[Closed] Healthcare Insurance: Anyone have it?

Me and the wife have it through work didn’t use it for twenty years, but one brain tumour sorted for the missus and about 10k in consultants, surgery and physio for me in the last few years has definitely been worth it,

We also have 24 hour GP by video call which has been really useful during Covid.

Through work. Physio on demand is the thing I’ve used the most.

Worth it I think as I know people who have been left to die on the NHS, misdiagnosed and also someone who was still very much alive pronounced dead. The NHS is virtually non existent.
If you can afford it, I'd get it.

Speak to a decent broker. It’s a complicated product with loads of different options. Make sure you understand which underwriting method the policy uses and the implications for you. Also check which hospitals are available in your area. Not all policies give the same level of cover.

nope and I never will

It will not cover you for most stuff you actually need ( A&E, GPs, eytc)

If your GP is useless change them. Private medicine is generally no better and often worse. Its main advantage is queue skipping for tests. Remeber GPs are private contractors - they are not NHS employees

I have physio on demand ( more or less) on the NHS here. I can contact a GP 24/7/365 on the NHS and I can get an appointment with my GP on any day I want including today

I recently had to use NHS home care palliative care stuff - none of which would be covered by private and all of which thru the NHS was exemplary

If your GP is useless change them

Not an option for all. In my town no GP surgery will take you onto their books if you already have a GP in the town.

Not an option for all. In my town no GP surgery will take you onto their books if you already have a GP in the town.

I am pretty sure that they cannot enforce that - if your GP is really useless ( not that you expect a service they cannot provide) then change them - there are channels to do so. Make a formal complaint about them - their status as private contractors makes it difficult for the NHS to ensure good care but the gps have a contract with the NHS that can be enforced

Yes, through work.

Again, physio has been the only thing I've used it for.

My mum has it and has used it for shoulder surgery. Knocked the wait time down from "good luck" to 6 weeks. It want severe enough to meet the criteria so the expectation was pain management and limited physio.

I'd probably not have it if it was not a work benefit. A course of physio probably costs £1000? I'd just pay that to go private if the NHS wasn't quick enough. For minor things that is always an option.

See what the costs are. It can be very expensive for individuals. It's normally a benefit through work as the collective risk is lower.

A course of physio probably costs £1000

my local private physio is £60 for the first visit - £40 after a course is usually around 4- 6 visitis ( unless you want the physio to do everything rather than working on it at home)

so the actual cost is way way less

my local private physio is £60 for the first visit – £40 after a course is usually around 4- 6 visitis

Mine is £45 an hour, rarely need more than 2-3 visits, so I've no idea where £1000 came from.

I've had and used private healthcare that I had through work 25 years ago. Yes, it was nice, but as TJ says it doesn't cover the kind of things you really need, and as a 52 year old with a variety of injury issues, and a disabled wife, I'm unlikely to be able to afford it anyway.

"Mostly" the benefits are the hotel services that private hospitals can offer are better than NHS services. So, nicer room, better food, faster treatment. There might be a wider choice of drugs for specific conditions. (more niche stuff that the NHS won't buy, or pay for.) But, bear in mind, There's no emergency care, if you've got any chronic issues, you may not get cover or if you do, the premiums are V high. And remember that children are prioritised in the NHS system so the wait times are lower anyway (so family cover may be less of an incentive to change)

I've seen excellent results in the private sector, and treatments that have been done speedily and with outstanding care and attention, but I've seen that in the NHS as well.

I think going private in certain situations can be sensible, dental, cosmetic treatments, audiology,  or dermatology for instance, but you can buy those "one off" without the need for plans.

Yes through work. When I broke lots of things, including my wrist in three places, the NHS answer at the first follow up at three weeks was to leave it to set at 60 degrees off the correct angle, wait three to six months then rebreak it and reset. The private option when I mentioned I had insurance was an operation the following day to insert a plate. The relief on the face of the fracture clinic consultant was palpable.

It may be a cheaper option to put the money aside each month for when you need it. If you’ve had any previous health issues then there will be exclusions. Other countries do healthcare properly (mandated insurance and no exclusions). COVID complications will be an exclusion. My company got that in early likely for fear of being swamped.

I also pay to see a consultant dermatologist once a year for a thorough skin cancer check. This is partly to keep my sole remaining sister’s mind at rest after our family’s history. It’s excluded from my insurance and the NHS doesn’t do preventative monitoring - it does crisis management regardless of history.

