Private Medical Cover

cfw1994

Diddidi said:

I went through this decision process when I was made redundant and then decided to take early retirement. I had various quotes from different providers and in the end just decided to put into a savings account what I would have spent on a policy (£300 per month). That way, I have total control of the funds, no messing about with authorisations and, if I never use it, then it goes to my estate. If I need treatment I’d go for for NHS but perhaps pay for tests etc privately to reduce the waiting game. Having said that, DH was diagnosed with cancer 2 years ago and NHS was brilliant.

That, in a nutshell, is our logic & method (although I wouldn’t say we ring-fenced it for health only…more the ethos of self-funding 👍

Ibrahim5

Cobbler_tone said:

I have found BUPA getting more restrictive and access to certain treatment harder, with definitely longer wait times, or at least increased travel to get in. No doubt linked to the failing NHS.

Failing NHS. You mean failing BUPA. So many specialists won't have anything to do with BUPA. That's why you have to wait or travel to one of the few remaining ones that will. Lots of specialists will only take credit card payments now. Leave the patient to try and extract money from insurance companies.

MyRealNameToo

Diddidi said:

I went through this decision process when I was made redundant and then decided to take early retirement. I had various quotes from different providers and in the end just decided to put into a savings account what I would have spent on a policy (£300 per month). That way, I have total control of the funds, no messing about with authorisations and, if I never use it, then it goes to my estate. If I need treatment I’d go for for NHS but perhaps pay for tests etc privately to reduce the waiting game. Having said that, DH was diagnosed with cancer 2 years ago and NHS was brilliant.

Insurance is a risk transfer mechanism, you exchange the risk of a big loss for the definite small loss (aka the premiums). 

So sure if you develop no medical conditions then having the £300 a month in your own bank account is great but if you have a major illness your £300 a month you've been saving won't come close to paying for private medical care. 

Within 2 years of transferring to a private policy the Mrs had to spend almost 2 months in a private hospital at a cost well over £60,000. NHS had long waiting lists and any inpatient treatment would have been on an open ward rather than a private room. She wasnt bed bound during her treatment and the private hospital had decent food menus, a full schedule of activities she could choose to be involved in or not etc. NHS would have been sitting in the same bed all day every day for weeks. 

Have had two claims since that and at the moment our payouts are about double what we have paid in so far. Obviously we are a minority but you risk being a minority with your savings pot. 

For certain things, in particular cancer, the NHS does tend to be good and responsive but there are plenty of things they arent. Father and his brother both had major heart attacks on the same day, both were quickly determined to need a triple bypass. His brother had treatment under PMI within a few weeks and was back home within the month and lived another 25 years. My father was in hospital for 4 months with the operation keep getting pushed back and he died on the operating table when they finally got round to it.

PMI does heavily push the fact they have access to other treatments not available on the NHS for Cancer. Whilst it's true for some cancers I'm not sure it's as universal as they make out. 

MetaPhysical

This is my biggest concern about early retirement that I am about to take at 58.  I am also covered under BUPA with my employer and have had issues with my right hip, it is ok at the moment after some physio and I need to cycle a lot to keep the joint exercised and strengthened (and the time to do this is one the reasons I want to retire).  My consultant has said it is not bad enough at the moment to warrant replacement but it definitely will need replacing in five to ten years but it may need it sooner.  It depends he says.

What am I to do?  I am hopefully getting a large PCLS in January as long as Rachel Thieves doesn't scrap it.  I may just put some of that in an investment account and just forget about it and that will hopefully pay for it to be done privately.

MyRealNameToo

What premiums are you being quoted? 

Given the average cost of a hip replacement its likely the premiums would be significantly more over 5-10 years than the cost of a private hip replacement so if thats your only concern then putting the money aside would probably be more economical but if you want cover for other things that may happen in the interim then that makes PMI look more attractive. 

MetaPhysical

I don't think PMI would cover my existing hip.  I am pretty certain I'd need to declare it as a pre-existing condition.  This would mean PMI would be for new conditions that develop.  One never knows of course but I partly think banking the money that would have gone into PMI and keeping it in a slush fund.

I may phone my consultant's secretary and ask what happens in this situation.  For example, can I transfer to be one of his NHS patients if the hip kicks off again in the next few months.

MyRealNameToo

MetaPhysical said:

I don't think PMI would cover my existing hip.  I am pretty certain I'd need to declare it as a pre-existing condition.  This would mean PMI would be for new conditions that develop.  One never knows of course but I partly think banking the money that would have gone into PMI and keeping it in a slush fund.

I may phone my consultant's secretary and ask what happens in this situation.  For example, can I transfer to be one of his NHS patients if the hip kicks off again in the next few months.

Well thats generally the purpose of continuing your employers cover, that either your employers cover included pre-existing conditions or you developed the condition whilst in the employment of them and so its not considered pre-existing in relation to the continuation of cover. 

