Health Shield: health cash plans, claims and cover

Health Shield is a UK friendly society that sells health cash plans: insurance that pays a set amount back towards everyday health costs you have already paid for, such as a dental check-up, an eye test, a trip to a physiotherapist or a prescription. It is not private medical insurance, and it does not pay for private hospital treatment. It sells its plans under the Health Shield name, and its register entry lists a previous name of Transport Hospital Fund¹.

Health Shield is a friendly society, a mutual structure rather than a company owned by shareholders, and it appears on the Bank of England list of UK insurers authorised to carry out contracts of insurance¹.

This page covers what a Health Shield plan is, how a claim is assessed and paid, who can join, how to buy and manage a plan, how to complain, and how money with the firm is protected. Health Shield publishes its own plan documents and current figures on its website, and those are the figures that apply to your plan.

What a Health Shield health cash plan is

A health cash plan is a type of insurance that pays money back towards health costs you have already paid. You pay a regular premium, and when you have a treatment or appointment that your plan covers, you send in the receipt and the plan pays a set amount towards it. The Financial Ombudsman Service lists cash plans among the main types of private medical insurance policy, alongside individual policies, group policies, dental policies, 6-week plans and international private medical insurance policies⁴.

That places a cash plan in the same broad family as private medical insurance, but the two work differently. Private medical insurance covers the cost of investigating and treating medical or dental conditions, and typically covers a wide range of medical services from specialist consultations to surgery and hospital stays⁴. A cash plan does not pay the hospital or the specialist. It reimburses you, up to the limits set out in your plan, for costs such as a dental check-up, an eye test, a physiotherapy session or a prescription.

Health Shield sells its plans under the Health Shield brand, and its register entry lists Health Shield as its current trading name¹. The firm is a friendly society, a mutual structure rather than a company owned by shareholders.

If you want the wider picture of how health and protection insurance fits together, the insurance guide and the protection insurance guide set out the main types side by side.

How a health cash plan pays out

The mechanics are simple: you pay for the treatment, keep the receipt, submit a claim, and the plan pays money back into your bank account. Health Shield describes the process as money back in your pocket in four simple steps, and says that once a claim is approved the money will be paid back into your bank account, typically within three to five working days³.

Two things decide what you get back. The first is whether the treatment is covered by your particular plan. Health Shield's own guidance is to check your membership plan to make sure the treatment is covered before booking anything³. The second is the receipt. Health Shield asks for an itemised receipt, so a till slip that shows only a total may not be enough³.

A cash plan is not the same as a personal health budget or NHS continuing healthcare, both of which are NHS-funded support for your health needs rather than insurance you buy⁶. It is also separate from the cover a private medical insurance policy gives: private medical insurance typically does not cover emergency treatment, and individual policies are unlikely to cover treatment for pre-existing conditions⁵.

Who can get a Health Shield plan

Health Shield sells individual plans and also works with employers, so some people join through work rather than buying directly. If your employer runs a health or wellbeing scheme, the practical first step is to ask your HR team what policies are in place, because the plan you can join, and the terms, will be the ones your employer has arranged⁸.

For plans bought directly, the same broad rules that apply to health insurance apply here. Insurers assess the risk they are taking on, and for individual private medical insurance policies that assessment commonly uses either full medical underwriting or moratorium underwriting⁶. Underwriting is how an insurer decides what it will and will not cover, and it is why a new policy typically will not cover conditions that were already known to you, or for which you had symptoms, before you took the policy out⁹.

Age matters in this market. The cost of private health insurance is based on your age, where you live and your chosen level of cover, so the premium for the same cover rises as you get older⁶. On the question of whether cover stops at a certain age, Which? has reported that none of the providers it analysed in its review of private health insurance providers place age limits on their cover for existing customers⁹.

Health Shield's own plan documents set out the eligibility rules, the cover levels and the limits that apply to each plan, and those are the terms that govern your membership.

Making a claim: paid in days, not weeks

Health Shield's stated aim is to assess a claim within two working days, and to pay an approved claim typically within three to five working days after that³. That is quick by the standards of insurance claims generally. For comparison, the Financial Services Compensation Scheme says most of its claims take between five months and one year, which shows how much the timescale depends on what is being assessed¹⁰.

