Universal Credit and BUPA Insurance

Nebulous93

I have suffered from suspected CPTSD since 2019. I do have a Doctor's letter that confirms this however it is dated 2020.

Also I am transgender and have been attacked a lot over the years (I'll come back to this).

Since I was dismissed from my job in March 2022 due to ill-health, I was okay financially because I had my one off death-in-service payment from my dad. 

Coming back to being transgender - the last attack (2021) was the reason I was unable to work. A blow to the face and two blows to the side. I was scared to leave the house. I did get an appointment for an ultrasound due to ongoing pain and everything was fine. 

I took out a BUPA this time last year.

4-5 months ago I developed back pain which got worse and saw my NHS GP.

Both my NHS MRI and second ultrasound have come back clear. I am disappointed with the NHS report because I expected it to be more in depth. Not even half an A4 page with 'no further action needed' on it. I am on a strong painkillers which there is not a restriction on to reorder. 

I've asked for everything to be sent to myself (I was given reasons that I cannot have it because it may affect my mental health and a Doctor needs to be present) so got a summary basically. 

So I asked for a referral with everything to be sent to the nearest private hospital that is a member of BUPA and one to be sent to me as I explained that despite I have no family nearby (I am the eldest at 29) and back issues indirectly caused my mother's death. I have seen MRIs several times of my mum's spine and after finding her dead I think I can handle an image if there is nothing wrong. 

Will the DWP accept anything from private medical services? I'm thinking in my head that it'll be assumed that if  have private health insurance then I don't need support.

Thank you in advance for any help. 

calcotti

Nebulous93 said:

Will the DWP accept anything from private medical services? I'm thinking in my head that it'll be assumed that if  have private health insurance then I don't need support.

Your UC entitlement entirely depends on your financial circumstances. Being able to obtain private health care has no relevance, if your policy pays you any income that will be taken into account.

You could also consider new style ESA which is not means tested.

if you claim both ESA and UC the ESA will be deducted from UC so claiming both will not increase your total income.

You can use a benefits calculator to check entitlement.

Nebulous93

calcotti said:

Nebulous93 said:

Will the DWP accept anything from private medical services? I'm thinking in my head that it'll be assumed that if  have private health insurance then I don't need support.

Your UC entitlement entirely depends on your financial circumstances. Being able to obtain private health care has no relevance, if your policy pays you any income that will be taken into account.

You could also consider new style ESA which is not means tested.

if you claim both ESA and UC the ESA will be deducted from UC so claiming both will not increase your total income.

You can use a benefits calculator to check entitlement.

I do not get any financial help from it unless I have to stay overnight in hospital along with some other reasons I won't go into - but if you are in hospital your Universal Credit is paused anyway, I think - I don't get this system.

peteuk

Im no expert but the length of stay in hospital determines if/when your UC stops. (A quick google didn’t help as there’s numerous suggestions)

However should Bupa pay you for it, then I would, as suggested declare it to the DWP.  As you dont want it coming back on you at a later date.

As for your MRI, I dont understand, if there’s nothing on it (which may be the case) then there is no reason for you not to see it.  I can’t see any benefit to the hospital to lie about the results. Did you verbally ask for them or complete a SAR?  If they want a doctor present, then go for it.

poppy12345

Nebulous93 said:

calcotti said:

Nebulous93 said:

Will the DWP accept anything from private medical services? I'm thinking in my head that it'll be assumed that if  have private health insurance then I don't need support.

Your UC entitlement entirely depends on your financial circumstances. Being able to obtain private health care has no relevance, if your policy pays you any income that will be taken into account.

You could also consider new style ESA which is not means tested.

if you claim both ESA and UC the ESA will be deducted from UC so claiming both will not increase your total income.

You can use a benefits calculator to check entitlement.

 but if you are in hospital your Universal Credit is paused anyway, I think

That's not correct. It maybe reduced if you're in hospital for more than 6 months. https://www.disabilityrightsuk.org/universal-credit-hospital

For disability benefits such as PIP/DLA then these will stop if you're in hospital for more than 28 days. The day you go in and come home are not counted.

Days of less than 28 are linked, so if you go in for 15 days and then go home but back in before 28 days then the days are linked, so a further 13 days in hospital and they will stop.

calcotti

poppy12345 said: For disability benefits such as PIP/DLA then these will stop if you're in hospital for more than 28 days. The day you go in and come home are not counted. 

But not if the claimant is paying in full for the hospital stay which would include funding through private insurance.

Nebulous93

Thank you for everyone's contributions. I look back in hindsight and think I am glad I took this policy out. 

I have placed a Subject Access Request through. I personally want to see my spine MRI. It is my spine - as said above; If there is nothing wrong then just show me. 

It's causing me more worries not knowing than knowing. It's putting strain on my arms and legs to help support myself. 

I am glad to hear that the DWP should accept anything found as as evidence from a medical professional.