Apply online (Private plans)

Bank details

These details enable us to pay claims directly into your bank account.Your details are safe on our SSL certified secure server.

Account Holders Name*

Bank / Building Society name*

Bank / Building Society address

Sort Code*

Account Number*

Use a different bank for payments*

I am happy for claim payments to be paid into this account
I would like claim payments to be paid into a different account

Account Holders Name*

Bank / Building Society name*

Bank / Building Society address

Sort Code*

Account Number*

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bank details

Why do you need my bank details?

We need this in order to pay claims into your bank account. You bank details are stored safely and securely by Paycare.

Additional details

Congratulations! You get one month for free.

Do you have a promotional code?

How did you hear about Paycare?

You have chosen 'Other', please give details in the box below:*

You chose Direct Level 1 : £7.24 per month

You chose Direct Level 2 : 14.47 per month

You chose Direct Level 3 : £21.71 per month

You chose Direct Level 4 : £28.89 per month

You chose Direct Level 5 : £43.36 per month

I declare, on behalf of everyone covered by this application, that all the information that I have given is, to the best of my knowledge and belief, accurate, true and complete. I have read and understand fully the Privacy Statement, IPID and Policy Documents and have had the opportunity to raise any queries with Paycare. I agree to abide by the Policy Rules.

Please note there is a waiting period of 13 weeks after your policy start date, before you are eligible to make a claim. Wellbeing Services will be available from your Policy start date in yoru MyPaycare login area.

Name

This field is for validation purposes and should be left unchanged.

Apply now - Private Health Cash Plan

Up to 100% claim back

No medical required

Dependent children covered

Tailored benefits

Online & paper claims

Easy to set up

Step 1 of 3

Your details

Why do you need my gender and date of birth?

GDPR- personal details

Why do you need my contact details?

How and why are you going to contact me?

Medical details

GDPR- medical details

Why do you need my medical history?

Direct - Terms

Bank details

bank details

Why do you need my bank details?

Additional details