What is an NHS cash benefit?

Private medical treatment can be costly, as our research into the UK's average cost of common surgeries has shown. That research focused on treatments that will, at most, only require a night or two in hospital, with many taking place as day patient cases with no overnight stay needed.

The costs start to spiral for complex conditions that require an extended hospital stay as an in-patient.

Health insurers' primary reason for offering an NHS cash benefit is to encourage policyholders to use free NHS services where possible, which reduces the insurer's costs.

Chris Steele, founder of myTribe explains:

‍"An NHS cash benefit comes with most health insurance policies, yet it's an aspect that's often overlooked. As the NHS currently has close to a record waiting list for non-urgent treatments, you might think that this benefit is somewhat redundant; however, waiting times vary significantly across the country, and urgent cases are still prioritised. If you can get treatment via the NHS, the advantages are twofold, as in addition to the cashback, you will also avoid your no-claims discount being affected if you have one, helping to keep your future premiums manageable."

Chris Steele

Cert CII (F1, IF7 & I10), Founder and Insurance Expert

Each insurer has different exclusions in relation to their NHS cash benefits, but here are some of those to be mindful of:

• Anything that your plan wouldn't usually cover, so pre-existing and chronic conditions will be excluded.
• Some exclude mental health hospitalisation.
• Most will exclude hospital stays if you're admitted due to a visit to A&E, although some say it's just the first three days that'll be excluded.
• If you switch from an NHS hospital to a private hospital, your insurer will usually not pay the cash benefit for the time you spent in the NHS.

Why you should always look to use your NHS cash benefit when you can

If you claim for private medical treatment there's a couple of costs to factor into your decision making process, specifically your excess and how the claim will affect your no claims discount. While your excess may be a modest one-off cost that you can afford, seeing your no claims discount reduce can lead to far higher, and potentially unaffordable renewal premiums down the line.

If, and it's a big if with the current state of the NHS, you can get the treatment you need via the NHS instead of claiming on your private health insurance, not only will you likely get a cash benefit, but you won't have to pay your excess, nor will the claim affect your no claims discount - it's win, win, win.

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Here's what the leading health insurance providers offer with respect to NHS cash benefits:

Aviva

Aviva will pay you £100 per night for up to 30 nights when you're admitted to an NHS hospital as an in-patient, but if you choose their six-week NHS option, this benefit isn't available if you can get your treatment within that time from the NHS.

In addition, Aviva will pay you £100 for each day you receive treatment on the NHS for cancer as an in-patient and day-patient, with out-patient radiotherapy, chemotherapy or blood transfusions, and other cancer-related surgical procedures also included. They'll even pay that benefit if you receive intravenous chemotherapy at home. While you can't claim more than £100 per 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 a night up to £2,000 a year when you're admitted for in-patient treatment to an NHS hospital, a little less than 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-patient, out-patient and in-patient treatments. However, bear in mind, 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 the terms will differ on their other places such as inSpire.

Bupa

Whether you opt for Treatment and Care or Comprehensive, Bupa's health insurance offers the same with respect to NHS cash benefits: £50 per night, up to 35 nights a year.

In addition, Bupa offers a separate cash benefit for the treatment of cancer via the NHS: £100 per night for in-patient treatment, £100 for out-patient, day patient, or NHS home treatment, with no apparent limits from what we can see in their policy documentation.

Freedom

Freedom Health Insurance and their Elite plan will pay you £200 each night you spend in an NHS hospital for elective (non-urgent) in-patient treatment that the policy would otherwise cover and £100 for each day you spend in an NHS hospital as a day-patient for elective treatment.

Looking at their policy documents, we can't see whether there's an annual limit applied to these claims; however, as the benefit is purely for non-urgent, elective treatment, we'd assume that time spent in hospital for those will, by their nature, be relatively short, limiting the size of these claims.

The Exeter

The Exeter offers £150 per night for up to 30 nights of NHS treatment, which is more than some of the others we've examined in this article.

The Exeter also will pay you the same £150 per night for up to 30 nights of cancer treatment via the NHS; however, from what we can see, this doesn't extend to day-patient, out-patient and home treatments, so it is a little more limited than others.

Vitality

Vitality is among the most generous in terms of how much they'll pay per night at £250, but there's a limit of £2,000 per year, equating to 8 nights in an NHS hospital. In addition, Vitality will pay you £125 per day (up to a maximum of £500) for day-patient treatments.

With Vitality's Advanced Cancer cover, they'll pay £100 for each day or night of treatment up to a maximum of £10,000 per person in any plan year.

WPA

WPA has a slightly different approach in that they pay a benefit based on the amount of time spent in an NHS hospital. For non-cancer treatment, they'll pay £150 per day or night for less than three nights, which increases to £200 per night for stays longer than three nights. In addition, WPA offers a cash benefit of £150 per day for out-patient complex scans and NHS out-patient procedures. WPA have the highest annual limit of those we've looked at in this article, at £4,500.

If you opt to add Cancer Care to your policy, you'll also benefit from up to £6,000 a year for eligible NHS cancer treatments. Depending on the type of treatment, you'll receive between £150 and £200 per day/night.

Most insurers require you to submit your NHS cash benefit claim within 3-6 months of being discharged from hospital, and in most cases, you don't need pre-authorisation for the claim. Please bear in mind that all insurers have restrictions, and there will be things that won't be covered and, therefore, not eligible to receive cashback. Contact your insurer, visit their website or use their app to look at how you can claim the cash benefit.

We hope you found this helpful guide; it's one aspect of often complicated health insurance policies. If you'd like to learn more, please read our other guides or request a comparison quote and get free, personalised, expert advice.

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