Health insurance for a child with pending condition

[WhatTheEel]

Hello,

After several months of wondering and worrying and getting nowhere with my local GP (I am a huge advocate of the NHS, so believe me, I don't want to start bashing), I took my thirteen year old to a private paediatric endocrinologist who strongly suspects (as I have) Cushing's Syndrome. It has not been diagnosed. The consultant is starting with a cortisol urine test and an x-ray (I have paid out of pocket for the consultation and will pay as well out of pocket for the urine test... the x-ray I will ask our GP to order).

I would like to take out insurance. To repeat, a diagnosis has not been made and the tests have not yet been done. But if the diagnosis is Cushing's, we're looking at long-term treatment which would almost for certain involve a surgery to remove a pituitary tumour. I have to be prepared here and my family GP is ok for minor stuff but has proven to be rather disappointing with regards to the concerns I've had for my child, especially with regards to referrals.

I'd like to continue dealing with this consultant Paediatric endocrinologist at the Portland Hospital. But I can't continue to pay out of pocket. It's just not going to be managable.

I would like advice about health insurance for my child: What company is good/reliable, who offers more bang for buck, who is flexible, etc. Just any insight would be most appreciative. I've never had health insurance here in the UK, so it's all new to me.

Many thanks!

As your already getting tests done, its unlikely that an insurance company will cover your child. Its a possible pre diagnosed condition.
I would suggest but only in my experience, the specialist who diagnosed the problem might refer you back to the NHS. That was with spire/bupa hospitals.

It'll be pre-existing so you won't get cover for it and, in any case, health insurance doesn't cover long term conditions. If you already had the insurance, they'd pay for one or two appointments and then stop. I have just taken out insurance and there is a huge long form in which you'd have to declare all the recent appointments (with your GP and the consultant) and they would then exclude anything arising from them.

FWIW I think BUPA and PPP are rubbish, WPA and Pruhealth have a better reputation.

Sorry, it's the NHS or paying privately.

You are very very unlikely to get insurance, I'm sorry. Whilst you don't have a definitive diagnosis, you do have an extensive paper trail of symptoms and appointments; most insurers define "pre existing" as anything you have had investigated, or are in the process of doing so, even before diagnosis.

You could try a specialist broker, but it's very unlikely.

for example - from the WPA website:

^Your plan is not intended to cover the cost of medical conditions/symptoms and related conditions that arose before the start of the plan - these are called ´pre-existing conditions´ (unless declared to and agreed in writing by WPA under the underwriting terms outlined below). A related condition is one that is caused by, or could be the cause of, another condition.

To prevent customers from joining with the foreknowledge of a claim, your plan also does not cover any medical conditions/symptoms, whether diagnosed or not, which arise in the first 14 days of cover (90 days for cancer conditions - also referred to as deferment period). If you have private medical insurance with another insurer and this offers comparable cover we may be able to waive these 14 and 90 day deferment periods. Your plan does not cover the cost of all medical treatments and you should check your plan carefully so you know which treatments are covered, and any limits on this cover.^

Your child may not have an exact diagnosis, but the problem has certainly already arisen

damn italics fail! you get the point.

I would change GP to one recommend by other's.

Once you have a diagnosis a letter of complaint to the GP practice Manager about the lack of referral is a must. Quote the NICE guidelines etc and you may even get a refund.

Also once you have a diagnosis the NHS can't refuse you care.

you are v v v unlikely to get private insurance. you can continue to pay privately or just transfer to specialist paediatric nhs care. the gp wont have much involvement if it is a serious health condition. you might want to ask for recommendations for the best consultants/hospitals. hope your son is ok

You won't get a refund for private care from the NHS! complain if you feel the care was sub-standard but don't expect that to be the outcome. Pituitary tumours and Cushing's are pretty rare and sadly it isn't uncommon for there to be some delay with diagnosing rare conditions. Good luck to you and your child.