Private care or NHS?

[girli1111]

My RA care has been under the NHS so far (last 13 years). In recent months my partners job has changed and we will both now have access to private health cover through AXA which apparently will include pre existing conditions. My NHS care has been good, but what has not been good has been the very regular cancellation and rescheduling of appointments i.e. The admin side of things. Is it straightforward to switch to private care and would people recommend doing so if you have the option? I'm in Berkshire, so would be looking at hospitals/clinics in the Reading area, thanks

[dtech]

You need to check with the private health care. Whilst private medical insurance say they cover existing conditions, most won't allow the regular ongoing appointments etc. I was intiallially diagnosed using my private insurance but had to switch to the NHS for the regular rheumy appointments, blood tests, medication etc. It worked out fine for me as it was the same consultant at the NHS hospital. Good luck.😁

[Philip in reply to dtech]

Absolutely as above, there also used to be or maybe still lol, the NHS can refuse you any help or medications or treatments because you've been seen privately unless it was done on the NHS and by thier Drs,

Best of luck Chuck.

Philip

Hi dtech, hope your keeping well.

[dtech in reply to Philip]

Fine thanks Phillip. Well, as well as can be expected 😉

[Hidden in reply to dtech]

Dtech took the words right out of my mouth. 😉 Also, if you need access to medications that require CCG funding e.g. anti-TNFs, you need to be in the NHS system.

[dtech in reply to Hidden]

You been listening to Meatloaf again crashdoll? 'You took the words right outta my mouth...' etc.🤣😂

[helixhelix]

Even if they cover pre-existing conditions they often have rather strict limits on chronic conditions which means you can't get much ongoing care. If you can afford it, then having private cover can be useful as a top-up for extra things, but look carefully at the small print of what is and isn't covered and the annual limits.

[girli1111]

Thanks for replies - looks like staying with NHS is the way to go

[Downtime]

I started off going private when I had my initial diagnosis and my insurance provider said I could only have so many appointments , blood tests etc privately. I then went to our state health system ( I live in the Channel Islands) and it made no difference as it was the same consultant. In fact the care is pretty good. I have regular appointments and if I need to, I call his secretary and she makes an immediate appointment with him for me. Just like private health really.

I think with chronic diseases the amount of cover is limited.

[Barrister]

Most private healthcare in the U.K. doesn't cover medication unless you are an inpatient. My husband was working abroad and we had an international policy which was excellent and covered all of our medication, even my biologics. However, now we are based back in the U.K., our BUPA healthcare, though good, will not cover any medication. It does cover our pre-existing illnesses, just no meds. You might find that getting a few appointments with your rheumatologist may help as he/she could write to your NHS rheumatologist with any updates that may be recommended but ultimately your NHS rheumatologist will be the one who decides on your meds. Clemmie

[Entero]

Hi, I second all of the above, but have a couple of things to add. Firstly having had Crohn's disease for eleven years I've only ever seen my consultant privately Despite being extremely senior, when my disease is active he's in constant contact and even in the long periods of remission in between flares, he responds to my questions via emails within a matter of hours if not immediately. I always expected this was because I was private until (through this forum) I met one of his NHS patients and discovered she has exactly the same relationship with him. We both love him!

When I developed suspected RA last year, he referred me to a Rheumy colleague who I've seen 4 times now and he advised that most of his patients get a GP referal to his NHS practice for interim monitoring. This I've done (appt in October...) and will make the case with my insurance company when my condition is such that I need an appt more urgently. My GP prescribes my Mtx injections under the Rheumy's direction . I work in the NHS myself and the private/NHS relationship is a complex and contentious one. But I find most staff are quite pragmatic about it, recognising that resources are tightly stretched and if some people are able and willing to pay for their care they're potentially leaving more resources available for others. Good luck x

[girli1111 in reply to Entero]

Thank you, that's really helpful

[FionaHerts]

I have private health care with Axa PPP through my husband's job. They are great if you need to see a consultant about a particular problem and get it sorted out, but they won't cover any long term monitoring or any preventative treatments.

For example, 6 years ago I had a polyp cut out of my bowel during a colonoscopy. I have to have repeat colonoscopies every 3 years to see if any other polyps have grown (had another cut out 3 years ago). Axa paid for my initial colonoscopy as I was having pain and bowel problems, but they won't pay for any of the 3 yearly colonoscopies because they consider they are a preventative measure.

My husband has kidney disease which was diagnosed privately and all the investigatory procedures paid for, but he had to transfer to NHS for his ongoing monitoring.

I've stuck with nhs for my Rheumatology because it's a life long condition and I'll need monitoring and consultant help for many years. Axa have a outpatients allowance, on the scheme I'm in it's £1500 a year and the cost of all consultant appointments and diagnostic tests (except for MRI) are deducted from this. It can dwindle quite quickly, with consultants charging up to £250 per appointment and especially as private hospitals charge over £50 for a simple blood test. On top of that, any ultrasound or X-rays get deducted from your outpatients allowance. Once you exceed your allowance you have to pay for all your treatment until the beginning of April when your outpatients allowance is reset at £1500.

I know Axa have different schemes, it's worth fnding out what's included on yours and if you have an outpatients allowance.

Also worth looking at who is worked my privately. In my area it's just the same consultant's who work in the NHS hospitals locally.