AIBU to balk at paying nearly £100 towards a private health referral (BUPA only paying £15?)

[Jamdown123]

So, I have a women's condition which is common post-birth. I work for the NHS, believe in the NHS, have gone to the NHS. The waiting list is REALLY long, many many months.

My partner has private health insurance through work and he reminded me that he put me on it. Great, I thought. BUPA say they need an eligibility for to be completed by my GP (NHS). The GP says they charge £104 to complete it. BUPA say they will pay only £15 towards it!

So I have to pa £90 for the referral. AIBU to be p'd off at this? That's two weeks shopping at LIDL for my family! Either GP is having. laugh (probably not), or BU{PA is being ridiculous? The GP has said they have health with BUPA a lot in the past and have just sent the invoice for the form and it has been paid. So why the change now?

I understand the excess/co-pay part of health insurance but £90? I just feel bad about BUPA.

Has anyone else had this experience?

Would you not just have the pay the excess? Feel like Bupa should be paying for this and charging you the excess.

But once you have paid the excess you won't need to pay any further towards treatment.

It's not an excess though it appears to be functioning like one. The gp has to complete a form saying I came to them about it and I need a referral. I feel its part of the process that should be covered. When my gp said they'd never heard of a patient paying itm I wondered whether bupa had become stingy recently, maybe since covid?

Go to another GP about it. You can shop around for Pre-treatment questionnaires & most will do them immediately after you register. My practice charges £30 but another practice charges £200+. A private GP locally makes a lot of money from the latter practice because he charges £30 for a 10 min appt and £30 for the questionnaire and will fill out the questionnaire for anyone registered at any GP practice. You may have GPs like that locally.

That's the excess though... I had a hysterectomy through BUPA about 5 years ago. My initial appointment with the consultant was billed at about £150 and I paid £100 of that. But everything else - all the scans, the operation, anaesthetics, hospital stay was covered in full.

It’s normal.

Just think of the £ks you’ve saved by having Bupa insurance, or the months on an NHS waiting list.

Health insurance is never completely free.

So BUPA say you need a referal from your GP but will only pay £15 for it when the GP charges £104. Personally I think BUPA are being very tight only offering £15 but probably because GP's are taking the piss, they probably print off the referral sign it and that's all there is to it, £104 for 2 minutes work. You're saving the NHS money by going private while GP's try to milk the situation.

I find any kind of insurance company though tries to find a way to get out of paying for as much as they can unfortunately. It's pretty shit what ever way you look at it OP.

I suspect what Bupa have asked for is a 'history and onset' report from your GP to satisfy themselves that it wasn't a pre-existing condition and therefore excluded from insurance cover. This is fairly common when making claims early in your membership of a health insurance scheme - my guess is that you've been registered on the policy for less than a year or you've already declared a lot of pre-existing conditions. And of course, if the letter says that it's a problem you've had for years before you joined Bupa then you won't be covered at all.

The £15 they offer towards it is normal, although that hasn't risen in over 20 years. The £104 your GP wants is a total rip off.

That seems steep. Just today I had a test done at a private hospital, which I self-funded due to urgency and waiting lists (it wasn't hideously expensive either, less than £100).

When I asked my NHS consultant to refer me to the private service they simply sent an email confirming that the needed the test done. Even if the pre-appointment paperwork is more extensive than a quick email, £100 seems like a lot!

£104 is a massive fee. I'd be far more annoyed at your GP for the fee than BUPA...

£15 is a bit stingy, but £104 is insanity. A quick Google suggests that £30/40 would be average; and then you'd be splitting it with BUPA, which wouldn't be so bad.

Your GP is taking the piss. Here are the recommended fees for private referrals from the BMA.

www.bma.org.uk/pay-and-contracts/fees/fees-for-gps/what-to-charge-your-patients-guide-for-gps

Yanbu
What a load of crap.
I have never heard of the GP charging for a referral and I use them for loads of things!!!

I just make an appointment and just ask for an open referral then go see my health insurer

Oh gosh this sounds like the fault of your GP entirely! £104 is a total rip off!

This is a mess when you’re in medical difficulty and all you need is help. Your GP sort of IS taking the piss though, yes. BUPA is offering that because of what the average cost of a GP referral for specialist care should be. There’s a whole site just offering to help you get a referral from £34. So no, you should NOT be paying £100 but your GP also shouldn’t have been charging it. Like they said, they did it because BUPA would just pay the invoice, no questions asked.

However, the site I found seems only for London ( doctap.co.uk/services/specialist-referrals/ ). But I’m sure there are nationwide sites. And probably others just for London, too.

@Ozanj

Go to another GP about it. You can shop around for Pre-treatment questionnaires & most will do them immediately after you register. My practice charges £30 but another practice charges £200+. A private GP locally makes a lot of money from the latter practice because he charges £30 for a 10 min appt and £30 for the questionnaire and will fill out the questionnaire for anyone registered at any GP practice. You may have GPs like that locally.

£30 for a 10 minute appointment is only £180 an hour. I would love to earn that much, but it wouldn't be considered anything more than peanuts in the world of GPs, especially private ones.

Bit even if op did not pay for the letter, she would be charged the excess against the consultation fee.

Bit even if op did not pay for the letter, she would be charged the excess against the consultation fee.

I have BUPA insurance through work and there's no excess - but some do, the rate will be set by the company or her DH might have had a choice.

It doesn't sound like this the excess, though, just that they'll only pay £15 towards the referral letter.

Is it that BUPA think a reasonable fee for the letter is £15 but the GP charges £104?. You do have to wonder why the letter should cost so much, although more than £15 would be reasonable .

My GP has never charged me for a private referral letter, and they have done them same day for me too.

I have had two cancers treated via BUPA and have paid 2 years excess fees of £150 only. BUPA have paid out over £100k.

Depends on the underwriting. Sounds like you have a moratorium policy where you have to get a history and onset form done for each condition, as opposed to a fully underwritten policy where you only have to get the pretreatment form for symptoms that started within the first 12 months. It's the gp taking the piss by charging so much! This is completely separate to any excess or co pay.

I've used BUPA through my work policy and my GP didn't charge for putting in a referral to them although she was probably glad to get me off her back the only thing I paid was the policy excess.

Could you get the Babylon app? It’s covered under my BUPA policy and is a private GP via a video call. Bupa allows access to it for free then you only need to pay for excess on the referral. But check with bupa before you use it as they had to give me a special code.

I’ve only ever used BUPA once and didn’t have to pay anything. I’d been straight to A&E so didn’t have a GP referral but there was definitely no excess.