Medical cash plans

A clear guide to cash plans

Medical cash plans are simple insurance policies that pay you back a set amount towards everyday healthcare costs. Think dental check-ups, new glasses, physiotherapy, or a counselling session. You keep using the NHS as normal for most care, but when you choose private or routine services, the plan helps with the bill by reimbursing a fixed cash amount, up to your annual limits.

Why are more people considering them now? Many households are feeling the pinch of NHS delays and rising out-of-pocket costs. In 2024, people in the UK paid over £1.2 billion personally for private treatment as waiting lists reached around 7.5 million treatment pathways. For some, that meant dipping into savings to fund a scan, dental work, or therapy. Cash plans aim to cushion these routine costs without the high price tag of full private medical insurance.

Prices vary. Some employer schemes start from a few pounds a month per employee, while individual plans generally range higher depending on age and cover level. Typical consumer premiums can sit anywhere from roughly £45 to £150 a month at the top end for broader benefits and higher limits. The key is to match your benefits to the services you actually use.

This guide walks through how cover works, what is and is not included, and the practical steps to claim. We will keep it clear and balanced, so you can judge whether a cash plan supports your health needs and budget.

What is covered and how claims work

Most cash plans include set allowances for common services: routine dental treatment and hygienist visits, eye tests and prescription glasses, physiotherapy and chiropractic care, some alternative therapies, and a contribution towards private GP or specialist consultations. Many now include mental health support, such as counselling or online therapy, reflecting higher demand among working-age adults. Some policies offer hospital in-patient day rates, maternity grants, or diagnostic scanning allowances.

You usually pay for treatment upfront and then claim back a portion by submitting your receipt. Claims are often handled via an app, with payments made to your bank once approved. Insurers cap reimbursements per benefit and per policy year. For example, a mid-tier plan might pay up to a set amount annually for dental and a separate allowance for optical. If your receipt exceeds the limit, you cover the difference.

Limitations matter. Cosmetic dentistry, experimental treatments, or procedures without clinical need are typically excluded. Pre-existing conditions may be covered for routine costs only after a waiting period, or not at all for certain benefits. Some benefits require referrals or treatment by registered practitioners. There may be maximum claim frequencies, such as one eye test per year. Always check the schedule of benefits and any waiting periods before relying on cover.

Simple example: You spend £120 on a dental check-up and treatment. Your plan pays 75 percent up to £100 for the year. You would receive £90, leaving £30 at your expense. If you have already claimed £100 this year for dental, no further dental reimbursement would apply until renewal.

Who is likely to benefit

Cash plans suit people who value regular, predictable support with everyday health costs rather than full private treatment for serious conditions. Busy families needing dental and optical care, workers who use physiotherapy, and those seeking timely counselling or private GP access often find good value. Employers use cash plans to offer broad wellbeing support to whole teams at a manageable cost, helping reduce minor issues from escalating.

If you already have private medical insurance, a cash plan can complement it by handling routine costs and freeing PMI for major claims. If you rarely see dentists, opticians, or therapists, or you are fully comfortable waiting for NHS services, a cash plan may not provide strong value. The decision should come down to the services you genuinely expect to use and the limits offered at each price point.

Choosing a level of cover

1. Entry level - core essentials

   • Typical benefits: dental check-ups and basic treatment, eye test, low optical allowance, limited physiotherapy.
   • Best for: first-time buyers wanting modest help with the most common costs.

2. Standard - balanced everyday support

   • Typical benefits: higher dental limits, improved optical allowance for frames or lenses, more sessions for physio or chiropractic, some mental health support, private GP access.
   • Best for: individuals and families with routine dental and optical needs plus occasional therapy.

3. Comprehensive - higher limits and extras

   • Typical benefits: strong allowances across dental, optical, and therapies; diagnostics contribution; in-patient day rates; broader mental health options; dependants covered.
   • Best for: households using multiple services each year who want fewer shortfalls.

4. Optional add-ons

   • Examples: enhanced diagnostics, increased counselling sessions, worldwide accidental injury cover, maternity cash benefit, higher therapy limits.
   • Consider if: you consistently exceed standard limits or want targeted protection for a known need.

