • payment details

Can I save my quote and come back to it later?

Yes you can save your quote online for a later date. The quote will be emailed to you including your online reference number and policy details.

What do I need to buy a Simplyhealth plan online?

You will need the bank sort code and account number of the bank which your direct debits will be taken from.

Making a claim - troubleshooting

I am trying to upload my claim and the circle just keeps going round? 

Close down browser and try again. 

Where can I change my email address online?

This can be found under ‘Security settings’ as it doubles up as your username. 

When I click ‘Make a claim’ I am being presented with another log in page? 

Close down browser and try again.

I can see my claiming history from my old plan?

Please return to ‘My account’ and ensure you have selected the correct policy number you wish to view. 

Simply Cash Plan FAQ

We've answered some common questions about the Simply Cash Plan for individuals.

 

If you do not currently have a policy with us and your question isn't answered here, please contact us on 0330 102 5392.

 

If you're an existing customer please refer to your policy terms and conditions as your product may differ to the one shown on the website. If you still can't find what you're looking for, please call our customer services team on 0370 908 3481*, we're always happy to help.

Administering your policy

Is a cash plan the same as private medical insurance?

No, a cash plan offers money back on everyday healthcare bills, like trips to the optician, dentist or physiotherapist, up to annual limits. Traditional private medical insurance gives you more comprehensive cover for medical conditions and can include consultations, diagnosis and surgery.

Can I cover my parents or siblings on my plan?

No, parents and siblings would need to take out a plan in their own right. You can only cover yourself, partner or spouse and up to four children on your plan.

Can I add my partner or children to my plan?

Providing they permanently live with you, you can add up to four of your children or your partner's children up to the age of 18 to your policy, free of charge.

You can add your resident partner for an additional premium as long as they are 79 or under. 

To add people to your policy, simply call our Customer Services team on 0370 908 3481*.

Can I increase my cover level?

You can increase your cover level once a year, up to the age of 79, but you must stay at that level for a minimum of 12 months before being able to change it again.

Find out more about different levels of cover.

Your benefits

Can I pick and choose the benefits to suit my needs?

It is a set plan so you are covered for all of the benefits listed and you can't add or take anything away. Some additional benefits are available on level 2 and above which maybe better suited to your needs.

Are pre-existing conditions covered?

The great thing about Simplyhealth is that you can start claiming straight away (excluding New Child Payment which has a 12 month qualifying period), even if you already need treatment when you join.

However, you cannot claim for pre-existing conditions under hospital cover for the first 12 months. 

Does a Simply Cash Plan cover Denplan premiums?

The Simply Cash Plan dental benefit will only cover dental treatment. Dental practice plan payments and dental insurance premiums are not covered.

Are X-rays and scans covered?

X-rays and scans are not covered by your Simply Cash Plan.

Claims and claiming

Can I claim on my Simply Cash Plan as well as any other health insurance I may have?

Yes, providing the total reimbursement does not exceed the value of the costs you have incurred. Please read your terms and conditions for further information about your cover.

How do I claim for contact lenses?

You need to get printed confirmation from your optician of the amount you've paid for your contact lenses. Claims for contact lenses must be received within six months of the date of purchase, with a receipt.

How do I claim for new child payment?

You need to complete and submit a claim form, which must be accompanied by a copy of your child's birth certificate. 

If you've registered for an online account, you can log in to submit a claim. Alternatively, you can give our Customer Services team a call on 0370 908 3481.

What do I need to make a claim?

To make a claim on your Simply Cash Plan, you'll need:

  1. A fully completed claim form. If you've registered for an online account, you can log in to submit a claim. Alternatively, you can give our Customer Services team a call on 0370 908 3481.
  2. The original supporting documentation (for example an original receipt - we do not accept copies) that together should leave us in no doubt about:
  • the name of the patient
  • the details of the practitioner or establishment and the service or treatment that they have provided
  • the date of the service or treatment and the amount paid for that service or treatment

If you're submitting a hospital claim send your claim form and a copy of your discharge letter as evidence of your admission. If you do not have your discharge letter you can get the hospital cover section of the claim form stamped and signed by a doctor, nurse, or medical record department from the hospital where you were a patient.

