Medical Insurance Cost Cutting Plan Article Discussion Area

g7tjb

I'm a little confused and bemused by PMI at the moment... I want a policy for myself (43), husband (48) and son (5), that simply ensures that we get swift attention if a sinister lump or bump or heart flutter occurs. Then if the diagnosis came back that medical attention was required, would I be able to switch to the NHS for treatment? If I go for the 'putting money aside' savings fund, what's the worst case scenario if, say one of us developed cancer. How much would private treatment cost then, and would it be necessary for swift attention, or would the NHS step in? In fact, how much do such things as MRIs, CAT scans etc cost? Hence.... a little confused!

Errata

My personal experience is that a sinister lump or bump will be dealt with at the speed of light by a GP, and appropriately treated at the speed of light in an NHS hospital; either the local district general or the regional cancer centre.
So far, my treatment over the last 15 months will have cost tens of thousands of pounds, and will continue to do so for the forseeable future.
Can't comment on a 'heart flutter' as I'm not sure what you mean.

Rocking_Rooster

g7tjb wrote: »

I'm a little confused and bemused by PMI at the moment... I want a policy for myself (43), husband (48) and son (5), that simply ensures that we get swift attention if a sinister lump or bump or heart flutter occurs. Then if the diagnosis came back that medical attention was required, would I be able to switch to the NHS for treatment? If I go for the 'putting money aside' savings fund, what's the worst case scenario if, say one of us developed cancer. How much would private treatment cost then, and would it be necessary for swift attention, or would the NHS step in? In fact, how much do such things as MRIs, CAT scans etc cost? Hence.... a little confused!

The more expensive scans can cost quite alot around £700 or sometimes more.

Obviously if you do not take out health insurance and were to self insure and just put money aside and in future you never need health insurance then you will have made the right decision.

On the other side of the coin if you do not take out health insurance and then in 6 months one of you gets cancer needs cancer drugs some of which can cost over £50,000 and are not covered by the NHS you may be very thankful you did.

There are a million and one things that can go wrong with us that is one example of many.

The NHS are excellent in some areas but poor in others. Health insurance for alot of people (including me) tops up area's where the NHS is poor i.e. it gets them:

1. Quicker access to a top consultant/treatment/operations etc. Sometimes the NHS can take months and months for some consultations/treatment/diagnostic tests/operations etc and it is usually far far quicker privately. They also tend to test you more thouroughly privately and in a nicer enviroment.

2. Private hospitals which although generally less well equipped are much cleaner i.e. my local nuffield boasts it has never has a case of MRSA which is very reassuring. We have all heard the horror stories of people going in to NHS hospitals for something minor and not coming out alive due to a hospital superbug. Which is one of the biggest reasons many people now go private.

3. Better choice of drugs. For example the NHS do not cover quite a few cancer drugs that can cost £50,000 plus per year. Some people can remortgage their houses for these drugs and end up financially ruined.

4. It is a generally a nicer place to recover/visit compared to an NHS ward, usually with: Your own nice clean room, with ensuite bathroom, nice menu, your own sky TV, private visiting hours, telephone, less strict rules etc

As i said earlier the NHS is excellent in many areas. Private health insurance should not be viewed as something that replaces the NHS as it can't in many areas i.e. Private hospitals do not cater for A&E (Accident and emergency). It should be viewed as something that compliments it. A deluxe top up version? ...perhaps.

There is nothing we own more important than our families health. Some people simply choose to top up themselves what the state (our tax money) provides free at the point of use.

g7tjb

Thank you for your response. I hear a lot about the NHS not providing expensive drugs from people trying to sell PMI and this is why I wanted some completely independant unbiased advice. Looking at CancerHelpUK, this article addresses most of the issues you raise. On balance, I think I'll seek further advice from independant sources.

dizzie

Hi g7tjb,

I guess it depends what you want. If you are mainly worried about cancer and heart problems, there are specific policies around that just cover these illnesses (e.g. AXA PPP) and they'll be a lot, lot cheaper than taking out standard PHI. If these are the things you want, then look carefully and ensure that you won't fall foul of any "chronic conditions excluded" clause.

The areas where I feel that the NHS tends to be patchy are in the conditions which affect your quality of life (as opposed to the life threatening ones)....so things like mental health, or orthopaedic/musculoskeletal problems. But be aware that insurers also tend to use NICE guidelines to decide whether they will pay for treatments.New treatments are often not covered until they have been "on the go" for a number of years and have "proved" themselves to the NICE committee, so just because a treatment exists, you cannot assume that the insurer will pay for it.

