to think private healthcare is a con?

[ChocolateBiscuitCake]

DH has private health cover for our family through work. It is a very comprehensive scheme and we have claimed for a few things over the years and never really thought much of it.

DH starts a new job next month which does not have a healthcare policy so I have been shopping around today to find a policy for my family.

But the more I speak to insurers, the more I am starting to think that the whole thing is a complete con when you are no longer under a company scheme?

The general gist of getting new cover is:

• We are no longer covered for pre-existing conditions (DS's reflux, my PCOS and monitoring of moles)
• If we make any claims, we lose a no claims bonus so the cost each year will increase if we make claims (previously, the cost may have gone up but DH's ex-employers covered the cost).
• Bupa, for example, will only pay 'up to' a certain amount to see certain consultants. They essentially cover for adequate doctors and may not cover the 'top' consultants so we would have to pay anyway
• No pregnancy related cover (have ongoing SPD post pregnancy and have an abdominal hernia that will need attention once I am certain we are having no more children!)

They want to charge £3-4k for our family of five for a year.

AIBU to think that we are unlikely to spend that much even if we pay to see specialists directly? Other than the absence of a private room and TV (!!), surely the NHS cover if one of the children got really sick suddenly?

I am so confused - it all just seems a bit of a con. Or am I missing something? What is the real benefit of Private Health Cover (when not through a company policy?)

NHS all the way. I bloody love the NHS. It's just about the only thing that makes me proud to be British.

NHS is fab, we are so lucky to have it. I have never felt it has let me down in an emergency and I have had a few!!

Chocolate, get your DH to look at whether his company policy will provide continuity of cover. I know that if I leave my job I can transfer the plan to a personal one and I think pre-existing stuff is then covered - obviously check that though. Our policy is with BUPA.

The NHS rocks, and your story tells us exactly why, OP.

£3000 - £4000 seems very high; we pay £75 per month for the two of us (kids aren't on as there is very little private paediatric work done, so no point).

A lot of insurers do cover pregnancy; BUPA do, but you need to screw the information out of them. They will pay for private CS if there would be an immediate risk to the life of the mother.

I do agree though and for that reason am probably going to cancel ours (once they pay for the CS...)

There is none.
If you want to go to a private hospital, then you can pay at the time.
You have the back up of the NHS. If the kids get sick suddenly then the last p,ace you want to be is a private hospital. IMHO

I don't think it's worth it unless your company pays for it. I think the Nhs is fab though, not necessarily for the small stuff, but amazing when it comes to really serious health problems.

I've found it good, have claimed about what I've spent on it, I use the NHS mostly but where a GP is fobbing you off and you say "I have insurance if that makes a difference" OOOO it suddenly does and you get a referal

at the moment I have a great GP so no need to play the insurance card, but when I've been unlucky with previous GPs its been fantastic

The NHS can't really be faulted in emergencies, things like your spd and hernia may well take a good while for the NHS to deal with but I suppose you could use some of your £3-4k to see consultants, physics etc privately like you say.

We have private healthcare from my DH's work and it's only been me that's had to use it - for some steroid injections. The convenience of having the appts at a times that suited me was great, and the private room and bacon butty following the procedures were very much appreciated but far from essential. I think if we were in your position, we wouldn't take out private healthcare ourselves so YANBU IMO.

Private healthcare cover is an insurance policy, and so like all insurance policy you pay an amount that is on average more than you will claim back, but nice if you have if you really need it.

Realistically what would healthcare would you need that you cant get on the NHS, that BUPA will provide, and that will cost more than the £3-4k each year that you would be saving? A single op could cost far more than that, but you most likely wouldnt be doing that each year.

Tricycletops - Aviva will take on the pre-existing stuff but at a cost of £3.5k!! We haven't 'spent' that much had we paid directly in the last 5 years.

My hernia op will cost £6k if I choose to get it done privately but the insurers won't actually pay as it is deemed pregnancy related and is usually carried out by a plastic surgeon (I am entitled to get it done on the NHS but would rather not have the scars of a junior surgeons handiwork!). 'Cosmetic surgery' is not covered although the op is medically necessary!

I genuinely can't see the benefit of paying for private health cover (unless an employer is picking up the bill!)?

Anotheroneplease - all the insurers will only pay for private CS if there is a medical requirement e.g. breech baby, plactenta previa etc. Unless your cover is different?

