Tell me about private health insurance and private urgent care

[Runningupthehillagain]

After several issues this year, most recently over the weekend, we are now looking at private health insurance.

I’m not so much concerned about premiums but I want a provider with excellent service and cover when it most matters. Would love to hear personal experience and recommendations.

Private insurance doesn't cover A&E or emergency care. Private hospitals don't offer those services.

In an emergency you are reliant on the NHS. If you subsequently require hospital care or other treatments then your insurance provider can kick in and arrange those treatments.

What Erin said. It’s really “only” good for planned treatment - chronic diseases are also usually excluded from the point of diagnosis. Sone schemes may offer a certain annual amount to spend on chronic illness, but that varies.
Pre-existing conditions are also generally excluded.

One thing to consider is outpatient cover, which is usually offered at multiple levels. This covers things like consultant appointments, “simple” tests such as x-rays or blood tests etc.

Provider-wise, I’ve had Bupa and was happy, now got WPA and also very happy. Both were / are work schemes though and I understand they’re usually “easier” as pre-existing conditions aren’t excluded, which takes away a lot of the pain.

Some private hospitals now have urgent treatment centres, but anything serious and they'll call you an ambulance to a NHS A&E

Private hospitals do have urgent care. There’s some in London, Manchester and Birmingham that I know of. I expect there are others.

You can be seen and admitted for various things although not all private insurances cover this.

Theyre not for things like stokes, blood clots or heart attacks though. Urgent but not immediately life threatening.

Could you share your experience of which provider you use?

I’ve been considering WPA - how are they when making claims? Whats their customer service like?

Can you share your experience with your provider?

Are you happy to share your experience with your provider? Thanks

We used to be with Bupa and then switched to Axa. No claims with Axa yet fortunately and Bupa were fine for the small claims we had. No pre-existing illnesses were allowed when we took it out. They even excluded infantile wheezing from my then 16 yr old daughter. The standard PMI policies don’t cover emergency care and I see them as “jump the queue” cover if any of us get anything serious that might have a big waiting time on the NHS. We also have a £500 excess per person per year to keep the premium down and this means we only really see it as emergency cover. If I need physio for example, I’ll probable be able to get a course of that on the NHS or privately for less than £500z

Most insurance companies will only cover the cost of emergency care if you then have to be admitted. It’s also worth noting that most private hospitals do not have ICU or HDU. This means that for serious conditions they cannot operate on you. In London, only the central hospitals do - London Clinic, Wellington etc. And being covered for these puts up the premium dramatically. I also know that the private hospitals in the Newcastle area are the same.

I’ve had insurance with Bupa an Vitality, both fine, straightforward

however please remember that as a personal individual applying for Private med insurance you will have to either 1- declare all pre existing conditions and these may be excluded (most likely) by underwriters or 2- have a moratorium clause where anything pre existing won’t be covered until you have had so many years free of medical treatment advice or medication even over the counter

medical history disregarded isnt available to new personal clients at vitality, some providers may insure it and it is extremely expensive as it’s clear your taking it out to cover something not as a just in case,

urgent care centres, yes there are some across the country but med insurance doesn’t cover these costs, as it covers something pre planned and pre authorised only

Most insurance companies cover the cost of emergency care after your admitted and AFTER you have been stabilised for a set number of days

We have private health insurance through employer and it is through AXA. For urgent care we still need to use NHS. For everything else, it’s great. It include all pre existing conditions. Process is simple - for GP we have doctor care anywhere and for consultants the referral is given same day using the service. A GP appointment is usually same day within an hour.
AXA usually gets back within 2-3 days for consultant referral with 3-4 options and we book our own appointments. There are usually a lot of appointments available and mostly within a week.
As for tests, DD had an ultrasound and MRI and DH had an MRI. All paid for by insurance without issues. We do have to pay an excess of £125 once per year per person but only if we go to a consultant.

Depends what you mean by urgent care. Accident or acute medical emergency would be at nhs hospital as would any excluded conditions. Some have private wards and units attached. Referrals for outpatients, treatment or scans could be private and usually much quicker. Many policies pay a daily rate for using nhs inpatient care if admitted for a covered condition.

Can you share who you use and your experience with them? Thanks

Assuming UK, for urgent care I believe you’re processed through NHS. Private healthcare is mostly elective. If you go ahead remember that pre-existing conditions are generally not covered by policy.

I’ve never had to claim yet but am with WPA as it’s the one Which recommended.

Two friends in thirties and 40s with different types of cancer were with Bupa and Axa respectively and had excellent experiences. Everything provided down to taxis to and from the chemo clinic (rural and over 45 min drive).

It’s worth it in my opinion - I see it as the cost of lunch in a gastropub a month to not add to the stress of potentially being diagnosed with a life threatening illness. Friends with NHS cancer care have been a lot more uncomfortable. Alive and grateful, but also saying “get fucking health insurance if you don’t have it - I wish I had.”

Thank you. This is very helpful. Having access to a GP would be amazing! at the moment I’m only ever to get an appointment with a nurse practitioner.

Can I ask, do they do routine blood tests? Again, our local trust’s Phlebotomy have been on strike for almost a year and appointments at the GP have to be booked four weeks in advance (and then you’ll find the GP surgery will “misplace” the blood sample; and then refuse to take any more as “they can’t read the writing on the form”!) Yes, one blood test has taken almost three months to complete.

Can you please share who your provider is and your experience?

BUPA policy, 2 Spire Healthcare Hospitals nearby. I’ve attended for gynaecology issues (end result was radical hysterectomy), an eye issue (ongoing), dental care (ongoing). No issues…did have free cover with work but now retired I pay monthly.

You should have access to a gp service which may order bloods. Check which hospitals are in nearby and which providers use them. Some services may not be offered everywhere, our local one does not have a mri scanner for example, the next one is a 20/30 minute drive away,

I'm with Axa, only made one claim and it was easy enough and dealt with quickly. I had cancer and didn't use PMI, the NHS had me on a fast track so there was no benefit to using PMI.

I think you need to shop around.

A simple google/ AI search will bring up the main ones in the UK.

Look at their websites and give some basic info about yourself and get a quote.
IT IS VERY IMPORTANT TO READ ALL THE SMALL PRINT IN THE POLICY BEFORE YOU DECIDE.

There is a variation and I've heard that Vitality won't cover any consultant of your choice, only ones they have on their lists . (Although they all check out consultants before they agree to pay up.)

We've had private insurance for 40 years through work then paying for it in retirement.

I pay just under £2K pa. I'm late 60s. A few years back it was only £75 a month.
The premiums have all risen lately as more and more people are turning to private insurance.

For my cover, I get access to premium London hospitals, unlimited amounts for serious illnesses, but I didn't include dental cover which offset the cost of premium London hospitals.

@Runningupthehillagain You cannot demand something like a blood test. or any test.

The way it works is that you first get a GP referral to a consultant. If the consultant suggests tests, you then ask the provider if they are happy to cover it.

Many of the insurers now have GPs you can access by phone or video and rather than waiting to see your own GP they can (if they think it's necessary) refer you to a consultant (who you choose.)

Insurance does not cover chronic or existing conditions. Usually you have to wait for 2 years (or longer) to be covered for an existing condition that may be in remission.

@Runningupthehillagain This has a lot of info and summary views from hundreds of people:
https://www.which.co.uk/money/insurance/health-insurance/get-the-best-private-health-insurance-a2BPc9a7R62E