UKC

Afternoon all,

As per the post title I'm after recommendations of private health insurance providers.

41 year old male with no preexisting ailments (that I know of!) and my partner, 37 year old female with no preexisting ailments (that she knows of!)

Would it be cheaper to go on separate policies or a joint?

Cheers in advance,

Dave 

My work rolled out free Bupa insurance a couple of years ago. I paid extra to include the whole family.

Every time we tried to use it (and I mean every time) they said it wasn't covered under the policy. I don't know the details of what level of cover we had. Never did find a clear description.

I gouged my leg and needed stitches, wife had a skin condition, can't remember the other things, but non were pre-existing.

They were great at answering the phone, just not at providing any support.

I cancelled it and saved the tax.

Since Bupa is seen as a flagship private insurance in the UK I suspect others may just be as bad.

We have AXA via work, its been good when I have unfortunately needed to use it.

However it really depends on the level of cover you go for I would imagine, hence shop around I guess and think about what is important vs. not important in terms of coverage and excess.

I know that some specialist clinics (e.g. physio's) will only deal with the 'big' companies as the invoicing/charges with small ones are too complex/time consuming

Someone I know has Vitality which I think rewards you if you make healthy choices which they like - not sure how it works and I am not aware they have made a claim so can't comment on that part.

Not sure why you'd need private medical care for stitches in your leg - would have thought A&E would have dealt with that?

I've had no issues claiming through work BUPA scheme for physio.

Went through my wife's BUPA for my daughter (kids added free on her policy) a couple of years ago and my wife's currently having follow up care for a broken elbow on it.

Mine has now introduced an excess for some treatments, and my wife's paying one for her elbow.

Note - if you're going to claim on it, try and do it immediately after it renews - otherwise, depending on length of treatment, you may get stung for another excess when the policy renews, even if it's for ongoing treatment of the same condition!

Appreciate the replies, thank you.

It may be that I don't understand what private health care exists for. Or I just don't appreciate the benefits (yet).

For me it's to be seen quickly, no fuss, get on and get the care you need.

I did miss "speak" on my previous message. With my leg they did say they could see me, but not until the following day. In my mind this undermines the whole reason for private healthcare.

I have no doubt for things like cancer it's great, but for everyday issues, I'm pretty happy with the NHS at the moment.

I think what frustrated me about it was a private company was paying for private medical care, however all my treatment was being paid for with public money. That's just wrong.

If you are paying for private healthcare, it should be taking pressure off the NHS.

Private healthcare is usually for elective/planned activity (e.g. hip replacement) and rehabilitation (e.g. physio) along with management of conditions (e.g. back pain via physio appointment, treatment for mental health).

In the UK (unlike the USA) it is not used for emergency/immediate care....this is provided via NHS A&E.

Private also didn't use to be for seeing a GP (the pathway was usually see an NHS GP and get a referral to a private consultant/for private scans/test), but increasingly this is now being offered by private providers (i.e. you see a private GP)

You really don't understand a lot! First off BUPA isn't a private company, it is a mutual not-for-profit insurance company.

More relevant is in virtually ever country I am acquainted with A and E is there for everybody regardless of their ability to pay, this also the case in the USA under the EMTALA act where aĺl hospitals with an AE department are required to treat patients and they are reimbursed (or not). I have private health insurance in Germany as a self-employed person but my local hospital treats me without question as they are obliged to do, they can only charge my insurance if I remain overnight in their facilities for the stay costs. After that one is referred to a specialist for further treatment which is the billed. It costs my local hospital (which is owned by the local district) millions every year.

There may be one or two BUPA clinics offering A&E but I doubt it.

I've got Bupa cash plan through work. It's basically where you can claim the cash back for certain treatments. They have rejected nearly every claim first time around for various petty reasons, many of which are their mistakes. They have always paid out in the end but they do make it as difficult as possible. A more cynical person might think that this is intentional to avoid paying.

