Check the fee for your procedure

Check what fees apply to procedures covered under our medical insurance policies.

Policyholders

Simplyhealth - along with other medical insurers - keep premiums at an acceptable level by specifying the fees payable to medical specialists.  These fees are based on historical claims data combined with advice from medical experts and are constantly evolving.

You may wish to check the fees that are payable to ensure that your policy covers the final bill. In the vast majority of cases there will be no problem but there may occasionally be specialists whose fees exceed the amount we will pay.  In these cases you will need to fund the difference.

To check fees ahead of your procedure:

  • Enter the 'CCSD' code for the procedure you're about to undergo in the field below
  • If your surgeon has not already given you the applicable information, ask them for the CCSD code(s) that apply to your treatment
  • If that's not possible, try searching by keyword.

Multiple procedures

  • Where two procedures are carried out by the same surgeon during the same operating session we will pay an additional 25% of the fee maxima for the most complex procedure
  • Where three or more procedures are carried out by the same surgeon during the same operating session we will pay an additional 40% of the fee maxima for the most complex procedure

Please note we will not pay additional fees for codes AC100, A5210, S5210, W9040 or A7350, the fee for pain relief is included in the main CCSD code.

Bilateral procedures

Common bilateral procedures are listed in the schedule with their own single code. For all other bilateral procedures we will allow an additional 66% of the fee maxima of the primary code.

If you have any questions at any point - or if you need to arrange any private treatment - please call us on 0800 294 7302

Medical specialists

If you're carrying out a procedure that isn't coded, call us on 0800 854 929 or apply for a new code via www.ccsd.org.uk. Unacceptable code combinations and other matters relating to our charging structure are covered in our fee schedule explanatory notes.  Please note, we don't provide cover for experimental or unproved procedures.

If you know that your charges are above the limits set out in this fee schedule, please inform your patient.

Contact us

If you're a policyholder:
0800 294 7302

Mon to Fri: 8am to 6pm 
or email us

If you're a medical specialist:
0800 854 929

Mon to Fri: 9am to 5pm
or email us