With the way waiting lists are at the moment I wouldn’t hesitate to get private cover. I’m about to use mine for an operation for a hearing/balance issue at the moment. On the NHS I wouldn’t even get a date for the initial appointment. Don’t forget most consultants work for the NHS & privately so in terms of the standard of treatment there’s no difference between the two. Private hospitals are nicer.

Obviously, you are still paying for the NHS through your taxes, so if you want to pay again for the benefits of private treatment, it's your money and your choice.

I get private through work. I am a big believer in the ideas and principles of the NHS but after so many years of underfunding and slicing off bits to the private sector it is a shadow of its former self. I agree with a lot of what TJ says but a few examples from the wife and I.

Original Ankle Break – NHS doing their thing*
NHS – Ambulance takes be from lying on the floor to A&E. I am given pain relieving driugs until a surgeon can be found to operate. Surgeon operates and saves my foot.
Private – Please call back on Monday with a referral

A very badly damaged shoulder ligament. - NHS Cost restraints prevent optimal choice
NHS – Cut the ligament, stitch up the damage and accept you will never raise your arm above your head again.
Private – Same consultant. Insert some guide 'pipe' and re-attach the two ends of the tendon followed by 12 weeks of carefully monitored physio starting as soon as possible after the surgery.

Ankle Fusion – NHS cannot offer choice of surgery dates
NHS – We can add the extra bolts when your turn comes up on the waiting list in between 3 – 9 months. You will eb on sticks for 12 weeks following but we can't say when so you cannot plan your year.
Private – When would you like the surgery? Early autumn in four months time so that you can enjoy summer before going back on the sticks, that's fine.
note from the insurance company

Original Ankle Break – NHS doing their thing (Part 2)
NHS - 8.5 hours waiting in A&E being given morphine to stop the screams while they try to find someone, anyone who can operate on me. Recovery complicated to a 14 hour process because of the amount of morphine I was given prior to the operation. Wife unable to find out what was happening or even where I was because I was basically in a store room for the recovery because it was taking too long to keep me in the normal post-op recovery room but no-one had noted this so I was 'missing' for about 6 hours in a store cupboard with just the nurse allocated to me aware of where I was.

nope and I never will

It will not cover you for most stuff you actually need ( A&E, GPs, eytc)

mine (via work) does cover me for gp and provided virtual appointments long before covid. They are useful for the worried well and for trivial stuff where the gp is a gatekeeper. My GP friends tell me this is what clogs their surgery up - so we should encourage those people to all get private healthcare so people who have real or urgent issues requiring face to face or hand on treatment don’t get delayed.

If your GP is useless change them. Private medicine is generally no better and often worse. Its main advantage is queue skipping for tests.

I think faster treatment for elective surgery like shoulders, knees, etc - which for sporty people is actually possibly important. NHS is very good at taking injured sports people and delaying treatment so long they never go back to being active.

Remeber GPs are private contractors – they are not NHS employees

I’m not sure what your point is - it’s one of the messes of the nhs in my opinion. In essence we all have private healthcare paid for by NhS? Or despite tge N in the name there’s nothing standardised about it - my limited experience of private is that there is a consistency of service.

I have physio on demand ( more or less) on the NHS here.

Do you? Is that some special arrangement? There’s was an 8 week wait for GP to physio referrals locally before covid (god knows what it is now) and I believe most people only get a couple of sessions - whereas privately you might get 5 or 6 (of course that may be excessive to maximise fees).

I can contact a GP 24/7/365 on the NHS

no you can’t. You can call a call centre and IF you meet their assessment criteria you will get to speak to or see a GP. On my private scheme you can book to see a GP online usually within 24hr. There’s no screening. That is probably not a good use of resource - but if you want that service it exists at a cost.

and I can get an appointment with my GP on any day I want including today

You must be the only person in the U.K. who is confident of that. I’m confident I can get one this week, and that if I actually needed one today I could get one today but I don’t believe if I call my gp today about a sore hand I’ll be likely to get an appointment today. I know some practices do operate a turn up and wait policy - for people in work with minor ailments (or who perhaps just need a repeat prescription renewed that requires a quick face to face) that’s a major pain in the arse.