I've just had my LTKR done at a Spire hospital paid for by Bupa. We get it through work, and have to make a contribution, we don't get any reduction in price over doing it yourself, but our policy will cover pre existing illness' Which I believe most private health policies won't. 

From my first consultation to operation was eight weeks. Two weeks wait for the first consultation. I didn't need a GP referral, and self booked the consultation on line. I had x-rays at the first consultation, and an MRI three weeks later. The hospital and staff were excellent, can't fault them. Obviously you're paying for the service, but sometimes it's a price worth paying IMO.

Edit: If I want to add my wife on the policy, the price just doubles, no discount.

I had this through a previous employer and always got everything paid for without any quibbles.  Shame to hear that it seems to have gone downhill since then...

I had this through a previous employer and always got everything paid for without any quibbles.  Shame to hear that it seems to have gone downhill since then...

It's a limited company and it's not publicly owned therefore it's a private company. 

This wasn't the case for this policy as it wouldn't cover any pre existing conditions. So very much for unplanned problems.

The idea was to use this policy instead of your GP for example for a more speedy response. You can see why employers would want this for their staff.

But it's not speedy and many things aren't included and it's not for pre-existing conditions in my mind is of just limited value.

Anyone except BUPA.  Over the years and recently they have been absolutely awful, to the extent that recently they even returned some premiums, and still managed to keep on screwing things up.  As one example, they would not accept the consultant's procedure code for a one day procedure because it was on their system as needing an overnight stay.  You might think that that was easy to sort out, but you would be wrong.  And it's not BUPA  that gets to do the running around.

AXA PPP and Vitality have both been immeasurably better.  If you are active and use a Garmin you can drive your premiums down with Vitality

“This wasn't the case for this policy as it wouldn't cover any pre existing conditions. So very much for unplanned problems.”

Agreed, ‘unforseen’ non acute problems (i.e. I now need a hip replacement which I didn’t when I took out the policy) would be covered…..not I am bleeding right now and need immediate care. 

My reference to ‘planned’ activity was in the sense of “an operation scheduled for 2 weeks” so it’s planned  - sorry if wording was confusing - but the situation you described regarded stitches required immediate care which isn’t what private is used for/covers.

A plan which includes pre existing coverage or otherwise is a policy/cost decision.

The other option is to self-pay for things and to save the money that you would be using on insurance somewhere for this purpose. 

It is a private healthcare company limited by guarantee, meaning it has no shareholders and reinvests its profits...in itself.

Some people define that as a mutual.

A typical costing for a couple in their 60's is in the broad range of £4000/£5000 ish a year. There are of course variants on this.Saving that into a bank account easily builds up a fund to use as you want and always strikes me as a better option.

I find it annoying that you cannot seem  to buy private medical insurance with say a very high excess of £5000 and a lower premium.

Have a look at Benenden Health

I got it through work and although I haven't made use of it, Mrs T has. She had gall stones some years ago and had her gall bladder removed by key hole surgery. Everything about it was excellent and from first referral to the operation was only a couple of weeks.

Dave

More relevant is in virtually ever country I am acquainted with A and E is there for everybody regardless of their ability to pay, this also the case in the USA under the EMTALA act where aĺl hospitals with an AE department are required to treat patients and they are reimbursed (or not).

True in theory. I practice, I couldn't get through the door of an emergency room without showing my insurance or credit card. I was walking wounded - but you could see the bone through the gouge in my elbow. In LA, even people with gunshot wounds are hustled off to the hospitals downtown as soon as they can survive the journey. Apparently US Army medics get practice there for battlefield conditions. God help you if you don't have insurance in the US. It's why I've always been so against calls for private health insurance. No experience of top-up systems though.

Pity they do not cover things like cancer,brain and heart stuff. As thye say the NHS does this pretty well.

AXA PPP through work - can't knock it.

