health insurance cover

bruckshaw1

I have doubts about the transparency of some hospital charges when using an health insurance company.
I will shortly need a specific surgical procedure and I have an health insurance policy provided by my late employer with a modest benefit limit per annum. I would like to know in advance whether that figure is likely to be exceeded for a specific standard surgical procedure leaving me with a shortfall to pay myself. The charges for uninsured private patients are clearly listed online but the insurance company refuses to disclose the charges for insured patients on the basis that they are agreed with the hospital.
Do I not have the right to know what it is going to cost?

dunstonh

Do I not have the right to know what it is going to cost?

I would think that is a commercial arrangement between the hospital and the insurer and nothing to do with you. So, it would be down to their willingness to tell you or not.

bruckshaw1

I think it has much to do with me because I am the one who will have to make up the shortfall if the total invoiced to the insurance company for the procedure exceeds my policy limit. This has already happened to a member of my immediate family resulting in £2700 of excess costs. However I would not be interested in the actual figures if I had an assurance that the limit would not be exceeded.

Phill_Anderson

Yes, if you think by customer's point of view, then you are entitled to know the charges, which will be applicable for you, at-least they need to tell that it would be less or more than usual charges, so that you can have an estimate.


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