BupaCare Scale A, B ,C... lottery?

dizzie

Hi again Wutang. Fee assured consultants can't charge BUPA fee + 20% if they want any reimbursement at all from BUPA. The contract they have signed does not allow them to charge patients for shortfalls....and BUPA won't pay any more than the fee schedule. You watch - some of the best consultants will start refusing BUPA patients because of the changes brought in this year.

Trouble is that when they signed the contract, they didn't know that BUPA were going to not only NEVER increase the fees, but that they were actually going to slash them massively! The funding criteria about what they will and will not cover is all changing too, but again - it is the doctors that are being notified of all of this - not the poor unsuspecting paying client!

Some of the podiatrists already have told BUPA where to go...this year they brought in a new podiatry network in which the podiatrists have to accept BUPA pay rates or not get back on the BUPA network. They were offering £25 max for a follow up of up to 50 mins. A friend of ours recently parted company with BUPA because of this - Spire Hospital were charging him £28/hr for room rental so those rates couldn't even cover his costs let alone provide an income. They screwed the physios over a few years ago and now it is time for all the other healthcare professionals to get the BUPA treatment.

Believe me, things are changing rapidly with BUPA. Simply Health may have rubbish cancer care, but I presume that policy literature tells the client what they will and will not pay for at the outset. BUPA aren't telling the clients anything about the new rules and reimbursement levels they're bringing in. Watch this space Wutang....I stand by my opinion that of the major providers, they have now got to be the worst. And frankly, my experience with BUPA on the phone has been terrible - can't imagine Aviva to be any worse really.

PS I don't spend £260+ a month to have healthcare that (depending on the condition) might or might not be marginally better than the NHS. I don't want to pay for a straightjacket policy. I can understand that there has to be a limit to what they'll pay...but I want the option of paying the difference. And BUPA are denying me that.

styleye

July hospital list on bupa website still no information about which hospital has which scale of cover so lottery still goes on...IT COULD BE YOU!!

bupa.co.uk/jahia/webdav/site/bupacouk/shared/Documents/PDFs/Intermediaries/pdf/Hospitals-List.pdf


on the plus side open referral remains a choice on BUPACare

see page 10 (or 7/29 in adobe) read step 2

bupa.co.uk/jahia/webdav/site/bupacouk/shared/Documents/PDFs/Intermediaries/pdf/member-guide.pdf

Wutang_2

styleye wrote: »

July hospital list on bupa website still no information about which hospital has which scale of cover so lottery still goes on...IT COULD BE YOU!!

bupa.co.uk/jahia/webdav/site/bupacouk/shared/Documents/PDFs/Intermediaries/pdf/Hospitals-List.pdf


on the plus side open referral remains a choice on BUPACare

see page 10 (or 7/29 in adobe) read step 2

bupa.co.uk/jahia/webdav/site/bupacouk/shared/Documents/PDFs/Intermediaries/pdf/member-guide.pdf

Think you are somewhat missing the point.

The hospital list can say anything, its all about the consultants. OPEN REFERRAL is the issue as Bupa will not pay most consultant fees as they are stuck in another decade. Ring 10 private consultants and ask them if they are in a quandary at the moment.

The rift amongst private consultants is at its highest level due to 1.) patients wishing to see specific consultants but being denied due to the Bupa fee guidelines and 2.) the market share Bupa has in the market (god knows why, they are awful).

If you think the open referral scheme is the 'plus side', you need to research this a little more. Its an oxymoron.

styleye

Wutang wrote: »

Think you are somewhat missing the point.

The hospital list can say anything, its all about the consultants. OPEN REFERRAL is the issue as Bupa will not pay most consultant fees as they are stuck in another decade. Ring 10 private consultants and ask them if they are in a quandary at the moment.

The rift amongst private consultants is at its highest level due to 1.) patients wishing to see specific consultants but being denied due to the Bupa fee guidelines and 2.) the market share Bupa has in the market (god knows why, they are awful).

If you think the open referral scheme is the 'plus side', you need to research this a little more. Its an oxymoron.

with respect i believe you are missing the point, as I AGREE WITH YOU!!

On the "plus side", meaning after once again screwing up the hospital list by not including the scale, the "plus side" is the fact that open referral is an option.

