These plans aim to provide cashback benefits on selected medical care at private hospitals. This means that you are able to choose any private hospital in the UK, pay for your treatment and then be reimbursed for that cost for a fraction of the cost of traditional private medical cover.
Self-Pay Cash Plans
When you get a new condition, instead of choosing to wait on the NHS and possibly experience stress and uncertainty for a number of months, you pay for treatment at a private hospital and get reinbursed on those costs.
Self-Pay Cash Plans provide you with easy access to private medical treatment on new conditions diagnosed after your plan has started.
Although you do have to pay for the treatment upfront you get reinbursed up to your cover limit (which you can choose). This allows you to benefit from faster effective treatment without paying the higher costs associated with a traditional health insurance policy.
Claims Process provided by April UK
What does a treatment cost?
The actual cost of private medical treatment can vary dramatically depending upon the illness/injury.
To help you decide on the level of cover most appropriate for your needs; here is a guide on what you can expect private treatment to cost in a variety of circumstances.
Treatment falls into one of three categories.
Diagnostics - When you need to get a fast diagnosis using private consultants for improved chances of recovery and peace of mind!
Self-Pay Package Cover- You agree the treatment and care required with your consultant, pay for the care and claim for reinbursement.
Therapies - These are the treatments that you may require following surgery or an accident that you can get reinbursed for.
What is a "Self-Pay Package"?
A ‘self-pay package’ is predetermined by the hospital prior to treatment taking place and the costs will be negotiated by the patient. Typically it will include:
- Pre-operative assessment
- Hospital accommodation and meals
- Nursing care
- Hospital theatre fees, drugs and dressings whilst in hospital
- Surgeon and anaesthetist fees whilst in hospital
- Any necessary prosthesis where the procedure you undergo requires it
- X-rays, scans, physiotherapy, pathology, histology needed whilst in hospital
- Take home drugs for up to 14 days following discharge as prescribed by treating consultant
- Post-operative care where clinically required by the treating consultant including, removal of stitches, dressings or plaster, tests and scans and one follow-up consultation.
* Whenever you agree a self-pay package with a hospital, you will always receive an Admission Letter. This will detail exactly what is included in your package and you should always check it thoroughly to ensure it meets your requirements.
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You must be:
- Between the ages of 18 and 69 inclusive
- Resident in the UK, Isle of Man or Channel Islands
Simply call the provider to confirm your cover and request a claim form, which you’ll need to complete and return.
The provider will also require a referral letter and an original receipt showing that an expense has been incurred, or a letter from the hospital, doctor or specialist showing that a medical treatment/service has been used.
Any benefit due will be paid directly into your bank account by the provider.
› Chronic conditions (Diabetes, high blood pressure, etc.)
› Pre-existing conditions
› Cosmetic procedures
› HIV/AIDS or any related medical condition
› Pre-existing medical conditions
› Pregnancy, childbirth and fertility
› Preventative treatment
› Selected sports and hazardous pursuits
› Self-inflicted injury or illness
All conditions you are aware of, or in the opinion of the provider should be aware of, or have received treatment, are automatically excluded, unless you are symptom free and do not receive treatment or advice for the two years following your plan start date.
Yes, you can add your partner and/or your children (including newborn or adopted children) as dependants on your policy.
Some providers offer discounts for having additional family members on one plan
On a hospital cashback plan you can use any hospital
Waiting periods will apply on selected benefits. Please refer to the Policy Document for full information.
On the self-pay hospital plan there in no excess to pay
Full Medical Underwriting is usually a slightly cheaper option, your medical history will be taken over the phone so you will need to be prepared to answer questions.
As your medical history is known you will be told of any specific exclusions when you buy. However exclusions will remain for the life of the plan!
Moratorium Underwriting excludes any condition, disease, illness or injury or related condition, whether diagnosed or not, which you or your dependant in the last 5 years:
- received medication for
- asked for or received, medical advice or treatment for
- experienced symptoms of, or
- were to the best of your knowledge aware existed
Most providers however will cover these conditions after your policy has remained live for 2 years or longer and there has been no further: medication, symptoms or medical advice required relating to the issue in question.
The point is that the exclusions may not be permanent!
Yes you can cancel most plans at any time, however the following rules usually apply:
- If you cancel within the first 30 days you will receive a full refund
- If you cancel the plan within 12 months you may have to pay a cancellation charge which varies between provider
- When your plan comes up for renewal after 12 months you are free to change provider or cancel without charge.
The Diagnostic Cover benefit will provide cash back benefits for consultations and diagnostic tests so getting a crucial fast diagnosis is still covered.
However cancer treatment such as surgery, drugs, radiotherapy and chemotherapy are unlikely to be available from private hospitals as a self-pay package. Therefore this type of treatment is unlikely to be covered on your Hospital Self-Pay Cash Plan.
A ‘self-pay package’ is predetermined by the hospital prior to treatment taking place and the costs will be negotiated by the patient. Typically it will include:
- Pre-operative assessment
- Hospital accommodation and meals
- Nursing care
- Hospital theatre fees, drugs and dressings whilst in hospital
- Surgeon and anaesthetist fees whilst in hospital
- Any necessary prosthesis where the procedure you undergo requires it
- X-rays, scans, physiotherapy, pathology, histology needed whilst in hospital
- Take home drugs for up to 14 days following discharge as prescribed by treating consultant
- Post-operative care where clinically required by the treating consultant including, removal of stitches, dressings or plaster. Tests and scans. One follow-up consultation.
Whenever you agree a self-pay package with a hospital, you will always receive an Admission Letter. This will detail exactly what is included in your package and you should always check it thoroughly to ensure it meets your requirements.
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