Health Insurance

[terminal7]

Not sure whether this subject should be here or under a financial topic.

Anyway here goes - the OH and I have had BUPA for a number of years. Most years we have not claimed or did not reach the excess of £500 pp. Nevertheless, the premiums have unsurprisingly increased every year. Naturally some of this must be an actuarial/age related health calculation and some inflationary pressures. The latest premium hike now take us well into five figure territory. It would appear that we can get similar cover with Vitality (incl travel insurance - chopped by BUPA a few years ago).

Has anyone experience of Vitality or any other health care insurer? Vitality is offering about a 10% discount to the BUPA rate with the same excess - a saving above £1k pa.

T7

[DrFfybes]

MrsF had BUPA, it crept up over the years but "It was worth it as it paid for the physio". Adding and excess, reducing the cover, etc did bring it down from the ridiculous £250/MONTH it had crept up to unobserved by my accountant wife(!) but it soon was back over £100/month. The main driver for keeping it was the cost of her mum's private knee and hip ops.

After pouring circa £40-50k down the drain since we got married, I persuaded her to cancel it a couple of years ago. Since then she has had foot and back issues, and paid for private MRIs, Xrays, and treatment. I did some sums and realised that at her last premium of £140/month we were still several grand in profit. Her latest MRI was actually last weds but on the NHS, 5 weeks after the referral so waiting times have come down massively.

So basically, like many similar things, if you can take a large hit in the first couple of years whilst you let the premiums build up as a war chest then I really wouldn't bother. We don't insure the dog (at 15 years old the monthly premiums were almost the same as replacing her from the RSPCA), and I have a friend who is nearly £20k down paying McLaren for their extended warranty.

Paul

[Dod101]

MrsF had BUPA, it crept up over the years but "It was worth it as it paid for the physio". Adding and excess, reducing the cover, etc did bring it down from the ridiculous £250/MONTH it had crept up to unobserved by my accountant wife(!) but it soon was back over £100/month. The main driver for keeping it was the cost of her mum's private knee and hip ops.

After pouring circa £40-50k down the drain since we got married, I persuaded her to cancel it a couple of years ago. Since then she has had foot and back issues, and paid for private MRIs, Xrays, and treatment. I did some sums and realised that at her last premium of £140/month we were still several grand in profit. Her latest MRI was actually last weds but on the NHS, 5 weeks after the referral so waiting times have come down massively.

So basically, like many similar things, if you can take a large hit in the first couple of years whilst you let the premiums build up as a war chest then I really wouldn't bother. We don't insure the dog (at 15 years old the monthly premiums were almost the same as replacing her from the RSPCA), and I have a friend who is nearly £20k down paying McLaren for their extended warranty.

Paul

I gave up on private health insurance many years ago and a bit like boiler insurance I do not know why people pay the premiums. I have not needed any health attention until this last year and got MRI scans and the like via the NHS with very little delay. I have had two hip replacements on he NHS and again without any significant delay but I would pay if I felt I had to.

Dod

[yorkshirelad1]

Not sure whether this subject should be here or under a financial topic.

Anyway here goes - the OH and I have had BUPA for a number of years. Most years we have not claimed or did not reach the excess of £500 pp. Nevertheless, the premiums have unsurprisingly increased every year. Naturally some of this must be an actuarial/age related health calculation and some inflationary pressures. The latest premium hike now take us well into five figure territory. It would appear that we can get similar cover with Vitality (incl travel insurance - chopped by BUPA a few years ago).

Has anyone experience of Vitality or any other health care insurer? Vitality is offering about a 10% discount to the BUPA rate with the same excess - a saving above £1k pa.

T7

The most recent Which? magazine (Sept 2022) has an article on Private Healthcare
https://www.which.co.uk/news/article/private-health-is-it-worth-it-aZVlM1g7rTBP (probably paywalled)
(I have no connection with Which other than as a subscriber)

[BullDog]

I self insure. I think I'm ahead financially, but I don't really think about it. If I need to spend money on new new knees or hips etc in the next decade or so, so be it. I won't sit around in pain waiting for a couple of years. Life's literally too short for that.

