Private Health Insurance :is It Worth It???

A snowHead

I have just had my BUPA health insurance today which has gone up by 20% to £2400 pa (with £200 excess) . I am self employed ,53, and have had private health cover for about 20 years and only claimed once although my wife has had several ops over the last few years. When I started off it was about £500 pa and seemed reasonable but once you hit 50 they really start to push the prices up . As I am about to have a knee op I will renew this year but I just wondered what other peoples views are on private health insurance ? Specifically , assuming that the private route is taken , whether it is better to pay premiums or just " self insure " i.e. rather than pay a premium to a private health insurance company like BUPA just put the premium in a savings account and if a private op is needed in the future pay as you go drawing from the savings?????

A snowHead

brnttptr, an interesting question. 14 years ago when my OH urgently needed an operation and the NHS waiting list was too long we paid for it to be done privately (extending the mortgage to do so). Given that this was the first time there had been any question of needing to do this, in many years, it was certainly more cost-effective for us to pay for the operation (about £16K in all) than it would have been to pay for private insurance for the two of us for the previous X years. But I now subscribe to BUPA on the entirely irrational basis that as I'm 67, every year that I have no need of health insurance I should be so grateful that I'll be only too happy to have paid the money. wink

Well, the person's real but it's just a made up name, see?

http://www.benenden.co.uk
may be of interest as an alternative. Not quite the same thing as BUPA but might add peace of mind if you go down the self financing route.

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Try shopping around. I had my achilles done under insurance and then the premium virtually doubled. They showed no concern when I questioned the premium and said I would have to leave. So I did. New company not bothered by achilles as it was a one off and premium lower than before. Just keep an eye on it and be prepared to switch again as they will they to creep it up the following year. I think self insure has its merits but if you are ever unfortunate enough to need cancer super drugs then its merits may be less appealing.

Anyway, snowHeads is much more fun if you do.

How much better/quicker treatment do you get by going private than on the NHS? Insurance companies are in business to make money, not to service their "customers".

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RobW A question I have asked myself for the past 20 years ! I only found out when my wife was diagnosed with breast cancer. The Surgeon would have been the same either way but the critical difference was that by going private he was able to carry out surgery in one go within 3 days of the consultation .He told me that on the NHS he would have had to do three separate procedures over an 18-24 month period!! In addition to faster treatment you also get a private rather than shared room during your stay .

The NHS is excellent for many things e.g. A&E but where you need common types of surgery the NHS has limitations and there are many benefits from going private . So my question was "assuming the private route is taken is it better to pay premiums or self insure" . I accept Insurance Companies are there to make a profit and health insurance, like many other forms of insurance, plays on our fears to make us pay the premiums . Both my wife and I are very healthy and active and certainly did not see our medical problems coming . I suspect that had we had paid all of our premiums over the past 20 years into a savings pot and paid privately for each op we probably would have been slightly better off by now .

So I guess my position has changed in the past few years from begrudgingly paying premiums for private healthcare ( on the basis that as a taxpayer I should be able to use the NHS) to seeing the clear advantage
of having private health treatment but still not being sure of the best way to fund it . I agree with pamW much better to pay the premiums or put something aside and be lucky enough not to have to use it.

Thanks ian999 I will do that .I did not think it was worthwhile until wifes' treatment was finished but lets see .

Thanks snowyowl for the link .

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I stopped paying BUPA when things were rather tight and recently had some problems with my knee. I paid for to see a specialist and for an MRI plus appointment to get MRI results all before I was able to see my GP first available appointment. The cost was around £500 and we saved more than that in premiums in just 1yr let alone the years I had stopped paying plus BUPA excluded that knee due to a previous reconstruction so it would t have been covered any way!

Thankfully we were able to get the operation quite promptly via NHS due to the seriousness of it though it was a little galling to be told by the consultant that I shouldn't have been sent home from A&E it should have been sorted then!

After all it is free

OP, have you called Bupa with regard to reducing your premium? I did and by increasing my excess to £500 I got a worthwhile reduction in my premium. I am over 50 too!

