Health Cash Plans: The Funding Stream Most Clinics Ignore

A health cash plan reimburses the member for treatment they have already paid for, up to an annual limit per benefit category. Simplyhealth's retail consumer plan pays 75% of a receipt for physiotherapy, osteopathy, chiropractic, acupuncture or homeopathy up to an annual limit of £45 at level 1 and £195 at level 4. Westfield Health's Good4you plan pays 75% of therapy treatments up to £200 at level 1 and £1,250 at level 5. None of these providers settles with you. None of them has an application form for therapy practitioners. The only thing that decides whether your patient can claim is whether your registration appears on that provider's published accepted list.

That last sentence is the whole subject, and it is why cash plans sit in a blind spot. Practitioners look for an application process, find none, and conclude there is nothing there. Meanwhile the money is already moving: LaingBuisson's Health Cover UK Data Insights report, 20th edition, put the number of individuals holding a health cash plan at 2.89 million in 2023, with premium income of £435 million, up 4.6% on 2022.

Those 2.89 million people are mostly not Bupa customers. They are employees of mid-sized employers who bought a cash plan because full private medical insurance was too expensive, and they have a small annual allowance they are usually bad at spending.

What is a health cash plan, exactly?

A health cash plan is an insurance product that pays a member back a proportion of what they spend on everyday healthcare, up to a fixed annual limit for each benefit.

It is not private medical insurance. There is no pre-authorisation, no referral requirement on most benefits, no fee schedule, and no network. The member picks whoever they like, pays in full, uploads a receipt and gets money into their bank account.

The main UK providers are Simplyhealth, Westfield Health, Health Shield, Medicash, Paycare, BHSF and UK Healthcare. Most sell both individual plans and corporate plans bought by an employer for its staff.

The distinction that matters commercially is this one:

Read down that table and the reframe falls out. A cash plan is not a payer. It is a discount your patient receives after you have already been paid in full. It costs you no fee reduction, no contract, no authorisation tracking and no cash-flow delay. What it costs you is a slightly more detailed receipt.

That makes it the only form of third-party funding where the practitioner gives up nothing. It also makes it small, which is the catch covered further down.

Which professions can actually be claimed against?

This is the question that decides whether the rest of the article is relevant to you, and the answer is published.

For the statutorily regulated professions it is simple. Every provider accepts the statutory regulator, and most accept nothing else:

Verified 11 October 2026 against Simplyhealth's consumer plan terms (document code T-C-SHPCONSUMER2-0926), Medicash's own "find a practitioner" page and Paycare's qualifications directory. Simplyhealth's wording for acupuncture is genuinely that loose; every other therapy benefit in the same document names a statutory regulator.

For everything outside statutory regulation, the answer is concentrated in one register and one provider.

The CNHC table that nobody shows practitioners

The Complementary and Natural Healthcare Council holds a register accredited by the Professional Standards Authority and covers 18 disciplines, including sports massage, massage therapy, sports therapy, reflexology, nutritional therapy, shiatsu, craniosacral therapy and hypnotherapy.

CNHC publishes which cash plans recognise its registration, and for what. This is the list, as published on 11 October 2026:

CNHC says of its own list: "This is not a definitive list and we will be adding to it on an ongoing basis."

Four things fall out of that table, and none of them is obvious from any practitioner forum.

Health Shield is not one option among five. For a soft tissue or massage therapist it is close to the whole market, because it is the only provider that reimburses CNHC massage and sports massage on individual plans as well as corporate ones, and it pays 100% rather than a percentage.

Westfield's recognition is employer-specific. A sports massage therapist whose local patients are on a Westfield plan may or may not be claimable depending on which plan their employer bought. That is not something you can find out from Westfield's public pages. It is something the patient finds out from their own table of cover.

The two best-known names on the high street, Simplyhealth and Medicash, do not recognise CNHC at all. If you are a reflexologist and the patient in front of you has a Simplyhealth plan, there is no claim, however well qualified you are.

UK Healthcare attaches a condition none of the others do: a GP referral. Its CNHC reimbursement for aromatherapy, reflexology and remedial massage is conditional on the member having been referred by a GP. CNHC notes that GMC guidance permits GPs to refer to practitioners on an Accredited Register, so the route exists, but it is a step the patient has to take before they see you and it is invisible on the receipt. The two narrowest providers are worth knowing for the same reason: BHSF reimburses CNHC registration for reflexology only, at 100% up to £200 a year, and Paycare for hypnotherapy only, at 100% up to £150 a year. If that is not your discipline, those two names can be crossed off and you have three providers left, not seven.