The fact it is there at all is frankly daft, but it is and the "plus side" is that for BUPACare policy holders it remains an option i.e not compulsory so you can still get a named referral AND YOU HAVE A CHOICE if you are inclined (or unstable in my opinion) to let a BUPA call centre decide for you. So the "plus side" is that you don't have to use it....i feel i am repeating myself.:o

dizzie

Just thought I'd post this link as confirmation of some of the things that BUPA is up to:

http://bma.org.uk/news-views-analysis/news/2012/july/bupa-demands-consultants-cut-fees

BUPA's excuse is that as medicine has advanced, then procedures have become quicker, easier and cheaper to perform. Basically, this is a pile of cr*p! Can you tell me how this is the case say for a soft tissue injection....you have a needle, a syringe, some steroid and local anaesthetic - none of which have gotten cheaper in the last 20 years. You have facility overheads and medical indemnity which has gone up massively...and you have a skilled professional with many years training and experience. So why almost halve the cost of reimbursement now.

Anyone considering this insurer...or indeed anyone still with them needs to read some of the latest reviews on the web. The changes introduced this year will have a massive impact on your pocket if and when you need to claim!!
:mad:

smilew

looks like one insurer is keen on taking bupa customers due to their daft open referral scheme.

wpa.co.uk

from their website

"Freedom to choose"

"Some private health insurance companies in the UK now make the decision as to the Consultant you will see.

WPA believes in your right to choose - where you, in conjunction with your doctor, make an informed choice as to the right Specialist based on your needs and circumstances.

WPA believes firmly that this should be a clinical and not a commercial decision."

AMEN to that

styleye

BUPA still not publishing lists of hospital with the scale. Same old rubbish that it "does not affect the care" you receive. However here it is finally in the small print and for the first time:

facility charges for day patient treatment and in-patient treatment: recognised facility WITHIN SCALE of cover: paid in full

*a recognised facility in HIGHER SCALE ROOM THAN SCALE OF COVER or a facility that is not recognised: up to £200 each day for day-patient treatment or each night for in-patient treatment for all the facility charges and not for each service or charge individually


Of course BUPA don't tell you in advance which hospitals have which scale of room until you fall ill. The last time they used their brains and thought about their members was in 2006 here you will see the hospitals with the scale:

bupa.co.uk/jahia/webdav/site/bupacouk/shared/Documents/PDFs/Literature/hospital-list-participating.pdf

The link above is from 2006.

So now in addition to most top consultants (yes BUPA THEY REALLY ARE!!) leaving BUPA fee assured status, meaning you end up paying extra to cover the shortfall for each consultation, you now have the genuine possibility of believing you are covered for all the hospitals on your list, only to be told WHEN YOU FALL ILL, that although your hospital is on the list and recognised the room scale means you can't go there, or you pay the shortfall for each night you are there.

Wasn't insurance always meant to protect against unforeseen circumstances that may arise. I guess if you know when you will fall ill, what type of major illness you will have and which hospital and consultant will be required ALL IN ADVANCE then your BUPA cover could be bought in good faith otherwise it still could be you....

styleye

Well enough is enough time to move. Tired of seeing this link on every decent consultants website.

http://www.fipo.org/newsletters/Number4FIPO-PatientLeaflet-May2012.pdf

All recommend WPA.

Does anybody know of any discounts to get a cheaper deal with wpa. I know BUPA had wacky ideas about joing the rac or david lloyd. Any codes or tricks to reduce the cover with WPA would be appreciated.

wozearly

styleye wrote: »

Well enough is enough time to move. Tired of seeing this link on every decent consultants website.

http://www.fipo.org/newsletters/Number4FIPO-PatientLeaflet-May2012.pdf

All recommend WPA.

Does anybody know of any discounts to get a cheaper deal with wpa. I know BUPA had wacky ideas about joing the rac or david lloyd. Any codes or tricks to reduce the cover with WPA would be appreciated.

Currently there's a general 20% discount to new customers before the end of the month.(http://www.wpa.org.uk/products/discount.aspx)

I'm not aware of any affiliate deals, and even if there were its unlikely you'd beat the 20% (and the small print indicates it wouldn't be cumulative).

Definitely look over the cover (if you haven't already) and the amount you'll be expected to contribute to treatment yourself with WPA. As a small provider, some of their policies (not all) are radically different to the more mainstream alternatives, so don't make any assumptions from the start!