[bungeejumper]

I dropped my BUPA membership about two years ago, after my monthly premiums hit £260 (aged 71), and I haven't regretted it yet, touch wood.

I did try haggling for a lower premium, but the remarkably pleasant customer service woman was making it clear that sadly she had no space for negotiation, and even increasing my excess from £200 to the maximum £500 would only make about £12 a month of difference to my premium. So it was thanks, but no thanks, and we parted amicably.

It did, however, force me to do some serious thinking about my changing needs. I'd started with BUPA aged about 40, when a self-employed person with no company sickness scheme would have felt a bit exposed without some sort of fast-track route to treatment. But as a retiree, that argument no longer made much sense.

Well, almost. During those thirty-odd years I'd had a stage one cancer which had been promptly and expertly removed by a fantastic NHS. But I can count myself lucky that I hadn't had the cancer during lockdown, when the many months of waiting for appointments would have shredded my nerves completely. I'd have been claiming on the insurance cover, no question.

Against that, at 71, I was lucky enough to have a decent financial cushion in the form of an adequate DC pension fund, plus a nice home that would have allowed plenty of scope for finding quick funding, should it ever have become necessary. And the kids were well launched and were/are both earning far more than I ever did. I've set up a trust for our granddaughter which should ease her path through college, but otherwise we wouldn't wince if we have to spend our money on health and welfare, instead of leaving it all to them when we croak. That's just how the cookie crumbles. And that's what capital is for, is it not?

Others might not be in quite such a favourable position, but those are the kinds of questions that informed our decision. A minor concern is that it'll cost me a lot more for travel insurance now that I've got a cancer tag on my health record for the rest of my life (you never lose it), but hey, I reckon we can deal with that hurdle.

BJ

[Laughton]

We use National Friendly and have done for a number of years. They seem to operate aslightly differently from most others. For instance they have separate policies for out patient and in patient cover (we have both). Our policies give in patient cover for up to £1M per year and tht re-sets to £1M per year at each anniversary.

We've been with many of the others (I can't even remember all the names). National Friendly was a LOT cheaper than the other offerings at the time we moved. So far, we've not had any problems making claims (1 major each in the past 6 or 7 years).

This is not really a recommendation - you need to check to see if what they offer suits you. They are not well known.

https://nationalfriendly.co.uk

[Steveam]

I’ve self insured since I retired 20 years ago. The NHS has its ups and downs as we all know. For emergencies there really is little/no alternative. I’d probably be fine with NHS for knees/hips etc and I’ve recently used the NHS for a short course of organ specific chemotherapy. [I was having some urine issues, contacted my GP who said he’d refer me to a consultant but to expect 6-8 weeks, decided to go privately and saw consultant and had ultrasounds, scans, cystoscopy, ablation, blue-light cystoscopy. Consultant then said I’d need chemotherapy and I asked about transferring to the NHS - under the same consultant and for the same treatment and he said yes - I think moving to the NHS delayed the start of treatment by about three weeks. The private part of this treatment was about £15k]. Treatment has gone well and I can’t fault the mix and match approach I was able to use - I was able to get a clear and early diagnosis very quickly by going privately.

A few years ago (beginning of Covid) I started having dreadful headaches tried the GP and got nowhere so got my self a referral to a consultant. I think she was very good but there were blood tests, scans, more blood tests, referrals to other consultants, yet more scans and further blood tests, consultations with other consultants, a short hospital stay (£800 per night++ I’ve stayed in worse hotels) and endless costly private prescriptions which were delivered to my door at astronomical costs. I admit that I was desperate and ignored the costs but the whole thing was a nightmare and the final cost was just over £50k. Was it worth it? I seem to have recovered - I was eventually on very strong antivirals and painkillers - and the diagnosis was never certain. Much of the cost was in ruling things out (two different brain scans to establish that there didn’t seem to be anything wrong except old age). The consultants I saw were a consultant GP (I was back and forth once or twice a month for 12 months £400 per visit), neurologist twice, virologist, oncologist … the coordination was nonexistent - it was prima donnas rather than a team. I, desperately I’ll as I was, had to chase up appointments and coordinate specialists via their secretaries - and the bills had to be paid before the appointment. The whole thing was a nightmare. I contrast this with a friend who has had serious cancer which had spread - his treatment has been superb and well coordinated across departments and specialists and he’s had ONE point of contact - his cancer nurse.