What about non-CNHC routes?

Health Shield publishes its own accepted accreditations list, which runs far wider than CNHC and includes bodies CNHC does not verify. Its sports, remedial, deep tissue and pre-natal massage category accepts BASRaT, CNHC, CThA, FHT, a Higher National Diploma, IIHHT, IMTA, the Institute for Soft Tissue Therapists, ITEC, LCSP, the London School of Sports Massage, the Massage Training Institute, NAMMT, the Sports Massage Association, SMTO, the Society of Sports Therapists, the Sports Therapy Association, the Sports Therapy Organisation and VTCT.

For acupuncture, Health Shield accepts AACP, AAC, ACI, AFPA, ATCM/TCM, BAcC, BAWMA, BMAS and FTCMP. Westfield names BMAS, the British Acupuncture Council, the Federation of Traditional Chinese Medicine Practitioners and others.

So the practical rule for an unregulated profession is: one good accreditation opens some providers, and only a mapping exercise tells you which. Our companion reference, which registration each insurer and cash plan accepts, is the matrix version of that mapping.

How does a practitioner get onto a cash plan list?

You do not, and this is the part that wastes the most time.

No UK health cash plan provider reviewed here operates a practitioner application process for therapy benefits. Their published positions are explicit about it:

• Westfield Health: "We don't recommend particular practitioners, but to help you find your nearest practitioner, we've compiled the following list of websites."
• Medicash: "Although we are not able to recommend any specific practitioner", followed by a list of professional body websites.
• Paycare: "The Bodies and Qualifications that are recognised by Paycare to provide treatment are shown below."

What each provider calls a "find a practitioner" page is a list of links to the professional registers. The register is the gate. The provider does not keep a directory of individuals and has no interest in building one.

So there are exactly three things you can do, and they are all upstream of the insurer.

1. Hold a registration that appears on the provider's accepted list. For a regulated profession you already do. For an unregulated one, CNHC is the single registration with the widest reach, because five cash plan providers name it. The annual registration fee is £75 for your first discipline and £10 for each additional discipline up to four, after which further disciplines are free.

CNHC does not take applications directly. Professional associations act as Verifying Organisations and check your training, insurance and experience. For sports massage the Verifying Organisations include the Sports Massage Association and the Scottish Massage Therapists Organisation, and the SMA will assess an application for an administration fee without requiring you to join as a member.

The £75 is not the whole cost, and the ongoing obligation is the part to check before you commit. CNHC requires a registrant in a single discipline to complete at least 15 hours of CPD a year, of which 10 must be directly relevant to that discipline and 5 may be more general professional learning. A registrant in two disciplines needs 25 hours and in three needs 35, because the rule is 10 hours per discipline plus 5 general. CNHC also audits a random sample of registrants each year, asks them to produce a completed CPD log sheet for their last full registration year, and says failure to comply could affect registration.

That changes the arithmetic on the £10 additional-discipline fee more than the fee itself does. If you already do continuing education in your main discipline, 15 hours is a reason to write it down rather than an extra burden. If you are registering a second and third discipline purely to widen cash plan reach, you have signed up to 35 hours a year and a log sheet that may be inspected, for a benefit that depends on which provider your patient's employer happened to buy.

2. Make your receipt claimable. Covered in detail below. This is the only operational work involved.

3. Tell patients the benefit exists. Not "we accept Simplyhealth", which is misleading because no cash plan is accepted by anyone. Something closer to: "If you have a health cash plan through work, most of them pay back part of this. Ask your HR team what your table of cover says for physiotherapy, and I will put the detail they need on your receipt."

That sentence is worth more than any application form would have been, because almost nobody says it.

What is the money actually worth?

Here is where the enthusiasm has to be calibrated, and where most published writing about cash plans quietly stops.

Take Simplyhealth's retail consumer plan, table of cover TOC-RETCONSUMER-0926. The "healthy body" benefit covers physiotherapy, osteopathy, chiropractic, acupuncture and homeopathy, at 75% of the receipt up to an annual limit per person:

At the UK physiotherapy follow-up median of around £63 a session, a level 1 member's entire annual therapy allowance is one appointment. A level 4 member gets four.

Westfield Health's Good4you plan is more generous. Therapy treatments reimburse at 75% across all five levels, with annual limits of £200, £425, £625, £850 and £1,250. At level 5 that is £1,667 of treatment spend covered at 75%, which is a genuine course of care. At level 1 it is £267, or about four sessions.

