Almost every week, someone sitting on our treatment table in Tunbridge Wells says a version of the same sentence: “I think I might have something through work, but I’ve no idea if it covers this.”
Usually, they do. And usually, it does.
A surprising number of people are paying for treatment out of their own pocket while a perfectly good health benefit sits unused in an app they downloaded when they joined their employer and haven’t opened since. Others assume the opposite, that because they have “private health insurance”, everything is automatically paid for and get a nasty surprise when a claim is declined.
Both situations come down to the same thing: health cover in the UK comes in two very different flavours, and they work in completely different ways.
This guide explains both, tells you what to check before your first appointment, and sets out where our practitioners stand with the main insurers.
The two types of cover and why the difference matters
There are two broad products that people mean when they say “I’ve got health cover”.
1. A health cash plan
A health cash plan is the simpler of the two, and it’s the one most people don’t realise they have. It’s usually a modest monthly premium, often somewhere in the region of £10–£30 a month and plenty of employers provide one as a staff benefit alongside your pension and holiday.
A cash plan isn’t really insurance in the way most people picture it. It’s more like a pot of money for everyday healthcare. You get an annual allowance across categories such as dental, optical, and the one that matters here therapy treatments, which typically covers osteopathy, physiotherapy, chiropractic and acupuncture, often under one shared limit.
The mechanics are refreshingly simple:
- You book your appointment.
- You pay us as normal.
- You keep the receipt.
- You submit it to your plan provider, usually through an app or online portal.
- They pay you back; either the full amount or a percentage, up to your annual limit.
Common cash plan providers include Simplyhealth, Medicash, Westfield Health, Health Shield, Paycare, BHSF and Sovereign Health Care, and there are plenty of others.
The big advantage: you generally don’t need a GP referral, and you don’t need permission in advance. You choose your practitioner and claim the money back afterwards.
There is one condition worth knowing about. Cash plans require your practitioner to be properly registered with the relevant professional body. For osteopaths in the UK, that’s the General Osteopathic Council (GOsC), it is illegal to call yourself an osteopath in this country without being on that register. Every osteopath at AG Osteopathy is GOsC registered, so treatment with any of us qualifies.
That’s what people mean when they say a cash plan can be used “with any provider”. You’re not restricted to a list, you just need a qualified, registered practitioner and a valid receipt.
2. Private medical insurance (PMI)
This is the traditional product: WPA, Vitality, AXA Health, Aviva, Bupa and similar. Higher premiums, and designed for something quite different, diagnosing and treating new, acute medical problems, up to and including consultant appointments, scans and surgery.
PMI can absolutely cover osteopathy, and often does. But there are more hoops, and it’s worth knowing what they are before you book rather than after.
Your practitioner usually needs to be recognised by that specific insurer. Not just qualified and registered; individually approved by the insurer, with a provider number on their system. This is the single most common reason claims get rejected.
You’ll usually need a referral or authorisation first. Traditionally that meant seeing your GP. Increasingly, insurers have their own faster route: AXA Health has a muscles, bones and joints service that can refer you for osteopathy or physiotherapy without a GP appointment, and Vitality has a direct access pathway through its app and Care Hub. Either way, the key step is the same, contact your insurer before your first appointment and get an authorisation code. Most claims that go wrong go wrong at this point.
Cover is for acute problems, not maintenance. Every major insurer excludes pre-existing conditions and long-term chronic problems. If you’ve had grumbling lower back pain for eleven years, a PMI claim is unlikely to succeed. If you did your calf playing five-a-side in Dunorlan Park a fortnight ago, that’s exactly what the policy is for.
There will be a limit. It might be a number of sessions (AXA, for instance, commonly covers up to ten sessions a year with a participating therapist before further approval is needed), or a financial cap on outpatient treatment for the year, or both. There may also be an excess to pay before cover kicks in.
Where our practitioners stand
Angus Gould, Verity Kelsey, Silas Tye and Josh Wisson are all recognised by WPA, Vitality, AXA and Aviva for osteopathy and shockwave therapy.
