BUPA health insurance

[JonahofArk]

I have been contemplating getting private health insurance for a while and have decided to start researching it properly. I wanted to ask about BUPA-if you have health insurance with them, are you happy with the service you receive? Are there any negatives?

Or, if you have health insurance with another provider can you let me know who with and if you rate them highly?

Bumping this for you @JonahofArk as it is something I have been planning to do for far to long

I have Bupa through work and I find it really annoying and the service archaic tbh. They don’t have any kind of online portal (or if they do, I don’t have it/know about it) so everything is done over the phone or by them writing to you which just seems bizarre in this day and age. I have to call them for an authorisation code for any treatment I need, it’s not like pet insurance where you turn up, pay, then claim it back.

The only positive from it (aside from the fact it pays for private treatment) is I get the Babylon GP app for free, and I’ve used it a few times when I can’t get appointments at my normal GP. It was a Babylon doctor that referred me for some tests I needed, which Bupa then paid for, and it all happened pretty quickly but there was a lot of back and forth with phoning Bupa to ensure they could cover it. I’ve no experience of other insurers so I don’t know if this is all normal service or if others have the option of booking things online and having your authorisation codes sent via email or text which I would much prefer.

@TedMullins thanks for the info , it is odd that they dont have a online system , I wonder if it is due to fraud / or data protection worries but in this day and age you thin there would be a way of protecting their clients .
TBH I quite like the idea of not having to pay out for treatment then claim it back as I could not afford anything major ( hence looking for insurance ) but there should be a easy way to do it .
If you need emergency treatment the last thing you will want / be able to do is make a dozen phone calls !

We have the full/premium package through work and it's been amazing.

Yes you do have to call up and get an authorisation code, but I've found it to be a quick a painless call. For me it was easier than getting the a GP appointment for the initial symptoms.

The great thing for us was that rather than getting whatever consultant is available we were able to research and choose a consultant that specialised in the condition. We then called Bupa got the authorisation code, and went direct to that consultants PA who arranged everything at locations and times that suited us. All follow up appointments didn't require new codes, we just contacted the consultants PA and she dealt with it all.

My experience is you can usually have authorisation within 24hours and get seen with 3 weeks.

I didn’t find it a quick painless call at all, several rounds of “press 1 for this, 2 for that…” etc. I did have to call every time I got another test/treatment, the consultant’s PA did not do this for me so I think that rather depends on the PA. in my case, the tests I had with a consultant didn’t uncover/help my condition and there was no relevant treatment that he could provide. Because private consultants have a speciality, in my experience the one I saw did not then make a referral to someone else - he sent me back to my GP because there was nothing more he could do for me, but on the NHS I assume I’d have been referred direct to another department. I’ve found the entire process arduous and complicated and while it is quick, on balance I would say I prefer the NHS

It is interesting to see there are very different opinions on the same company , I guess some of it may be down to the PAs and how busy / accommodating they are .
I wonder if this part of the issue , there should be a set standard across the board no matter what you illness / injury is.

Recently just used our Bupa for the first time, was really good. Not sure what you want to know? I only spoke to them once on the phone and got through straight away and the lady was lovely. Couldn’t have one of my suggested investigations (barium swallow) as Bupa don’t cover it so would have had to go to the non private hospital and I guess pay for it myself, but I didn’t need to in the end as by then we’d figured out the problem.

(I mean, NHS hospital as a private patient and therefore pay for it myself)

The consultant and PAs aren’t anything to do with your insurance though are they? I went to a Nuffield hospital and they accepted all sorts of insurance. My consultant’s PA has been surprisingly poor though - I’m sure she’s lovely but her emails were atrocious, no SPAG and as if she was texting a friend!

I’ve had bupa and AXA. I really like axa personally - includes the free virtual gp service which is good. Eg when dd had an issue on holiday I did a video appointment with a gp there and then. Was very handy.

I've never had private insurance but I have worked in a private hospital.

