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.

DD had her prolactin blood test done as requested by gynaecologist. The gynaecologist was a private referral. As per AXA, any diagnostic requested by consultants are covered and are pre approved.
I am not sure about routine blood tests though as I get it through my NHS GP surgery.

I have used AXA PPP for years through a work scheme and they have been excellent. All the staff are lovely and the claim process is really straightforward. Would recommend.

Most PMI is to treat acute medical conditions. Think new symptoms, hysterectomies, heart conditions etc. A routine blood test would not usually fall under that umbrella. Acute exacerbations of chronic pre existing conditions are often covered, but not routine monitoring. I used to be a claims assessor for AXA. Most of the comprehensive schemes with medical history disregarded and low excesses are corporate schemes. We are now covered with Vitality through DPs job, but, as others have said, they will only cover treatment with certain consultants.

I've had private healthcare for years through work.
Being approved for treatment had always taken reems of evidence while they look for any possible way to get out of paying for it.
Treatment has been fine.
Treatment for children has been fine apart from, it's in an adult hospital so no toys etc. Just a hospital room.
My FIL had private health insurance his whole life and hardly ever used it. Was always in good health, no operations etc. When he started getting elderly and health started to decline, his insurance refused to cover him anymore and his policy couldn't be renewed.
My MIL also had private health insurance her whole life. Changed insurance providers, then after a year or so needed an operation. Operation wasn't covered because she'd seen a doctor before switching providers about something she thought unrelated and forgot to list it.

I have a doctor friend who does some private work. He says he much prefers seeing his private patients because there's hardly ever anything wrong with them

I used a broker called Usay Compare and they check annually for the best deal. First year was with The Exeter (well worth looking at because they are a mutual model) and second year with BUPA. Whoever you choose do be sure to review it regularly. I didn’t for a long while and my premium crept up and up.

Originally we were with Cigna and now Axa. Both are excellent. Axa also offer a private online clinician service anytime of the day. You can speak to a clinician online for advice and they refer you to a specialist if necessary.

My understanding is that some private hospitals do now have Intensive Care Wards, many set up during Covid when the NHS took over many private hospitals for their non Covid patients. I recently had knee replacement surgery at The Spire in Manchester and they are a centre of excellence for heart and cardiac care so do have an ICU ward. But their main focus is more routine surgery like orthopaedics.

My insurance is with AXA/PPA and if you are considering them, make sure you read the T and Cs very carefully. I was originally with a different insurance provider who were amalgamated with AXA/PPA about 15 years ago. I am on a basic Core level and had to pay for all my outpatient visits - seeing the consultant and any tests done. That cost me over £600! I was not covered for physio either so am currently paying privately, £60 a visit, for essential work after knee replacement surgery. Once surgery was agreed, I got a code from the consultant indicating what the operation was and then got the go ahead from AXA.

Unfortunately at 5.30 pm the day before my surgery, I got a phone call from the consultants secretary saying that the anaesthetist was not willing to do the surgery due to an issue with my heart picked up at a basic ECG at a pre op assessment. Fortunately, being a private patient, they had got me booked in to see a cardiologist consultant at 830am the following day. I was given a longer echo cardio gram which luckily showed nothing that would affect an operation so I was able to be admitted and the surgery took place that afternoon. That cost me another £900 as I was classed as an outpatient and the procedure had not been approved by my insurance company.

So all in all, a rather expensive experience but I did get two nights in my own
en suite room instead of one night on a ward under the NHS! I also had my own nurse assigned to look after me.

The excess for me was only £100 but I might look into getting a higher one to reduce my monthly payments when I renew. That covers me for any claims within 12 months so I’ll be sure to get my second knee replaced later this year! I might not need to pay for a consultants visit as we are going to look at dates when I see him next week for my six week check. I’m also hoping I won’t have to have more X-rays as both knees were X-rayed just a few months ago.

The problem I had when comparing different providers as that most will not include pre existing conditions so my knee problems and osteoarthritis would be excluded. I knew I needed both knees replacing and hips are fairly common operations in people my age so I had to stay with my existing company, AXA/PPA in order to be covered

I've got Benenden Healthcare. Have a look at it, I've used it a few times, one being a full hysterectomy at a Spire Hospital.

I was referred and had the operation within 5 weeks. I ended up staying in 7 days as I was quite poorly and it was all covered.

I've used AXA for fifteen years. Zero complaints. I'm referred to the Spire by choice. Have been able to choose preferred consultants, clinics and hospitals. It's all run very smoothly up to now.

These are all so helpful comments, thank you so much. I hasn’t considered using a broker - that might be a sensible option as a first step as I’ve already had follow up calls from providers following some online quotes. Thank you everyone, this exactly what I was hoping for so thank you for sharing.

We as a family have been with AXA for over 25 years, we’ve found them great to deal with, they were particularly helpful when my DH had a heart attack early on in Covid. They gave me a personal advisor to deal with who was great. DH needed a triple heart bypass and all private hospitals were passed over to the NHS at the time, but somehow AXA and the NHS staff managed to get my DH into a private hospital to wait for his procedure to take place. Everything was covered apart from medication that he came home with. I had my gallbladder removed last year, didn’t have to speak to anyone at AXA, all sorted through account. Yes, it’s expensive, we’ve now only got cover for inpatient and have a £1000 excess, but I can say we’ve been happy with their care. I did contact a broker once, who was aggressively selling a policy that we didn’t want, was no cheaper than existing and obviously didn’t cover existing illnesses.

I was happy with service at AXA just couldn't afford the premiums. You will still need a referral letter from your GP and use a consultant from their list. I have three private hospitals near me, so it was quite handy. Used them for urology, gynae, nephrology, DVT/vascular, eye issues.

Some NHS GPs won't even take on other NHS prescriptions.

I have claimed once on private health insurance organised through work and it was Axa - they were fine.

I had one year's personal insurance with Vitality, I didn't have to claim and got platinum status and they still put my premiums up. Fortunately I changed jobs and got cover through work again.

I am now with Bupa and have used their GP/nurse service once but also made a claim but I didn't need it in the end because the NHS did it.