Private Health Insurance

Private Health Insurance

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prand

Original Poster:

6,021 posts

203 months

Monday 15th February 2010
quotequote all
I have developed a somewhat painful and distressing, but not life-threatening medical condition. I visited my GP whose treatment does not improve matters, and my condition is worsening. He suggests I go and visit a specialist.

Great news - I am in the private medical scheme provided through my work. They have given me a card with a dedicated phone number, so I ring it.

Bad news - I have to pay £100 excess (expected, so not too surprised by this)

Bad news - Private Medical Co have to approve an appointment with a specialist. But I have to prove that this is not an existing condition to me joining the scheme. Private Medical Co send me a form, which I have to complete and sign, then I have to take it to my GP to send back confirmation I am not lying.

Bad News - So after detouring to the surgery, I have just received an invoice for £30 from my GP surgery to return by FAX the form to Private Medical Co (there is nothing in my medical notes beyond receiving Tetanus and Polio in about 1988)

Bad news - Medical Co say it they don't cover GP's expenses, so I have to pay this fee myself.

Bad News - Even though they have received the fax, Private Medical Co says it takes 24hrs to process fax (by the "Fax Champion") to confirm I have no previous, so I can't still book an appointment

I'm not a major user of healthcare, so are my expectations of going private all wrong? (I'm expecting private clinics with friendly and underworked staff, tea and biscuits, and a stress-free "leave all this to us" experience).

I do understand I am dealing with an insurance company, who are very careful who give money to, but really, when it's taken a couple of weeks to get this far, and is going to cost me a fair bit of money, is it really worth it?



ThatPhilBrettGuy

11,809 posts

247 months

Monday 15th February 2010
quotequote all
prand said:
....I am in the private medical scheme provided through my work. They have given me a card with a dedicated phone number...


....
I'm not a major user of healthcare, so are my expectations of going private all wrong? (I'm expecting private clinics with friendly and underworked staff, tea and biscuits, and a stress-free "leave all this to us" experience).
Basically it depends on what your company is prepared to sign up to. Sounds like they've gone for the basic value package. As you've found not all private schemes are equal. For example some places ignore all medical history.

prand

Original Poster:

6,021 posts

203 months

Monday 15th February 2010
quotequote all
Yes indeed. It seems like it's more my company providing us with some rather basic cover to say "you get company health insurance" as part of my package (and I understand it works out very, very expensive to give the general population "fuly comp").

I have given our HR people some feedback on this "benefit", because given I have to pay a fair chunk of this in tax, a £100 excess, and these incidental expenses it seems anything but a benefit, adn it's hard to see what I would actually get out of this.




Broomsticklady

1,095 posts

212 months

Monday 15th February 2010
quotequote all
Don't despair yet!! Once you've got thru the hoops and loops, you'll get the single room, tea and biscuits et al that you're looking for - it's just that like any other insurance policy if they can wriggle out they will!!

Neil.D

2,878 posts

213 months

Monday 15th February 2010
quotequote all
I have just made a claim through medical insurance with a knee issue.

Despite the initial dissapointment with your bills let me assure you - private healthcare is awesome.

No waiting, no queues, no full waiting rooms - just brilliant.

A bit if a spend to avoid the wasted time + stress with the NHS and its all worth it.



Sad thing is that the NHS should be like this but we just have too many people to pay for - but thats another story.

prand

Original Poster:

6,021 posts

203 months

Tuesday 16th February 2010
quotequote all
Neil.D said:
I have just made a claim through medical insurance with a knee issue.

Despite the initial dissapointment with your bills let me assure you - private healthcare is awesome.

No waiting, no queues, no full waiting rooms - just brilliant.

A bit if a spend to avoid the wasted time + stress with the NHS and its all worth it.

Sad thing is that the NHS should be like this but we just have too many people to pay for - but thats another story.
That's the thing - I am experiencing wasted time and stress, and unexpected expense trying to see the same specialist my GP would have referred me to anyway (although with a longer wait). Hardly an awesome service IMO.

As above, I do think this is because I am using my work healthcare, which is not as comprehensive as it seems.

btom

480 posts

276 months

Tuesday 16th February 2010
quotequote all
prand said:
Neil.D said:
I have just made a claim through medical insurance with a knee issue.

Despite the initial dissapointment with your bills let me assure you - private healthcare is awesome.

No waiting, no queues, no full waiting rooms - just brilliant.

A bit if a spend to avoid the wasted time + stress with the NHS and its all worth it.

Sad thing is that the NHS should be like this but we just have too many people to pay for - but thats another story.
That's the thing - I am experiencing wasted time and stress, and unexpected expense trying to see the same specialist my GP would have referred me to anyway (although with a longer wait). Hardly an awesome service IMO.

As above, I do think this is because I am using my work healthcare, which is not as comprehensive as it seems.
To be honest its more to do with how the policy is underwritten. Your have moratorium cover - insurers sell it on the basis that you don't need to divulge any medical history - if you were fully underwritten then the insurer would have been able to sign off treatment pretty much immediately and you could have seen the specialist immediately.


prand

Original Poster:

6,021 posts

203 months

Tuesday 16th February 2010
quotequote all
This moratorium thing has been getting me a bit annoyed. Why wait until I am sick and in need of attention to then start asking for doctor's records etc? I guess when you have a few thousand people all being introduced to a new scheme then this way round is more practical from an admin point of view.

At least I have been able to speak to one of our HR people about this today and this has made me feel a lot better (not sure he thinks so after having someone venting at him for 15 minutes!)

taffyracer

2,093 posts

250 months

Wednesday 17th February 2010
quotequote all
sorry to hijack but I need to take out some private health cover, I know of Bupa but what others are considered to be decent, some pointers would be very handy?

Neil.D

2,878 posts

213 months

Wednesday 17th February 2010
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Im with Aviva - I have the diagnosis policy (or called something similar). With that I got to see a consultant within a week, an MRI scan and a physio within 2. Costs £50PM.

Coco H

4,237 posts

244 months

Thursday 18th February 2010
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I have a policy that covers pre-existing conditions - AXA PPP I think. They did some treatment 2 years apart for me. No compliants at all.

The trouble is the one time I needed healthcare cover badly - it wouldnt cover me as it was all pregnancy related issues

Maxf

8,425 posts

248 months

Thursday 18th February 2010
quotequote all
taffyracer said:
sorry to hijack but I need to take out some private health cover, I know of Bupa but what others are considered to be decent, some pointers would be very handy?
Its a minefield, so do lots of reading. For example, AXA PPP through my work are great - but my physio says they are awful as private policies as they 'overcharge' things - for example you might be allowed £1000 worth of physio and the physio might charge the insurers £50 a session. The insurers actually doc £100 a session from your £1000 (example amounts). Apparently this is quite common.

Defcon5

6,300 posts

198 months

Thursday 18th February 2010
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Can your GP not refer you to a specialist, for free?

Beardy10

23,731 posts

182 months

Monday 22nd February 2010
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I think you should check whether your GP is allowed to charge you £30 for sending that Fax, they are definitely not allowed to charge for referral letters.

My GP charged me £20 for a referral letter about a year ago which I paid because I didn't know better. My wife used to be a practice nurse who told me GP's weren't allowed to charge, I checked online and low and behold she was right. I didn't even bother checking with the GP, I just reported him as he's a miserable old git! I don't use that surgery any more and hadn't move through pure intertia on my part.