I worked in Cardiology so didn't have much to do with the billing other than putting the correct codes in, but we got the occasional query and it was always BUPA and they could be quite snooty. When you go into a private hospital you sign paperwork that means you are liable for anything your insurance doesn't pay for.

BUPA being as big as it is decides how much it will pay for a procedure so if BUPA says a hip replacement costs £12000 that's what they pay regardless of the actual cost.

Lots of hospitals don't bill on top because they want to keep BUPA patients but they can do so it's worth baring in mind.

It's also worth checking if the insurance is world wide if you travel.

Most holiday insurance expect you to use local services if you are on holiday, the local NHS equivalent, but private health insurance can give you more options. Also if a treatment is available in one country but not the UK you may have an option to go abroad.

Another thing to consider is where you live and the access to services.

If you are in London you have an array of private hospitals and clinics to choose from.

If you live somewhere were there is only one private hospital in 100 mile radius you might be better going with that company whether it is BUPA, Spire, BMI whatever.

One last thing is to check that they will cover you in an NHS hospital. There are two reasons for this, lots on NHS hospitals have private wings or wards.

The other is if something goes wrong while you are in a private hospital you may need to be transferred to an NHS hospital. But as you are not an NHS patient you can be charged for this.

Also will they pay for an ambulance to transfer you?

I have BUPA and think it's a complete rip off. Unfortunately I was diagnosed with a chronic condition while on them and now can never move because no one else will ever insure me for it.

They don't pay for anything preventative, chronic (except an acute flare up), travel or maternity.

Basically it's useful if you get cancer or need a hip operation and need to skip the NHS queue.

@sashh

I've never had private insurance but I have worked in a private hospital.

I worked in Cardiology so didn't have much to do with the billing other than putting the correct codes in, but we got the occasional query and it was always BUPA and they could be quite snooty. When you go into a private hospital you sign paperwork that means you are liable for anything your insurance doesn't pay for.

BUPA being as big as it is decides how much it will pay for a procedure so if BUPA says a hip replacement costs £12000 that's what they pay regardless of the actual cost.

Lots of hospitals don't bill on top because they want to keep BUPA patients but they can do so it's worth baring in mind.

It's also worth checking if the insurance is world wide if you travel.

Most holiday insurance expect you to use local services if you are on holiday, the local NHS equivalent, but private health insurance can give you more options. Also if a treatment is available in one country but not the UK you may have an option to go abroad.

Another thing to consider is where you live and the access to services.

If you are in London you have an array of private hospitals and clinics to choose from.

If you live somewhere were there is only one private hospital in 100 mile radius you might be better going with that company whether it is BUPA, Spire, BMI whatever.

One last thing is to check that they will cover you in an NHS hospital. There are two reasons for this, lots on NHS hospitals have private wings or wards.

The other is if something goes wrong while you are in a private hospital you may need to be transferred to an NHS hospital. But as you are not an NHS patient you can be charged for this.

Also will they pay for an ambulance to transfer you?

Hi @sashh - can you elaborate when you say that if I have to be referred back to the NHS then I could be charged? Do you mean charged by the NHS? I may be showing my naivety here but I'll still be eligible for NHS care even if I have health insurance won't I?

Thanks all for your comments. @AlCalavicci it's definitely something I've thought about for a while and I've gotten a quote from BUPA which seems pretty reasonable so I'm just weighing up the options.

I do have a couple of hospitals to choose from relatively locally and I'm planning on moving to a much bigger city in the next few years so there shouldn't be an issue there.

In terms of the general service, I hear what some of you are saying about the service but unfortunately I think the service that the NHS provides is only going to get worse. And I'd like to have the option of going private, particularly when it comes to initial diagnosis of illnesses. I know a couple of people who have had to practically beg their GPs to refer them for further tests and I don't want to be in that position.

Another question-to those that pay for the insurance themselves, do the premiums increase dramatically year on year?

We were with BUPA for over 20 years, and their rates kept going up and up, so we changed.

I was also irritated that they didn't cover 'chronic' conditions - my DM had an ongoing heart condition, which meant that she saw her cardiologist twice a year. Never any hospital treatment. They wouldn't cover it.

