Beneden health insurance

BriNylon

Has anyone tried Beneden health insurance?
I cannot work out the difference.   Any experiences appreciated.

Undervalued

No direct experience but from memory is the big difference that they only pay for private treatment at their discretion if there is a wait of more than X weeks on the NHS.

Normal insurance would be obliged to pay providing your claim meets the terms and conditions.

So it all comes down to your confidence (or otherwise) about "their discretion". Given how much cheaper it is I assume there must be relatively few payouts?

BriNylon

Undervalued said:

No direct experience but from memory is the big difference that they only pay for private treatment at their discretion if there is a wait of more than X weeks on the NHS.

Normal insurance would be obliged to pay providing your claim meets the terms and conditions.

So it all comes down to your confidence (or otherwise) about "their discretion". Given how much cheaper it is I assume there must be relatively few payouts?

Exactly.  The only difference I can see is that it's at their discretion.

Undervalued

BriNylon said:

Undervalued said:

No direct experience but from memory is the big difference that they only pay for private treatment at their discretion if there is a wait of more than X weeks on the NHS.

Normal insurance would be obliged to pay providing your claim meets the terms and conditions.

So it all comes down to your confidence (or otherwise) about "their discretion". Given how much cheaper it is I assume there must be relatively few payouts?

Exactly.  The only difference I can see is that it's at their discretion.

Which could be a big, big, difference! No idea how you assess the likelihood of actually getting private treatment if needed - which is why I didn't pursue it.

It will be interesting to hear if anybody has first hand experience. 

gwync

We have been members of Benenden for a few years now, since retirement when workplace medical insurance was no longer possible.  The premiums are reasonable compared to most companies, a local private consultancy is available if the wait to see an NHS consultant is greater than 6 weeks, useful if you are concerned about waiting for a diagnosis. I used the service recently and the diagnosis was not as serious as I had feared.  We also have the Benenden Cash Plan so I was then able to receive some physiotherapy which has cleared the problem.  My husband was injured recently and was in hospital for 7 days, we were then able to claim £20 per day which helped with my parking and his TV costs.  The cash plan pays out on dental, podiatry and optical costs within a reasonable annual limit.   We have also used the same day telephone consultancy with their in house doctor who offered useful advice on a couple of occasions.  We have always found the staff very helpful and sympathetic on the telephone. 

Ibizafan

My OH and I have been members for many years, having been in public sector jobs, although the membership criteria has now changed. Fortunately we have yet to use it, but for the small amount of money paid out, we are happy to keep paying in, although now retired. Those who I know who have used it have been very satisfied with the service.

uknick

I can only say that membership of Benenden is a no brainer at the current prices.
As others have said, it speeds up access to initial diagnosis and for some conditions, the treatment.

As an example, I had a knee problem last year.  I lived with it for about 6 months, then went to my GP.  He diagnosed housemaid's knee (which was completely wrong) and put me forward for an ultrasound scan on the NHS (after I insisted on a scan).  Waiting time for an NHS scan was over 8 weeks.  Once I knew this, I contacted Benenden who agreed money for a diagnosis which included consultant time, tests and scans. 

By luck, it was during the summer holidays last year, I saw a consultant within a couple of days.  Then, on the same day; I saw him, had an MRI and received the results from him.  He suggested physiotherapy and Beneden authorised 6 sessions with no quibble.

The only downsides (which I admit are pretty minor) with Benenden are

a) there is a limit of £1,800 for each case,
b) before they authorise any work you have to have a referral letter from your GP,
c) the consultant MUST be on the BUPA approved fee list (not all are) and,
d) there is a 6 month qualifying period  after starting your membership before they'll pay for any treatment. (But that's pretty standard for medical insurance)

Undervalued

uknick said:

I can only say that membership of Benenden is a no brainer at the current prices.
As others have said, it speeds up access to initial diagnosis and for some conditions, the treatment.

