Health insurance policies in the UK have a number of features, one of which is the NHS cash benefit. In this article we explain what NHS cash benefit is and when you can use it.
How NHS cash benefit usually works
When you take out a private health insurance policy it will more than likely have something called an “NHS cash benefit” Here’s what you can generally expect from it:
- If you choose to be treated in an NHS hospital instead of privately, your insurer will pay you a cash benefit, usually between £50-£200 per night.
- Some insurance companies will also reimburse you for day and outpatient treatments, especially if they are related to cancer.
- Hospital stay must be for acceptable treatment and condition, subject to normal exclusions.
- The insurer will pay the compensation directly to your bank account.
- Most insurers have annual maximum limits for NHS cash benefits of between £2,000-£4,500.
- NHS cash benefits do not usually require you to pay an excess and will not affect your claims discount.
Why do insurers offer NHS cash compensation?
Private medical treatment can be expensive, as our research into the average cost of common operations in the UK has shown. That research focused on treatments that would require at most only one or two nights in hospital, with many taking place as day patients without the need for an overnight stay.
Costs are starting to skyrocket for complex conditions that require extended hospital stays.
The primary reason for health insurers to offer NHS cash compensation is to encourage policyholders to use free NHS services where possible, which reduces costs for insurers.
The benefits of NHS cash benefit for the insured and the insurer
Common exclusions from NHS cash benefits:
Each insurer has different exclusions in relation to NHS cash benefits, but here are some of them to bear in mind:
- Anything your plan doesn’t usually cover, so pre-existing and chronic conditions will be excluded.
- Some rule out hospitalization for mental health.
- Most will exclude a hospital stay if you are admitted for an emergency room visit, although some say only the first three days will be excluded.
- If you transfer from an NHS hospital to a private hospital, your insurer will not usually pay for the time you spent in the NHS.
Why you should always use your NHS cash benefit when you can
If you make a claim for private medical treatment, there are several costs you need to consider in the decision-making process, particularly your excess and how the claim will affect your no-claims discount. While your excess may be a modest one-off cost you can afford, reducing your no-claims discount can lead to much higher and potentially unaffordable renewal premiums.
If, and it’s a big if with the current state of the NHS, you can get the treatment you need through the NHS instead of going to your private health insurance, not only are you likely to be reimbursed, but you won’t have to pay your excess, nor will a claim affect your no-claim discount – it’s a win, win, win.
What do leading private health insurance providers offer?
Here’s what the leading health insurance providers offer in terms of NHS cash benefits:
Aviva
Aviva will pay you £100 per night for up to 30 nights when you are admitted to an NHS hospital as an inpatient, but if you choose their six week NHS option, this benefit is not available if you can get treatment within that time from the NHS .
In addition, Aviva will pay you £100 for every day you receive cancer treatment on the NHS as an inpatient and day patient, with outpatient radiotherapy, chemotherapy or blood transfusions, and other cancer-related surgery. . They will even pay that fee if you are receiving IV chemotherapy at home. Although you can’t claim more than £100 a day under the NHS Cancer Cash Benefit, we can’t find any other limits in their terms and conditions.
Axa Health
Axa Health’s personal health policy provides a cash payment of £50 per night up to £2,000 per year when you’re admitted to an NHS hospital for inpatient treatment, slightly less than the others we’ve covered in this article.
In relation to cancer treatment, if you opt for Comprehensive Cancer Cover, Axa will pay £50 per day, up to a maximum of £2,000 per year for day treatment, outpatient and inpatient treatment. However, please note that this is only for their personal health plan with comprehensive cancer cover. If you opt for “NHS Cancer Support” there is no cash benefit and terms will differ from other sites such as inSpire.
Bupa
Whether you opt for Treatment and Care or Comprehensive, Bup’s health insurance offers the same in terms of NHS cash benefits: £50 per night, up to 35 nights per year.
In addition, Bupa offers a separate cash benefit for NHS cancer treatment: £100 per night for inpatient treatment, £100 for outpatient, day treatment or NHS home treatment, with no apparent limits to what you can see in their policy documentation.
Freedom
Freedom Health Insurance and their Elite plan will pay you £200 for every night you spend in an NHS hospital for electoral (non-emergency) hospital treatment that would normally be covered by the policy and £100 for each day you spend in an NHS hospital as an elective day patient.
Looking at their policy documents, we can’t see if there is an annual cap applied to those claims; however, since the benefit relates solely to non-urgent, elective treatment, we would assume that the time spent in hospital for them would, by its nature, be relatively short, limiting the size of these claims.
Exeter
Exeter offers £150 per night for up to 30 nights of NHS treatment, which is more than some of the others we’ve looked at in this article.
Exeter will also pay you the same £150 per night for up to 30 nights of NHS cancer treatment; however, as far as we can see, it does not apply to day, outpatient and home treatments, so it is a bit more limited than others.
Vitality
Vitality is among the most generous in terms of how much it will pay per night from £250, but there is a cap of £2,000 per year, which equates to 8 nights in an NHS hospital. In addition, Vitality will pay you £125 per day (up to a maximum of £500) for daily patient treatments.
With Vitality’s Advanced Cancer cover, it will pay £100 for each day or night of treatment up to a maximum of £10,000 per person in any plan year.
WPA
The WPA takes a slightly different approach in that they pay a fee based on time spent in an NHS hospital. For non-cancer treatment they will pay £150 per day or night for less than three nights, rising to £200 per night for stays of more than three nights. In addition, the WPA offers reimbursement of £150 per day for complex outpatient tests and NHS outpatient procedures. The WPA has the highest annual limit of those we’ve looked at in this article, at £4,500.
If you choose to add cancer care to your policy, you’ll also benefit from up to £6,000 a year for eligible NHS cancer treatment. Depending on the type of treatment, you will receive between £150 and £200 per day/night.
How to claim using your NHS cash benefit
Most insurers require you to make an NHS cash claim within 3-6 months of being discharged from hospital, and in most cases you don’t need prior authorization to make a claim. Please note that all insurers have restrictions and there will be things that will not be covered and therefore not eligible for a refund. Contact your insurer, visit their website or use their app to see how you can claim cash compensation.
How to get free advice
We hope you found this guide useful; it is one aspect of often complicated health insurance policies. If you want to find out more, read our other guides or request a comparison quote and get free, personalized, expert advice.
