Claiming through medical insurance can be simple if you follow these steps. From checking your policy to getting approval, we walk you through the entire process so you can get the care you need.
Claiming through medical insurance can be simple if you follow these steps:
Look at your policy documents to see what is covered. Make sure your treatment is included and check if you need pre-authorisation.
Most claims need a referral from your GP or a specialist. Some policies accept open referrals, which let you choose your treatment provider.
Call your insurance company or use their online account to tell them about your claim. Their claims team will guide you through the process.
Many insurers ask for a claim form. Fill it out and include your referral letter, policy number, and any documents from your treatment provider.
The insurer will review your claim and give authorisation if it's covered. Make sure you have this approval before starting treatment.
Once approved, you can schedule your treatment with the authorised healthcare provider. For in-patient care, the insurer often works directly with the hospital.
By following these steps, you can make your claim smoothly and get the care you need.
If you paid for treatment upfront, you could still claim your money back. Here's how:
Keep receipts from the healthcare provider. These must include details of the treatment, dates, and costs.
Many insurers have forms on their websites. Fill out the form and add your policy number and reference number.
Include receipts, referral letters, and any medical records.
Submit the form and documents online or by post, depending on your insurer's process.
The insurer will check your claim. If it's approved, they will pay the money into your bank account.
This process helps you get back what you spent on approved treatments.
Some insurers are better than others for claims. Well-known providers like Bupa, Vitality, and AXA Health are often rated highly for their claims processes. Here's what to look for:
Fast Claims: Choose insurers with easy claims systems, like online submissions or digital GP services.
Good Coverage: Make sure the policy covers the treatments you may need, like physiotherapy or mental health support.
Reliable Support: Look at customer reviews for feedback on claims teams and service.
To find the right medical insurance, use insurance guides or ask a broker for advice. They can help you choose the best plan for your needs.
If you need to make a claim on someone else's insurance, follow these steps:
Ask the person for their policy number and details about their insurance plan.
Call the insurance company and explain the situation. Share the policy details and your information.
Provide any needed paperwork, like receipts or a claim form. You may also need a reference number.
The insurance company will review the claim. Once approved, they will either pay directly or reimburse you.
This process helps you access the benefits of the policy without confusion.
Need help with a claim? We guide you through the process — free.
Private health insurance helps you get faster medical care. Here's how it works:
Choose a health insurance policy based on your needs. Plans can cover hospital stays, mental health, and more.
Pay monthly premiums to keep the policy active. Costs depend on your age, coverage, and other factors.
For most treatments, you'll need a GP referral or an open referral.
Contact your insurer to start a claim. They'll give you authorisation for treatment and guide you through the steps.
Once approved, you can book your treatment at a private hospital or clinic.
Private health insurance offers quicker care and personalised options, which can help you avoid long NHS waits.
Bupa is known for fast claims. Here's how it works:
Use their app, website, or phone number to tell them about your claim. Have your policy number and referral ready.
Simple claims are usually approved in a day or two. More complex cases might take longer.
Once approved, arrange your treatment with the chosen provider.
If you paid upfront, Bupa usually reimburses you within five working days.
Bupa makes claiming quick and easy, so you can focus on your health.
Yes, it's possible to get health insurance with pre-existing conditions, but coverage varies:
Pre-existing conditions can become eligible for cover after a two-year period if you're symptom-free and don't seek treatment during that time.
The insurer reviews your full medical history. Conditions related to pre-existing issues may be excluded, but this is clearly outlined from the start.
If switching to a new insurer, CPME lets you carry over existing exclusions without restarting the moratorium period.
Some providers offer tailored health insurance plans for chronic conditions or ongoing medical treatment.
When considering pre-existing conditions, consult an insurance company or broker for further information on the type of cover available.
Most private health insurance policies ask for a GP referral before treatment, but there are exceptions:
Open Referral: Some insurers let you see a consultant without a specific GP recommendation.
Digital GP Services: Many policies include online GP access, making it easy to get quick referrals.
Direct Access: For services like physiotherapy or mental health care, some insurers allow you to go straight to a specialist.
Cash Plans: These may cover dental or optical treatments without needing a referral.
Always check your health insurance policy for details on whether a GP referral is needed.
Here's what you'll need to file a health insurance claim:
Claim Form: Complete the form from your insurer. You can find it online or in your policy documents.
Policy Number: Add your policy number to confirm your health insurance cover.
Referral Letter: Include a GP referral or open referral if the treatment needs it.
Receipts and Bills: Provide invoices from the healthcare provider or treatment centre.
Medical Reports: Share records from your GP service if asked.
Authorisation Number: Include this if your insurer pre-approved the treatment.
Some private healthcare options don't need a GP referral, like mental health support or physiotherapy. Check your policy terms or ask your claims team to confirm what's required for a smooth claims process.
In most cases, you can visit your own GP to get a referral for private treatment. This referral is usually required by health insurance providers before they approve your claim. Some policies also include digital GP services, which let you get a referral quickly online.
For many types of private treatment, a GP referral is required. However, some insurance providers allow direct access for specific services like physiotherapy or mental health support. Check your policy details to see if you can skip a referral for certain treatments. Our guide to how to get private healthcare covers the full pathway from referral to authorisation.
Travel insurance generally covers emergency medical care while you're abroad. However, it doesn't usually include ongoing private treatment for pre-existing conditions or routine care. If you need coverage for specific private treatments while travelling, speak to your insurance provider to explore additional options.
Some private health insurance plans include cover for GP appointments, either in person or through a digital GP service. This benefit can save you time and help you access healthcare faster. Check your policy to see if this is included.
This site is run by My Health Protected, an FCA-authorised broker. Our guides compare UK private health insurance providers and are reviewed regularly against current insurer wording.
We aim to give you a clear, honest read on each insurer and plan, including how the claims process works in practice. Always read your own policy documents and check details directly with your insurer or a broker before you buy or switch.
If you would like a quote, or a second opinion on a plan you already hold, contact us. The advice is free, independent and without obligation.
The information on this site is for general guidance only and not professional advice. For tailored advice or a personalised quote, contact us directly.
Get a free, no-obligation comparison from our expert brokers. We'll find you the right cover at the right price.
Patrick Baxter is the founder of My Health Protected, an FCA-authorised independent health insurance broker based in London. LinkedIn →
