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Anyone got private health insurance they have claimed on and been really happy with?

(7 Posts)
Sleepwhenidie Sat 08-Jun-13 13:56:40

We have private health insurance with BUPA, costs us approx £350pm for family of 5.

Last year we had experience of claiming for surgery for DS1 and discovered that there are restrictions on fees paid to surgeons, which basically means that if you live in London, as we do, where most private doctors charge more than those outside, you end up paying extra. Also medicine following surgery was not covered. DS1 had surgery recently and we ended up paying £100 excess (fair enough, standard), £70 for antibiotics and painkillers following surgery, plus approx £200 excess fees that were over and prove BUPA's approved fee level for the procedure hmm. They also wiggled out of paying for another consultation for DS for something else that they claimed was a "developmental" (as opposed to pre-existing, which they initially claimed) health problem so not covered.

Now I have a referral from GP for tests for me, have called BUPA for referral and been told that actual tests will be covered but same thing applies re limit on consultant fees and excess and also that the consultation fee will not be covered shock, so basically, my visit to private consultant in order to get the tests done privately is going to cost me approx £250. Feeling very irritated that this is not really what I expect as a result of paying huge insurance premiums, no other type of insurance seems to sting you like this or wiggle out of paying...cars, buildings, contents, they charge you your stated excess and check claim is genuine and reasonable then pay (IME). Think I will just go back to GP for NHS referral and tests and go private from there if treatment is required.

Is it just BUPA that is like this or are there better health insurance companies out there?

And yes, before anyone says it, I know I could have read the small print regarding the cover but I don't thing you read through those things with a full understanding of process and possible scenarios....at least I don't. I am also fully aware that I am very lucky to have the option of private healthcare, but I still feel like I am being slightly ripped off.

crashdoll Sat 08-Jun-13 17:17:00

I have Bupa and it is unlimited for consultant's fees, diagnostic tests (bloods, x-rays etc) and inpatient/outpatients surgeries/admission. I do have a limit for therapies which includes physio, hydro and other similar treatments. I have never had a problem for them trying not to pay for anything. However, medications will never be covered, even if you are discharged from hospital with an instruction to take X medication. It sounds like you how a lowish level policy. I pay £1100 per year (one adult) and have a £200 excess.

In recent years, Bupa have been tightening up on consultants who charge a fortune, so they have a list of Bupa approved consultants (basically, doctors who agree to a set charge and will not charge extortionate amounts). If you choose to use a doctor who is not Bupa approved, you run the risk of having to pay the extra. They should tell you on the phone that your chosen doctor is not Bupa approved before they give you the authorisation number, so that you can make an informed choice.

I don't think you are being ripped off at all. I just don't think you have the best band of cover to suit your needs.

ItsYonliMe Sat 08-Jun-13 17:25:32

There are many different levels of BUPA cover. We are very lucky in that we have the gold cover - the highest they provide. This is via DHs work (we are overseas) To get this level of cover for me alone ( I checked out as I thought we might be leaving the company) was going to cost £200 a month.

I think you get what you pay for cover-wise. It is expensive. Why don't you think about self insuring (pay all the money you would be paying in to an account which you only use for medical matters). Often this is the best way.

Lonecatwithkitten Sat 08-Jun-13 17:28:20

I would suspect it is down to the level of cover you have. I am with aviva and pay £650 per year just for me. My current consult does not subscribe to the approved fees list, however, so far they have settled every bill without question.

ItsYonliMe Sat 08-Jun-13 17:30:05

...i lied. I just checked the email they sent me with a quote for the lower insurance policy. They quoted 8, 426 dollars ( I assume USD) for a year. For me, alone. And that doesn't cover travel to USA.

Waferthinmint Sat 08-Jun-13 17:30:13

Message withdrawn at poster's request.

ClareG88 Tue 11-Mar-14 00:15:28

Bupa is trying to control the market here as they have the greatest slice of it - their charges have gone up year on year but their cover grown more limited - they are taking away patient choice and 'telling' patients who to see based in cost not experience - so u are not always seeing the right expert for you - self pay costs are not as high as you'd imagine at all and can be negotiated within reason - if u do want priv insurance I wud def advise to shop around- just about every other insurance co out there is cheaper than Bupa - I work in this industry and see this every day - 'trust me' as they say!

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