This new plan replaces the existing Preferential, Accessible and Simply Private Health plans, which closed to new business on 1 July and, in broad outline, follows the modular concept of the Simply Employee Health Plan we reviewed in July, albeit in simpler form. Since September, existing clients have started to migrate to the new plan.
The plan has a modular format and is available with a choice of three hospital networks: National (providing national coverage), Metropolitan (adding additional, more expensive, hospitals around London) and Connections (Simplyhealth’s open referral option, which it calls ‘an assisted referral option with a more limited hospital choice’).
The core benefit is Diagnosis cover. This mandatory element pays for specialists’ fees; diagnostic tests; an NHS cash benefit (£250 each day); Non-GP referred access to physiotherapy for joint or muscle pain (through the Rapid Access to Physiotherapy service); private ambulance), and parent accompanying child.
Two optional benefits can be added:
Treatment cover: This pays for hospital treatment; specialists’ treatment fees; physiotherapy; complementary therapies (physiotherapy; osteopathy; chiropody/podiatry; chiropractic; acupuncture, and homeopathy); dental surgery (specific conditions only and through a dentist in the Simplyhealth Denplan network), and psychiatric treatment (max 28 days a year as an inpatient, with treatment arranged through the Simplyhealth Mental Health Management service); complications of pregnancy; NHS cash benefit (£250 per day); Private ambulance; home nursing; parent accompanying child, and new child payment (£150 each child). Treatment for cancer and for heart conditions is excluded.
Treatment for heart and cancer: This brings back in treatment for those two conditions. Cover can be in full or restricted to a lifetime limit of £50,000 for each.
Cover is available to UK residents over 18 (there is no upper age limit) and their partners and children. Excesses of £150, £200; £250; £300; £400; £500; £1,000; £2,000, or £5,000 can be chosen, giving premium discounts of 3-59%. Clients get a no claims discount (NCD) – automatically starting on Level 11 (60% discount) and can then go up in annual increments to Level 15, which offers a 75% discount. Claims of not more than £250 in a year maintain the NCD level at the next renewal, those between £251-£1K mean a one level fall, those between £1-3K incur a two level fall, those £3K-£10K a three level fall and those over £10K incur a four level fall. All treatment must be pre-authorised.
Underwriting can be full medical, moratorium (5/2/2 rolling moratorium) or switched from an existing insurer.
What They Say
Head of employer marketing, Howard Hughes, said: "We are delighted to introduce a new plan to provide individual customers with a greatest ever choice of coverage. From low cost cash plans to meet every day health expenses to a comprehensive private medical insurance plan built up from a number of modules, Simplyhealth customers can choose coverage to suit any budget, all supported by world class service."
What We Say
"Simplyhealth has had the unenviable task of replacing a raft of existing products with just one for individuals and so simplifying its proposition. In doing so, it has focused on giving cover for diagnostics rather than paying for in/daypatient treatment. That enables it to offer a low starting cost – especially as it can also offer a wide range of excesses, open referrals and an automatic no claims discount.
"This approach also enables it to make cancer and heart treatment optional – a sensible option, given the expense of such treatment and the focus the NHS now gives to both.
"We have concerns about NCDs – frequent claiming can see very dramatic price increases – but Simplyhealth has introduced a tiered system to minimise the risk for most people. The end result is a strong alternative, but much will depend on price and advisers being able to precisely match the various options to what any particular client wants."