That recognition matters more than it sounds. It means we’re already on those insurers’ systems as approved providers, so when you ring to get your treatment authorised, we’re the kind of clinic they’ll say yes to.
And because every one of our osteopaths is GOsC registered, treatment with any of us is claimable on a health cash plan, whichever provider your plan is with.
What about shockwave therapy?
Shockwave therapy is one of our most effective tools for stubborn tendon problems: plantar fasciitis, Achilles tendinopathy, tennis and golfer’s elbow, patellar tendinopathy. The kind of injury that’s been there for months and hasn’t budged.
Cover for it is more variable than for hands-on osteopathy. Some insurers still treat it as a specialist or developing treatment, and cover can depend on your policy level and on whether you’ve tried other approaches first, which, for the tendon problems shockwave is best at, you very often have.
Our advice is specific: when you call your insurer, use the full term “extracorporeal shockwave therapy (ESWT)” and ask whether it’s covered under your policy for your particular condition. Asking about “shockwave” alone sometimes draws a blank from the call handler.
If it isn’t covered, a cash plan will often still contribute, and we’ll always be upfront with you about the cost either way. Our current fees are on our pricing page.
Five questions to ask your insurer before you book
Two minutes on the phone saves a lot of hassle. Whether it’s your provider’s app, the number on the back of your card, or your HR team, ask:
- Is osteopathy covered on my policy? (For a cash plan, ask what your annual therapy treatments limit is and what percentage you get back.)
- Do I need a GP referral, or can I self-refer?
- Do I need an authorisation code before my first appointment?
- How many sessions, or how much, am I covered for this policy year?
- Is there an excess, and have I already paid it this year?
Then have a look at your policy documents for anything about pre-existing conditions, that’s where most declined PMI claims come from.
How it works at our clinic
We’d rather sort this out before you’re on the table than after.
- If you’re on a cash plan: book in as normal. You pay at the appointment, we give you a receipt with everything your provider needs on it, and you claim the money back. No paperwork from us required, and no waiting.
- If you’re on private medical insurance: ring your insurer first and get your authorisation code. Bring it to your appointment along with your policy number, and let us know which insurer you’re with when you book so we can make sure you see a practitioner who’s recognised by them.
- If you’re not sure what you’ve got: dig out the benefits section of your staff handbook, or ask HR whether there’s a health cash plan on the scheme. It’s one of the most commonly forgotten employee benefits there is.
And if you’re still unsure whether we’re the right people for the problem you’ve got, our free 15-minute consultation is there for exactly that. No commitment, no treatment, just a conversation about what’s going on and whether we can help.
Frequently asked questions
Do I need a GP referral to see an osteopath? Not to see us, osteopaths are primary healthcare practitioners in the UK, so you can book directly. You may need a referral or authorisation for your insurer to pay, depending on your policy.
Can I use my health cash plan for sports massage or acupuncture? Often yes. Most plans group therapy treatments together and include acupuncture; sports massage varies more between providers. Check your plan’s therapy list before you claim.
My insurance only covers part of the cost. Can I pay the difference? Yes. Plenty of our patients claim what they can and pay the balance themselves.
What if my claim gets rejected? Ask your insurer for the specific reason, it’s usually one of three things: no prior authorisation, a practitioner they don’t recognise, or a pre-existing condition exclusion. The first two are fixable next time round.
Do you offer this at your Tunbridge Wells clinic only? Our clinic is on Upper Grosvenor Road in Tunbridge Wells, and we see patients from across the surrounding area including Tonbridge, Southborough, Crowborough and Paddock Wood.
Ready to get booked in?
If you’ve got cover, use it. If you haven’t, we’ll be straight with you about the cost and what results to expect.
Book an appointment or call us on 01892 249095 and if you’re not certain what your policy covers, tell us who you’re insured with and we’ll help you work it out.
This article is general guidance. Policies differ and insurers change their terms, so always confirm the details with your own provider before booking.
