Health insurance: I am looking I to getting some... - Headway

Headway

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Health insurance

ored13 profile image
18 Replies

I am looking I to getting some private health insurance (because I have lost a lot of faith in the NHS over the past few months) and worry that my husband won't get the Cate and rehabilitation he needs when he is discharged in the future. Any suggestions or thoughts. Would him having a recently acquired brain injury impact on our ability to get insurance?

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ored13 profile image
ored13
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Purpleclax profile image
Purpleclax

I have a left hemiplegia and am insured with bupa. Brilliant treatment mri arranged in 4 days results 3 days later.

Painting-girl profile image
Painting-girl

Hi Ored, it could make the insurance very expensive, or the insurers could seek to exclude treatment for your husband's BI. (Insurers probably won't cover pre-existing conditions.)

The really big problem with medical insurance is that it is only really geared to quick acute treatment, so once the insurer has decided a condition is chronic, they will then refuse to cover any further treatment - these decisions are quite arbitrary too, by the way. Once they decide that treatment is actually rehabilitation they will stop funding you.

The other issue for those of us wanting cover for brain injuries - the best people to go to are usually neuropsychiatrists and neuropsychologists. Even though you are getting treatment for a brain injury, these consultants are often classed as part of the 'psychiatric' part of your medical cover - which is likely to have an annual cost limit on it (even if it is included in the policy - sometimes it is just an optional add-on). I actually think this is very unfair to people with BI.

Also, like many insurances, once you claim on them, the premium goes up each year (it can actually sometimes be beneficial to cancel and take out a new policy each year because of this - but don't ever cancel an insurance policy without getting the new one in place first). I had been using the insurance my company paid for for my MTBI treatment When my employment was ended last year, the insurers offered me the chance to swap it into a personal policy - at the whopping cost of £800 plus a month! And any 'rehab' would still not be covered 😱 At those costs it is much cheaper to pay as I go.

For an Idea of medical bills, I had a very good Central London (i e. very expensive) neuropsychiatrist at £150 for 30 minutes, and a local neuropsychologist who does BI rehab in the local NHS trust for £90 for 50 minutes, and a brilliant central London concussion specialist physio for £80 for 30 minutes. So I did rack up a lot of bills on the insurance policy before they pulled the funding.

However I also spent a lot of my own money because of the policy excess on each claim, and when the policy cap on psychiatric cover kicked in each year - so it's not a cost free option. I haven't tallied it up, but think that roughly the insurance policy pays about half your medical costs on average.

I'm not putting these numbers in to brag, and I know they won't be affordable for most people. I was just lucky to be in the right job at the time. If anything, it demonstrates how battling the NHS for treatment is a viable option.

I've been noticing comments here about serious BI falling through the cracks on the NHS, I'm not so sure that mild TBI gets much, if any, help from the NHS -but would love to know if anyone has a different experience with concussion / MTBI?

Ored, if you still want to look into it, your best bet to research the market would be to ask an independent financial adviser, who can research the whole market quite quickly for you so that you can see whether it is affordable or not. Some insurers cover different conditions more thoroughly than others - so it is worth shopping around and reading the small print - a good IFA wiill help with this - and frequently take commission from the provider, rather than bill you direct. Any recommendation from them should explain clearly in their (probably rather long winded) letter to you, why the conditions covered are particularly useful to you. Don't buy any policy until you have received this 'suitability report' and if you don't recognise your requirements that you've asked about, don't commit either. Sadly not all advisers are created equal. Chartered independent financial advisors will have trained to degree level during their working life, and are a safer bet. ( If the advisor is 'tied' they will only recommend companies that they work with all the time ).

Everyone will be bored to tears reading this post!!! Sorry!!! 🤣

Jen x

Lollipopslife profile image
Lollipopslife in reply to Painting-girl

Hello Ored, I wish I could be of help- I hope you find a solution. I got ABI 15 years ago (in a coma etc) but I have fallen through the cracks with the NHS. In fact, I am sure my record is not complete and I am now fed up that I Dont even know where to begin. I only just decided now to change my GP, look for for a private neurologist etc. But then, do think things through properly and I think your husband is lucky because he will have you contacting the NHS to fight for his needs . I have found that it helps to have someone speaking for you -good luck

ored13 profile image
ored13 in reply to Lollipopslife

Yes there seems to be this constant need to battle it out. It's exhausting. This group is pretty helpful with those like you giving those who are new advice and the odd warning which is so important and thank you.

Lollipopslife profile image
Lollipopslife in reply to Painting-girl

Hello Painting -girl, I am wondering if you could give more info on the medical professionals you mentioned in your post, please. I have been considering private consultations for a long time now (just to speak to a professional and get an up to date info/care of my condition, symptoms etc) - I am completely fed up with NHS and I GP Dont listen each time I ask them to refer me to a neurologist 🤷🏽‍♀️ and I dont have anyone to speak for me.

Painting-girl profile image
Painting-girl in reply to Lollipopslife

So sorry to hear that Lollipopslife.

A neurologist would probably be a good place to start. Part of their remit is to refer you on for other treatments.

I had concussion - so not the same as you - so other specialist neurologists might be better for you? They seem to work with teams of people on rehab.

Happy to help, but if it was me, I would talk to Headway in confidence first about what specialist might help you - and what would be the best direction to go in first - then you still need a referral from your GP for the consultants, whether they are private or not. You can't just go direct to a consultant neurologist or neuropsychiatrist yourself.

