Private medical insurance - when should I... - Endometriosis UK

Endometriosis UK

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Private medical insurance - when should I make a claim?

esperanza100
esperanza100

I have stage 3 endometrosis and recently I have experienced more pain. The doctors have asked me to consider surgery. This month I joined my company's private medical insurance scheme. The scheme has a clause that says that if you have a flair up of a medical condition you may be able to get private cover. Given the increased pain I have been feeling I would like to make a claim. Can someone tell me if it would be too soon for me to make a claim in April - 1 month after I joined the scheme?

*Context

I have suffered with endometriosis for 17 years - but I feel I was let down by the NHS doctors - and was only diagnosed 2 years ago when I went private. I had to pay for the operation myself because I didn't have private medical insurance at the time. After the operation I ran out of money so I went for check-ups on the NHS. However my last appointment in particular left me in tears and highly distressed because I believe the consultant I spoke to did not deal with my situation in a sympathetic and understanding way. This is one of the reasons why I want to try and go private.

Any advice you could give me would be most appreciated.

Thank you

8 Replies
oldestnewest

I went private through my work after the nhs kept cancelling my consultations and all I did was give them a call and asked if an endo laparoscopy with excision is covered and then the rest followed. I wouldn't delay it I'd just ring and ask if you would be able to do it :) and you'll get in pretty quickly, took me two weeks for a consultation and then two weeks after I was booked in for the lap. Oh and I would research the doctors of the hospitals you can choose from before you book anything in cos it's best to go with one who specialises in endo, some regular guarnatolgiests can miss it. Hope it all goes well x

esperanza100
esperanza100 in reply to C765

thank you v much for your encouragement. I appreciate it. In your experience do you think the fact that I just started on the insurance less than a month ago would make a difference?

C765
C765 in reply to esperanza100

I know people from my work who claimed after a few weeks and they were ok. I've even see people join cos they wanted to claim straight away. I would just ring up and try. :)

I went private with Bupa. Just give them a call and ask - group policies are usually far less restrictive than personal policies

esperanza100
esperanza100 in reply to Vixylix

thank you v much for your encouragement. I appreciate it. In your experience do you think the fact that I just started on the insurance less than a month ago would make a difference?

Vixylix
Vixylix in reply to esperanza100

I don’t think it should but it all depends on the conditions on your policy. I believe with my group policy I could claim immediately. Please don’t feel concerned about calling them - they’ll be able to tell you exactly what the correct procedure is, e.g. my bupa health care requires pre-authorisation to be able to claim but my old axa policy required a form to be completed. If you have your policy conditions booklet that should give you a lot of info.

It depends whether the policy excludes pre-existing conditions, and they usually exclude chronic conditions in terms of long-term monitoring, but as you say flare-ups, so short-term treatment, can be covered. Not trying to put you off just making you aware of the possible challenges. So have a look in your policy T&Cs for these things, and if still unsure as the others have said just ring up your insurer. Good luck x

thanks v much for your support

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