To submit a claim you need four things to hand: your member number, your current bank details so the plan can pay you, your email address, and a valid receipt³. Most claims can be submitted online. Paper claims have to go in by post, using the details on the paper claim form³.

Some claims cannot be made online at all. Claims relating to maternity, hospital, critical illness and personal accident protection need a paper claim form, and maternity and hospital claims also need an official stamp from your care provider³.

How to buy or join a Health Shield plan

There are two routes. You can buy a plan directly from Health Shield, or you can join through an employer that has arranged cover for its staff. If you are not sure which applies to you, the employer route is worth checking first, because a workplace scheme may already include you or offer terms you cannot get as an individual⁸.

Before choosing a plan, it helps to know what you actually spend on health costs in a year: dental check-ups and treatment, eye tests and glasses or contact lenses, physiotherapy, prescriptions, and anything else the plan covers. A cash plan pays back set amounts towards those costs, so the value depends on how much of the covered spending you do. Health Shield's own plan documents set out the cover levels and the amounts payable under each plan.

If you are comparing this with other ways of covering health costs, the insurance guide explains how the different types of policy fit together, and the protection insurance guide covers the policies that pay out when something goes wrong rather than reimbursing everyday costs.

Managing your plan online

Health Shield's claims process is built around online submission, with the paper route kept for the claim types that need it³. Managing a plan online means keeping a few details current: your email address, so correspondence reaches you, and your bank details, so approved claims are paid to the right account³.

The practical habits that make a cash plan work are unglamorous. Keep receipts as you go rather than trying to reconstruct a year of spending later, and check the itemised receipt is actually itemised before you leave the practice or the shop³. Before booking a treatment, check the plan covers it, because a claim for something outside the plan will not be paid however good the receipt is³.

If you also hold other financial products and want to keep track of what is protected where, the consumer protection guide explains the main schemes in one place.

Complaints and where to get help

If something goes wrong with a Health Shield plan, the first step is to complain to Health Shield itself. A complaint gives the firm the chance to put the problem right before it goes further. You can write to the head office address (Complaints, Health Shield Friendly Society, Electra Way, Crewe, Cheshire, CW1 6HS), telephone 01270 617723, email, or complete and submit the online complaint form¹. If you are unhappy with the response, or the complaint is not answered within eight weeks, you can refer it to the Financial Ombudsman Service¹.

If the firm's final response does not resolve the matter, the next step is the Financial Ombudsman Service, which is free to consumers. The ombudsman handles complaints about private medical insurance, including cash plans, and it can look at how a claim was assessed or how a policy was sold⁴.

Complaining about insurance is not the same as complaining about a bank or a phone company, and the routes differ. If your problem is with a bank rather than an insurer, the current accounts guide and the consumer protection guide set out where to take it. If you are worried about a firm that has stopped trading or a scam, the scams and fraud guide explains the warning signs and who to tell.

How Health Shield is regulated and your protection

Health Shield is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Its register entry shows a status of Authorised with a status effective date of 1 December 2001, a firm reference number of 205304, and Health Shield as its current trading name¹. It also appears on the Bank of England list of insurers incorporated in the UK and authorised to carry out contracts of insurance².

You can check any firm's status yourself. The FCA's firm checker is a tool for consumers to check whether financial services firms are authorised and have permission to sell products and services, and the FCA register is where you can check whether a provider or adviser is authorised by the PRA or the FCA¹¹. The Financial Services Compensation Scheme's protection checker draws its results from the FCA's Financial Services Register, so the two should agree¹³.

Where protection applies, it depends on the firm having been authorised. The FSCS says it can only protect you if the FCA has authorised your pension provider, and more generally that the FCA or PRA must have authorised the firm when you used it¹⁴. The FSCS also says that for investment protection the provider must be authorised by the FCA or the PRA¹⁶.

Insurance protection is not the same as the protection that applies to money in a bank account. If your question is about deposits rather than insurance, the savings guide and the banks directory explain how deposit protection works and which brands share a limit. If a firm you hold a policy with fails, the FSCS sets out what it covers and how a claim is made, and its own guidance says most FSCS claims take between five months and one year¹⁰.