Recently my DD has had to see her consultant regarding PCOS. Again, they covered the first couple of appointments, but now that it's diagnosed and confirmed, it's classed as a chronic condition, and they will no longer cover her for her annual check up.

These were both BUPA incidents, but I'm not sure any other health insurance company would respond differently. I'm feeling pretty indifferent to private health cover at the moment - DH and I are thinking of saving the £6k a year we have paid historically, and use it when we have to for private care.

@ajandjjmum
Thats mad ! I thought they would cover you for whatever you need , not just the diagnoses and first few treatments.
So what happens next will your DD and DM have to pay for the treatment themselves or can they go back to the NHS for treatment ?

As a dr wpa pay promptly and appear to cover ongoing health conditions ( may depend on which policy taken out) Chevk whether they only cover acute problems and also what your excess is.

[quote AlCalavicci]@ajandjjmum
Thats mad ! I thought they would cover you for whatever you need , not just the diagnoses and first few treatments.
So what happens next will your DD and DM have to pay for the treatment themselves or can they go back to the NHS for treatment ?[/quote]
DM is sadly no longer with us, but she stopped paying her thousands every year, and paid the annual £250 to her cardiac consultant herself. She would have been able to pay for private care had it been necessary, but she essentially died of old age here at home with us, which was all we could have asked for.

DD was charged £600 for her appt. a couple of months ago, for blood tests and a consultation. The guy is brilliant, so worth it. But when you think that her company is paying around £2k a year for her, it's just wrong.

Another random thought. A close friend has recently been diagnosed with lung cancer, and the treatment she has received from the NHS has been wonderful. However, she and her DH have had a couple of private appointments with a consultant, who basically has the time to explain things properly, and they feel that they can ask daft questions! Maximum charge is £250, but because she's having her treatment on the NHS, private healthcare won't cover these appointments - not that they care, they would happily pay anything that might help, but it's the principle!

I'll go and rant away privately now!

BUPA rates for the top London consultants (if those are people you’d use) are low and so you may need to pay a top up to cover fees. I have the highest level of cover with AXA which covers he shortfall (two of my consultants required a top up).
I wouldn’t want to be without health insurance in the current climate and used it during lockdown.

Dh just got it through his employers but with Axa, 2nd month we both needed some dental all covered up to £500 a year
It’s w fantastic no excess policy and with the shit the nhs is in and us both now in our 40’s was a no brainer for us to get me on policy too

Maybe look at other providers

I have just brought some insurance after having left my old company where I got it as a perk. I used a broker and they were excellent. Asked what was important to me, i.e did I want Central London cover etc.

They looked at all providers and gave me pros and cons for each one. Eventually went with Exeter.

Hi @sashh - can you elaborate when you say that if I have to be referred back to the NHS then I could be charged? Do you mean charged by the NHS? I may be showing my naivety here but I'll still be eligible for NHS care even if I have health insurance won't I?

I'm not an expert but as I understand it:

You are still eligible for NHS treatment, you can pay for private healthcare but what you can't do is half and half for the same treatment.

So you probably already do this when you visit the dentist. As an NHS patient you pay (or get free) for an NHS check up and an NHS scale and polish, but if you want an appointment with the hygienist, then you pay because that is private and it is a different appointment, even if that is you walking into the room next door.

Cataract surgery, the NHS will only use a single vision lense, usually for distance and you need glasses for close work.

Privately varifocal lenses are available.

If you need the surgery it may well be the same Dr but you choose NHS or private, you cannot buy the varifocal lenses and have them fitted by the NHS.

You will always get emergency treatment as does everyone whether they are UK residents or tourists or even here illegally.

The problems can arise if you start a treatment privately and then transfer to the NHS.

There has to be a distinction between NHS and private treatment. Exceptions can be made for clinical need but no one knows if that will happen.

So say you have an operation after which you need 5 days rest in hospital, all approved by your insurance.