Tip: Start with the benefits you are sure to use, then add options only if limits feel tight during the first year.

What it costs and why

Prices are illustrative and not guaranteed. Insurers set terms individually and can change them at renewal.

Can you apply

Most adults living in the UK can apply, and many plans allow partners and dependants to be added. Insurers will ask for basic personal details, your UK address, and bank information for premiums and reimbursements. Some may request information about recent treatment or pre-existing conditions for certain benefits, but medical underwriting is typically lighter than private medical insurance.

Common restrictions include waiting periods for specific benefits, maximum claim limits per year, and requirements to use registered or accredited practitioners. Claims must usually be supported by itemised receipts issued in the UK. You might be declined or restricted if you cannot verify residency, if therapy is not clinically indicated, or if the provider is not appropriately registered. Check the insurer’s list of acceptable practitioners before booking treatment.

From quote to claim

1. Get quotes based on your age, location, and cover needs.
2. Compare benefit tables and annual limits against expected usage.
3. Check exclusions, waiting periods, and practitioner requirements.
4. Choose a level, add dependants or optional extras if needed.
5. Apply online, set up payment, and read the policy schedule carefully.
6. Book treatment with a registered practitioner and keep itemised receipts.
7. Submit claims via app or portal with clear proof of payment.
8. Track reimbursements and review limits before renewing.

Advantages and trade-offs

Key checks before you commit

Review the full schedule of benefits and the annual limits for each category, alongside any sub-limits per claim. Confirm waiting periods, particularly for dental treatment, therapies, and maternity cash benefits. Note any excess or co-payment rules, practitioner registration requirements, and claim frequency caps. Ask how claims are verified and how quickly reimbursements are paid. Check renewal terms, as premiums and limits can change each year. Finally, keep copies of itemised invoices and payment receipts for every claim to avoid delays.

Alternatives to consider

1. Private medical insurance - covers diagnosis and treatment for acute conditions in private facilities. Better for major surgery and cancer care, but usually costs more.
2. Dental insurance - targeted dental cover with defined treatment bands. Useful if you have regular or complex dental work planned.
3. Health savings pots - setting aside money monthly for routine care. Offers flexibility but no insurer contribution.
4. Workplace wellbeing schemes - may include virtual GP, mental health support, and discounts. Helpful add-ons but not insurance.

Frequently asked questions

Q: Do cash plans replace the NHS or private medical insurance? A: No. They are designed to contribute towards everyday costs like dental, optical, and therapies. You can still use the NHS. For major diagnosis and treatment, private medical insurance is more appropriate.

Q: How do I claim and how quickly will I be paid? A: You typically pay the provider, submit a receipt via the insurer’s app or portal, and receive reimbursement once approved. Timelines vary, but many insurers pay within a few working days.

Q: Are pre-existing conditions covered? A: It depends on the benefit. Routine dental and optical are usually covered regardless, while therapy or diagnostics may have waiting periods or exclusions for pre-existing issues. Always check the policy wording.

Q: Can I choose my own dentist, optician, or physiotherapist? A: Yes, provided they meet the insurer’s registration and accreditation requirements. Using non-approved providers can lead to declined claims, so verify before booking treatment.

Q: Will my premium increase after I claim? A: Heavy usage can influence renewal pricing, especially on individual plans. Group schemes may smooth the impact. Insurers reassess prices and benefits each renewal year.

Q: What is not covered? A: Cosmetic or elective treatments, experimental procedures, non-registered practitioners, and services without clinical need are commonly excluded. Some plans restrict overseas treatment unless specified.

Q: Can employers offer cash plans to all staff? A: Yes. Many UK employers use cash plans to support whole workforces at modest cost, helping employees access routine care and reducing pressure on other benefits.

What to do next

List the routine health costs you expect this year and match them to benefit tables and limits. Compare a few levels of cover and check exclusions carefully. If you are part of a workplace scheme, review the employer option and dependants cover. Take your time and pick the plan that clearly fits your budget and likely usage.

Important information

This guide provides general information only and is not personal financial advice. Features and prices vary by insurer. Always read the policy documents, schedules, and exclusions in full, and confirm provider eligibility before you buy or claim.