So the honest summary is that a cash plan funds the beginning of an episode, not the episode. The limit is also shared across everything in its own benefit row, so on a level 4 Simplyhealth plan a patient who spent £120 of the £195 on an osteopath in March has £75 left for your physiotherapy in October.

What the limit is not shared with is the neighbouring benefit, and this trips people up because the figures look identical. On the same table of cover, chiropody and podiatry carry their own annual limit of £45, £75, £135 and £195, separate from the therapy row. A patient who used their whole chiropody allowance has not touched the pot your invoice comes out of. Two pots, same numbers, and no way to tell from the outside which one a patient has spent.

This has a specific commercial consequence that is worth more than the reimbursement itself. The cash plan does not change what you charge or what the course of treatment costs. It changes the price of saying yes to the first appointment. A patient weighing up whether to spend £70 finding out what is wrong with their shoulder behaves differently when £52.50 of that comes back. That is a conversion lever on the initial assessment, which is exactly the appointment most practices struggle to fill. If your diary has gaps, it is worth more to you than it looks; if you have a three-week waiting list, it is worth almost nothing. The same logic as diary utilisation: a funding source only pays if it fills a slot that would otherwise have been empty.

Do not price around it

Four reasons not to adjust your fees because of cash plans.

You cannot see the member's level, their remaining balance, or what else they have claimed this year. You will not be told. Two patients on "a Simplyhealth plan" may have £45 and £770 of annual limit respectively, because corporate plans are far more generous than retail ones. The limit resets on the plan's own anniversary, not on yours. And the member has no obligation to claim at all, so a discount you build in is a discount you have given away.

Price your work on your own economics, the way the physiotherapy fee guide and the osteopathy fee guide set out, and treat the reimbursement as the patient's business.

Why does claim-back beat direct settlement?

The one genuine advantage of cash plans over insurer work is cash flow, and it comes from the thing that looks like a weakness.

With a recognised insurer, you invoice after treatment, often through a clearing house, and you wait. The invoice can be rejected over a code, a date or a missing authorisation number, and you chase it. Your money sits in somebody else's system for weeks. That whole machinery is why insurer work is administratively expensive, and it is covered in how insurer panels work.

With a cash plan, the patient pays you at the appointment and then becomes your claims department, at no cost to you. Every provider examined here pays the member's own bank account. Health Shield's published process is four steps: check the accreditation, pay for treatment and get an itemised receipt, submit, and get the money back. It aims to assess a claim within two working days and pay within three to five. Westfield's process is the same shape. Paycare's is the same. Simplyhealth's T&Cs put the money into "the bank account you would like your claims to be paid into".

Health Shield's first step is also the one worth repeating to patients, because the provider puts it before booking rather than after: check the practitioner holds an accepted accreditation before the appointment. The one exception it publishes is that no practitioner qualification is required for dental or optical claims, which is a reasonable summary of how seriously the therapy requirement is meant to be taken.

No cash plan reviewed here settles directly with a therapy practitioner. That is usually described as a drawback. It is the reason the product costs you nothing.

The deadlines are the patient's problem too, but they are worth knowing because a patient who misses one will blame your receipt:

Paycare's 13 weeks is the one that catches people. A patient who stockpiles receipts to claim at the end of the year will have lost the early ones.

What does the receipt have to show?

This is the only real work, and it is where claims fail. Each provider publishes its own requirement. Build a receipt that satisfies all of them and you never think about it again.

The superset, drawn from Simplyhealth, Westfield Health, Paycare and Health Shield:

• The patient's full name. Not "Mr Patel". The name on the policy.
• Your name, and for therapy claims your qualification and your registration or membership number. Paycare's FAQ asks specifically for "the name and qualifications of the practitioner you saw".
• Your clinic name, address and contact details.
• The treatment, named. "Physiotherapy, 30 minute follow-up" is claimable. "Treatment" is not. "Appointment" is not.
• The date of the treatment, and the date of payment if they differ.
• The amount paid, and the fact that it has been paid.
• Each item separately. Westfield asks for a list of any sundry items purchased. If you sold a support or a theraband alongside the session, itemise it, because it is covered under a different rule from the treatment.
• A unique receipt or invoice number, so a resubmission can be matched.

And the three things that get a claim refused outright, from Simplyhealth's own terms. It does not accept unpaid invoices, credit or debit card receipts on their own, or receipts that have been altered.

That second one is the common failure. A patient who pays by card, screenshots the card machine slip and submits it will be refused, and will come back to you annoyed. The answer is to issue a proper itemised receipt every time rather than on request.

