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FAQs for all plans

Administering your policy

When does my cover start?

You’re covered from your policy start date, for treatments had on or after that date. This is subject to any relevant qualifying periods. But if you’re not entirely happy with your choice, you have a 14 day ‘cooling off’ period from receipt of your policy documents.
 

We’ll refund the premium for the cooling off period. However, we will deduct the costs of any claims paid during that time. If the cost of your claims is greater than the premium, then you won’t be entitled to a refund.

Can I change my level of cover?

You can increase or decrease your level of cover once during your renewal year. If you do decide to change, however, you will be unable to change it again until your next renewal date.
 

Please be sure to check your policy documents. Some plans do not have renewal dates. In which case, if you do change your level of cover, you then need to stay on the same level for at least 12 months. If you’re unsure, feel free to contact us.
 

Your health cover should remain useful, and right for your needs. We recommend you review your plan on a regular basis. Please let us know any significant changes to your requirements.

Can I add my partner to my plan?

You can add your partner, providing they are:

  • permanently living with you
  • aged 79 or under.

They will have their own entitlements to claim.

How do I make a complaint?

Our goal is to provide the highest levels of service and care at all times. We are customer driven, and always keen to improve. We may not always get it right, and if this happens we want to hear from you. You’re welcome to raise any concern, complaint or recommendation you have. To get in touch with our Customer Services team, you can:

  • ring 0370 908 3481
  • send an email to [email protected]
  • start a Livechat on our website
  • write to:
     

Simplyhealth Customer Services

Hambleden House

Waterloo Court

Andover

Hampshire

SP10 1LQ
 

We can send full details of our complaints procedure upon request.

Does cover continue when I reach 79?

Yes. You keep your policy for as long as you need. However, you cannot increase your level of cover after your 80th birthday. But you’re welcome to decrease, if you so wish.

Can I use my spouse or child's entitlement, if they don’t use it?

No, everyone gets their own entitlements. They're specific to each person named on the policy. If you've used up yours, don't worry. Everyone’s entitlements reset annually, on your renewal date.

When do my benefits reset?

Your entitlements begin on your policy start date. Then reset again on your renewal date. Your summary of cover will confirm the dates for your policy year, or you can find them by registering online.
 

If you have a plan through your employer, your benefits will reset on the group renewal date. This date can be found in your summary of cover.

I have a cash plan through my employer. What do I need to do if I'm leaving my workplace?

You may be able to keep your plan and pay by Direct Debit. Or you can apply for a personal cash plan, to ensure you always have cover. Call our Customer Options team on 0370 908 3304 to discuss the available choices.

Is this private medical insurance?

No, our health cash plan offers money back on everyday healthcare costs, like optical and dental bills, up to annual limits. We let you choose your own treatment providers – as long as they're registered.

Can I add my children to my plan?

You’re welcome to add up to four of you or your partner’s children, up to the age of 18. They will have their own entitlements to claim.

Please be sure to check your policy documents. Some plans let you add more than four children. Some also let you add children up to the age of 24, if they’re in full time education. If you’re unsure, feel free to contact us.

Can I cover my parents or siblings on my plan?

Please be sure to check your policy documents. Our plans differ in who can be covered, and how many people can be on the plan. If you’re unsure, feel free to contact us.

What happens if I have more than one Simplyhealth plan?

You may decide to take out a cash and dental plan, for example. Or have an additional plan provided by your employer. In any case, you’re welcome to claim on either or both policies, up to your maximum entitlements. However, the amount you claim back cannot exceed the value of what you’ve paid.

What is the duration of my cover?

Your cover starts from the date that we include you on the policy. It then carries on until the renewal date. It will carry on from one renewal date to the next, until either we, your employer, or the policyholder cancel it.

Can people on my plan be on different levels?

No, everyone who's on the plan will be on the same level as the policyholder. 

What happens if my personal details change?

If you have a change of address, email, bank account or anything, just let us know. You can call in, send us an email, or start a Livechat.

Who do I need to call?

To discuss an existing cash plan, call: 0370 908 3481
 

For queries regarding your dental plan: 0370 908 3476
 

If you’d like to discuss cancelling your cover with us: 0370 908 3304
 

Or to speak to our Telesales team about setting up new cover: 0330 102 5392

Claims and claiming

When can I claim?

You can start claiming straight away, for treatment had on or after your start date. This is subject to any relevant qualifying periods, or exclusions.

What do I need to make a claim?

To make a claim on your cash plan:
 

Once you’ve had your treatment and paid for it, you'll need a full, itemised receipt. One which clearly shows:

  • the name of the patient
  • the details of the practitioner or establishment
  • the service or treatment that they have provided
  • the date of the service or treatment
  • the amount paid for that service or treatment
     

To make a claim on your dental plan:
 

1. Once you’ve had your treatment and paid for it, request from your dentist a statement of accounts. One which clearly shows:

  • the name of the patient
  • the details of the practitioner or establishment
  • the service or treatment that they have provided
  • the date of the service or treatment
  • the amount paid, itemised to show the cost of each individual treatment
     

2. For claims over £500 you may be asked to provide more information, such as your dental records.
 

Both cash and dental plan claims must be submitted with a completed claim form. To make that easier for you, both can be claimed online. Just register for or log in to your self service account to get started. You’ll need a scan or photo of your receipt/statement ready.

