Health insurance not covering ongoing Eylea injections

[Mpatz]

I have just discovered that my private health insurance (gold level AXA PPP) will only reimburse for the first 3 months of Eylea injections for my wAMD. Does anyone in the UK have/know of a better private insurance package that will cover longer treatment? Am I going to have to now switch to NHS treatment?

[Hidden]

The NHS provides eyelea so treatment will be the same. You may need to keep an eye on appt. dates and advocate for yourself more than with a private provider but if you can't find another insurer ( I'd be amazed if you can for this treatment) don't worry about somehow losing out.

Good luck going forwards.

[dbjones in reply to Hidden]

I started with Lucentis/Avantis on nhs around 4 years ago. I had an admin delay between optician report and being seen by consultant at NHS (surgery/optician muddle) during which my left eye deteriorated. My right eye deteriorated later so I could not drive or read properlybut was repaired by injections of Eyelea. I was on 4 weekly injections of Eyelea, now on ten week intervals. Can read,drive, work and enjoy life. NHS has been great since admin snafu at start.

I have a membrane and slight cataract in left eye and NHS consultant surgeon (Southampton) I was sent to recommends no surgery as it may worsen AMD in left eye. Very happy with discussions, info and treatment from Salisbury n Eye clinic. Brain sorts out poor vision but peripheral vision on left eye with good performance by right eye. Glasses necessary for near and close and far and swapping them is a pain but better than varifocals for vision. One discovery, experienced nurse is often better at injections than consultant or doctor! Carol at Salisbury clinic was Queen of the Needles). Probably had more than 20 injections, no real worries about going for them. Relationship is with Eye clinic. Very rarely see GP now.

Warning - nothing certain with AMD as cases vary so much. Do no getover-tired as brain needs rest to cope with adapting to vision changes (which in my case it does do).

[Rosalyn-helpline Partner]

Dear Mpatz,

It is unusual for health insurance providers to cover more than the first 2 or 3 injections. Since working on the Advice and Information line, I have not heard of any cases where they have covered more. Your private ophthalmologist should be able to organise transition over to the NHS for you. In some cases you may be seeing the same ophthalmologist privately who would then also be seeing you on the NHS.

Please contact us if you would like to discuss this further.

The Macular Society Advice and Information service is open 9am – 5pm Monday to Friday on 0300 3030 111.

Alternately, you can contact us via:

[e-mail]

Kind regards,

[Hrosie]

I too had health insurance with AXAPPP & they would not cover my injections at all & I had paid in many years and never used the insurance . I initially had 3 injections of Avastin, 3 years ago, privately and tried to claim but it was refused. I have since received Lucentis injections at an NHS eye clinic where they have looked after me really well. Needless to say, I cancelled my private health insurance 3 years ago as first time I needed to use it it was refused. Issue with insurer was that treatment for wet AMD is ongoing. Lesson learnt - Investing the £1,000's I paid into the private scheme would have been more sensible.

[Mpatz in reply to Hrosie]

Yes. Sounds like I am in the same boat. I am seriously considering cancelling my cover too. It seems like they will cover some chronic conditions, but not AMD. Probably only life threatening conditions.

[TimWhittle]

I have had mine every month for the past three years on the NHS, why go private?

[Nobe]

I gave up private health insurance years ago when I had a heart condition, Had BUPA asked their questions abou.t my heart condition instead of the condions of paymen. I would have been left stress free