If you're making a New child payment claim we may ask you for supporting documents, for example a birth or stillbirth certificate, or adoption papers.

Why do I have to pay the hospital a fee for completing my claim form?

Some hospitals charge for the completion of claim forms.  To avoid this charge you can send us the original discharge letter which the hospital is legally obliged to give you.

My claims are currently being paid by cheque. Can they be paid straight into my bank account?

Yes, to make life easier for you, we can pay your claims straight into your bank account. All you need to do is register for an online account and under your selected health plan, complete the bank and payment details form and we'll do the rest.

Simply Dental Plan FAQ

We've answered our customers' most common questions about the Simply Dental Plan.

 

If you do not currently have a policy with us and your question isn't answered here, please contact us on 0330 102 5393.

 

If you're an existing customer please refer to your policy terms and conditions as your product may differ to the one shown on the website. If you still can't find what you're looking for, please call our customer services team on 0370 908 3476, we're always happy to help.

Claims and claiming

What can I claim for?

Subject to annual limits you will receive up to 100% of your money back for check ups - which includes investigations and x-rays and up to 75% of your money back on scale and polish fees - as soon as your plan starts.

After three months you'll be able to claim back a proportion of your costs for dental treatment (including crowns, bridges, onlays and inlays, up to certain limits).  You'll also be covered for dental accidents, emergency visits to a dentist and hospital admissions.

Please note that pre-existing conditions or treatment identified in the qualifying period and cosmetic dentistry/procedures are not covered.  If you have not had a check up for 2 years prior to taking out your policy, treatment identified in the first check up will not be covered.

From three months a single payment of £5,000 is payable if you are diagnosed with primary mouth cancer. Secondary Mouth Cancer, or conditions where you have been diagnosed with any mouth cancer or are having investigations or waiting for the outcome of tests before or during the three month qualifying period is not covered.

For full details of what benefits are covered, read about the Simply Dental Plan.

How are my claims paid?

To make life easier for you, Simplyhealth provides a service which pays your money directly into your bank account sending you confirmation in the post or by email.

What do I need to make a claim?

To make a claim on your Simply Dental Plan:

1. Send us a fully completed claim form, along with original supporting documentation (for example an original receipt or statement of account - we do not accept copies) that together should leave us in no doubt about the name of the patient, the details of the practitioner or establishment and the service or treatment that they have provided, the date of the service or treatment and the amount paid for that service or treatment 

2. For claims over £500 you must submit full clinical records provided by the dentist

3. If you've registered for an online account, you can log in to submit a claim. Alternatively, you can give our Customer Services team a call on 0370 908 3481.

For further details of how to claim, refer to the Terms and Conditions in section 5 of your Simply Dental Plan Policy Document - part 2, or check out the dental how to claim guide.

If you have any queries, call our customer services team on 0370 908 3476* - we're always happy to help.

When will I receive money back from my claim?

We normally settle claims within a few days. Sometimes we may ask for further information which may delay payment of your claim.

Your benefits in detail

When do my annual benefits start and end?

Your annual benefits commence from your policy start date and begin again on the same day every year. Maintenance benefits are available as soon as you take out your policy. Treatment, Accident, Emergency and Hospital Cover benefits are available once your policy has been in place for three months. There is also a three-month qualifying period for mouth cancer cover. Any unused annual benefits will not be carried over to the next claiming year. Please refer to your Simply Dental Plan Policy Documents for further details.

Are there any qualifying periods?

Dental treatment, accident and emergency benefits and Mouth Cancer cover are available once your plan has been in place for three months.

  • Dental treatment: Only treatment that is clinically necessary will be covered. Cosmetic or aesthetic procedures, orthodontic treatment, dental implants and veneers are not covered.
  • Dental accident cover: If you are in an accident and your teeth are damaged after completion of the three-month qualifying period, you can claim 100% of the cost of permanent or temporary treatment required (up to £5,000 a year), providing dental attention is sought within 30 days.
  • Mouth cancer cover: Please note you will not be able to claim mouth cancer cover if you have previously been diagnosed with any mouth cancer or if you have been referred by your dentist or GP for diagnostic or exploratory tests before your registration date or during the three month qualifying period.