Overall, given that you can afford it, I’d mix and match private and the NHS.

Going back to the original question about insurance. My sister and brother-in-law had health insurance for many, many years. They made a relatively small claim in their mid 70s and their ongoing renewal premiums became insurmountable. OTOH I have a friend diagnosed with cancer and she has had excellent private care and it’s ongoing and seen as one event so covered.

To quote Bette Davis: Old age ain’t for sissies.

Best wishes, Steve

[Dod101]

I’ve self insured since I retired 20 years ago. The NHS has its ups and downs as we all know. For emergencies there really is little/no alternative. I’d probably be fine with NHS for knees/hips etc and I’ve recently used the NHS for a short course of organ specific chemotherapy. [I was having some urine issues, contacted my GP who said he’d refer me to a consultant but to expect 6-8 weeks, decided to go privately and saw consultant and had ultrasounds, scans, cystoscopy, ablation, blue-light cystoscopy. Consultant then said I’d need chemotherapy and I asked about transferring to the NHS - under the same consultant and for the same treatment and he said yes - I think moving to the NHS delayed the start of treatment by about three weeks. The private part of this treatment was about £15k]. Treatment has gone well and I can’t fault the mix and match approach I was able to use - I was able to get a clear and early diagnosis very quickly by going privately.

A few years ago (beginning of Covid) I started having dreadful headaches tried the GP and got nowhere so got my self a referral to a consultant. I think she was very good but there were blood tests, scans, more blood tests, referrals to other consultants, yet more scans and further blood tests, consultations with other consultants, a short hospital stay (£800 per night++ I’ve stayed in worse hotels) and endless costly private prescriptions which were delivered to my door at astronomical costs. I admit that I was desperate and ignored the costs but the whole thing was a nightmare and the final cost was just over £50k. Was it worth it? I seem to have recovered - I was eventually on very strong antivirals and painkillers - and the diagnosis was never certain. Much of the cost was in ruling things out (two different brain scans to establish that there didn’t seem to be anything wrong except old age). The consultants I saw were a consultant GP (I was back and forth once or twice a month for 12 months £400 per visit), neurologist twice, virologist, oncologist … the coordination was nonexistent - it was prima donnas rather than a team. I, desperately I’ll as I was, had to chase up appointments and coordinate specialists via their secretaries - and the bills had to be paid before the appointment. The whole thing was a nightmare. I contrast this with a friend who has had serious cancer which had spread - his treatment has been superb and well coordinated across departments and specialists and he’s had ONE point of contact - his cancer nurse.

Overall, given that you can afford it, I’d mix and match private and the NHS.

Going back to the original question about insurance. My sister and brother-in-law had health insurance for many, many years. They made a relatively small claim in their mid 70s and their ongoing renewal premiums became insurmountable. OTOH I have a friend diagnosed with cancer and she has had excellent private care and it’s ongoing and seen as one event so covered.

To quote Bette Davis: Old age ain’t for sissies.

Best wishes, Steve

I must be very fortunate where I live because I would I am quite sure have got all these investigations from the NHS with little delay judging by my recent and ongoing experience with the NHS. I always have the suspicion with private treatment that it is great for specific stuff like say a hip replacement. They can quote a price ahead of the op and you then get what you pay for. OTOH for non specific investigation, wow, that is where the private consultants come into their own. Open ended costs for both sides and no incentive whatever for the consultants to do other than a 'thorough' investigation. You could have had a lot of ops for £50,000! I would have thrown myself at the mercy of the NHS.

I doubt that a private health insurer would have allowed costs to get so out of hand and they would probably have reached the same (inconclusive) result much more cheaply. Your prima donnas would I think have been kept in check.

