Medicash: health cash plans, dental cover and how it works

Medicash is a UK health cash plan provider. Rather than paying for private treatment, its plans pay cash back towards health costs you have already paid for, such as dental check-ups, glasses, physiotherapy and consultations. It sells individual, couples and family plans, and also offers corporate health cash plans for employers¹.

It sells to individuals, couples and families, and to employers who want to offer a health benefit to staff. Plans are arranged in levels, and the level you choose sets the maximum you can claim back for each type of treatment. You can claim as many times as you like up to that maximum, and most benefits can be claimed from the date shown on your Policy Schedule³.

Two rules matter more than any other. Claims must be made within 26 weeks of the date you received treatment or were discharged from hospital, or Medicash will not accept liability to pay them, and no claims are paid until your first premium has been received³.

What a Medicash health cash plan is

A health cash plan is not the same thing as private medical insurance. Private medical insurance covers the cost of investigating and treating medical or dental conditions, and health insurance more broadly covers private medical treatment and gives access to private healthcare services⁵. A cash plan works the other way round: you pay for the treatment, then claim a set amount back.

That difference shapes what the plan is good for. A cash plan suits regular, predictable costs, the check-up, the new glasses, the physio session. It does not buy you a private hospital bed or a consultant of your choice.

Medicash's plans run on a benefit table. Each benefit has a maximum, and the period over which you can claim that maximum is usually 12 months, though the plan documents say to check your own benefit table³. Your policy renews automatically every month as long as you keep paying premiums and keep to the terms and conditions³.

There are exclusions that catch people out. Personal Accident cover stops on your 66th birthday, though other benefits continue³. The hospital benefit is not payable for a pre-existing condition for three years from the start of the policy, or at the higher rate for three years after an increase in cover³. A pre-existing medical condition is defined as an illness or injury you had before your policy began or was renewed⁷.

Individual health cash plans from Medicash

Medicash sells individual cover at several levels, and the level you pick decides how much each benefit pays out. The Solo Plan covers one adult plus dependent children³. If you want to cover a partner, including a same-sex partner, you need the Dual Plan, which is also available at a range of levels³.

Cover is designed around individuals, couples or families. You can cover up to four dependent children up to the age of 16, or 19 if they are in full-time education, for some benefits at no extra cost³.

The Wellbeing plan includes maternity cover: it pays a lump sum on the birth of a child or the adoption of a child under the age of three, with a 12 month waiting period before that benefit becomes payable³. The birth or adoption benefit is not paid if the birth or adoption happens within the first 12 months of the policy, and it is paid at the lower rate for 12 months after an increase in cover³.

For the wider market this sits in, see insurance, which explains how cash plans, private medical insurance and protection policies differ.

Medicash corporate plans for employers

Employers buy Medicash cover as a staff benefit, usually priced per employee rather than per plan level. This is a common pattern in UK workplace benefits: employers have typically used either contract-based arrangements, such as group personal pensions, or trust-based ones such as master trusts, and health benefits sit alongside those⁸.

Employees covered by a group permanent health policy taken out by an employer for the employee's benefit fall within the complaint-handling rules, which means the same route to the Financial Ombudsman Service applies to them as to individual policyholders⁹.

If you are an employee trying to work out what a benefit costs you, your payslip is the place to look. Employers can choose whether they provide printed or electronic payslips, so if you receive yours online, that is where deductions and benefit information will appear¹⁰.

Employers weighing up a health benefit against other spending should note that the plan is a contract between the employer and Medicash, and the benefits available to staff are set by the scheme the employer chooses.

Dental benefit and paying off dental schemes

Dental cover is one of the main reasons people take out a cash plan. Medicash's health cash plans cover routine dental treatments and can reimburse part of an existing dental care plan you are already paying for. Cosmetic treatment such as teeth whitening is not covered, and how much you can claim back each year depends on your chosen level of cover³.

It is worth knowing what the state provides before deciding how much dental cover you need, because for some households NHS dental treatment is already free. You are entitled to free NHS dental treatment if you receive the guarantee credit part of Pension Credit, and Pension Credit also brings vouchers towards glasses or contact lenses and possible help with rent or Council Tax². Free NHS dental treatment is also available if you or your partner get income-based Jobseeker's Allowance, income-related Employment and Support Allowance, the guarantee credit part of Pension Credit, Universal Credit, or tax credits if you meet certain criteria¹².

Help with NHS dental treatment, glasses and transport costs for hospital appointments is available to people getting the guarantee credit part of Pension Credit¹³. A War Pensioner who needs dental treatment because of the condition or conditions they get a War Pension for may be reimbursed the full cost of NHS treatment within the appropriate band¹⁴.

If you are weighing up whether to pay for dental care privately or through a plan, benefits sets out the help that is available on low incomes.

