Health Cash Plans Explained: How They Differ From Private Health Insurance

If you've seen plans from Westfield Health, Simplyhealth, Medicash, Health Shield, Hive, or Benenden alongside Bupa or AXA on a comparison site, it's worth understanding upfront: these are a genuinely different product from private medical insurance (PMI), not a cheaper version of the same thing.

What a health cash plan actually does

A health cash plan reimburses you a percentage of routine healthcare costs you've already paid for — typically dental check-ups and treatment, eye tests and glasses, physiotherapy, osteopathy, chiropractic, and sometimes prescriptions or specialist consultations. You pay the practitioner yourself, then claim back a portion (often 50–100%, depending on the category and your plan tier) up to an annual cap per benefit type.

This is fundamentally different from how PMI works. PMI insures you against the cost of private hospital treatment, surgery, and cancer care — things you hope never to need but that would be expensive if you did. A cash plan instead helps with costs you'll almost certainly have anyway: most adults see a dentist and optician regularly, so a cash plan is designed to make routine, predictable spending cheaper over time, not to protect you against a catastrophic one-off medical cost.

What's typically covered

Across the major UK providers, you'll generally find reimbursement for:

• Dental check-ups, treatment, and sometimes orthodontics
• Optical tests, glasses, and contact lenses
• Physiotherapy, osteopathy, chiropractic, and acupuncture
• Prescription charges
• Specialist consultations and diagnostic tests (on some plans)
• A cash benefit for hospital stays (a fixed amount per night, separate from the reimbursement mechanism above)

What's typically NOT covered

This is the part that matters most to understand before treating a cash plan as a PMI substitute:

• Private hospital treatment or surgery — cash plans don't fund this the way PMI does
• Cancer treatment — most cash plans explicitly exclude this; it's one of the biggest differences from even basic PMI
• Pre-existing or chronic condition management — same general exclusion pattern as PMI

Benenden Health: a related but distinct model

Benenden Health sits adjacent to cash plans but works differently again — it's a membership scheme offering discretionary access to diagnostics and treatment specifically when NHS waits exceed a set threshold, rather than reimbursing routine costs you've paid yourself. "Discretionary" is the key word: it's not a contractual insurance payout the way a cash plan claim is. Benenden also explicitly excludes private cancer treatment.

How the major UK cash plan providers compare

Provider	From	Known for
Westfield Health	£8.58/month	Lowest published entry price; free dependent child cover; Eldercare support service
Simplyhealth	~£10/month	UK's largest provider (~2.5 million customers); strongest dental benefit caps on top tiers
Medicash	~£9/month	Affordable entry pricing; broad therapy category coverage
Health Shield	~£12/month	FCA/PRA-regulated; dependent children included on its Select plan
Hive	~£11/month	Simple, no-frills structure for core dental/optical/therapy reimbursement
Benenden Health	£15.85/month	Discretionary NHS-wait-time backstop, not reimbursement-based

Prices reflect entry-level tiers; most providers offer 3–6 tiers with progressively higher annual caps, and most households end up choosing a mid-tier plan once they map their actual annual dental/optical/therapy spend against the entry tier's caps.

Is a cash plan worth it?

If you already see a dentist and optician regularly, and especially if you use physiotherapy or similar therapies, a cash plan can genuinely pay for itself — the FCA has noted that cash plans offer better claims-to-premium value than most other insurance products, precisely because the payouts are for things you were going to spend money on anyway. The value case is weakest if you rarely use any of the covered services, in which case you're paying a monthly premium for reimbursement you'll rarely claim.

Cash plan vs PMI: do you need one, the other, or both?

They solve different problems, so the honest answer for many people is "both, if budget allows" — a cash plan for predictable routine costs, and PMI for the unpredictable, expensive scenario you hope never happens. If you have to choose one, think about which risk worries you more: the cost of dental and optical bills adding up over a year, or the cost and wait time of needing a hospital procedure or cancer treatment.

Compare real plans

Use our comparison tool to see the UK's leading PMI providers side by side, and see our cash plans and membership schemes section on the homepage for Westfield, Simplyhealth, Medicash, Health Shield, Hive, and Benenden compared directly against each other.

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Prices and features in this guide are indicative and based on publicly available product information. Benefit caps, tiers, and exclusions vary by provider and plan level — always check the current benefit table before purchasing. This article is for general information only and is not financial or insurance advice.