General exclusions for Simply Personal Health

What's not covered?

There are a number of general exclusions that apply to Simply Personal Health. They are as follows:

  • Treatment of chronic conditions. These are long term conditions that cannot be cured and where treatment will usually only relieve symptoms
  • Any exclusions specific to cover as shown on your client's Membership Certificate
  • Pre existing medical conditions - which have not been disclosed and accepted by us for benefit
  • Treatment that has not been arranged and authorised through our helpline  
  • AIDS and HIV
  • Addictions and substance abuse
  • Cosmetic treatment
  • Dental treatment - We do not pay for any dental treatment except for the operations listed in the 'dental surgery' benefit
  • Development or behavioural problems
  • Dialysis
  • Drugs, dressings and medical appliances
  • Experimental or unproven treatment
  • Eyesight - We do not pay for treatment of short sight or long sight, for example glasses, contact lenses or laser eyesight surgery. We will pay for treatment of an eyesight problem which is an acute condition, for example a cataract or detached retina
  • GP treatments and charges
  • Medical information, claim forms
  • Overseas treatment
  • Pregnancy, childbirth and fertility treatment
  • Preventative treatment
  • Rehabilitation, convalescence and general nursing care
  • Screening and monitoring
  • Self inflicted injury
  • Sport - professional sportsmen and women and dangerous sports
  • Transplants
  • War and dangerous substance contamination
  • Weight loss treatment

For full details please refer your client to Section 2 of the Simply Personal Health policy document (Connections hospital network) or Simply Personal Health policy document (National and Metropolitan hospital networks)

 Simply Personal Health Connections (498 kb)

 Simply Personal Health National and Metropolitan (469 kb)

Need help?

If you would like more information please contact us on:

Health plans

0330 1025 337

Mon to Fri: 8am to 6pm

or email us.

Hospital locator

Find a hospital for treatment if you are a PMI customerGot a health insurance plan? Need treatment?

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Employees leaving a company scheme?

From 1st August Simplyhealth no longer provides continuation quotations for customers leaving company schemes.  Please call AXA PPP healthcare, who now provide special continuation terms for these customers.

0800 33 33 11

Mon to Fri: 8am to 8pm
Sat: 9am to 1pm
Or email them

Do you have a question?
Then visit our page for Simply Personal Health where we answer some of the most Frequently Asked Questions we receive.