
As an FCA-authorised expert with over 800,000 policies arranged, WeCovr is dedicated to demystifying the world of health cover. In this guide, we dive deep into Simplyhealth's offerings, exploring how their popular health cash plans differ from comprehensive private medical insurance (PMI) and helping you decide which is right for your needs in the UK.
Before we explore Simplyhealth in detail, it's vital to understand the fundamental difference between a health cash plan and private medical insurance. They serve entirely different purposes, and confusing the two is a common pitfall for consumers.
Think of it like this: a health cash plan is your everyday health wallet. It helps you budget for and reclaim costs on routine, predictable healthcare like dental check-ups, eye tests, and physiotherapy.
In contrast, Private Medical Insurance (PMI) is your high-level protection for the unexpected. It’s designed to cover the significant costs of diagnosing and treating serious, acute medical conditions, offering you swift access to specialists and private hospitals, bypassing potential NHS waiting lists.
Here’s a clear breakdown:
| Feature | Health Cash Plan (e.g., Simplyhealth) | Private Medical Insurance (PMI) |
|---|---|---|
| Primary Purpose | Budgeting for routine healthcare expenses. | Covering major, unexpected medical events. |
| Core Coverage | Dental, optical, physiotherapy, therapies. | In-patient/day-patient treatment, surgery, cancer care, diagnostics. |
| Best For | predictable costs you know you'll incur. | "What if" scenarios and serious health concerns. |
| Typical Monthly Cost | £10 - £70 | £40 - £150+ |
| How It Works | You pay for treatment, then claim the cash back up to annual limits. | The insurer pays the hospital or specialist directly (usually). |
| Medical Underwriting | Usually none. You can often join without a medical questionnaire. | Always required. Your health history is assessed. |
| Pre-existing Conditions | Usually covered after a qualifying period (e.g., for dental). | Not covered. PMI is for new, acute conditions post-policy start. |
| Chronic Conditions | Not covered. | Not covered. Management of long-term conditions is via the NHS. |
Understanding this distinction is the single most important step in choosing the right cover for you and your family.
Simplyhealth is one of the most recognised names in the UK's everyday health market. With a history stretching back over 150 years, they have established themselves as a leading provider of health cash plans, dental plans, and mobility aids.
Unlike many insurers, Simplyhealth has a strong community-focused ethos. As a company without shareholders, they reinvest profits back into the business, customer experience, and charitable causes. Their primary focus isn't on major surgery or cancer care; it's on helping people manage their day-to-day health and wellbeing.
Key characteristics of Simplyhealth:
They are not a provider of traditional private medical insurance. Instead, they occupy a specific, valuable niche in the UK health landscape: helping you manage the costs that PMI doesn't touch.
A Simplyhealth Health Plan is a straightforward insurance product. You choose a level of cover, pay a fixed monthly premium, and in return, you can claim back 100% of the money you spend on a range of healthcare treatments, up to a set annual limit for each category.
Let's use a real-life example.
Meet Alex: Alex has a Simplyhealth Level 2 plan, which costs him around £24 a month.
Within the year, Alex has claimed £450 (£95 + £25 + £180 + £150). His plan cost him £288 for the year (£24 x 12). He's already £162 ahead, plus he still has benefit limits remaining for other therapies.
Simplyhealth typically offers several tiers of cover, allowing you to pick a plan that matches your budget and expected usage. While specifics can change, the structure generally looks like this:
| Benefit Category | Example Level 1 | Example Level 2 | Example Level 3 | Example Level 4 |
|---|---|---|---|---|
| Monthly Premium (Approx.) | £13.50 | £24.00 | £38.00 | £59.00 |
| Dental (Check-ups, treatment) | £70 | £135 | £210 | £350 |
| Optical (Tests, glasses, lenses) | £70 | £135 | £210 | £350 |
| Physiotherapy & Osteopathy | £150 | £250 | £400 | £600 |
| Diagnostics (Consultations, scans) | £150 | £250 | £400 | £600 |
| Prescriptions & Inoculations | £25 | £40 | £60 | £100 |
| Hospital Stays (NHS/Private) | Up to £60/night | Up to £90/night | Up to £120/night | Up to £180/night |
Important Note: These are illustrative figures for 2025 to demonstrate how the plans scale. Always check the latest policy documents for precise benefit limits.
