Private Healthcare Question (is it worth it?)

[cyberscooby]

Hi All,

Totally new to this forum although I use the website as my main resource in regards to my diabetes.

Some quick info about me: I'm 33 years old, male, living in the UK, diagnosed with Type 1 aged 29 - I am more than happy with the care I receive from the NHS for my diabetes.

I got a new job in October last year and I've found that I qualify for Private Healthcare where all I have to do is pay the tax on it (20%) - the company pay for the main chunk of it. It obviously doesn't cover pre-existing conditions which is fine, this is for anything non-related, but my main question is: is it worth doing?

I'm asking this mainly as I know they will try to exclude anything that could be diabetes related, which lets face it could be a fairly long list! How far would the healthcare company take it though to ensure that I wouldn't be covered for things?

Anyone with any experience of this I'd love to hear from - money isn't really the issue here - I just want to know what I'm getting into before I make my decision.

 

[m1dnc]

I've been with BUPA for as long as I remember, and well worth it. It doesn't cover anything diabetes itself, as they take the view that chronic conditions like this are NHS territory. They do cover things that may be indirectly related such as eye, heart etc problems and other complications though. You have to read the small print for the particular cover you are being offered. If you're joining a large group scheme they may even ignore individual pre-existing conditions.

And it's good to join when you're young and keep the cover as you age and have more need. It's all down to the small print though.

 

[Dasroots]

I would say it's worth it especially how the NHS is currently going. Even if it doesn't cover DM related things in my oppion it's still worth it.

 

[Lilian]

I am with BUPA - the downside: The excess. Make sure you are not ill when it is due. I had a procedure in the month before it was due so had to pay it. Then there was a follow up in the month after the excess was due. So that year I actually had to pay twice the access. Another was that I saw a consultant for a problem. He discovered polyps and said that I need testing every two years. However the testing every two years was not paid for by BUPA so I had to use the NHS for this anyway, yet still paying a lot to BUPA every month. They wont accept any previous ailments or things arising until after two years have passed. Also every age band you go through the cost goes up substantially. So as you get older and more at risk it costs more, and maybe there will come a time when it is needed most but can no longer afford it, so they have all that money you have given them and you still have to use the NHS. However that being said there are advantages for acute conditions, cancer etc. and if you can afford it there is no problem.

 

[Barbie1]

I work for a company that provides Bupa to employees. The main issue is to remember exactly what is the purpose of PMI (Private Medical Insurance), which is to provide speedy access to treatment when NHS would be too slow (we usually say if the waiting list is 6 weeks or more). Many people see the benefit of a private room a good thing, though it can often be more encouraging psychologically to share a ward with other similarly affected people, in my view.
But it is never intended to cover acute conditions where NHS will deal with it straight away (such as heart attacks or Cancer, where NHS care is usually excellent), but nor is it intended to cover long term chronic diseases such as Diabetes, where there is no prospect the treatment will result in success. Or cure!
It is intended to provide a resolution to situations where the treatment can be defined, and an end is in sight. Although it may be that a certain operation for instance does not succeed as well as hoped and more care is needed, say extra physiotherapy or a repeat procedure. These would usually be accommodated, but nothing of any long term nature, like a chronic condition.
So to cut to the chase. Although the diabetes care and maintenance will definitely not be covered, if you develop any complications that require say an operation, it is most likely that you could get that done privately if that is what you want. But do check the terms of the policy carefully to see if there really is any exclusion of pre-existing conditions and if so what are the terms - some polices may only exclude certain things f9or the first couple of years for instance.
Hope this helps

 

[Diabeticliberty]

I had BUPA cover in a previous job that I had. I rang them with a condition which was causing me some issues. They told me that the condition was not covered but the advisor I spoke to got a little bit 'creative' in completing a form regarding the condition I had and I saw a specialist 6 days later. The NHS waiting list for the condition was 18 months. Private health insurance is worth every penny in my opinion.

 

[DeusXM]

I would actually look at this from quite a different position, which is 'am I comfortable with the idea that my income entitles me to be prioritised for treatment over other equally sick people?'

That isn't supposed to be as judgy as it sounds by the way! Just something to think about, and I'm sure should I ever be in a life or death situation, I'd suddenly be far less philosophical about it!

 

[Northerner]

I had private health cover with a previous employer and it really worked well for me. Hardly ever had an ailment in my life, and this was prior to my diabetes diagnosis, so never thought I would have occasion to need it. However, I was running a marathon in Stockholm in 2004 and my right femur decided to snap at mile 23 😱 When I got back I was told I wouldn't be able to see an orthopaedic consultant for 6 weeks, but was able to 'go private' and saw one the following week. I also saw a non-NHS sports physiotherapist of my choice (the one I saw on the NHS was only used to dealing with elderly people, not marathon runners hoping to get back running again!) and he got me back running within 6 months - he was excellent. I did exceed the amount the company health provided for, but only by a tiny fraction of the overall cost. So yes, it's worth it, you never know what can happen! 😱 🙂

 

[Northerner]

I'm sure should I ever be in a life or death situation, I'd suddenly be far less philosophical about it!