We are lucky that my husband gets free AXA PPP cover through work and I am also covered through his work (but we pay my premium). In 14 yrs I've only used it once when I had my wisdom teeth extracted in a private hospital. I would suggest shopping around and seeing how much AXA PPP would charge.

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brnttptr, I would suggest that the nature of insurance is such that you are more likely to come out ahead financially if you self insure. However it is also sensible to to insure against possibilities that could leave you with a major problem that can otherwise be mitigated through insurance.
In your situation being self employed if illness may stop you from working and you could not otherwise afford an operation or treatment that is non urgent and therefore readily available on the NHS insurance is a pretty sensible thing to have otherwise it is luxury that only you can decide what value you place on it.

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snowymum, The "free" cover though work isn't really free - you (he) still have to pay tax on it as a benefit-in-kind.

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I think the real issue in the UK is the huge difference in cost between NHS treatment and going private. We are very, very lucky to have the NHS, but it is far from perfect. I cannot see how the NHS can ever get rid of waiting lists while it fails to recover the different levels of willingness to pay of different people in society. That is unlikely to happen because it would be suicide for any politician to propose it. In its absence we are left with a choice between NHS take-it-or-leave-it and paying a massive premium for the benefits of going private. Most of Europe manages healthcare better.

RobW, but the tax paid is far less than an individual policy would cost.

You know it makes sense.

Hells Bells, I don't disagree. But it's something to be aware of.

Otherwise you'll just go on seeing the one name:

RobW, hubby has cover through work, he has more than benefited for the cost in tax over the years, mainly for physiotherapy which he uses frequently since his neck injury.

A snowHead

I declare a conflict of interest as I treat private patients but the following observations from my patients may be of interest.

They are insurance companies and behave like insurance companies.
They are not interested in your individual concerns unless they fall within their protocols ( for some that is still comprehensive)
Length of time as a customer counts for very little ,protesting about your loyalty usually falls on deaf ears
The large companies seem mainly interested in corporate accounts so individuals seem to get a pretty raw deal.
Some are subbing out things like physio to corporates like Nuffield who pay peanuts ( read into that what you want)
Insurers are increasingly diverting patients to whoever is the cheapest doctor as they consider all doctors to be equivalent as long as they meet certain basic requirements.
The quality of cover is now a really big issue.
The PmI market seems to be splitting into top cover and restrictive cover. If you have restrictive cover you will find your choices limited? . You may not be able to pick your doctor or even where you are seen and lots of things will not be covered. You will have restricted cover for things like physio that may not be adequate to cover necessary post op rehab . You would be expected to top up. There is lots of topping up going on compared to five years ago. If you have top level cover you can have treatment carried out where you want , by whom you want and it will be covered without question.
You can reduce premiums by adding in exclusions like big excesses or agreeing not to use certain hospitals like central London. You might exclude conditions like psychiatry.
Self paying is rising both because a number are giving it up but mainly because people are frustrated with NHS. Self pay is offered as fixed price in some places.
If you are taking out individual policies look at the smaller insurers as they seem to often have less aggressive restrictions.

A snowHead

I've had two surgeries in three years. Both by surgeons I have selected, both top in their field. Both times in private hospitals in Central London with top quality care. No quibbles from my insurer about the surgeons or hospitals (I pay £48 per month and have a £150 excess). One of the downsides is a limit of £500 worth of physio per year, which did not fully cover the required post-surgery rehab.

Thinking about it now, I could probably have paid for all of this as a self-pay patient without any hassle if I had put £48 per month into savings...

Well, the person's real but it's just a made up name, see?

Johnathan Bell Interesting observations, most of which I have often heard from older friends, particularly"length of time as customers counts for very little" . Personally like Zero G I have never had any problems with BUPA in the past three years in either hospital or Surgeon selection. My physio limit was £1000 but this depends on your excess (mine is £250) and exclusions.