With the no claims malarky, I would be put in a position of not seeking medical care so as to keep the insurance bill down. Surely that defeats the purpose of having cover?

Arrggghhh - like I said, have I missed something?

"Realistically what would healthcare would you need that you cant get on the NHS, that BUPA will provide"

the ops I've had on BUPA are done on the NHS, probably by the same surgeon and same agency nurses..
what I COULDN'T get on the NHS was a referral in the first place, that was were insurance came in

once you are IN the system and referred and diagnosed the NHS is as good as private, its just sometimes easier to get that foot in with insurance unfortunately

Totally agree that it isn't worth it; I intend to just pay for anything we do need when I cancel our policy.

Yes, the CS cover does need to be medically related; "immediate risk to the life of the mother".

I have looked into "cash back" policies which cover the every day stuff (dentist, optician etc) but some also cover initial consultant appointments. Very often, that is the important thing; once you have seen a consultant and had relevant tests carried out, you could go back to the NHS for any necessary treatment. It is usually the initial appointment which has the long waiting list.

Thanks for all your responses.

I think my biggest fear of not having cover is the risk of not being covered if someone in the family got cancer, for example.

Am I right in thinking that the children would be looked after immediately on the NHS?

What about adults? All the insurers have said that they cover ALL cancer care costs - but in my ignorance, why would the NHS not take care of us if, god forbid, someone became ill?

X post with monkeymoma on the "once you are in and diagnosed" point.

So just take out a cash back policy, or just pay for one appointment as and when you need it. Unlikely to be £3000 per year! A cash back policy would also cover stuff like physio, so that is the route I intend to go down.

I think it is only worth it if you want non-urgent stuff dealt with quickly with the benefit of convienant appointments and private rooms.

Which judging by your comment about junior surgeons must be important to you.

I wouldn't pay for it- I prefer to stash money for an emergency and pay direct rather than lining bupas pockets.

Only time I would have used it, I was in agony and the NHS has exceeded their 'target wait of no more than 16weeks' by a full 4weeks! I sent a begging email to the consultant asking for a quote to go on his private list and he said 'come in next week while Im at x different hospital and I will do it on the nhs'.

Not all cancer drugs are approved by NICE (i.e. the expensive ones). If that is your concern you can get limited cancer cover, which is much cheaper.

"why would the NHS not take care of us if, god forbid, someone became ill"

of course they would, once you were in the system, my experience is that getting your symptoms taken seriously in the first place is very hit n miss, and with say cancer, time till first diagnosis is key so it depends on how much your local GPS fob people off IMO

I feel my insurance is unnessesary at the mo because I have a GP who does listen and refer if necessary, but with previous GPs insurance was the only way to get anything diagnosed

Yes chocolate the NHS would pay all cancer care costs and it is likely to be quick and efficient. The private companies are using this as a scary lure.

What you might want to up is your critical illness cover to support loss of earnings in such circumstances.

Thanks monkey and Anotherone...it is dawning on me that it is much more cost effective to "pay as you go". I can't believe that any family pay for this cover outside of a company policy?!

If, for example, I wanted my moles to be reviewed, could I pay to see a consultant privately and then, if there were a problem, take the findings to my GP for them to be dealt with on the NHS?

You see I tend to think private healthcare is good for seeing someone quickly for the minor stuff but for the big stuff I know the nhs is excellent.

We're with AVIVA through DH's business and I've found them very good and my 3rd child gets free cover as its buy 2 get one free which I found rather hilarious

"If, for example, I wanted my moles to be reviewed, could I pay to see a consultant privately and then, if there were a problem, take the findings to my GP for them to be dealt with on the NHS?"

I'm sure you could because private chiropractors often pick up cancers on x-rays which they then refer back to people's NHS GPs

If you're lucky, its a con.

If, on the other hand, one of your family has various serious and not bogstandard conditions, and your company provides cover, then its fantastic.

My DH has quite a complex set of issues which fortunately don't pre-exist the cover we get from my company - he has been able to see top specialists he simply wouldn't have been able to access otherwise. At some point he will need surgery, and its the sort of thing where the success rate varies hugely according to the skill of the surgeon. We're very fortunate that my company has this scheme, since DH had to give up his own FT job because of his health issues. Fortunate too that I love my job because this absolutely buys my loyalty - no way am I retiring till he's had his surgery!

Critical illness cover for DH sounds like a very good idea. I will look into that instead. Thanks sarcalogos