Wednesday, 15 February 2012

Private healthcare - realistically

I decided to get a rough quote for private healthcare, just to see how it would work for someone like me, with a back problem, arthritis, a history of mental health problems, and other ongoing niggling issues.

In short, it wouldn't.

There you go, now you know!

In a little more detail, I spoke to a very polite chap at Usay Compare to get a quote. He explained private health insurance would allow me to see a specialist straight away, rather than after 18 weeks on the NHS, and that if I needed to go to hospital I would get a private room with a TV & en-suite bathroom.

He asked how old I was (30), where I lived (S.E. London), what my job was (desk job), if I had a partner (yes), if I smoked (no), and if I had had any surgery or medical investigations in the last five years. I have.

It was explained that any insurance policy I got would have a "moratorium" whereby anything I'd had investigated in the last five years couldn't be covered under the policy, but if I had no symptoms for two years, the policy would cover it after two years. Asthma was considered chronic, and would never be covered.

Here is where it will get very personal.

In the last five years I have had:

- a hysterectomy (as part of gender reassignment)
- blood tests to check for inflammatory markers, anemia,  Vitamin D deficiency, diabetes, thyroid dysfunction.
- counselling
- Gender identity clinic appointments
- An MRI of my inner-ears
- An MRI of my lower spine
- X-rays of my hips
- Lung function tests
- Vestibular function tests
- Dyspraxia assessment
- ADHD assessment
- Physiotherapy
- Neurology referral.

I've been diagnosed with asthma, osteoarthritis, herniated discs, and non-specific inner-ear dysfunction. I'm also dyspraxic.

What would be covered by a health insurance policy?

Medications not linked to any of the above, investigations not linked to any of the above, hospital treatment not linked to any of the above, and cancer treatment.

Isn't that wonderfully generous?  It's not realistic that any of those conditions will cause me no symptoms for two years, so I can reasonably assume a private insurer wouldn't ever cover those things. Basically, the NHS would still have to cover 90% of my medical treatment, but I know if I fall and break a leg I can go private. Unless the insurer decides that my fall was caused by vertigo or dyspraxia.

My anti-inflammatories, painkillers, anti-vertigo meds, bronchodilator, steroid inhaler, and hormone replacement would all still have to be provided by the NHS.

My physio would have to be provided by the NHS.

I'd still be paying £10.40 a month for my prescription pre-payment certificate.

I was given an estimated quote of £33.33 from Aviva, or £59 from Bupa to cover, well, not very much at all.


I've had the paperwork through that outlines the things this policy wouldn't cover:

- Pre-existing conditions unless expressly included.
- long term or chronic conditions
- HIV / AIDS and related conditions
 - treatment for pregnancy or childbirth
- diagnostic tests and treatment for infertility
- surgical or medical appliances such as neurostimulators (e.g. cochlear implants) and crutches
- charges by a GP, medical practitioner or specialist for completion of a claim form
- alcoholism, alcohol abuse, drug abuse, solvent abuse and other addictive conditions
- treatment undertaken by a specialist without a GP referral
- psycho-geriatric conditions
- kidney dialysis
- cosmetic treatment (except following an accident or surgery for cancer(
- take home-drugs or dressings
- professional sports injuries
- experimental treatment (limited benefit may be available)
- treatment required as a result of war, terrorism or contamination by radioactivity or chemicals
- self-inflicted injury
- sexual dysfunction
- sleep disorders and sleep problems such as snoring or sleep apnoea
- treatment for warts or verrucas
- weight loss surgery.

1 comment:

The Goldfish said...

The other big issue about private insurance - for anything - is that insurance companies work very hard, much harder than the state, on avoiding paying out. So even if you signed up with a clean bill of health, I'd expect them to find reasons not to pay out for certain conditions, things they'd consider self-inflicted, or exaggerated, or conditions which they'd say were pre-existing even though you had no clue. And you can guarantee that they would insist any broken leg was a result of dyspraxia.

The experience of American friends makes me so nervous of all this. They have all the same problems we have sorting out car insurance, except it's medication or therapy they desperately need, as opposed to a busted bumper.

One friend had had an operation on a brain tumour and the follow-up scan, only to be told that her insurance didn't cover her seeing a doctor to find out the results...