Private health insurance is it worth it.

[Sitdowncupoftea]

Obviously all policies are different however I'm wondering if anyone on here has private heath insurance and they think its worth it.

Just a warning that using insurance which comes as a perk with a job means that you don’t have to worry about the premium going up.
When we switched to our own policy it came as quite a shock how much difference to the following years premium a claim made. We are now much more careful about what we do private and claim for.

not true, some insurances accept private gp services or self referral

With respect @pinkbalconyrailing I have never in 35 years of having private insurance, with different companies (due to them being employment benefits) not found a single one that will pay for self-referrals without going via a GP. (And yes, a private GP is possible perhaps.)

I have though made appts with private consultants, and paid for those myself, where the consultant doesn't want a GP referral.

Not all conditions need a gp referral. Some insurers offer direct access, such as for msk conditions or suspected cancer. Some also offer a virtual gp service included in the policy. If you're admitted to a ward from a&e, you can then transfer to private. If you prefer to stay with the NHS and its something that would have been covered privately, then yes, some policies offer cash back. With a personal policy, you will be underwritten so pre existing conditions won't be covered, but some can be reviewed if you stay symptom, treatment, medication and advice free for 2 years. Is it worth it? For me, yes. I've had treatment that it would have taken me a long time to get on the NHS.

Not all conditions need a gp referral. Some insurers offer direct access, such as for msk conditions or suspected cancer @Mabelface Do you have personal experience of either? what's msk?

I am genuinely puzzled by this because no policy I've had would ever accept a self-referral to a consultant without a GP's 'ok'. That is to stop people using their private cover for trivial issues that don't warrant a consultation OR for some money-greedy consultants knowingly seeing patients when they know it's not necessary.

My DP had cancer diagnosed and surgery recently and the way it worked was he was referred by a GP for tests - at his request. He could not have booked the tests and expected the insurer to pay.

Anyway- I think this thread has maybe run its course. The OP was clear that she was looking for cover for an existing condition and I think everyone's explained that it isn't possible.

Direct access is done by one of the insurer's clinicians who will then refer on to the relevant physician. Msk is muscles, joints and bones. I work for an insurer

@pinkbalconyrailing

all private insurance cover needs a GP referral to access private appts

not true, some insurances accept private gp services or self referral

This is true on mine you can self refer for some conditions/ complaints related to msk

Self referral for physio is included

Our private GP refers us to private specialists and the insurer picks up the bill you don't need an NHS doctor involved at all.

I'd say it's definitely worth having private healthcare and will become more the norm as the years go on. DS has been treated for numerous ailments and the counselling he has has been fantastic, he was on a never ending waitlist on the NHS.

@Mabelface My own insurers have only recently- since Covid and reduction in GP appts- offered virtual GP appts which can be used for referrals to a specialist. It did not exist pre-Covid with them (and they are very good) to my knowledge.

Musculaskeletal treatment- physio- has always been available without an NHS referral but they do need some details, of course.

They do, which is why we use direct access.

Our insurer offers virtual gp appointments. But I have a question to anyone who has used this service. Are the consultations free as part of your cover and go you have your register with them and therefore deregister with your nhs gp?

I've known of people seeing a consultant privately then being transferred to their NHS list and when they are treated depends on the severity of the problem
It used to happen in the past because they could get away with it. This is now much more scrutinised and if found out, the consultant us likely to get a big telling off so it's much less if occurrence now.

@lazymum99 My insurers offered a virtual GP appt and it's through a central number (not actually theirs) . The service is not meant to replace your own GP, it's an extra at the moment I think due to Covid. There is no registration process, you simply make an appt via the call centre and the GP phones you at an agreed time. It's free.

Check your policy documents to make sure it's part of your cover. You don't need to deregister with your gp.

Hmm. DH and I ceased ours several years ago because the premiums for full cover in London hit about £6k per annum and we took the view it was better to stash the money away. If one of us got cancer we could afford private care and are financially able to do so.

Where it was worthwhile was for the DC and I paid until they were 18 when the premiums tripled I think. It was brilliant when dd had a severely broken leg and meant consuktations were when we could make them and tailored to her. She spent 5 weeks in a thigh high cast and was then exrayed and it was cut down to make her significantly more comfortable which would not have been provided on the NHS although they did the initial op after A&E admission - can't fault the op itself but the ward experience was shocking. The real benefit was when she developed anxiety and depression at 16 and it covered the cost of 5 sessions of therapy (she probably needed about 40) but more importantly the cost of consultations with a consultant specialist psychiatrist and some day patient therapy at an excellent provider. There was no support whatsoever from the NHS/CAMHS and I am quite sure without private care she would have deteriorated to high tier 3 or even 4 and the journey back to health wpuld have been significantly greater or perhaps not possible. She did make a good recovery and our savimg grace was that the insurance company helpednus find the right psychiatrist for her when our GP would not and CAMHS wouldn't accept her.

For DS it covered really good specialist support and advice when he had chronic asthma as a baby and no progress was being made under the NHS seeing a different reg at every appointment and receiving some questionable advicd from various nurses about administration of his meds through a spacer which escalated us onto a nebuliser at home an downward spiral, a cpl of cons with an excellent dr and one session with a specialist asthma nurse had him on an upward trajectory within a week, an ear op at 8 and a sports injury at 15.

@OhTheRoses
I'm sure you are happy with your decision to stop the cover, but all I'd say is you might want to reconsider based on my experience. My DP's premium went up as he wanted it to cover full cancer care, having had cancer, and it was a bit more than your quote- just for him. We did the maths and decided to go with it, based on the actual costs of MRI and CT scans which are still being done and will be for many years. A single PET scan is over £3K and on top of that there are blood tests and consultations. In other words, it's cheaper at the moment to have the cover, which covers everything, than pay as you go. It also means he is getting monitored far more than via the NHS especially at the moment. You might be underestimating the cost of paying for treatment for cancer ops/ treatment, which can go on for a long time and some insurers will cover expensive drugs not used by the NHS.

It depends on your priorities and how much spare cash you have. It is great for getting seen and dealt with quickly if you have something non life threatening that is effecting your every day life eg an arthritic joint or a chronic illness requiring regular outpatient appointments. You can to some extent choose your specialist and when to see them. The doctors are the same ones that you will see in the NHS and from that point of view the expertise will not be greater. There is little or no emergency care in the NHS and some specialties eg paediatrics and maternity are not always well covered in the private sector. Private hospitals don't usually have the same out of hours back up of services eg x ray, junior doctors, blood services so if you my frail elderly relation for example it would be unlikely that private health care would cover significant surgery and even if they did most doctors would not advise private sector surgery for this group of patients . You might feel that it would be better to save the money and pay for your private hip op when it comes along or you might like the security of knowing that if it comes to a chronic disease let's say Crohns or rheumatoid arthritis you could have regular appointments with a specialist of your choice that fit around your lifestyle and for which you don't have to pay.