I wonder if there are any studies which show how likely and how often one is to need hospital treatment during adult life ? and how much the top 10 most expensive common operations cost ? The Insurance companies must have these numbers to work out the premiums based on the probabilities . Would be very interesting to know to make a more informed decision .

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brnttptr,

That data will be well protected , any actuaries out there!

I think insuring the kids before teens probably a waste of money but it does seem a bit neglectful to insure myself but not them!

The risk is reflected in the premiums.
The need, particularly for expensive care( cancer, joint replacement cardiac etc ) kicks in after you have paid up for decades. So they hike the premiums to punitive levels to get rid of you. Sadly the group who seem to be most likely to give up their insurance are the over 60s . I've heard of premiums in excess if £5000 PA in this age group.

Anyway, snowHeads is much more fun if you do.

Jonathan Bell . Agreed . Should have saved the money for the past 20 years and would now have more than enough for pay as you go ......but too late now ! I took our boys off cover at the age of 21 and it did feel selfish but saved £500 in premiums. One of my good friend's Mother , who is 80 , and has not had that many medical problems , has had her premium increased to £6,000 pa and can't really afford it but after 40 years of cover is afraid to stop now!

Any comments from skiers in the Insurance Industry or actuaries ?????????????????

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I find it useful - it's free access to physio and specialist that would have taken ages and cost an arm and a leg otherwise. Erm, not literally. Though with some of the NHS you can never be sure Wink

I'm covered through the family company so our premiums are negligable, and mine didn't go up after a few consultations and 10 sessions of physio at least.

However, I can see that when you get past a certain point, paying for it personally rather than through employment would be stupidly expensive. Some of these numbers being mentioned are obscene! If you've been paying all your life into a "kitty" then surely you should have access to the money you've contributed when you're in need... Oh wait that's common sense and not in the interests of profit. Grr.

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if it is just things like physio there are also health care cash back schemes (which I have one I salary sacrifice through work into), so I was able to claim back a lot of my physio appointments that I had through that (not all of them, but then it doesn't cost me much to have in the first place).

My hubby gets private health care through work (and their work has a physio on staff for injuries which is really good) but my employer isn't so enlightened.

After all it is free

brnttptr, In my opinion, BUPA is saving my life. Worth every pound. My claims so far in the last 9 months are pretty close to £100,000 and that's ongoing. I'm getting treatment that isn't available on the NHS. Your choice, what's more important?

Spyderman, wow. Thanks for posting, this is the sort of detail people are looking for In making the decision. I am shocked to read that life saving treatment that you require isn't available on the NHS.

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Spyderman Wow ! I don't question the benefits of private vs NHS . It was mainly whether paying premiums (which I do now) or self insure is the best way forward .

Your very good point highlights the fact that what we are really insuring for ,apart from more choice , faster time to op etc are those injuries/treatments that are very expensive and that cost significantly more than the premiums we pay .
i.e. its a small chance event but nice to at least have the cover to get the best treatment possible when it happens.

I will just pay the premiums now !

Thanks again and I hope the treatment is going well .

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brnttptr, Thanks,

My diagnosis was made privately and i was on my third course of treatment before the first appointment for the very first scan was available on the NHS, so would have been about 3 months behind the game. Treatment both drug and procedure just isn't available for NHS on cost grounds. I have my Professor's mobile phone number for help 24/7 and I've used it, no issues.

I thought self insurance too after paying the premium for years, but depending on what treatment you need can you afford £ 100,000 a year plus ongoing for several years, do you sell your house when your money runs out or do you fall back on the NHS and not get the treatment you need?

Since my diagnosis, my friends have mostly signed up t oBUPA if they hadn't been covered already, just because they've seen my situation and the alternative if I hadn't been insured. One went without a holiday this year to pay for their family cover.

If you can afford it or even if you can't it should be a priority in my view, take it from someone with first hand experience.

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I've only ever had NHS treatment which saved my life. Admittedly it took ages (over a year for diagnosis and a further 8 months for treatment), but I couldn't fault the staff and care I had. Private health insurance is out of my reach financially, even if I gave up the two skiing holidays per year.

