Using Private Health Insurance to Investigate/Diagnose Pre-existing Conditions

srcat

I seem to have various medically unexplained conditions and the NHS isn't being helpful. I don't know anything about health insurance and googling isn't providing the answers I'm looking for. What I'm wondering is if private health insurance will help cover the costs of investigating and diagnosing pre-existing symptoms that so far don't a complet explanation? I'm not hoping for it to cover the costs of treating those conditions, as I know they don't provide that for preexisting conditions, but I was wondering if they cover the costs of consultations and tests for them?


Also, would it be a good plan to get a plan for a year just for purposes of diagnosing? How much should I expect to pay?

Dr_Crypto

Probably not.
In general they will ask about symptoms when you take out the policy and will either decline cover or exclude them. The other way is that they will let you have the policy but if you make a claim inside the first year or so will ask for more information from your GP and may exclude the claim on that basis.

Remember that all private doctors worth seeing are also NHS doctors. In general I'm very suspicious of purely private doctors, although there are exceptions - such as an older doctor who has retired from the NHS but is winding down by keeping their private practice open.

If you want a private consultation you can always pay cash for it. Most consultants will require a GP referral.

srcat

Dr_Crypto wrote: »

Probably not.
In general they will ask about symptoms when you take out the policy and will either decline cover or exclude them. The other way is that they will let you have the policy but if you make a claim inside the first year or so will ask for more information from your GP and may exclude the claim on that basis.

Remember that all private doctors worth seeing are also NHS doctors. In general I'm very suspicious of purely private doctors, although there are exceptions - such as an older doctor who has retired from the NHS but is winding down by keeping their private practice open.

If you want a private consultation you can always pay cash for it. Most consultants will require a GP referral.

It's not that I want to see a private consultant, it's that I want to choose which hospital/consultant I'm seen by and also not wait 6 months for an appointment. NHS is good if you're lucky enough to have a widely recognized well-established condition, but if you don't you're screwed and you'll be cycled forever through consultants who may not even be the relevant medical field, are stingy with tests and don't know what they're doing . It wastes years of your life and it's not worth it.

I really thought medical insurance would at least cover examinations of those prexisting conditions. Pretty much everything other than injuries can be considered pre-existing conditions, where do they draw the line?

Manxman_in_exile

AIUI you already have the right to choose a NHS hospital/consultant.


Find the website for your local NHS Clinical Commissioning Group and search for something like "Patient Choice".


I used to work in the NHS but have no idea how patient choice works - if it works at all. (I suspect it has many catches and exceptions).


EDIT: You can always opt to see a NHS consultant privately for an initial consultation/investigation. Most of them have private patients as well as NHS. My GP made a private referral for me to a cardiologist five years ago - I admit it was because I wanted to be seen quicker than on the NHS, but you're allowed to do so.

Dr_Crypto

srcat wrote: »

I really thought medical insurance would at least cover examinations of those prexisting conditions. Pretty much everything other than injuries can be considered pre-existing conditions, where do they draw the line?

Generally if it is symptomatic at the time you took out the policy, certainly if you were consulting doctors about it prior to taking out the cover.

It is often very difficult to see a specific Consultant on the NHS now with the ways referrals are made. Even if the GP asks for Dr X to see you unless Dr X is the only person at that hospital in that specialty you will get sent to a particular team eg gastro.

It might be worth having an initial private consultation with the person you want to see and then they can transfer you to their NHS practice (this is allowed in some cases, not all). Having tests privately can become very expensive.

sheramber

Have a look at Benenden Health https://www.benenden.co.uk/

Sncjw

If you see a consultant privately for initial consultation and you require treatment and then want it on the NHS. Well you would have to to start the process all over again as you will go to the back of the queue. You won’t be able to queue jump from private to nhs . Just if you think you are going to do that.

lisyloo

srcat wrote: »

IPretty much everything other than injuries can be considered pre-existing conditions, where do they draw the line?

I don’t think that’s the case.
If you suddenly notice a odd looking mole or start being breathless, then those are not pre-existing. If you haven’t seen a doctor a about it it or left something without treatment e.g. a Huge mole, then it’s not preexisting.

If you see a consultant privately for initial consultation and you require treatment and then want it on the NHS. Well you would have to to start the process all over again as you will go to the back of the queue. You won’t be able to queue jump from private to nhs . Just if you think you are going to do that.

This is not my understanding and I know several people who do this and it was what I was going to suggest.
If you want to go to the NHS then you will indeed need an initial consultation but if you have been diagnosed e.g. cancer, then you would not be put into the slow queue for tests. Once you’d been diagnosed you would go straight to a consultant.
I know people who do this because test are relatively cheap and it’s often the slow part of the NHS.

Perhaps the other poster lives in a different are with different rules but I know people in Bristol and Surrey who jump the queue this way.

Dymphna60

do you believe that you have condition X but your dr(s) don’t ? Or is it that you are unwell but don’t have any idea what is wrong?
If it’s the first one is there an investigation that would diagnose it ,for example an MRI ?
Expensive privately but you would have an answer and could be referred to the correct nhs consultant clinic .
If it’s the 2nd private health care would have the same problem as nhs .
Private health insurance is a business they would not give you hundreds / thousands pounds worth of tests for a £50 premium unfortunately or a lot of us would be doing it .

csgohan4

Private insurance do not cover existing symptoms, diagnosed or undiagnosed, if you want it covered, it will be self funded.


Most private consultants are/were also NHS consultants. You need to rein in your expectations and you will likely go through the same tests and costing you more money.


Doctors don't have the answers to everything specialist or not, however one thing NHS does best is rule out and quickly treat cancer.


However I have private medical insurance myself as I cannot afford to be off work for too long. Waiting 2 years for a knee replacement is not an option for me

Manxman_in_exile

Sncjw wrote: »

If you see a consultant privately for initial consultation and you require treatment and then want it on the NHS. Well you would have to to start the process all over again as you will go to the back of the queue. You won’t be able to queue jump from private to nhs . Just if you think you are going to do that.

I think you might be missing the point. What the OP appears to be complaining about is that he can't get a diagnosis on the NHS(?), and wants to see a consultant of his choice, or is wondering if he can get a diagnosis by taking out private health insurance - he's not reached the stage of needing any intervention yet.


As in #4, the OP already has a qualified right under Patient Choice to see a consultant of their choice, or to be referred to a hospital of their choice. They need to see how that works in their area by looking at the website of their local NHS Clinical Care Commissioning Group, or by simply asking their GP. (Having worked in the NHS I can imagine it's nowhere as simple as I may make it appear. I'm also not sure how you second guess your GP as to who the best person to be referred to is.)


They can also see a consultant of their own choice privately or ask their GP to make a private referral to a NHS consultant (although it's not as common as it used to be, many NHS consultants maintain a private list). The point of this would be to speed up diagnosis and to find out quicker if you've got a real medical problem. (I've done this myself to see a cardiologist and he told me there was nothing wrong with me. If treatment were required, you'd then have to decide whether to pay for the treatment privately, or join the NHS queue.


I think the idea of taking out private insurance just to get a diagnosis is plain daft. First, you might be seen by the same doctor as you would on the NHS, and second, if there were a positive diagnosis, I'm worried that it could be considered pre-existing, even if not yet diagnosed. (Presumably the OP is experiencing odd symptoms which are of concern to them and has already been seen under the NHS, so it would have to be declared, even if not diagnosed.)