I recently had to use NHS home care palliative care stuff – none of which would be covered by private and all of which thru the NHS was exemplary

I’m in the fortunate position not to have needed this either on nhs or privately. However my private policy does have some provisions in it - I’ve not studied them in depth as of course each case will be different and with all insurers they nuance comes when you make a claim. However, if all the worried well and hobbling footballers use their private policy does it not free up resource for those who don’t have time to wait?

I have physio on demand ( more or less) on the NHS here. I can contact a GP 24/7/365 on the NHS and I can get an appointment with my GP on any day I want including today

Scottish NHS must be working better than English NHS then.

If I want to see an NHS physio I need a referral through the doctor. To get a referral through my GP I need to either play the 8am call queue game or book 2 weeks in advance. Once I have said referral (which they don’t seem overly keen on giving for a running injury that is not a long term issue) I need to wait another month to get an appointment, likely with a physio who doesn’t specialise in the work I need.

So yeah, like many above, I had it through work and use it for physio as I can see who I want at short notice.

That’s not to criticise the NHS (well, the 8am call game is always an annoyance…), most of the stuff I go to the physio for would fix itself in 3 months, I just want it fixed sooner and so don’t mind paying/using the company insurance for it.

The NHS is virtually non existent

You see a lot of shite posted on STW but this really does take the biscuit!!

I recently had to use NHS home care palliative care stuff – none of which would be covered by private

Sorry TJ, but you're incorrect. Many years ago cancer cover was excluded however it is now offered as an optional cover with home nursing and palliative care included

If your GP is useless change them

sounds good in theory, in some rural areas that's simply not a realistic option though. Not everyone lives in a capital city with all the benefits that brings after all

NHS – Cut the ligament, stitch up the damage and accept you will never raise your arm above your head again.

You see this sort of "fix over function and form" a lot in the NHS. the NHS audiology will allow you to hear -  maybe if you suffer from the correct sort of deafness, and don't mind having a large aid. Spectacles, will allow you to see, aren't comfortable or limited choice, dentures that will allow you to talk or eat, but don't look anything like actual teeth...All these sorts of things are routinely better bought privately.

I would say check out Benenden as a "plug the gaps" option, as actual private insurance is £££ (hence why people tend either to get it through work, or self-fund).

Pays for diagnostic appt with a consultant (which is often the slow bit in the NHS) and may also then offer you an op if the NHS wait is long & you're in distress.

Being "young retired" I am going to go for Benenden + NHS + self-fund when I lose coverage from the OH's health insurance upon their retirement.

NHS is very good at taking injured sports people and delaying treatment so long they never go back to being active.

Not my experience - of 4 different traumatic injuries to 3 different people

no you can’t

Actually yes I can - thats how it works. Again I have used this service a few times including two out of hours visits

You must be the only person in the U.K. who is confident of that.

Nope - every patient in the UK has that right for urgent treatment and every patient on my GPs list gets this automatically - they simply have a[ppointments available on the day - a well organised GP service

However my private policy does have some provisions in it

That will be next to useless

does your private provision include a electric profiling bed delivered within 24 hours? daily nurse visits to change the pump, express entry to the hospice without going thru the system, support from experienced palliative care nurses, visits from experience palliative care care assistances that last an hour for 2 CAs that is arranged at my convenience?

if all the worried well and hobbling footballers use their private policy does it not free up resource for those who don’t have time to wait?

NOpe - its takes resources from the poor to give to the rich - anbd also the private healthcare comanies do not train or pay for the trained staff they take

Private medicine makes the average persons healthcare worse by removing resources from the system and wasting them on the worried well and minor ailments there is a finite pool of staff

Do you? Is that some special arrangement?

Only in that thats a clinic in NHS lothian thats self refferal

I’m not sure what your point is

That the GPs being private contractors are very variable in
the service they provide. Mine does far more than the basic NHS contract makes them do - which is why they are good GPs

Boarding BOb - there is no way on earth that any private cover would provide the level of expertise and palliative care that was provided on the NHS. for a start the experience palliative care staff are not available to the private companies nor do they have access to the resources. Many of the services are simply not available privatly.

I too have private healthcare through work. I've used it twice, once for surgery to remove a ganglion cyst on my write middle finger that stopped me typing, once for my wife to have her hip replaced. In both cases it was purely for queue jumping, NHS would not provide a time for the cyst and hip was a 3 year wait (having been in the system for 3 years already with treatments ranging from painkillers to acupuncture). My wife could hardly walk at that point.