You know it makes sense.

queen bodecia . The NHS is excellent and has amazing staff . The only problem is that it will always be cash strapped and that will often place limitations on what it can provide. We all want and demand better ,quicker and more expensive healthcare on the NHS but the reality is that ,as a country, we cannot afford it on the current basis and none of the political parties are brave enough to change it .

Otherwise you'll just go on seeing the one name:

queen bodecia, Agreed, the NHS is excellent, the problem is initially getting into the system, it just takes too long.

I've just had an emergency operational under the NHS, admitted via casualty last friday night. The service, care and staff were exemplary, I them transferred to the private dept, initially because they couldn't find me a bed on a ward, the private wing had space, so in effect I freed up a bed for someone else. The consultant that undertook the emergency surgery under the NHS, took me on as a private patient for the last week I've spent in hospital, again freeing up the costs from the NHS. Best of all the Govt. taxes me for the benefit of my company paying for my private health insurance, how is that fair?

A snowHead

brnttptr,

A snowHead

Well, the person's real but it's just a made up name, see?

philwig, I have good physiotherapy on the NHS, but I have also had indifferent physiotherapy on the NHS. I have only ever had excellent physio privately. So my advice would be to go for the private now rather than wait to find out what the NHS is like.

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Mine was a waste of time after smashing my knee up last year, ended up seeing the same surgeon on the Nhs as I would have done private, he said to go into Nhs and he had a better tool kit at the main hospital than he did at the private one...

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At this present time I cannot speak highly enough of the treatment given by the NHS. A brain operation costing over 20k which could have only taken place in Sheffield or Cologne, Germany. This was paid by the NHS. My criticism is the speediness of consultants. The consult in Sheffield told me had I seen the Bristol consultant in Jan 2012 following a seizure in Nov 2011. I would have been operated on in Feb 2012. I didn't actually get to see Bristol consultant until May 2012, then Sheffield consultant Aug 2012 and finally operation took place Nov 2012. The loss of life was 30%.

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The physio I received at my rugby club for free certainly put to shame any I have received from the NHS. I have never failed to be disappointed by NHS physio, but conversely have good experiences of all other forms of their care (except one useless dentist).

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I have had very poor NHS Physio but recently I had very good NHS Physio as well. Though while in the waiting room I couldn't help over hearing her arguing with somebody about a new system they were putting in that was reducing her time with eah patient and remove her gaps between appointments which she used to update all the notes and records. Sadly I got the feeling (hopefully I am wrong) she wasn't going to staying NHS for much longer as from what I was hearing as she felt she just could't do the job with less time to get for he real root of the problem etc

After all it is free

I had NHS physio after I'd ruptured the disk in my back. The emphasis was simply on getting me mobile, working, paying taxes and not needing any more NHS time. There was little thought given to restoring me to my physical prime so I could get back to being active. I had a couple of short sessions was told "You're OK - don't do anything that hurts" and sent on my way.

I had some private physio as well, and the emphasis here was getting me back into rowing. This was somewhat unwise with hindsight given the extent of my original injury, but the guy did a great job, assessing me very thoroughly and designing a treatment/exercise programme that would hopefully restore me to my physical prime. Luckily, this was covered by employers' BUPA, as the bills, of which I got copies, soon added up to a fair chunk!

I guess you get what you (or someone on your behalf) pays for.

My claims from June to end of year 2013 with BUPA have been £64,000, this is ongoing, this year will be considerably higher, I've probably exceeded that so far up to now with future treatment treatment I know for sure from now on adding considerably to the claim costs.

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Mr mogulski and I are fairly fit OAPs who have never had private medical cover. The only op either have needed was my acl repair 10 years ago. National Health waiting list was 9 months so I paid privately and had it done straight away. I would do that again if either of us needed something. Must have saved £1000s by not paying for insurance - but that only works while you stay fit!!

Help!!

Private Health Insurance :is It Worth It???

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