You asked about costs of x-rays/MRIs. In our area (Yorkshire), a plain x-ray is roughly £100 and an MRI ranges from £270 to £600 depending on which hospital you go to. Inpatient stays can severely bump up a private healthcare bill (and there are policies on the market that just cover inpatient treatments, which are again cheaper than policies that give you cover for everything - i.e. inpatient/day-case/outpatient.) As far as inpatient stays are concerned, you tend to get a private room if you're in a private hospital and many pride themselves on having an MRSA-free status....some even test you before they'll agree to carry out a procedure on you to ensure that you are not a carrier of MRSA. But private hospitals like straighforward cases. Get a complication and you'll be transferred to the NHS in a flash!

Maybe the best thing to do is to look at the different types of policies exist and compare the costs and benefits in order to make a decision.

Errata

AFAIK all NHS hospitals now test for MRSA before in-patient, or day case, treatment and many local hospitals now have 4 bedded, 2 bedded and single rooms. The one sovereign benefit of an NHS hospital is that all specialisms are on-site including good medical night cover. If something goes awry in a private hospital, the patient can find themselves being transferred to the local NHS hospital for treatment.
If there is money to spare that won't be missed, then a subscription to a private health scheme can be a good idea, but it's always wise to ascertain which private or NHS hospital will deliver the best care for any particular health problem.

misfire22

Rocking_Rooster wrote: »

You really need to sit down with a independent (whole of market) health insurance specialist broker who will ask you all the appropriate questions. Then do a market review for you and make recommendations from there. Their advice is usually free, they do make a commission from any policies you decide to take out via them. They get the same commission the direct sales agents get. They can often get better deals through insurers than you can going direct due to the high volume of business they put through insurers. Because they are independent their advice is unbiased and they have to give best advice to stay compliant under the FSA. In saying that there are good and bad ones the same as in any other field or industry.

There are a lot of factors that need to be taken into account here. A few burning questions would be:

1. Who is he currently insured through and what is the name of the scheme/policy?
2. When is the renewal date on that policy?
3. Has he actually made a claim on that policy in the last 12 months?
4. I take it he went to hospital and had treatment on his shoulder?
5. What form of underwriting is he currently on i.e. moratorium or FMU (full medical underwriting)

Your choice of underwriting could be hugely important when it comes to getting existing conditions covered (i.e. his shoulder). CPME (continued personal medical exclusion) commonly known as switch underwriting is ideally the best form of underwriting for him. However most insurers in their cpme switch application forms ask if he has claimed or had hospital treatment in the last 12 months. The fact that he almost certainly has slams most doors shut on this unfortunately. So he may have to wait 12 months.

i.e. Bupa will cover 16 year olds as long as he isn't professional or semi professional. Premiums start at £10.88 monthly on their best value for money plan client choice (only available through reputable brokerages). However they ask in their cpme switch application form if anyone has had treatment in hospital or seen a consultant in the last months. If you cannot tick no to this then you are unable to join on cpme switch.

Obviously you can start him again with most insurers on a brand new policy on a standard rolling moratorium underwriting = Any medical condition you have had in the last 5 years may not be eligible to be claimed upon until you have gone 2 years advice (i.e. a consultation), treatment (i.e. physio, pills etc) and symptom free, from the start date of the policy. This means if his shoulder keeps playing up and he has advice, treatment
and or symptoms his shoulder (and related conditions) may never be covered until he manages to go two year advice treatment and symptom free.

Exeter Friendly offer a good fully comprehensive policy and are good for those with no current health insurance cover and Pre existing conditions as they offer a fixed moratorium underwriting = Any condition suffered 5 years prior to the join date of the policy may be excluded from cover for the first two years of the policy. After the first two years your medical history is effectively wiped clean and you can claim on old conditions just as you can on new ones.

All of these are of course subject to the insurers terms and conditions of the policies.

Thanks for this. Exeter Friendly dont cover 16 year olds on their own!

Rocking_Rooster

g7tjb wrote: »

Thank you for your response. I hear a lot about the NHS not providing expensive drugs from people trying to sell PMI and this is why I wanted some completely independant unbiased advice. Looking at CancerHelpUK, this article addresses most of the issues you raise. On balance, I think I'll seek further advice from independant sources.

[FONT=&quot]Are you talking about this link?:

(please paste into your browser)[/FONT]

[FONT=&quot]cancerhelp.org.uk/about-cancer/cancer-questions/is-private-treatment-better-than-nhs[/FONT]
[FONT=&quot]
A good very independent assessment in my opinion.