1. Excess = £100 per person per year ... payable if/when you first use the service.  We don't use it often .. so often go years without paying a thing for it.  In the few times we have used it .. we've generally been satisfied.
2. Nothing to do with emergency care ... you go to minor injuries/A&E for that.
3. It's basically a queue skip.  Imagine the situation where your GP referred you the consultant and you got an appointment for the NHS consultant in, for example, 6x weeks time.   Call AXA .. and you might be seen in a couple of days.  Often at a time that is convenient with you .. and sometimes to the effect "we can see you this afternoon - if you can get to us".  There is probably an important point here about compounding time in treatment.  If you can't actually get the treatment without 1st going through the consultant .. then you want to see the consultant ASAP to get the clock started on your treatment.  
4. Often now they bundle GP access in with the price ... I value this highly given how tricky it can be to get a GP appointment these days.  Obviously ... you don't get to see "your" GP ... you get to see "a" GP on zoom.  If you are a generally healthy person who just quickly need to something checked out/quickly needs to run something past a suitably qualified person - works pretty well.  You book an appointment in the app ... often you can be speaking to a GP on zoom in < 30 mins.  We've even used it on holiday with a sick kid.  I don't recall a cost associated with this ... 
5. You do sometimes have to do the work yourself.  Example - they might issue you a code + tell you which services locally are in plan .. and you call them yourself to make an appointment giving them the code.  Physio being a good example.   You can get them to make the appointment for you ... but you might loose another day in that.  We found it just as easy to get code out of them and then call up providers directly asking to be seen same day.  

Last point:  I've noticed a difference in, for example, physio if you self refer vs if you get a GP referral for a physio.  I think the same thing happens in the NHS.  Obviously .. they try to save money where they can.  IMO - if you self refer - you get to see one of their pool physio's.  Last time I needed physio I first used their GP service to get a GP referral for physio and then called them up asking "can you give me a list of approved sport physios close to me".  This appeared to open up other options because I had the GP referral in hand.

It's presumably owned by its members - what would you call say Nationwide or the Co-op?  A mutual is kind of a third option from those two.

We've got an access-to-private-GPs thing - only problem with that is that private prescriptions can be expensive particularly if it's an ongoing thing.

Echoing these statements, though I've not had to pay an excess.

It's always been incredibly fast to get an appointment. I once got GP appointment same day, referred to doctor for tests which was scheduled in two days after. Compared to my experiences with the NHS it was night and day.

Thankfully I haven't had to use it extensively but I've generally been fairly impressed with them. I am always still a bit nervous that I accidentally end up getting treatment they refuse to pay for and I'm lumped with a large bill. I'm also wary of using it too much and potentially have to pay a lot more for insurance in the future if I took the plan on myself (not sure if that is how it works).

Not sure if this is just a Scotland thing but anything I've been prescribed privately, I send an email to my local NHS GP who then provide me the prescription (which in Scotland is completely free).

I think *in theory* if you access treatment outside the NHS that course of treatment is then stuck outside the NHS.  However, some GPs might be more helpful and willing to take it on as yours seems to be.

Maybe, honestly never thought about it and don't see how it's relevant to the discussion.

For the record I didn't originally refer to Bupa as a private company. The private company in my post was referring to my Employer who was paying Bupa. 

The point I was making is it's private money, yet all my healthcare needs was being paid by public money.

But to answer your question, it required a quick google.

https://www.investopedia.com/terms/m/mutualcompany.asp

It still sounds like a private company to me, but happy to call it whatever the majority want to call it.

They are private because their shares (which they don't have) are not publicly available for purchase.

I had AXA PPP through work and needed to continue cover after I stopped working.

First years cover cost circa £5,000. Second year the premium jumped to £9,000. I thought that expensive…

I dropped the insurance and now use savings to pay for private healthcare if needed.

"The point I was making is it's private money, yet all my healthcare needs was being paid by public money"

....In reality all the healthcare that wasn't covered by your policy (i.e. emergency healthcare, pre-existing conditions, named excluded conditions) was being paid by public money

I am not trying to be inflammatory, I am concerned you don't seem to have understood the product you purchased.

That is madness. It costs us around £300-450 a year per employee. Do you know what the company paid for you previously?