My first neurologist referred me onto the second one - but I remember him saying that one choice of another neurologist to help me with long lasting effects after concussion, actually only did NHS patients.

Did you see a neurologist originally? Can you ask the GP to refer you back to them?

The concussion physio was

puresportsmed.com/team/theo...

And you can find a neuropsychologist near you on bps.org.uk - the British psychological society - I went for someone chartered who was doing BI rehab in the local hospital trust, and she's been great for where I was at that point..

Neurologist number 2 was

drcockerell.co.uk/contact.h...

I've only seen him once before he referred me on. But he doesn't seem to specialise in your injury - so I don't know how much help he would be-(and he was expensive)

But as you can see you have to go via your GP. So suggest you talk to Headway, then armed with that info, go to your GP for the referral.

It wouldn't be good to spend your money on someone who doesn't specifically specialise in ABI

Jen 🌸

Lollipopslife profile image
Lollipopslife in reply to Painting-girl

Thanks for your detailed reply Painting-girl. Funny enough, I do know Dr Cockrell and another reputable neurologist but thanks to the NHS/GP’s who didn't post letters/reply etc, I got lost in the system 🤦🏽‍♀️. I will start looking into things now because I need to start looking after myself more now especially when I was asked last week what type of arthritis I have and I could not respond because I do not know 🙄 all I know was I was told I have arthritis 🤷🏽‍♀️ and there are lots of other things I need a specialist to sort out. Anyway, thank you very much once again.

Painting-girl profile image
Painting-girl in reply to Lollipopslife

Hi L, oh how funny that you know Dr Cockerell too. How did you come across him? He sent me to Dr Bourke, the neuropsychiatrist he works with. He's been very good.

Yes, get yourself back into the system I think. It's difficult isn't it, that when we need help, we're least likely to be able to advocate for ourselves?

With my GP surgery I can see all my records online - on a phone app now - would you be able to get similar for a good read through from your surgery? Might that help?

So sorry about your arthritis, are you in much pain with it?

Hope you get somewhere -and that Headway can give you some pointers in the right direction, to get somewhere with your GP

Let me know how you get on?

Jen 🌸 x

ored13 profile image
ored13 in reply to Painting-girl

No not bored!!! It's very useful. I spoke to someone today and decided that for what it's going to cost me per month I would be better just going private for a couple of things along with the NHS. And they would not cover pre& existing conditions until 2 years of good behaviour.

So yes definitely going to abandon this idea I think and just look at the plan to move house to include somewhere with a good surgery etc.

Sigh add it to my list😆

Painting-girl profile image
Painting-girl in reply to ored13

Glad it was useful ored, if a bit long 😊

If you talk to Headway and then go into your GP on a double or triple appointment slot booked upfront, to explain to them what referrals are needed - and only then, if they aren't forthcoming, ask if it might be easier to go private if necessary - do you think that might work?

Hope you find some solutions

Jen 🌸 x

ored13 profile image
ored13 in reply to Painting-girl

Honestly Jen, I'm just shooting in the dark at the moment. I think I'm obsessing slightly over the future. What will need to be done, how much support we will need. How much further the rehabilitation road will be. I have none of these answers and I think I have to probably wait and cross that bridge when I get there. Our current GP surgery is awful. They wouldn't give you the time needed. So I guess finding a good practice may well be key.

Painting-girl profile image
Painting-girl in reply to ored13

Hi Ored,Not surprised, you've had a really horrendous few months to cope with, but I'm so glad your husband has made the progress he has. Yes, perhaps deal with one thing at a time, but it doesn't hurt to find out what you can now either.

Have you had time to look at the NHS GP lists with their rating and reviews? The only trouble I found here locally, is because they operate catchment areas, I actually only have a choice of two GP surgeries anyway.

Take care

Jen x

ored13 profile image
ored13 in reply to Painting-girl

Hi. I haven't no. Guess that's definitely one to add to my list. I hate the thought that rehab post hospital is a postcode lottery. It make me feel really reasonable uncomfortable!

ored13 profile image
ored13 in reply to Painting-girl

Is this an open list that I can just Google?

Painting-girl profile image
Painting-girl in reply to ored13

Hi Ored, yes, I can't see the exact one I used a few years ago ( which also gave catchment area, and treatment stats I think) but I found this today gp-patient.co.uk/#

And there's the Care Quality Commission ( CQC) might be worth looking at too?

ored13 profile image
ored13 in reply to Painting-girl

Excellent!!!! Thank you for that!

bridgeit profile image
bridgeit

Well, my insurer, which has just been taken over by BUPA, would exclude existing conditions from all claims.

I can also confirm Painting-Girl's post, that chronic conditions are also usually excluded from claims. In my insurer's case, so is any required revision surgery and on-going regular scans after the 3 month post-operative period. Scans can be very expensive.

For more info on how the NHS deals with private patient and NHS care cross overs, it might be worth you taking a look at this site:

nhs.uk/common-health-questi...

It might also be worth having a look at this organization:

benenden.co.uk/ which offers more flexible arrangements.

One final thing: be absolutely up front with all the issues that you'd be seeking cover for and, as already advised, shop around!

All the best.

ored13 profile image
ored13 in reply to bridgeit

Oh great thank you so much for the info. There seems to be so very many gray areas. Also that I may just get myself into trouble! 😳

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