existing customers - formerly PHSA

• by post

If you would like to contact us in writing, please write to:

Engage Mutual Customer Service Department

Hornbeam Park Avenue

Harrogate

HG2 8XE

• by phone

Please call our health plan team FREE on 0800 389 4433†

• by email

hcp.info@engagemutual.com

If you wish to make a change to the details that we hold about you, for example:

• your address

• scale of cover

• dependants included in your membership

• payment details

you may do so by advising us using our contact details above. 

You may also terminate your membership by simply advising us in the same way.  Please always quote your Registration Number, as shown on your Registration Certificate.

If you change your name we will require either the Marriage Certificate, Divorce Documentation or Deed Poll, together with samples of both your old and new signatures.

Your eligibility to claim, and the amount of benefit payable, is dependent on the scale of cover on which you are registered.  For advice on your entitlements, or to request a Claim Form, please feel free to contact us on the details above. 

You can download a Medicaid Claim Form here

In addition to the Claim Form, the documentation required is as follows:

• for Hospital Benefits:  the relevant section of the Claim Form completed, signed and stamped by the hospital

• for Maternity/Paternity Benefits:  the Birth Certificate

• for all other Benefits:  the original receipted account for the treatment or service received.  The receipt must show the name of the practitioner, the name of the patient, the amount paid and the date.  Photocopies, faxes, credit card vouchers and duplicates are not accepted.  We will keep the receipt, but will provide you with a copy on request.  Claims are usually settled within 48 hours of receipt.

The claim should be sent to us at the address shown in contact details above within 6 months of receiving treatment.

If your claim is for a medical condition for which you have claimed recently, there is no need to submit another Claim Form.  A fully completed Claim Form should, however, always be sent with any claim for a new condition. 

The claim should be sent to us at the address shown in contact details above within 6 months of receiving treatment.

You can download a Medicare Claim Form here

The process:

• hospitals will usually send the bills to us and we will pay them directly

• if however, you have received a bill, simply forward it to us at the address above

• please let us know whether you have paid the bill so we know where to send the money.

Even where we make claim payments to Hospitals and Specialists direct, the contract for the treatment is between the Hospital/Specialist and the Patient.  This means, in turn, that you are liable to pay any charges for private treatment which are not met in full by us.  As a party to the contract, you also have the right to agree terms with the providers of the treatment before it takes place and to challenge any charges subsequently made which are felt to be incorrect.

Private hospitals will usually expect you to pay on discharge for any services which are not covered by Medicare, such as newspapers, visitors’ meals and drugs prescribed for use after discharge. 

If you are in any doubt about your entitlements we will be happy to advise you.