Not really if you buy as an individual and all depends on coverage and age. As pointed out earlier some are dirt cheap but do not cover alot.

Well, yes, me and 16,000 others who work for the same employer as far as I can tell.

It's not as though we decided what service to go with, picked a product etc. We received an email saying we will soon have Bupa cover (back in 2023).

I've run a quick search in outlook and I haven't received any information on what the cover actually includes. I'm sure there's way's I can find out, but that would have been at the bottom of my list of things to do.

Apologies I had missed that part about you being 'auto enrolled'......hence its the policy your employer choose that has those exclusions (noting that emergency care is never included on private medical cover in the UK as far as I am aware)

My work also 'auto enrols' and AXA ( in reality the AXA policy my works has selected) have been great when its been needed.

Hence in conclusion for the OP its probably not 'which provider should I go with' more 'what policy do I need' in determining the best course of action.

No idea… it was a benefit that came with the job.

The irony being that I made no use of it at all for 20 years until the illness that I got caused me to stop working and I needed to continue the cover.

During the first year of my personal cover I had to have 2 scans, 1 X-ray, a 2 hour assessment, 2 consultations and 6 physio sessions. All totalled up the costs were less than the premium I paid.

They obviously reckoned I was then a potential high risk so effectively doubled the premium to get rid of me.

Not impressed.

This is probably a great conclusion.

Not to get rid of you, just ensuring that their risk was adequately covered should you continue with the coverage. That is usually how insurance works, and why insurance companies are generally quite successful at making money!

When you're through an employer the risk is spread across all the employees, as soon as you come out of that pool, they are a lot more interested in your individual risk.

Just got round to checking back on this.

Again, many thanks for the replies, some good insights in there. 

Interesting how widely available private medical care is becoming. I get free online GP appointments from my current account provider (and physio too which is quite handy). My work insists on me having private health insurance (covers family too to minimise time off). As said above it functions as a queue jumper on the NHS which seems ethically dubious.

I'm fairly certain from your posts that your employer had enrolled you in the exact same BUPA policy as mine. 

You should have received a copy of the policy documents directly from Bupa when you were enrolled, and they will resend this to you on each renewal. 

You have to read it carefully to make sure you understand exactly which clauses are covered or excluded from your policy. But it is all pretty clear if you read it carefully.

The documents also set out the sequence of how to claim for different things. This is not the same for every condition, and a number of conditions will require you to get it approved by Bupa before you seek medical advice.

The exclusion of pre-existing conditions is very clear,  as is their very broad definition of what makes something "pre-existing". Anything that you have had diagnosed or treated in the 5 years before joining is excluded until you go for a minimum of 2 consecutive years after joining with no treatment, symptoms, or diagnosis. So it can take 7+ years for something to no longer be considered pre-existing.

Opinions seem very divided at work when it comes to our Bupa cover. A number of people have had similar experiences to you, where everything has been rejected. They found it to be rubbish value for money and many have quit it. But there's others, who have clearly read and understood the policy well, who say it is good and that they have had no problem getting treatments approved. 

I have only recently joined, so have not yet had reason to use it, so most of the above is second hand info. Because of the horror stories that I had heard from some colleagues, I did read the policy documents extremely carefully to make sure I understood them before agreeing to join.

When it comes to cancer treatment in this country, whether you are better off being treated on the NHS or private cab be a bit of a lottery dependant on exactly where you live, what type of cancer you have, and the severity.

If you go private for radiotherapy near me, it could give you a more positive prognosis than on the NHS, it could be neutral, or it could be close to a death sentence.

The main issue is that even with the best cover, private healthcare is poorly developed in the UK, and most private hospitals don't offer a wide variety of treatments. It's more for things like hip replacement etc.

If there is anything they can't do, which is most things, they refer you the the NHS, but the NHS in most cases don't want to recognise any private diagnosis, and will send you at the back of the queue in the multi year waiting lists, to redo exactly the same tests you already did privately...