Dod

[mc2fool]

A few years ago (beginning of Covid) I started having dreadful headaches tried the GP and got nowhere so got my self a referral to a consultant. ... I seem to have recovered - I was eventually on very strong antivirals and painkillers - and the diagnosis was never certain.

OT, but does this look familiar? https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-019-1022-z

[Steveam]

I’ve self insured since I retired 20 years ago. The NHS has its ups and downs as we all know. For emergencies there really is little/no alternative. I’d probably be fine with NHS for knees/hips etc and I’ve recently used the NHS for a short course of organ specific chemotherapy. [I was having some urine issues, contacted my GP who said he’d refer me to a consultant but to expect 6-8 weeks, decided to go privately and saw consultant and had ultrasounds, scans, cystoscopy, ablation, blue-light cystoscopy. Consultant then said I’d need chemotherapy and I asked about transferring to the NHS - under the same consultant and for the same treatment and he said yes - I think moving to the NHS delayed the start of treatment by about three weeks. The private part of this treatment was about £15k]. Treatment has gone well and I can’t fault the mix and match approach I was able to use - I was able to get a clear and early diagnosis very quickly by going privately.

A few years ago (beginning of Covid) I started having dreadful headaches tried the GP and got nowhere so got my self a referral to a consultant. I think she was very good but there were blood tests, scans, more blood tests, referrals to other consultants, yet more scans and further blood tests, consultations with other consultants, a short hospital stay (£800 per night++ I’ve stayed in worse hotels) and endless costly private prescriptions which were delivered to my door at astronomical costs. I admit that I was desperate and ignored the costs but the whole thing was a nightmare and the final cost was just over £50k. Was it worth it? I seem to have recovered - I was eventually on very strong antivirals and painkillers - and the diagnosis was never certain. Much of the cost was in ruling things out (two different brain scans to establish that there didn’t seem to be anything wrong except old age). The consultants I saw were a consultant GP (I was back and forth once or twice a month for 12 months £400 per visit), neurologist twice, virologist, oncologist … the coordination was nonexistent - it was prima donnas rather than a team. I, desperately I’ll as I was, had to chase up appointments and coordinate specialists via their secretaries - and the bills had to be paid before the appointment. The whole thing was a nightmare. I contrast this with a friend who has had serious cancer which had spread - his treatment has been superb and well coordinated across departments and specialists and he’s had ONE point of contact - his cancer nurse.

Overall, given that you can afford it, I’d mix and match private and the NHS.

Going back to the original question about insurance. My sister and brother-in-law had health insurance for many, many years. They made a relatively small claim in their mid 70s and their ongoing renewal premiums became insurmountable. OTOH I have a friend diagnosed with cancer and she has had excellent private care and it’s ongoing and seen as one event so covered.

To quote Bette Davis: Old age ain’t for sissies.

Best wishes, Steve

I must be very fortunate where I live because I would I am quite sure have got all these investigations from the NHS with little delay judging by my recent and ongoing experience with the NHS. I always have the suspicion with private treatment that it is great for specific stuff like say a hip replacement. They can quote a price ahead of the op and you then get what you pay for. OTOH for non specific investigation, wow, that is where the private consultants come into their own. Open ended costs for both sides and no incentive whatever for the consultants to do other than a 'thorough' investigation. You could have had a lot of ops for £50,000! I would have thrown myself at the mercy of the NHS.

I doubt that a private health insurer would have allowed costs to get so out of hand and they would probably have reached the same (inconclusive) result much more cheaply. Your prima donnas would I think have been kept in check.