Modern cash plans offer more than just cashback. Simplyhealth plans typically come bundled with valuable digital services, including:
These add-ons significantly boost the value of the plans, providing proactive support that can help prevent minor issues from becoming major ones.
For those whose primary concern is dental costs, Simplyhealth also offers dedicated dental plans. These are more focused than the dental benefit within a broader cash plan and are designed to cover both routine and more significant dental work.
Unlike the "pay and claim" model of their cash plans, their dental plans often work on a model similar to Denplan (which Simplyhealth now owns).
The UK is facing a well-documented crisis in NHS dental access. A 2024 British Dental Association survey revealed that 9 out of 10 NHS dental practices across the UK were not accepting new adult patients. This forces millions to either forgo dental care or pay for private treatment, which can be expensive.
A dental plan from Simplyhealth can act as a financial safety net, making private dentistry more affordable. It allows you to see a dentist of your choice, when you need to, and reclaim a significant portion of the cost.
Example: The Cost of a Private Crown
This is the core of the matter. Many people ask, "Why do I need expensive PMI if a Simplyhealth plan covers my health costs?" The answer lies in the type and scale of those costs.
A cash plan is for the predictable. PMI is for the life-changing. Let's make the comparison crystal clear.
| Aspect of Cover | Simplyhealth Health Cash Plan | Private Medical Insurance (PMI) |
|---|---|---|
| Scenario 1: Routine Care | Ideal. Covers your dental check-ups, new glasses, and regular physio. | Not covered. PMI does not pay for routine, preventative care. |
| Scenario 2: Knee Pain | Helpful for initial stages. Can cover diagnostic consultation with a specialist (£250 limit) and subsequent physiotherapy sessions (£250 limit). | Essential for full treatment. Covers the MRI scan (£800+), specialist fees (£250+), and if needed, the knee replacement surgery (£15,000+). |
| Scenario 3: Cancer Diagnosis | Limited support. Might offer a small one-off payment on diagnosis or cover a consultation. | Comprehensive. Covers the entire treatment pathway: diagnostics, chemotherapy, radiotherapy, surgery, specialist drugs, and aftercare, costing £100,000+. |
| Purpose | Budgeting & Maintenance | Protection & Peace of Mind |
| Best For | People who regularly use dental, optical, and therapy services and want to manage these costs. | People who want to avoid long NHS waits for serious conditions and ensure access to the best possible care if they become unwell. |
| Key Limitation | Annual cash limits are low and won't cover major medical bills. | Does not cover pre-existing or chronic conditions. Not for day-to-day costs. |
As an independent PMI broker, WeCovr often advises clients that these two products are not competitors; they are complementary.
For ultimate peace of mind, many people choose to hold both types of policy.
Example: David's Comprehensive Cover David, a 45-year-old marketing manager, has a Bupa PMI policy and a Simplyhealth Level 3 cash plan.
Choosing the right health cover depends entirely on your personal circumstances, budget, and priorities.
You might consider a Simplyhealth plan if...
You will likely need full Private Medical Insurance if...
The UK health insurance market can feel complex, with dozens of providers and policy options. This is where an independent broker becomes an invaluable ally.
At WeCovr, we don't just sell you a policy. We provide expert, impartial advice to help you understand your options.
Furthermore, WeCovr clients who purchase PMI or Life Insurance gain complimentary access to our AI-powered nutrition app, CalorieHero, to support their wellness goals, and can receive exclusive discounts on other types of cover, like home or travel insurance. Our high customer satisfaction ratings reflect our commitment to providing a supportive and transparent service.
While insurance provides a crucial safety net, the foundation of a healthy life is built on daily habits. Investing in your wellbeing can reduce your reliance on medical services and improve your quality of life.
1. Nourish Your Body:
2. Prioritise Sleep:
3. Move Your Body:
4. Manage Your Mind:
Taking these small, consistent steps can have a huge impact on your long-term health, complementing the security that a good insurance plan provides.
Understanding the difference between everyday health plans and comprehensive private medical insurance is the key to making a confident decision. While Simplyhealth offers excellent value for managing routine costs, only full PMI provides the protection you need against serious health issues.
Let us help you navigate the options. Contact WeCovr today for a free, no-obligation quote and a clear, expert comparison of the UK's best private medical insurance policies.
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