Private medical cover

j.a.mcguire

On a recent medical some items were brought up which require further investigation.

I spoke to my private medical cover provider, and they have advised me that I could pursue the investigatory work under my private scheme held with them, however they could not advise me in advance what work I would be liable for and what work would be covered in their scheme until after they have received the bill from the hospital/medical centre coducting the work.

I suggested that I call the medical centre, and ask them to provide me with a quote in advance which I could pass onto my Insurance Company, the lady on the phone advised that this may still not give a clear picture until they ran the figures through the system.

She also advised that if I were to request a personal quote, that the figures would likely be different to the quote provided to my Insurance Company. She advised that my Insurance Company have set prices for individual tests/procedures, and the bill given to my Insurance Company is likely to be higher, than it would be on my personal bill.

* Isn't the fact that I cannot be informed of the cost up-front in breach of Trading Standards?
* Isn't the suggestion that there is one price for my Insurance Company and another price for me as an individual some form of price fixing, and illegal?

I feel I should reach out to a body / organisation regarding these issues, but I'm not sure who I should approach?

hollydays

What does your contract say?
What are the terms of the investigatory examination?
Have you clearly been told what the investigation will entail?
This sounds like a question you would be far better to Ask in writing to them.
Are there any declared pre existing conditions linked to this

BorisThomson

It's not unlawful to offer different prices to different parties. The NHS buys private services all the time (too often) and they will pay a different price to an individual patient. This would usually be less, but if not able to contract on a bulk buy basis (or very poorly negotiated) it could also be more.

pmduk

BorisThomson wrote: »

The NHS buys private services all the time (too often) and they will pay a different price to an individual patient. This would usually be less, but if not able to contract on a bulk buy

Too right, it saved my NHS trust £5000 by sending me to a BUPA owned hospital for surgery 12 years ago rather to a different NHS trust. Same Op, Same surgeon etc!


The BUPA hospital was geared up to do the op more frequently.