As an example, I had a knee problem last year.  I lived with it for about 6 months, then went to my GP.  He diagnosed housemaid's knee (which was completely wrong) and put me forward for an ultrasound scan on the NHS (after I insisted on a scan).  Waiting time for an NHS scan was over 8 weeks.  Once I knew this, I contacted Benenden who agreed money for a diagnosis which included consultant time, tests and scans. 

By luck, it was during the summer holidays last year, I saw a consultant within a couple of days.  Then, on the same day; I saw him, had an MRI and received the results from him.  He suggested physiotherapy and Beneden authorised 6 sessions with no quibble.

The only downsides (which I admit are pretty minor) with Benenden are

a) there is a limit of £1,800 for each case,
b) before they authorise any work you have to have a referral letter from your GP,
c) the consultant MUST be on the BUPA approved fee list (not all are) and,
d) there is a 6 month qualifying period  after starting your membership before they'll pay for any treatment. (But that's pretty standard for medical insurance)

That is all fine and I agree the prices are very attractive. However, the main question is about the discretionary aspect and how that is applied. With normal insurance, the company is legally obliged to pay any valid claim that complies with the terms and conditions of the policy. However, as I understand it, with Benenden any payment at all is "at their discretion". 

Given how much cheaper their prices are compared to BUPA etc, one must assume that on a significant number of occasions they must use their discretion not to pay? Does anybody have any experience of that?

uknick

My partner and I have been with them for nearly 30 years.  We've rarely had a case refused, and she, unfortunately, has had to use them many times.  I've used them for varicose veins, morton's neuroma and as said my knee, which turned out to be Rheumatoid Arthritis.  She's used them for, amongst other things allergy testing, gut disorders and eye problems.  The only time they refused a request was for a visit to see a dietician.  But, this was not surprising as it was a treatment, i.e. suggested diet, not for a diagnosis.

In my experience the discretion affects;

 a) as I said, you have to use BUPA fee assured consultants
b) if they offer the service at their own hospital.  As such they wish you to use the hospital.  However, as we live about 100 miles away they never insist and allow us to use a more local facility.
c) they won't generally pay for treatment unless it's on their list.  For instance, my knee needed to have a cyst aspirated and I had to pay for that.
d) you can only have one claim on the go at any time.

All that said, I agree they don't offer as comprehensive a service as say, BUPA.  But, I'm willing to bet BUPA doesn't cost about £150 per year. 

BriNylon

uknick said:

The only downsides (which I admit are pretty minor) with Benenden are

a) there is a limit of £1,800 for each case,

I did not realise that there was a limit for each case.  That is a pretty small limit.  
Like you I also had a Morton's Neuroma and I asked how much it would be to go private as the waiting list was very long.  From memory, I think the quote was about £10k which is why I am thinking about private health insurance.
I am also concerned about the "discretionary" aspect.  

uknick

BriNylon said:

uknick said:

The only downsides (which I admit are pretty minor) with Benenden are

a) there is a limit of £1,800 for each case,

I did not realise that there was a limit for each case.  That is a pretty small limit.  
Like you I also had a Morton's Neuroma and I asked how much it would be to go private as the waiting list was very long.  From memory, I think the quote was about £10k which is why I am thinking about private health insurance.
I am also concerned about the "discretionary" aspect.  

The £1,800 is generally for diagnostic work, not treatment.  However, treatment can be done by Benenden for free.  You need to look at the website to see which treatments are covered

With regard to Morton's Neuroma on the NHS, I was led to believe it would take months to get any treatment on the NHS.  However, I saw my GP in December, had an NHS ultrasound a week later and saw the NHS consultant in January.  As I only needed an injection, he would've done it there and then if I didn't have to drive home afterwards.  The injection was done about 2 months later, but please bear in mind, the foot pain wasn't too bad and I had lived with it for about 1 year, so I didn't push for one sooner. 

Due to the suggested NHS delay I did go down the private route, which was a disaster.  I saw the private consultant in December, he wanted X-rays and an ultrasound scan.  The x-ray appointment took 2 weeks as it was over the Xmas period.  The ultrasound couldn't be done as the machine was broken till January.  My NHS appointment was before the private hospital could do the ultrasound.  Therefore, I dropped the private route and went NHS.