BUPA coverage - kids mental health or ASD diagnosis

[stillsleeptraining]

Has anyone got experience re what is and isn't covered? I had an experience a few years ago where we were legitimately covered but because I'd used the wrong words in the initial call they refused to cover us! It was so frustrating as they refused to go back on the initial decision even though the policy documentation was clear!

Self pay. There will be a clause for you to pay the first, say £500, total claim will be limited and it will also be time limited.

finally they won’t cover a pre existing condition

you can self fund expect cost of £300 a £400 an hour for a psychiatrist

Thanks @MH1111

Oh Christ, that's not cheap, is it!! Do you have any specifics from their policies about what is/isn't covered?

I have looked but can't work it out! I need the secret manual they don't release

Bupa only pay for assessment if the child's mental health is affected and on their medical records.

This is going back some years 2016, I had BUPA. They would not cover the first £500, max claim £2k. Three years maximum time limit then no more claims even if you hadn’t used the £2k.

things may have changed now but I can’t imagine it’s become more generous!

I see a psychiatrist monthly and I’m paying £350 inc vat.

no chance of seeing someone on the nhs

I have cover with my work. Check your policy certificate to see what’s covered, you can web chat and ask about your policy and your excess.

I think I have a separate mental health cover on mine, I’d have to check though and from memory, I don’t believe anything after diagnosis is covered because there isn’t a cure for ASD and Bupa are all about covering areas that help a member recover back to their previous good health. I’m really not sure so best to contact them.

They will not cover ASD diagnosis or related therapies/referral/medication . They will cover some investigations to ascertain whether symptoms that may be ASD or may be something else eg gad where symptoms can overlap or appear similar.

Some policies have mental health cover too which might help you .

My daughter had anxiety and the NHS mental health team also mentioned ASD as a possibility so Bupa agreed to cover us for investigations to see which it was. If she got referred to needing an ASD diagnosis (she didn't) our cover would have stopped. For a GAD diagnosis she could access the mental health therapies.

For a private ASD assessment you're talking a minimum of £700 and usually upwards of £1000 as of this year's prices. I've looked at a few places. It's a long and in-depth process that can't be done in an hour (no matter what the NHS paediatrician tried to pull on us earlier this year).

My DS got his psychiatrist through BUPA earlier this year (cover through work). They paid for the initial 6 sessions and he was prescribed his antidepressants.

Not sure if ASD is covered though sorry - we went through CAMHS with that. 3 years from referral to diagnosis!

We have just paid for a private diagnosis for my DC. Bupa would not cover it. Our policy does however fund 20 sessions with a child psychologist which we are using

When dd was ill, BUPA covered up to £500 on therapy sessions, psychiatrist consultations (she had quite a few), and day patient therapy. In-patient cover was provided but we didn't need that, probably because we could access a psychiatrist when she needed it. It did not cover ASD, ADHD or Dyspraxia Assessments.

This was nearly 10 years ago now and I think the level of cover varies with the policy. I am aware they also continually vary their t&c's from year to year.

They paid out about £7k I recall. We spent about abother £5k to £6k on assessments and talking therapy.

Once she was diagnosed with ADHD the local MH Trust did agree to put her under the ADHD Service but it took a fair bit of advocacy.