How to Claim Your Health Insurance?

Claim Your Health Insurance: Steps and Tips

There are many things that people need to think about when it comes to their health insurance. One of the most important is what you can claim on your health insurance & how much it costs you if you have private medical treatment or an appointment. There are different types of treatments that may be covered, so I want to go over some of them with you now!
Guidelines in Claiming Excess Insurance

What You Can Claim For?

Private medical treatment such as dental surgery, psychiatric services, and pharmacy costs. You will not be able to claim these things if you go through the NHS or social care.

Think about it:

Private healthcare is much more expensive than public health insurance (NHS), but it does mean that some treatments may be covered by your company’s private medical insurance, which means they pay them on your behalf!

What You Can’t Claim For

Some treatments are not covered by private medical insurance, such as ambulance, dentistry (unless it’s an emergency) and eye care.

So, you will need to pay these out of your pocket if they’re not included in your health insurance plan, but there is some good news! If the treatment falls under one of the exclusions, then you may be able to reclaim this from NHS or social care depending on where you live, so I’ll tell you more about that below too.

Some things like dental surgery, psychiatric services1, and pharmacy costs might be excluded from private medical coverage, which means that when something happens, like a toothache or depression, sets in – even if it’s related to your health, you’ll have to pay out of pocket.

But wait, let me tell you something


  • Ambulance
  • Dental surgery (except for emergencies)
  • Psychiatric services (including therapy and counselling)
  • Pharmacy costs


Include this info on how people can claim these things if they need them? NHS or social care should cover it in some situations – The more important thing is that private medical insurance does not cover most dental work, which sucks when an emergency toothache comes up, so what are we supposed to do? There’s no easy answer, but until something changes, be financially prepared by keeping a small budget reserve set aside just in case. That way, you won’t have to worry about how you’re going to find the money for dental work or pay out of pocket if you need it.

How to Make a Claim

  • Notify the insurer as soon as possible of any change in statuses, such as a new job or changes to existing benefits.
  • Inform the insurer if you are planning on travelling abroad for more than 30 days (in some cases, this can be extended).
  • Ensure that all dependents’ information is up to date and accurate by contacting us when they turn 18 years old and again once there’s been a birthday.

First things first, find out what type of emergency it is. This includes accidents at work; car crashes with injuries requiring hospital care, natural disasters like earthquakes or floods which threaten your home or workplace, and more.

If the emergency is urgent but not life-threatening, call your health insurance company to see if they can make some exceptions and allow you to go to a doctor who’s covered by their plan (or wait until morning).

If it’s an emergency that could lead to death or significant injury without prompt attention, get yourself and anyone else in need of help immediate transportation to a hospital designated as an “emergency care facility.” Be sure someone has notified your insurer about this so that coverage will be provided.

Here’s why:

Claims for dental work have become less common, with most people paying out of pocket because many employers are dropping dental benefits during these challenging times. However, there is a loophole where you may still want to claim your dental benefits. If you’re hospitalized for an illness or injury, the hospital may offer free teeth cleaning at their expense.

You need to contact your GP with an opinion from someone who has experience assessing mental illness before claiming the company, as they may need a report on your condition before agreeing. There are many different types of treatments that may be covered, so I want to go over some of them with you now!

It’s true!

Private medical treatment such as dental surgery, psychiatric services, and pharmacy costs. You will not be able to claim these things if you go through the NHS or social care. However, if you have private healthcare, some treatments can be claimed (such as dentistry). This is because there’s less red tape involved in claiming back from employers than government agencies like Jobcentre Plus or Department of Work and Pensions2, which would include filling out lots of forms. Still, it doesn’t always cover everything, including help getting an occupational therapist or home care.

Appointments with a GP, consultant, or specialist are usually claimable for as long as they’re not just related to pregnancy and mental health/psychiatry appointments (as these are free under the NHS). Again, you can’t claim from the Government, but private providers would cover this cost, so it’s worth looking into if you need any help getting seen by your specialist!

Costs of Claiming

Your insurer pays the treatment provider themselves, but you may be required to pay an excess. The excess is around £80 for a GP appointment, £150 to see your private doctor goes up depending on how much treatment they give) and over £500 for the hospital admission.

The cost of a private appointment varies depending on the sector – for example, it costs £150 with my GP (a Private Doctor), but I pay £20 to see my NHS GP. Why? This is because Government sets different rates.

Where to Claim Back From?

Simply put:

For appointments not related to pregnancy and mental health/psychiatry, you can usually only claim back from employers or an insurer if it’s insurable as part of your employment package. Examples include medical treatments which might be covered, such as physiotherapy or occupational therapy after an accident, etc.; other types would need evidence that they were done about work – so check what companies offer before joining them!

What If Your Claim Is Rejected?

If your claim is rejected, you may need to pay the total cost of treatment and then make a fresh application for reimbursement from your employer or insurer. Can’t you afford this? The NHS has contracts with some providers to cover the cost if it was an emergency – so call them first!

If your health insurance refuses to cover medical treatment, ask them why they rejected your claim and clarify if the service was not covered.

If your health insurance policy does not cover a specific treatment you need, there are three options available:

You could pay for the procedure out of pocket and claim it to your insurer as an accident.

In this case, you will incur any other costs such as medications required to treat the injury incurred at no cost.

Find another health service provider that accepts both public and private health funds for payment so that one bill is issued with no additional extra charges. This only applies if both the doctor’s office or hospital they’re being treated at accepting these payments too.

Common Questions

How Long Does It Take To Make a Health Insurance Claim?

How Do I Fill Out a Health Insurance Claim Form?

How Do I Know If My Claim Is Accepted?

Can I Claim on Private Health Insurance If I Have a Chronic Condition?

In conclusion

In a nutshell,

Claims are the medical expenses that you can have your insurer cover. Usually, when people talk about claiming on their insurance, they mean claiming reimbursement of health care costs incurred or requesting to be reimbursed by an employer’s plan for services provided in addition to those covered under the company’s group coverage plan.

Don’t forget to always check with your insurer first before making any claims if they won’t payout.


Your Journey to Financial Success Starts Here