Your previous dental check ups

  • The timing of your last dental check-up affects the treatment you (or anyone covered under the policy) can claim for 
  • If you (or anyone covered under the plan) have not had a dental check-up within the two years prior to taking out the plan, any treatment identified at your first check-up after joining will not be covered 
  • If you (or anyone covered under the plan) have had a dental check-up within the two years prior to taking out the plan, you will not be covered for any treatment that is already planned, started or is recommended by your dentist either prior to joining or during the three month qualifying period 

Administering your policy

What is the duration of my cover?

The cover under your plan is monthly and runs from month to month until it is cancelled or otherwise comes to an end.

Can I reduce my cover level?

Provided you're covered by Level 2 or above, you can reduce your cover level at any time, as long as you've been at your current level for at least 12 months.

Find out about different levels of cover

Can I add my partner or children to my plan?

You can add your resident partner to your plan for an additional premium (age limits apply). You can also add children, if you choose to pay the additional monthly premium. This will cover up to four of your children, or your partner's children, up to the age of 18. Simply call our customer services team on 0370 908 3476*.

Can I increase my cover level?

You can increase your cover level once a year, up to the age of 79, but you must stay at that level for a minimum of 12 months before being able to change it again.

Find out about different levels of cover.

Can I use my spouse's entitlement if he/she is not going to use it?

No. Entitlements are specific to each individual named on the policy.

Simply Cash Plan 70 Plus FAQ

How are my benefits paid?

To make life easier for you, Simplyhealth provides a service which pays your benefits directly into your bank account, sending you confirmation in the post.

What do I do if I have changed my mind?

You have 14 days from receipt of your welcome pack in which to change your mind and receive a full refund from Simplyhealth, provided no claims have been made. Simply call customer services on 0370 908 3481*. After this period our standard cancellation rights apply - please refer to section 8 of the policy document - part 2

*Calls to 03 numbers are no more expensive than calling numbers starting with 01 or 02 and are included in free call packages from landlines and mobiles.

What is the duration of my cover?

The cover under your plan is monthly and runs from month to month until it is cancelled or otherwise comes to an end.

What happens if my personal details change?

So that your cover remains appropriate for your needs, it is important that you review it regularly and let us know about any significant changes to your healthcare requirements.

How do I make a complaint?

We aim to provide you with the very highest levels of customer service and care at all times. To maintain this service standard, we have a procedure you can use to raise any concern, complaint or recommendation you have by contacting Customer Services on 0370 908 3481* or writing to Simplyhealth Customer Services, at our registered office address of Hambleden House, Waterloo Court, Andover, Hampshire SP10 1LQ.

We will investigate any complaint and issue a final response. If you are not satisfied with our response, or we have not replied within eight weeks, you have the right to refer your complaint to:

Financial Ombudsman Service
Exchange Tower
London
E14 9SR

Telephone: 0800 023 4567

The Financial Ombudsman Service will only consider your complaint if you have given us the opportunity to resolve the matter first. Making a complaint to the Ombudsman will not affect any legal rights that you may have. We will send you full details of our complaints procedure if you ask us for them.

Self service

Am I registered for online self service already?

You will not be set up automatically to use self service. If you have not registered already then please contact our customer services department.

How do I unlock my account?

If you have tried to login using your username but with the wrong password your account will be locked and you'll need to contact our customer services department. Once they have reset your password, you may need to close your browser and clear your cookies (see our privacy and cookies pages for assistance) before your new password will work.

How do I login?

By clicking the login button at the top right of the page it will ask you for your username and password to login to your self service area.

I've reset my password but it doesn't work?

If you have reset your password, you may need to close your browser and clear your cookies (see our privacy and cookies pages for assistance) before your new password will work.

Simply Personal Accident Plan

The Simply Accident Plan is no longer available.

If you have any questions about this plan, please call 0370 908 3481.

Contact us

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New customers: 0800 197 6999

Simply Cash plan: 0370 908 3481

Simply Dental plan: 0370 908 3476

 

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