Dod

Hi Dod, I think you’re right about an insurer controlling the costs much better but I really was desperate. I ended up in A&E on two occasions to be told that they really couldn’t do anything further. With shame I can admit to crying when the ambulance arrived to take me to A&E when the ambulance man said something like “we’ll help you get through this”. I dreaded the weekends as my private consultant wouldn’t be available. On a number of occasions I was sat in a chair thinking about how to end things - suicide was a very real possibility. In this context the money was an irrelevance - I’m shocked at how upsetting it is to even recall that time. I pleaded with my GP to do something/anything and I got a referral to a headache clinic: likely wait 12 weeks. I’d have given half my kingdom for a cure

I think that the private sector comes into its own for specific and clear procedures (hips, knees, cataracts [where you can get lenses not available on the NHS]) but fails where there’s no clear diagnosis. The private sector also works well for getting diagnostic tests done early.

Best wishes, Steve

[Steveam]

A few years ago (beginning of Covid) I started having dreadful headaches tried the GP and got nowhere so got my self a referral to a consultant. ... I seem to have recovered - I was eventually on very strong antivirals and painkillers - and the diagnosis was never certain.

OT, but does this look familiar? https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-019-1022-z

Thank you mc2fool, The headaches don’t have the characteristics described. After unbelievably thorough tests the only thing found was a very high level of EBV (Epstein-Barr Virus) which is essentially glandular fever recurrence. Recent research is showing some links between EBV and MS. EBV is self limiting so I’d have got better regardless but there was never certainty about the diagnosis.

I’m sorry that I seem to have taken this rather a long way from the insurance issue of the OP.

Best wishes, Steve

[Dod101]

I must be very fortunate where I live because I would I am quite sure have got all these investigations from the NHS with little delay judging by my recent and ongoing experience with the NHS. I always have the suspicion with private treatment that it is great for specific stuff like say a hip replacement. They can quote a price ahead of the op and you then get what you pay for. OTOH for non specific investigation, wow, that is where the private consultants come into their own. Open ended costs for both sides and no incentive whatever for the consultants to do other than a 'thorough' investigation. You could have had a lot of ops for £50,000! I would have thrown myself at the mercy of the NHS.

I doubt that a private health insurer would have allowed costs to get so out of hand and they would probably have reached the same (inconclusive) result much more cheaply. Your prima donnas would I think have been kept in check.

Dod

Hi Dod, I think you’re right about an insurer controlling the costs much better but I really was desperate. I ended up in A&E on two occasions to be told that they really couldn’t do anything further. With shame I can admit to crying when the ambulance arrived to take me to A&E when the ambulance man said something like “we’ll help you get through this”. I dreaded the weekends as my private consultant wouldn’t be available. On a number of occasions I was sat in a chair thinking about how to end things - suicide was a very real possibility. In this context the money was an irrelevance - I’m shocked at how upsetting it is to even recall that time. I pleaded with my GP to do something/anything and I got a referral to a headache clinic: likely wait 12 weeks. I’d have given half my kingdom for a cure

I think that the private sector comes into its own for specific and clear procedures (hips, knees, cataracts [where you can get lenses not available on the NHS]) but fails where there’s no clear diagnosis. The private sector also works well for getting diagnostic tests done early.

Best wishes, Steve

I am really sorry to hear of your troubles. None of us could possibly know how we would have handled that sort of situation and to say anything more does not seem right. I hope that things have settled down now and that there is no recurrence.

Dod

[mc2fool]

OT, but does this look familiar? https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-019-1022-z

Thank you mc2fool, The headaches don’t have the characteristics described. After unbelievably thorough tests the only thing found was a very high level of EBV (Epstein-Barr Virus) which is essentially glandular fever recurrence. Recent research is showing some links between EBV and MS. EBV is self limiting so I’d have got better regardless but there was never certainty about the diagnosis.

I’m sorry that I seem to have taken this rather a long way from the insurance issue of the OP.

Best wishes, Steve

Ok, well as you might have guessed, I've had a couple of bouts of NDPH, the first several lasting months and the most recent over three years (gone now), so was just wondering if we were in the same boat. But as we agree, that's OT so let's wrap up that diversion now.

However, I think the observation from your experience that private is probably better for "fixed price" health matters and NHS for could-be-indefinite ones is a very interesting one.

[stewamax]

I use BUPA, but contain the cost by electing for a £2000 pa excess since the scheme I am on generally doesn't cover outpatient treatment anyway.