Most practice software makes this harder than it should be, because the default invoice is built for self-pay patients who only need a total. In Atlacare, services carry their own name and price so the treatment is described on the line item rather than lumped into a total, each invoice holds separate itemised lines with their own descriptions, and there is a notes field for the registration detail a cash plan asks for. Your registration number belongs in the invoice template, not retyped per patient.

Where this does not work

Five failure modes, all verifiable from the providers' own documents.

Sports massage is excluded by Simplyhealth unless a regulated clinician delivers it. Its consumer terms cover "sports massage provided by a HCPC registered physiotherapist as part of your treatment plan" and explicitly exclude "sports massage provided by a professional who is not a HCPC registered physiotherapist and does not form part of your treatment plan". The same construction appears under osteopathy and chiropractic. A soft tissue therapist working alone has no Simplyhealth claim at all, whatever their accreditation. Health Shield is the opposite case. The variation between providers on this single question is larger than the variation on anything else.

Classes are usually out. Simplyhealth's physiotherapy benefit excludes "exercise classes led by a physiotherapist, for example Pilates", and excludes x-rays and scans. If you are building group income, read the VAT and service-design side of it rather than assuming cash plans will fund it.

Paycare's qualifications directory covers eight categories only: acupuncture, reflexology, homeopathy, hypnotherapy, physiotherapy, osteopathy, chiropractic and chiropody. There is no massage, nutrition or counselling category in it. Paycare tells members to check an unlisted therapy with customer services before booking.

Some provider documentation is out of date, and you should expect it. Westfield's wellbeing and alternative therapies definitions document still lists "Physiotherapist registered with the Health Professions Council (HPC)", a body renamed the Health and Care Professions Council in 2012. These lists are maintained unevenly.

The lists change, and they narrow as often as they widen. Health Shield's accepted accreditations document for physiotherapy named HCPC, MCSP and SRP in its 2019 edition. Its live list, read on 11 October 2026, names HCPC and ISCP only. Chartered Society of Physiotherapy membership on its own no longer appears anywhere on it. An accreditation that was claimable five years ago may not be today, which is why the date you checked matters more than the fact that you once checked.

And the providers disagree with each other, so you cannot generalise from one. Nutritional therapy is the clearest case. Westfield Health accepts twelve bodies including BANT and the Association for Nutrition. Health Shield's "Nutritional Therapy including Dieticians" row accepts six (CNHC, CThA, FHT, HCPC, INDI and NNA) and includes neither, filing BANT under allergy and food intolerance testing instead. A nutritional therapist registered with the Association for Nutrition has a Westfield claim and no Health Shield claim, from the same qualification on the same day.

The sequence, if you want the income

1. Find your own row. Look up your registration on each provider's accepted list: CNHC publishes which plans recognise it, and Health Shield, Medicash, Paycare and Westfield each publish their own. Write down which providers you appear on.
2. If you appear on none, cost out CNHC. £75 a year for one discipline, verified through a Verifying Organisation. Five providers name it. Nothing else in the UK market has that reach for a single fee.
3. Find out what your local employers buy. Three or four large employers in your catchment account for most of the cash plan holders who will ever walk in. Ask patients who claim which provider they are with and keep a tally. This is the research that moves the number, and it takes a notebook.
4. Fix your receipt once. Add your qualification and registration number to the invoice template. Name the treatment on the line item. Itemise sundries. Never hand out a card slip.
5. Say the sentence at the point of booking. "If you have a health cash plan through work, ask what it pays for physiotherapy. I will put everything they need on your receipt."
6. Do not discount, do not advertise "we accept" a provider, and do not promise a figure. You cannot see their limit.

Step 3 is the one that separates practices that get cash plan patients from practices that merely qualify for them. Everything else is a one-off afternoon.

This is general commercial information, not insurance or financial advice. Cash plan benefit limits, accepted accreditations and claim deadlines change, vary by plan level and vary between individual and corporate policies. Figures here were taken from the providers' own published documents on 11 October 2026 and are cited with their document codes where available. Confirm current terms with the provider before relying on them.

Sources: CNHC, private health cash plans · Health Shield, accepted accreditations and qualifications · CNHC, apply to register · CNHC, continuing professional development, read 11 October 2026 · Simplyhealth, how to claim · Medicash, find a practitioner · Paycare, qualifications directory · Westfield Health, how to claim · LaingBuisson, Health Cover UK market

Related: Which registration each insurer and cash plan accepts · What Healthcode and the Private Practice Register actually are · How private health insurance panels work · What to charge for a physiotherapy session · What is a good diary utilisation rate?