Is private medical insurance worth it.

[Imthegingerbreadwoman]

I just had a quote for £138 a month for medical insurance which includes cancer care and appointments with a £500 access. This covers me, dha nd 4 kids. It does seem a little too good to be true. It was with aviva.

Does this sound right? It was only to have a look but I'm certainly thinking about it as looking at the way things are going it might be worth having?

Or am I being a drama llama? And this sounds too low a coverage price for 2 adults and 4 kids.

It does include gp appointments and diagnostics too and end of life care should it come to that

I have private medical cover through my work, it’s free for my self and I pay £48 a month for my 2 children as it’s discounted through work.
When I called them because the wait list to see an NHS speech therapist for the youngest has been going to almost 6 months, they said they don’t cover any development issue. Next I called them because another child’s eczema flared up and all the creams she was given on the NHS hasn’t been helping and they said referral to a dermatologist takes over a year, the insurance said that wasn’t covered.
I mean I still pay for them monthly but I’m almost getting annoyed at the amount of things I still have to depend on the NHS for as it’s not ‘covered’ so what’s the point of it all.

I've read it's better to save the same money each month & not touch it until needed. But that requires discipline

It’s low because it’s a large excess. The excess is what you would have to pay out each year before the insurance kicked in.

Surely the excess is what you would need to pay per condition rather than overall each year?

With pet insurance for example, a dog with ongoing ear problems would pay the agreed excess for that treatment. If they then needed an op for something unrelated the excess would need to be paid on that as well.

Be aware that private health insurance in the UK is cheap because of the NHS is picking up all the expensive stuff,
I work in private health care and our waiting lists are increasing and in some cases we have closed lists and the doctors are overwhelmed in their NHS posts, and now in their private posts. But we have private health care and if you can afford it go for it. Just remember you have it my poor sun suffered for 6 months with Ingrowing toenails and it was only an off hand remark which reminded me we had covered our children as well.

Even if the premium rises slightly due to diabetes take it if you can afford it. DH is an NHS consultant who also works privately and in his NHS clinics he is regularly seeing patients who have waited 12 months for appointments but his private patients very rarely wait more than two weeks. As a family we have private healthcare as we know the NHS is in crisis.

There is no price you can put on peace of mind knowing that your children would get treated rapidly should they need it.

Mine with axa is £500 excess for everything, not each condition.

I have it through work and there's quite a few exclusions, the big one being it doesn't cover chronic conditions. I am using it for DD's autism diagnosis but they were very clear that it would only cover diagnosis and not any counselling or other treatment after.

Tha ks everyone. A lot to think about. I'm still steered towards it. Because I think there will be a boom of it soon and proces going up!

I have it via work.
I recently went to my GP with a suspicious lump, they feted to refer and said there was a 8-12 week wait for a scan. I had it done 2 days later at a Private hospital and paid a £100 excess.
Luckily it was nothing but I didn’t have to spend up to 3 months worrying about it
If you can afford it definitely do it

@Hoppinggreen amazing news it was nothing! But yes peace of mind!

I'm with Bupa - well worth it but I would double check the diabetes cover for your DH. I don't think they cover long term, what they call 'chronic' issues - you get spat back to the NHS for those!

So I have attached the main parts of the policy. I think it looks good?

No, with private medical insurance the excess is per year rather than per condition. My excess is £100 per year for outpatient treatment. Once I've paid it, it doesn't matter what conditions I seek advice for as the excess is paid once and once only.

Rest

Mine covers:
6 sessions of physio

Consultations for non routine concerns such as a mole, breast lump, etc

Surgery - if I needed a knee replacement, etc. Cancer treatment.

It does not cover routine smears/breast screening or emergency treatment accessed through A&E. It does not cover private GP appointments.

Access for appointments is swift and means you see the consultant, rather than a registrar who changes at every appointment.

My insurance, albeit more than 20 years ago, covered a birth injury (unlike experience quoted above).

When dd was ill it covered only 5 sessions of therapy but covered the routine appointments with a psychiatrist as depression and anxiety were dealt with. It also covered day patient therapy for anorexia and her mental state. It did not cover the ADHD diagnosis. Overall it paid out about £8k but what was invaluable was seeing the psychiatrist. There was no help available for DD on the NHS. CAMHS declined to help because she didn't meet their bar. No way would she have got to see a psychiatrist through CAMHS.

It is important t@Imthegingerbreadwoman when you speak to the broker to establish what the policy covers.

Nearly done

Rest

Thank you @RosesAndHellebores

IMO it’s definitely worth it if you can afford it.

I had an issue last year which I tried to get sorted via the NHS first to avoid possible premium increases and paying an excess. I waited a month for a hospital referral (the GP said they usually ring to book people in for the procedure within a week which I thought sounded fine). At my hospital appointment I was told to book myself in again for 2 weeks’ time. The receptionist said I’d get an appointment letter in the post. As the 2 week point was approaching I called to chase and was told there were no available appointments for 6 weeks! At this point the issue I went for was back at square 1 and I was in a lot of pain. I went back to my GP for a private referral and the problem was resolved after 3 appointments/procedures, each 2 weeks apart which I know wouldn’t have been possible on the NHS. I’d probably still have the issue 18 months later if I’d waited for the NHS.

I’ve also been in the past for a fairly rare condition that as a child would have several student doctors all coming in for a look to see something they wouldn’t come across very often. I often ended up with a junior doctor who would inevitably have to go off and find someone more experienced or book me in again to see a consultant. Going private means you actually see the consultant rather than having an appointment for their clinic but seeing any doctor working under them.

I wouldn’t cancel our cover now unless we really couldn’t afford it.

I'm a bit wary of the brokers too as they gave me wrong information regarding life insurance before. So sorry if I'm asking too much. The experiences are eye openers

OP I'm not sure why you're posting a brochure here. Are you expecting us all to read it? You need to review the terms and conditions, and check the exclusions and the limits in the small print. That's where the important bits are. For example as a previous poster pointed out, chronic conditions are often excluded and your DH's diabetes is likely to be classed as a chronic condition so it's important you check this (rather than posting glossy brochure pages).

I'm with BUPA. £80 per month for me and 2dc. £150 excess. Everything covered as far as I know so I don't think your quote is particularly cheap tbh.

Its not as quick as I imagined. Still had to wait months to get a mole checked and a lot of ringing around. On balance though definitely worth it.

What underwriting is that for? Most individual private plans wont cover pre-existing conditions and sometimes related ones. So if your DH has diabetes he’s likely to be excluded for that and related conditions like eye or heart problems. Anything you or your kids have had in at least the last 5 years won’t be covered for at least the first 2 years, or at all depending on the underwriting.

Also most plans operate on a no claims discount basis so if you do claim be prepared for a steep price increase the next year.

I do have PMI but through my work so it’s medical history disregarded. I’ve only had to use it for things like physio but DH has used it for some scans etc and it’s been great. Just remember with a £500 excess really you’ll end up paying for anything small.

Also due to covid private waiting times are much higher than they used to be, so do bear that in mind!

in terms of cancer care, check what’s unlimited. Some policies say they cover unlimited cancer but in small print only cover two years of biological therapy, which is essentially a means of dropping patients when cancer treatments become more advanced/expensive. If you need cancer care (hopefully not), consider using it at the point chemo/prescribed therapies are not available on NHS or treatment options diverge between NHS and private: virtually all first line treatments will be the same between NHS/private, but increasingly include biologicals and you might spend your insurance on treatment you’d have got on the NHS. Speak from experience!