My leg wasn't a life or death situation, but it was certainly a 'quality of life' situation - I would have struggled to afford the care I got on my own, but if I hadn't got it my recovery would have been seriously hampered and potentially left me with problems - you need to be able to act quickly to rehabilitate a broken bone, especially when it's the biggest one in your body! 🙂 I think it was around that time that they started taxing it as a 'perk' - prior to that it was completely free to me.

 

[Caroline]

I'd read the fine print as I tend to be a bit sceptical about these things. Because the company is very careful about paying out, they will pin anything on to a pre existing condition they can.

Having said that my sister in law has private health insurance with the firm she works for which covers her and my brother up to (I thin) £250, so may be worth it if it covers wife/partner/next of kin or someone you care about.

 

[AndBreathe]

Hi All,

Totally new to this forum although I use the website as my main resource in regards to my diabetes.

Some quick info about me: I'm 33 years old, male, living in the UK, diagnosed with Type 1 aged 29 - I am more than happy with the care I receive from the NHS for my diabetes.

I got a new job in October last year and I've found that I qualify for Private Healthcare where all I have to do is pay the tax on it (20%) - the company pay for the main chunk of it. It obviously doesn't cover pre-existing conditions which is fine, this is for anything non-related, but my main question is: is it worth doing?

I'm asking this mainly as I know they will try to exclude anything that could be diabetes related, which lets face it could be a fairly long list! How far would the healthcare company take it though to ensure that I wouldn't be covered for things?

Anyone with any experience of this I'd love to hear from - money isn't really the issue here - I just want to know what I'm getting into before I make my decision.

As has been said already, do check the policy wording.

When I was working, in a proper job, my employer's PMI did cover pre-existing conditions for me, but not for family members. It didn't cover routine diabetes care though. It would have covered me for an initial "sorting it out", but not regular checks etc.

Much really depends upon where your risk dials are set. I had a small number of claims on it, some gynae issues where I had an issue and saw the Consultant same day as I called for an appointment to see my GP. GP called me back and from description asked me to pick up a letter and see Consultant the same day. (Everything worked out fine, in the end.) I also had some work done on my face by a plastic surgeon that the NHS would not have done because all sorts of reasons.

I'd suggest you investigate how much the premiums are, and therefore how much tax you would pay. To calculate that, the full premium amount would notionally be added to your total remuneration (so, include any bonuses or other taxable allowances in calculating your taxable remuneration), then apply the tax tables. I'm just pointing that out in case it would trip you over into a different tax band.

Could be worthwhile speaking to colleagues and see what their experiences have been, in any of them have made any claims.

 

[khskel]

I've got BUPA through work although I've never had any treatment through it last time I was in hospital I claimed £50 quid a night NHS inpatient benefit.

 

[DaveB]

Hi. I have BUPA privately for my wife and myself. My diabetes is excluded and so is anything to do with heart, circulatory system etc as my total cholesterol was slightly raised when I started the policy. The latter is stupid but so are insurance underwriters at times. I have taken a large excess as my risk and do watch over-lapping treatment years. BUPA is better than many other providers as they will usually agree to proceed in a phone call as long as you have a definition of the treatment number and the hospital and consultants name. Beware some insurers as you may have to submit a multi-page document with your life history and GP letter each time you need treatment; an absolute pain when you're really ill. I like the speed of treatment often the following week, the time with the consultant, the private room and you are in control.

 

[grainger]

I have private medical cover with AXA through my husbands policy. It covers everything (including all pre-existing) although I still use the NHS for my diabetes care as they've always been great - so i'm not sure what they'd offer in this regard.

I have a different view to some of the above posts as having had skin cancer I originally went nhs but was missed/forgotten after 6 months (due a check up every 3 months for minimum 2 years then 6 months for a further 3). So I switched to private - they have been incredible, I chose my consultant from a list so i could look at credentials and see who I felt had the best knowledge of my cancer etc...

I also believe, maybe wrongly that while I can be seen privately this frees up NHS appointments for those that cannot.

I've also been seen privately for physio (on a running injury) and grief counselling briefly.
From my experience I'd highly recommend.

 

[AndBreathe]

The other thing to check is how frequently the excess is applicable. With AXA PPP, it's each calendar year, from the renewal date of your policy. That's excellent if you have multiple claims in any given year. Alternatively, one could pay twice in just a couple of months, depending on unlucky timing.