I used the NHS when I broke my ankle 30 years ago. X-rays weren't clear, I was told I'd not broken it and to exercise it. It wasn't getting better after 3 months but the GP would not refer me. I ended up paying for another x-ray privately and physio. By that time, my ankle was a bit screwed up. The physio took me from unable to weight bear to almost normal and I gave up running for cycling to avoid impacts.

In an ideal world, the NHS would be funded sufficiently to avoid the need. Unfortunately it's not.

I'm lucky that I work for a large company to the healthcare is cheaper than it would be for me to buy it individually, the premium is the same regardless of age and I'm old.

 there is no way on earth that any private cover would provide the level of expertise and palliative care that was provided on the NHS

That sort of care is routinely available privately. Part of the company I worked for had a complex palliative service. Mostly paid for by insurance The doctors and nurses were both expert and caring.

nickc - try listening to what I say - it is simply not possible for a private company to give the level of palliative care that I received. cannot be done as they do not have access to the services needed - and I very much doubt they have staff with anything like the level of expertise

they might tell you they have but its simply not possible for them to do so

the other thing about private hospitals is if something goes wrong you are in a far worse position than you would be in an NHS hospital

The NHS is shit, try asking the 5 million people who are waiting for operations what they think.

NOpe – its takes resources from the poor to give to the rich – anbd also the private healthcare comanies do not train or pay for the trained staff they take

Private medicine makes the average persons healthcare worse by removing resources from the system and wasting them on the worried well and minor ailments there is a finite pool of staff

It’s funny that with all the resources taken away from it the NHS is still, according to you, functioning almost perfectly.

No - the NHS has real issues caused by shortage of resources and its provision varies by locality - I live in an area with very good provision - but private healthcare makes this worse not better

and I loathe with every fibre of my being the way that private healthcare lies and misleads and deliberately frightens people into paying for worse services with worse outcomes

Private healthcare palliative care simply cannot be as good - they do not have access to the expertise and resources. None of the palliative care specialists we used do any private work and that expertise is only found in the NHS.

 it is simply not possible for a private company to give the level of palliative care that I received. cannot be done as they do not have access to the services needed – and I very much doubt they have staff with anything like the level of expertise

And I'm telling you that it is perfectly possible. We had contracts with Insurance companies to provide just that sort of (often) end of life, and 365 care that you describe. Just because you're not personally aware of something, doesn't mean it can't (or doesn't) exist, the NHS aren't the sole employer of medical staff, nor are they the sine qua non when it comes to expertise in fact I'd say that in certain areas, they are miles behind current technology. Further, the idea that a clinician is solely in the private sector doesn't necessarily mean that the NHS suffers because of it, that's a daft argument Not all doctors and nurses are publicly trained

and I loathe with every fibre of my being

OK, I'm done here, same as religion, you don't/won't/can't see any alternative to your convictions. No point discussing it with you.

Not all doctors and nurses are publicly trained

Really - please describe the training programme they follw then because as far as I am aware there is only one pathway - via the NHS

And I’m telling you that it is perfectly possible

And I am telling you that you do not understand palliative care and its simply impossible for a private company to provide the level of expertise and service

do they have palliative care consultants available 24/7/365?

Let me give you one small example from my recent experience:

Julie was being cared for by me at home. Her pain control was slipping. I had given here oral doses but due to systemic shutdown they were not being absorbed properly and suddenly hit her leading her to be overloaded with analgesia. the district nurse prescribing specialist came to increase the sub cutaneous pump dosage. the nurse was concerned ( rightly) because Julie was over sedated.

the district nurse phoned the palliative care consultant on call to get advice - this was to a highly experience pallitave care specialist consultant who had been over seeing Julies care. after discussions a new pain relief scheme was set up using a GP to prescribe

This happened on a sunday afternoon. Now tell me that a private palliative care would have access to that expertise? they do not. simply not available to them

Edit - the issue here is Nickc that you do not understand what good palliative care provision is and what the limitations of private healthcare are
Name me an experienced palliative care consultant specialising in cancer of unknown primary that works in the private sector and is available for advice out of hours

Nickc please do tell me how nurses and doctors get trained outside of the NHS?

I guess that one thing we can all agree on is that private health insurers are not charities. They exist to make money (and seem to make a fair bit). That means that, on average, they have to take more money off you than they pay out. Of course some people will gain and some will lose, but on the whole active cyclists are probably going to be more likely to be losers than winners.