Digital health tools included with some plans

Medicash's own published material does not list a virtual GP service among its benefits. Virtual GP services are common elsewhere in the market: many health insurance policies offer flexible benefits including access to virtual GP services, and protection policies often include added benefits such as virtual GP services, vocational rehabilitation, mental health support and employee assistance programmes⁶.

Some health plans more widely offer preventative services such as regular health assessments, mental health support and lifestyle advice⁶. If a digital or remote service is the reason you are considering a plan, the benefit table for that specific plan is the document that decides it, and Medicash's own site carries the current version.

There is free NHS-approved support available outside insurance too. Every Mind Matters: Your mind plan is a free NHS-approved online tool¹⁶. For anyone managing money alongside a mental health condition, debt covers the options, including the breathing space scheme, which lasts for up to 60 days¹⁷.

How Medicash charges work: individual and per-employee pricing

Medicash does not publish a single price, because the price depends on the plan level and who is covered. Individual and family plans are priced by level, and employer schemes are priced per employee. This page does not carry rates; medicash.org has the current figures.

What is worth understanding is how charges are structured in this part of the market. Where charges are imposed on a member under a single charge structure, they are calculated solely by reference to the value of the member's rights under the scheme, and where a calculation covers a period shorter than a charges year it is done on a pro rata basis¹⁸. Where charges are agreed between parties, they must reasonably correspond to the provider's actual costs¹⁹. Platform charges in workplace arrangements are often calculated on a per member, per month basis²⁰.

For a consumer, the practical point is that a cash plan premium buys a fixed set of maximum payouts, not a fund that grows. The value of the plan depends on whether your actual health spending gets close to those maximums. If you claim little, the premium is money spent on cover you did not use; if you claim a lot, the maximums cap what you get back.

Prescription costs are a useful comparison when you are working out what you spend. Prescriptions are free in Northern Ireland, Scotland and Wales, but are charged in England, where the charge is set nationally and reviewed each year²¹. Prepayment certificates can reduce what you pay if you need several items a month, and the saving depends on how many prescriptions you collect and which certificate length you choose²². A medical exemption certificate lasts for 5 years and can be renewed if you are still eligible¹².

Who can get a Medicash plan

Medicash's plans are designed to cover individuals, couples or families, with up to four dependent children covered up to age 16, or 19 if in full-time education, for some benefits at no extra cost³. There is no stated upper age limit for joining, but Personal Accident cover ceases on your 66th birthday while other benefits continue³.

The main restriction is on pre-existing conditions. The hospital benefit is not payable for a pre-existing condition for three years from the start of the policy, or at the higher rate for three years following an increase in cover³. A pre-existing medical condition is an illness or injury you had before your policy began or was renewed⁷. The Financial Ombudsman Service handles complaints about pre-existing medical conditions, which tells you how often they become a dispute⁷.

If you are applying with a mental health condition, the routes open to you are the same as for any insurance: direct with an insurer, through an insurance adviser, or through a comparison website²³. An insurance broker can help you work out what cover you need, and using one is a regulated activity²⁴.

How Medicash is regulated and what protects your cover

Medicash is authorised by the Financial Conduct Authority with firm reference number 202242, authorised since 1 December 2001, and its current trading name is Medicash¹. It also appears on the Bank of England's list of insurers incorporated in the UK authorised to carry out contracts of insurance²⁵. The company is registered in England as a company limited by guarantee, company number 00258025, incorporated on 24 July 1931, and its registered status is active⁴.

Because the cover is insurance, the Financial Services Compensation Scheme can step in if an insurer fails. FSCS protection requires the insurer to be authorised by the Prudential Regulation Authority, and for health insurance claims the scheme covers 90% of the claim²⁶. The scheme is governed by the Policyholder Protection Rules²⁷. Protection applies only where the firm's activity is regulated by the PRA or the FCA, so it is worth checking that the specific product you are buying is a regulated insurance contract²⁸.

If something goes wrong, complain to Medicash first. If the complaint is not resolved, the Financial Ombudsman Service can look at it. The ombudsman handles complaints about private medical insurance and about pre-existing medical conditions, and the service is free to consumers⁵. Employees covered by a group policy taken out by an employer also fall within these complaint rules⁹.

For the wider framework, consumer protection explains how the ombudsman and compensation schemes fit together, and regulation-policy covers who makes the rules.

Contacting Medicash and complaining

Medicash's website is medicash.org, and its registered address is One Derby Square, Liverpool L2 1AB³. Claims can be made by downloading and completing a claim form and posting it with receipts, or through the Medicash app, available from the App Store and Google Play, which lets you submit a claim from a smartphone³. You will need a receipt from your practitioner after you have received and paid for treatment³.

If you are unhappy, the order is: complain to Medicash, then, if unresolved, take it to the Financial Ombudsman Service. The ombudsman's remit covers private medical insurance and pre-existing medical conditions⁵. For complaints about how a workplace scheme has been run, the ombudsman also handles complaints about pensions organised by employers²⁹.