Healthcare - insurance and NHS letting me down

[Lonelycats]

I have anaemia, hemoglobin is 8 and ferritin is 4. I’m wiped out, losing hair, need a nap every day and am failing at work and parenting. I also have elevated platelets and was referred to a haematologist for all of this. He offered me an iron infusion both to help me feel better but also because while I am anaemic they can’t investigate the elevated platelets. I also have a referral to a cardiologist but they too say that the anaemia should be treated first as low iron etc can cause irregularities, pain and increased heartbeat.

The insurance turned down this claim and won’t cover the infusion. They say my anaemia is/could be chronic in nature and as such is not covered by the policy. I should address this by dietary changes and supplements. I already do this! I’m very careful about what I eat and I’ve tried ferrous funerary and ferrous sulphate, I don’t tolerate it and it hasn’t brought up my levels meaningfully in the past.

In the past the NHS told me the same, I should eat leafy green vegetables and red meat and try supplements.

I can’t afford to pay for the infusion myself, it’s around £1000, so this is it. I’m
going to have to live like this.

Meanwhile my 85 year old father in law gets every single treatment and investigation he wants from his insurer, including private daily physio for months, they come to his home to help him build up strength following surgery. He had his hernia repaired in a matter of days - my hernia after pregnancy is painful too but I have not been offered any help with this. Granted he has several serious conditions so I’m not begrudging him the support, I just feel
like his well-being and quality of life is valued so much higher than mine.

As a woman you are just expected to get on with things, that’s what I feel. I know I am having a major pity party right now but am I unreasonable…

*ferrous fumerate, not funerary

Why can't you get it on the NHS if recommended by your consultant?

Is you FIL insured with the same company? If you have private insurance can they sort out your hernia?

Don’t blame the insurers - you have a policy which doesn’t cover chronic conditions and (presumably) pregnancy related issues, so they won’t pay for those.

I’ve recently had two iron infusions from the NHS so they do provide them. I’d explore that fully.

I hate to say this but I see this a lot in my work. Your FIL is probably charged an awful lot more than you pay. Each year his premiums will be reassessed wrt whatever the insurer paid for him the previous year.

You are probably not covered for chronic conditions.

I'm a massive supporter of gender inequality in healthcare, but this is not what this is.

I am surprised that you can't have the transfusion on the nhs if it is the recommended treatment by your consultant. I would discuss this again with your GP , whilst taking your oral iron etc.

they've offered you an iron infusion though... what else would you like? The cardiologist has a point re anaemia and cardiac problems. The haematologist has a point re the platelet count. Your insurer probably mentions chronic conditions in the small print you signed up to. Some hernias are more likely to cause serious problems (incarceration/strangulation) than others (and the implications if that happens are higher in someone with multiple serious conditions) - perhaps your FIL had one of those? What doses of oral supplements have you tried already - lower dose oral supplements are better tolerated than higher and work well - just taking one tablet daily or even alternate days may help.

Slightly lateral to the point but if you can’t tolerate daily oral iron you can take alternate days instead and see if that makes a difference. Some studies have shown absorption is actually better that way

Try two sachets of Spatone iron liquid each day. It's more effective than dietary iron and doesn't have the side effects.

Sometimes insurers will pay for acute flare ups of chronic conditions- but I would be pushing the NHS on this. I’d book another GP appointment and push for a referral- you rarely get to see the same GP twice so even if one’s said no if you keep pushing you should get what you need. You do need a long term plan though- the infusion will just be a temporary fix

can’t you have this on the NHS?

Have you followed nhs advice to eat the right foods and always have vitamin c when eating iron rich foods? Take supplements with orange juice?

Follow their advice then get levels checked, they do offer infusion if after 3 months dietary isn't working because dsd has just had one (the nurse practitioner recommended I came with her and basically confirmed her diet was iron rich before they referred on as most iron deficiency is due to dietary deficiencies)

@gogohmm yes I’m mindful of those things and have managed to bring my ferritin level up from 3 to nearly 5 thanks to that. It’s still low though but contrary to your dsd, my nhs gp did not offer any treatment beyond diet and supplements. I don’t think the pathway you describe exists in my area

the insurance is not covering the infusion… that’s what I was hoping for. And yes, the rest of the referrals are now redundant.

I know insurers don’t cover chronic conditions, but I’ve never been diagnosed with one. It’s the insurers opinion that this could be chronic, the haematologist just says it’s anaemia, not any specific kind at this point. The insurers definition of chronic is any condition which may require repeat treatment and of course anaemia can reoccur

I’ve tried this and Floradix but apparently it’s not helpful with iron stores, it has got to be ferrous sulphate/fumerate

This is an insurance problem, seems you've got inadequate insurance. One big issue with private insurance. People dont realise how many exclusions there are.

Cant you arrange an iron infusion on the NHS? Your haematologist should be able to arrange.

Is the NHS doctor refusing to give you the iron infusion? If not, please go ahead and have it. I have been in hospital having an IV treatment today and there were 2 people having iron and 2 people having blood. It is a bit basic and we all sit in a row on chairs, but it gets the job done.
You will take weeks to get those levels up just with diet and supplements.
I can't believe your GP wouldn't prescribe a suitable one with those levels.
You need to take it with vitamin c and don't have tea or coffee. That way you can absorb up to 4 times as much per dose.

Sorry, it seems my post was unclear. I don’t have any chronic conditions that I’m aware of, it’s the insurers view that all anaemia is chronic by their definition as it often requires repeat treatment.

FIL definitely pays a higher premium than I do, and my children pay less than I do - I would expect all of us to get the help we need though. My point is that some of the treatments FIL is offered are focused on quality of life and wellbeing, while I don’t feel that’s taken into consideration in my case. Not to help manage symptoms or to find out what is causing it. I was really looking forward to having this treatment as I can’t get on top of it by myself.

I accept that the NHS is really struggling and I don’t really expect them to help with a non emergency like this but I’m surprised at how little our expensive health insurance actually covers

But the initial question was whether I’m unreasonable to feel this way and I think I am. It’s just been so long, I’ve tried to sort this out since a few years now. What I’ve learnt now is that I should probably cancel the insurance. The premiums we’ve paid would have covered this treatment…

There will be a local NHS service - might be provided by haematology, might be provided by nephrology (because many renal patients need IV iron, so the service is already set up to treat them). Waiting list is unlikely to be long - ours is a couple of weeks. Go back to your GP and ask for a referral.

You should also be having investigations into the cause of your anaemia - if it is heavy periods, you should be offered treatment, as otherwise IV iron is like pouring water into a leaky bucket (probably why the iron tablets haven’t helped as well).

YANBU

You're insurance company is trying to weasel it's way out of paying by making excuses.

That's the problem with provate insurance,.and why people shouldn't let the government destroy the NHS.

The alternative doesn't bare thinking about