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

Absolutely, we can pay claims straight into your bank account. It can even be the same account you use to pay your direct debit.
 

To add your banking details, simply register for or login to your online account. Under your selected health plan, complete the bank and payment details form. We'll do the rest.

What if my details are incorrect on my claim form?

You can use a form with incorrect details. We mostly need your policy number and the barcode to be clearly visible.
 

Be sure to update your details when possible. You can do so through your online account, or by contacting us.

Where can I get more information or additional help when making a claim?

Refer to your policy documents. These will include what is and isn’t covered, and advice on claiming. If you’re unsure, feel free to contact us.

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

Some hospitals may charge you for the completion of claim forms. We don’t cover the cost of this charge. Instead, we accept claims submitted with a hospital discharge letter. You should be provided with one, but can ask the ward staff if necessary.

When will I receive money back from my claim?

Once received, we aim to process claims as quickly as possible. However, if information is missing from the claim form or receipt, this can take longer to process. And we may ask you for additional info.
 

Paid claims can take an additional three to five working days to arrive in your account. This depends entirely on your bank, and is beyond our control.

Your benefits and entitlements

What can I claim for?

Our plans let you claim for everyday healthcare costs, such as a dental check-up. What you can claim for, and the amounts you can claim, will depend on your plan type and level of cover.
 

You can see your personal entitlements in your online account. You can also access your policy documents, and visit the benefits page for a quick overview of your cover.

Can I pick and choose benefits to suit my needs?

It’s a set plan, so you’re covered for the benefits listed. You're unable to add or remove anything.
 

Your cover should remain useful, and right for your needs. We recommend you review your plan on a regular basis. Let us know any significant changes to your requirements.

Can I submit claims to use different year entitlements?

You’re welcome to submit claims whenever you can. However, we pay claims by the date of treatment, not the date we receive them.

What are the limits on my plan?

To see your personal entitlements, either register for or login to your online account, and visit the benefits pages.

Can I carry over my unused benefits into next year?

No, your benefits are set per claiming year.

Self service

Am I registered for online self service already?

We don’t set up self-service accounts automatically. But doing so is quick and easy. Visit our Home page and click on the register button to begin the process. You’ll need your policy number, a few personal details and an active email address.
 

However, if you are returning to Simplyhealth, it’s possible that your previous login will still work.
 

If you get stuck at all, please contact our customer services team.

Where do I find my entitlements, claims history and policy information?

Your policies are listed in the top left menu. Click one, to see all info relevant to that policy.

How do I login?

Click the login button at the top right of the page. You’ll need your username and password to access your account.

Can I download a claim form?

We don’t currently have the facility to download claim forms. You can request one be posted out to you. Click the 'request a claim form' link under any of your policy tabs.
 

You can also claim online, without having to post anything. Just take a photo or scan of your receipt, and submit it through the ‘make a claim’ process.

How do I unlock my account?

Your account will become locked if a login is input incorrectly three times. First, reset your password. Close your browser and then try again. If that doesn't work, try clearing your cookies. (See our privacy and cookies pages for assistance.) You can speak to our customer services department if you need any help.

 

Why do the benefits listed on the website differ to those shown in my account?

Our website displays the current Simplyhealth plans. These may differ from policies sold in the past. The correct details for your policy can be found in your self service account.
 

If you'd like to discuss switching your plan, you're welcome to call our Customer Options team on 0370 908 3304.

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

Close your browser and then try again. If that doesn't work, try clearing your cookies. (See our privacy and cookies pages for assistance.)

Also be sure to double check your username is correct too, just in case.

 

Claiming - troubleshooting

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

Try closing down your browser and starting again.

File size is too large?

You can try cropping the image down to size. Or change it to black and white. 

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

Try closing down your browser and starting again.

How do I change my email address online?

This is under ‘Security settings’. It doubles up as your username.

I am trying to make a claim online but can only see the option to ‘request a claim form’?

Before you can claim online, you’ll need to add Direct Credit details. Claims will then be paid directly into your bank account. To add these details, log in to your online account and visit the payment details tab. Please be aware this change can take up to 48 hours.
 

Alternatively, you may be trying to use a plan that is no longer active. Be sure you’ve selected your current, active plan before trying to claim. If you wish to claim on an inactive plan, please request a claim form.

I can’t claim or find my claims history?

Double check you've selected the right policy number you wish to view.

 

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Existing customers: 0370 908 3481

 

New customers: 0330 102 5392

 

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We'll get back to you as soon as we can. 

We exist to make it as easy as possible for people to access the healthcare treatments they need. This has been our purpose since 1872, and it still drives us today. We aim to serve as many people as possible in the UK – for the long term. We do this via health insurance services, lobbying, and helping our communities thrive.

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