About health care cash plans

Many forms of insurance are protection in the event of the unexpected happening. Health care cash plans are different; they are designed to pay out so you should check the benefits and make sure you will use it. If it is unlikely that you will make a claim, having a health care cash plan might not be right for you.

Any current ailments or conditions (often referred to as pre-existing conditions) that you have when you take out a health care cash plan often won't be covered. However with Sovereign Health Care this does not apply to optical, dental, chiropody/podiatry and health screening benefits. It's important that you check with the provider to find out if they will cover any pre-existing conditions or not, sometimes they may provide cover but for an additional premium.

You should check whether you need a GP referral for benefits you are likely to claim for. Claims for hospital consultant fees usually require a GP referral and this is the case with Sovereign Health Care. Some providers insist you have a GP referral for physiotherapy or other types of therapy, while others allow you to see a practitioner without referral. With Sovereign Health Care you don't need a GP referral for therapy claims however you must receive treatment from a qualified practitioner who is registered with an organisation recognised by Sovereign Health Care.

Most providers, including Sovereign Health Care, reserve the right to request from you, your GP or health care provider a medical report to verify a claim you make.

Which percentage payback rate is best?

This is not an easy question to answer and ultimately you must decide what is best for you. The right health care cash plan for you is dependant upon your own personal circumstances and how you intend to use it. It might be useful for you to think about which benefits you will definitely claim for and how much you've spent on them in the past. It's important that you read the terms and conditions of the health care cash plan and look at the benefit rules, the way the benefit year works and the payback amounts for the levels of cover. For example one scheme offering 100% payback up to a £90 limit may seem better than another scheme offering 50% payback up to a £120 limit but how does this work in practise? As a simple example, assume you have a receipt for £200. The 50% scheme would pay you back £100 whereas the 100% scheme would pay you £90. Furthermore you would have claimed your maximum entitlement with the 100% scheme whereas you'd still have £20 left to claim with the 50% scheme. 

Health care cash plan providers are required to be authorised and regulated by the Financial Services Authority (FSA). The majority of providers are also members of the British Health Care Association (BHCA). Over the past few years the health care cash plan market has consolidated as a result of mergers between providers so you might wish to check if the company you are dealing with is owned by someone else or if it's independent.

Sovereign Health Care is an independent, not-for-dividend company and is authorised and regulated by the FSA and a member of the BHCA.

Check to ensure you have at least a 14 day cooling off period which allows you to change your mind after your policy has commenced. Should you wish to cancel during this time you can receive a refund of premiums paid without penalty as long as you have not claimed.

Health care cash plans are designed to be used and include everyday benefits to support you with the costs of essential health care such as glasses, contact lenses and dental treatment. However they often include numerous other benefits that seem very usable but it's worth checking to establish if you are likely to use these extra benefits or indeed to find out if there is something similar available for free through the NHS. 

The time limit for making a claim for treatment received varies between providers. Some ask for claims to be made within 3 months of treatment whilst others allow a 6 month window in which to claim.

With Sovereign Health Care claims must be submitted with original receipts within 6 months of the date of treatment or the date of completion of in-patient treatment. 

When taking out a health care cash plan find out how quickly you can make a claim. Some companies have a qualifying period which is the time you must wait before you can make a claim.

Sovereign Health Care's usual qualifying period is 13 weeks but we are now waiving this so you can claim immediately for all benefits, with the exception of the maternity/adoption benefit which still has a 52 week qualifying period. This means you can claim immediately for treatment received on or after the date on your policy certificate. 

When buying a health care cash plan you might think it's too good to be true but the basic premise of a plan is that it's designed to be used and can help you financially when you receive treatment. Many health care cash plan companies have long histories and originate from local hospital funds that were set up before the NHS, indeed Sovereign Health Care was founded in 1873 as the Hospital Fund of Bradford. This long history often means health care cash plan have strong financial reserves and Sovereign Health Care is no exception.

Dependent upon your usage of the main benefits, which tends to be the optical and dental benefits, there may be times when you have paid in more than you have claimed, and conversely there may also be times when you have claimed more than you have paid in. Having a health care cash plan is a good way to budget towards the everyday costs of health care, by paying a small monthly amount you can claim cash back when you have received treatment. This means health treatment doesn't unexpectedly have to disrupt your normal spending habits and cost doesn't necessarily have to be a reason for delaying treatment. What's more a health care cash plan has a wide range of benefits so whatever stage of life you're at, there's likely to be a benefit that's of use to you.