Now maybe something goes wrong (nothing too drastic) and you need a second procedure and 3 more days recovery, and your insurance, for whatever reason, won't pay, then the NHS will treat you but they can bill you. Or you can stay in the private hospital and they will bill you.

Now it may well be that the mistake was by a member of the surgical team and you can claim against them but that won't be happening while you are recovering from an op.

This is what you need to check, what is in the small print. What normally happens.

And sometimes it's a grey area eg if you have a pacemaker implanted you will normally have 2-4 check ups in the first year and then ever 6 months or annually depending on your consultant.

Now if you have your pacemaker fitted privately you will probably have the first couple of checks included in your insurance but what happens after that?

Is it continuing treatment or not?

There is no problem if you continue to be insured and the insurance pays out but if it doesn't then, as I say, it is a grey area.

Now when I worked in the NHS we didn't bother asking who put your pacemaker in we just checked it, reprogrammed it if needed and sent for you in 6 months. But things have changed. Charging is getting more common.

I don't want to scare you, I just think it's something you need to ask about and get in writing. Obviously I hope you never need a cataract op or a pacemaker and I certainly don't want a procedure to go wrong.

I have Bupa and it’s been great. They have an online portal now. They also cover a chronic condition. Mine has been through work and have had loads of procedures through them. Have been very impressed.

@sashh

Hi @sashh - can you elaborate when you say that if I have to be referred back to the NHS then I could be charged? Do you mean charged by the NHS? I may be showing my naivety here but I'll still be eligible for NHS care even if I have health insurance won't I?

I'm not an expert but as I understand it:

You are still eligible for NHS treatment, you can pay for private healthcare but what you can't do is half and half for the same treatment.

So you probably already do this when you visit the dentist. As an NHS patient you pay (or get free) for an NHS check up and an NHS scale and polish, but if you want an appointment with the hygienist, then you pay because that is private and it is a different appointment, even if that is you walking into the room next door.

Cataract surgery, the NHS will only use a single vision lense, usually for distance and you need glasses for close work.

Privately varifocal lenses are available.

If you need the surgery it may well be the same Dr but you choose NHS or private, you cannot buy the varifocal lenses and have them fitted by the NHS.

You will always get emergency treatment as does everyone whether they are UK residents or tourists or even here illegally.

The problems can arise if you start a treatment privately and then transfer to the NHS.

There has to be a distinction between NHS and private treatment. Exceptions can be made for clinical need but no one knows if that will happen.

So say you have an operation after which you need 5 days rest in hospital, all approved by your insurance.

Now maybe something goes wrong (nothing too drastic) and you need a second procedure and 3 more days recovery, and your insurance, for whatever reason, won't pay, then the NHS will treat you but they can bill you. Or you can stay in the private hospital and they will bill you.

Now it may well be that the mistake was by a member of the surgical team and you can claim against them but that won't be happening while you are recovering from an op.

This is what you need to check, what is in the small print. What normally happens.

And sometimes it's a grey area eg if you have a pacemaker implanted you will normally have 2-4 check ups in the first year and then ever 6 months or annually depending on your consultant.

Now if you have your pacemaker fitted privately you will probably have the first couple of checks included in your insurance but what happens after that?

Is it continuing treatment or not?

There is no problem if you continue to be insured and the insurance pays out but if it doesn't then, as I say, it is a grey area.

Now when I worked in the NHS we didn't bother asking who put your pacemaker in we just checked it, reprogrammed it if needed and sent for you in 6 months. But things have changed. Charging is getting more common.

I don't want to scare you, I just think it's something you need to ask about and get in writing. Obviously I hope you never need a cataract op or a pacemaker and I certainly don't want a procedure to go wrong.

Thank you for your very detailed post-gives me a lot to think about that's for sure!

I've now gotten quotes from BUPA and Axa and am going to go through them to see if these and the other points made by PPs are addressed in their fine print.

Could I suggest Benenden Healthcare, Bupa are their partner, much cheaper, for a good level of cover. My family have been members for 25+ years, they are excellent IMHO.