You can go from Private to NHS, I did this with my arthritis. However you can choose your hospital not your clinician so whilst the consultant does work in the NHS hospital when the NHS picked up my case they allocated me to another consultant in the team (though see her walking about whilst I am there). Obviously the issue is the difference in timescales... I had MRIs, short term and long term treatment, including seeing a heptologist for a second opinion on the long term meds months before my first appointment with the NHS consultant

Diagnosis is very different though, whereas private did MRI of multiple joints in addition to the one I was complaining about under the NHS when I mentioned by elbow had started hurting too they said it sounded like it could be the start of a problem there too but the long term care is going to be the same so just keep taking the tablets... no MRI, not even an x-ray, to see what's going on and an appointment in 12 months time to see how its going. 

Albermarle

MyRealNameToo said:

MetaPhysical said:

I don't think PMI would cover my existing hip.  I am pretty certain I'd need to declare it as a pre-existing condition.  This would mean PMI would be for new conditions that develop.  One never knows of course but I partly think banking the money that would have gone into PMI and keeping it in a slush fund.

I may phone my consultant's secretary and ask what happens in this situation.  For example, can I transfer to be one of his NHS patients if the hip kicks off again in the next few months.

Well thats generally the purpose of continuing your employers cover, that either your employers cover included pre-existing conditions or you developed the condition whilst in the employment of them and so its not considered pre-existing in relation to the continuation of cover. 

You can go from Private to NHS, I did this with my arthritis. However you can choose your hospital not your clinician so whilst the consultant does work in the NHS hospital when the NHS picked up my case they allocated me to another consultant in the team (though see her walking about whilst I am there). Obviously the issue is the difference in timescales... I had MRIs, short term and long term treatment, including seeing a heptologist for a second opinion on the long term meds months before my first appointment with the NHS consultant

Diagnosis is very different though, whereas private did MRI of multiple joints in addition to the one I was complaining about under the NHS when I mentioned by elbow had started hurting too they said it sounded like it could be the start of a problem there too but the long term care is going to be the same so just keep taking the tablets... no MRI, not even an x-ray, to see what's going on and an appointment in 12 months time to see how its going. 

As they get paid for each MRI, then it is their interest to maximise the number, and a tendency to maybe  even overdiagnose ailments. 

MyRealNameToo

Albermarle said:

MyRealNameToo said:

MetaPhysical said:

I don't think PMI would cover my existing hip.  I am pretty certain I'd need to declare it as a pre-existing condition.  This would mean PMI would be for new conditions that develop.  One never knows of course but I partly think banking the money that would have gone into PMI and keeping it in a slush fund.

I may phone my consultant's secretary and ask what happens in this situation.  For example, can I transfer to be one of his NHS patients if the hip kicks off again in the next few months.

Well thats generally the purpose of continuing your employers cover, that either your employers cover included pre-existing conditions or you developed the condition whilst in the employment of them and so its not considered pre-existing in relation to the continuation of cover. 

You can go from Private to NHS, I did this with my arthritis. However you can choose your hospital not your clinician so whilst the consultant does work in the NHS hospital when the NHS picked up my case they allocated me to another consultant in the team (though see her walking about whilst I am there). Obviously the issue is the difference in timescales... I had MRIs, short term and long term treatment, including seeing a heptologist for a second opinion on the long term meds months before my first appointment with the NHS consultant

Diagnosis is very different though, whereas private did MRI of multiple joints in addition to the one I was complaining about under the NHS when I mentioned by elbow had started hurting too they said it sounded like it could be the start of a problem there too but the long term care is going to be the same so just keep taking the tablets... no MRI, not even an x-ray, to see what's going on and an appointment in 12 months time to see how its going. 

As they get paid for each MRI, then it is their interest to maximise the number, and a tendency to maybe  even overdiagnose ailments. 

Not to the same extent as the US where a fall and suspected broken tibia resulted in a whole body scan for my aunt.  They only get paid if the insurer agrees its appropriate investigation, you wouldnt get a UK insurer agreeing to such excessive investigation for a simple injury from a basic trip. 

Not suggesting their motivations are altruistic but it has benefits to you as the patient too. A friend had months of investigations which culminated in an MRI that got them their diagnosis so from consultant to diagnosis was about 9 months. I had bloods and MRI done the day after seeing the consultant, saw the consultant again a week later and had a diagnosis including that it was only in one joint, no issues with the two joints somewhat randomly scanned and a joint I have another issue with hasn't worsened and reconfirmed as not being arthritis. 

Did they get paid more for doing 4 joints rather than 1? Yes, but I also got a diagnosis within 2 weeks rather than 9 months and didnt have to undergo tests that came back as inconclusive and got an update on another condition at the same time. They also didnt waste money on the inconclusive tests (though obviously they could have been conclusive and thus avoided the higher cost of the MRI)

The NHS with its more limited funds do things the way they do for obvious reasons but costs are a significant consideration for them too hence trying cheaper diagnostic methods before going to the gold standard. 

topyam

In this dilemma now.
Lost my hubby a few months back, and Axa has offered to continue the cover. Still to get a quote.
I have three kids. 
From experience, the NHS is great with v urgent issues like cancer. But PMI comes into its own to get treatment faster. In my region, waiting lists are long. 

No idea what the standard figures for insurance for myself and three kids (no existing conditions) should be either. 

Feel i do owe it to myself to investigate it.
Having it is piece of mind for sure, but it's the ongoing cost.
Ah I don't know.