My general rule with insurance is to only insure something I couldn't afford to replace or live without (e.g. the house). So, I wouldn't be interested in paying insurance premiums to cover the cost of physio, for example, as I can just pay for that. I would be interested in insurance for those really massive bills, but that stuff is pretty much always excluded from the policy anyway.

One thing that does bug me with private providers is the way they take the money then throw any problems back to the NHS. I know somebody who paid for a private hip replacement as the NHS wait was too long. Fair enough. I can see why they did that. But when there were complications from the operation they were told to go back to their GP. If the private provider is going to take the money for doing the operation then they should absorb all of the risk, which includes sorting out the issues afterwards, not just throwing them back to the NHS. But that's getting OT

Now tell me that a private palliative care would have access to that expertise? they do not. simply not available to them

They do. I know this for a fact because it's what I've done for a living for the past 20 years. I know the resources that are available. I know the doctors, nurses and other specialists that work for us. I know the companies and advisors we use. I know the standard of care inside our facilities. I know the level of cover we provide. Etc.

I'm fully aware you were a nurse and also aware of your recent loss, but by your own admission you've never used private care and never will, so you really can't be an expert on it.

I have it through work but strictly speaking never used it because the NHS has been so good.
Two periods of cancer and the NHS really stepped up to the plate both times - basically things were organised within days.
I remember commenting to the consultant once how quick things were being processed and he replied "I'm going to walk you next door and get an xray done now whereas if you went private we would have to get approval first".
So all I've ever done is claim the cash alternative.

I have worked in private care, I have friends who have and I both Julie and my mother have used private healthcare

roverpig - name me the consultant palliative care specialist with decades of expertise in cancer of unknown primary you use?

Tell me what would have happened in the above scenario. where would that level of expertise come from?

I still want Nickc to describe the Non nhs training pathway for nurses, doctors and paramedics.

The NHS is shit, try asking the 5 million people who are waiting for operations what they think.

If there was no NHS, all those people would have no choice but to pay for their treatment, like the good old USofA.

The NHS is under unprecedented pressure, and it was deteriorating prior to Covid. That wasn't the fault of the NHS. Look higher - or lower, to the people who voted them in.

TJ goes over the top with his love of the NHS - it will be better in a Scottish city than rural England, but to call the NHS shit is insulting and ignorant.

And here in my corner of semi-rural England we've been able to self refer for NHS physio and mental health services for years, had no idea some places still required a GP referral.

I see it the same as any other insurance. Glad you had it when you use it, seems like a waste of money when you don't use it.

I have had private healthcare via work for last 25 years. Had 3 operations (all pretty much next day) rather than wait weeks/months by same consultant who would have performed the operation in NHS.

So as Nickc said "“Mostly” the benefits are the hotel services that private hospitals can offer are better than NHS services. So, nicer room, better food, faster treatment. " this is my experience with 3 operations and my wife's experience with 3 operations.
Looking at it from purely cost is not really relevant as each operation costs say £5,000 but you haven't gained money, you have just gained speed of treatment.

TJ goes over the top with his love of the NHS

perhaps I do but I believe its more because of my inside knowledge of private healthcare I am more aware of its limitations. for example a private hospital will not have the same medical cover at night and will not have access to the same resources if an issue arises - you get shipped off to the NHS when the situation gets serious. Ask your spire hospital what their "major heamorrahge protocol" is. ask them who is on the nightime crash team.

I reckon julies last month cost the NHS in the region of £20 000. I am certain no private provision could have matched it for expertise, easy of delivery and amount of staff time we took up

roverpig – name me the consultant palliative care specialist with decades of expertise in cancer of unknown primary you use?

Tell me what would have happened in the above scenario. where would that level of expertise come from?

I still want Nickc to describe the Non nhs training pathway for nurses, doctors and paramedics.

I used to work for a private medical insurance company assessing claims. Although it was 30 years ago.

At the time and I doubt it's different now. Having private medical cover as an individual and through work was very different. If it was through your company which was large and had many hundreds or thousands of people. The insurance company would cover things which they wouldn't cover if you were an individual. Or a smaller company. Basically the more the premium was worth to the company the better cover you got. Especially with things which could be argued as pre existing.

The first thing I did when assessing a claim was to get the policy document issued at the time the policy was taken out. Then find a way not to pay it.

@tjagain I think you are getting me confused with someone else 🙂