Regarding your question "would I be able to switch to the NHS for treatment"?

Yes, although at one stage some at the NHS were quite frankly being communists from hell about it and didn't want to take on people who had started going privately..... Then horrendous things like this started happening:

(please put this into google/search engine )[/FONT]
[FONT=&quot]
dailymail.co.uk/health/article-1016262/Grandmother-dies-NHS-cancer-treatment-withdrawn-paid-privately-life-extending-drug[/FONT]
[FONT=&quot]
This quite rightly this sparked huge outrage and now the NHS stance is far more sensible:

(please paste into your browser)[/FONT]

[FONT=&quot]nhs.uk/chq/Pages/2572.aspx?CategoryID=96&SubCategoryID=226

There are many drugs and cancer drugs in particular that are not available on the NHS and the list has been growing lately. Surprisingly probably the second most commonly known cancer drug (after herceptin) Avastin has now been taken off the list even though its cost has recently nearly halved.


(please paste into your browser )[/FONT]
[FONT=&quot]
guardian.co.uk/society/2010/aug/24/avastin-too-expensive-for-patients

The additional drugs and cancer drugs are one of the main reasons i have private health insurance together with quicker access to some consultants/treatment/surgery etc and the cleanliness of the hospitals. More and more private medical insurers are sending nurses to your home to administer some cancer drugs whenever possible which is to their credit.

As i have said in previous posts the private sector cannot compete with the NHS in many areas i.e. As plush and as nice as some of the private hospitals are the NHS is far far better equipped in terms of equipment (i.e. scanning machines) and personnel (top consultants, doctors, surgeons etc).

However i do not want to take chances when it come to my family health and in the event i need to go privately i think i have a good deal on my insurance. I am 34 i pay £28.13 monthly for myself my wife is 29 i pay £23.96 monthly and my son is 11 months i pay £10.88 for him on a very good policy via Bupa that is only available through top brokers.

Bupa for me although certainly not the cheapest are quite probably the best insurer as they have excellent service, uk call centres, cover, hospital lists and gold standard cancer cover. They have no limit on cancer drugs (unlike aviva, axa, standard life etc who have a 12 month limit on cancer drugs) Bupa also cover palliative care so they cover cover cancer at every stage even if your terminal (again aviva axa and standard life do not cover you once you have been diagnosed as terminal).

However there are 40+ health insurance providers out there. What’s right for one person may be different for another depending on their needs, wants, budget and past medical history in particular[/FONT]

Errata

More and more private medical insurers are sending nurses to your home to administer some cancer drugs whenever possible which is to their credit.

This is no different to what happens, if the circumstances warrant it, in the NHS. I was given the choice of hospital or home. I chose home.

Re Avastin. Research shows that it can prolong life by 6 weeks; that does not mean that it will.

Rocking_Rooster

Errata wrote: »

This is no different to what happens, if the circumstances warrant it, in the NHS. I was given the choice of hospital or home. I chose home.

Re Avastin. Research shows that it can prolong life by 6 weeks; that does not mean that it will.

Regarding being able to have cancer drugs etc at home on the NHS as well as private. I agree, its a good and fair point that you make here.

Regarding the Avastin point though. Am i missing something here? ....I never said it definately can prolong someones life by 6 weeks. It can also do much much more than this by the way:

In some cases has been given to patients who have been diagnosed as terminal and it has shrunk their tumor so much that it could be then be operated on thus saving their lives.

Here is one example (read link below 'I'm living proof that it works')

(copy and paste this link in your browser)

[FONT=&quot]guardian.co.uk/society/2010/aug/24/avastin-too-expensive-for-patients[/FONT]


My mum had breast cancer and had a mastectomy plus radiotherapy, my grandad was riddled with it and died, plus i have had friends and family who have suffered from this horrible dredded disease.

"more than one in three people will develop some form of cancer during their lifetime" - a scary statistic.

By the sounds of things you have had good treatment on the NHS with your cancer. I too had amazing treatment on the NHS when my then 5 month year old son had meningitis. Despite my job i'm not certainly not here to slag off the NHS. As i've previously kept saying they are excellent in certain areas.......but can be poor and lacking in others. Going private for some things is undoubtably beneficial for those who can afford to top up their NHS cover.

Private health insurance has been my job for over 10 years and it is something i am passionate about. Apologies if i do go on a bit at times.