Health insurance

[Whathefisgoingon]

I took out health insurance a few months ago and on Monday I’ve got a dermatology appointment with a private consultant. Happy to pay out of pocket for the consultation but if I require any further investigations (biopsy etc) I’d potentially like to claim.

Can I contact my insurer after my appointment to find out if they’ll cover? Or do I need to involve them from the get go? I don’t want to speak to them right now as the consultation may well be the end of the matter.

You should contact them when you know what further tests you might need.

No - you need to involve them from the beginning. In order for them to cover anything you need a specific authorisation code to give to the hospital/clinic which they will only provide once you’ve contacted them re: the condition concerned. It’s unfortunately not as simple as booking to see a consultant etc and then asking them afterwards to cover it

@clipclop5 So I have to call them first thing tomorrow and explain I’ve got an appointment in the afternoon?

I’d realistically say your best bet is to rearrange the appointment. It normally takes at least a few days for claims to be approved. It took Bupa 3 whole weeks to approve a claim for teen DD last year

@clipclop5 3 weeks!?? That’s insanity. The whole reason we took it out in the first place was to avoid long waits!

Bupa have always given me the claim authorisation number onthe phone the first time I call up. I've never waited longer than 20 minutes!

@Magenta82 It’s Bupa I’m with, but never used it. Let’s hope I have a similar experience!

I'm with Bupa and I've been able to get authorisation code on the phone straight away
Ring tomorrow and get it.

Have you had a GP referral? My understanding of the private set up in the UK is that for most companies and most things you are required to have a GP referral to the specialist for it to be covered. Absolutely ridiculous set up and a complete waste of NHS time.

@TheTeenageYears this is true. I don’t believe it applies to dermatology though! Also, with my cover you have access to virtual GP’s who can do the referral for you.

Actually I do have a referral, but it’s the GP referring me within the NHS, so will take months.

Can I ask them for a copy of that tomorrow and use that as a referral for the insurance?

It depends on the level of cover you have. I have core cover so I pay for the initial consultants appointment then my insurance will pay for subsequent treatment. I did phone the company before seeing the orthopaedic consultant last month to make sure that the insurance would cover all the tests and scans as well as the necessary operation.

I needed a gp referral first, the consultant said without the referral, the insurance company would not pay his costs. In fact, as we agreed that I will weigh up my options before proceeding further, I will need another referral in the new year if I want to see the consultant again for the treatment.