Private health care with us here at Joint Reaction is open to all, whether you have health insurance or are paying yourself (known as self-funding or self-pay). The level of private care is exactly the same, and you’ll always know what the costs are in advance of any treatment or surgery.
Have I already got health insurance?
You might have private health already and not even know you have it! It’s worth checking if you:
- Hold private health insurance you have taken out yourself (and forgotten about!)
- Have a health / medical benefits package provided by your employer
- Are covered by your spouse’s or partner’s work health benefits cover
If you already have a private medical insurance policy you set up yourself, then it is likely to cover part, if not all of your treatment. Your employer might also provide you with medical insurance as a benefit, under a Group / Corporate Health Insurance plan. While what’s covered does vary a lot, that company medical insurance may also cover your spouse, partner or family too, so it’s well worth checking!
What is private health insurance?
Private Medical Insurance (PMI) is insurance designed to complement the treatments you can receive on the NHS. It does not cover acute/emergency care. (You would need to go to Accident and Emergency at your nearest general hospital for this).
Most private health insurance is tailored to the person or people covered by the policy in terms of:
- Level of coverage
- Who is being covered
- Specific exclusions, such as pre-existing health issues
What does medical insurance usually cover?
Not all medical insurance is the same. Depending on the level of cover you choose, the insurance policy will make clear exactly what medical bills the insurer will pay for. Some include the initial tests and diagnosis by a specialist private consultant, for example and others exclude that stage but will cover private treatment and/or surgery.
The top tier Comprehensive Cover usually includes cover for all stages of your care, including:
- Inpatient care (treatments which require an overnight hospital stay)
- Day-patient care (no hospital stay)
- Outpatient care including initial consultations, specialist diagnostics (MRI/CT scans) and follow-up appointments before and after hospital treatment.
So a comprehensive medical insurance policy would normally cover all your costs with Joint Reaction, from first diagnosis to final physio / treatment session and sign-off.
However, your policy might impose an excess amount you need to pay yourself (similar to car insurance), or a maximum amount that will be paid per condition. You will also need to get your appointment costs approved by your insurer before you come to see us and advise them of the resulting treatment and care costs too.
Health insurance exclusions
If you have previously been treated for a chronic condition, illness or injury before you applied for your private medical insurance, it won’t generally be covered in your policy. This may include “incurable and long-lasting conditions, like diabetes and epilepsy” (1) and also arthritis. This is known as “Moratorium underwriting”, which means that companies will cover treatment for new medical conditions that arise after the policy begins, but not those you have had in the past. (3)
Also, as MSE reminds:
“Watch out for exclusions. Chronic conditions aren’t usually covered, beyond initial diagnosis. And pre-existing conditions usually aren’t covered at all, unless it’s been a long while since it last troubled you.”(4)
Elective surgery
Private medical insurance usually covers “elective surgery”. This is planned surgery that you need but isn’t urgent and includes hip/knee replacements and most orthopaedic surgery we perform here at Joint Reaction.
What should I look for in private medical insurance?
According to the BMA,
“It is crucial that the PMI cover you buy ensures the following when you need treatment:
- That you have insurance cover for the conditions for which you may require treatment
- That you have, in conjunction with your GP, free choice of Consultant with the right to top-up fees if they exceed the insurance reimbursement.
- That you have the option of choosing the hospital where you receive treatment and if necessary are able to top-up the charges if you require to use a hospital that charges more than your insurance cover.” (2)
Will the NHS pay for private treatment?
No, but the NHS can still be part of your overall treatment plan. For example, you may come to see one of our private consultants for a rapid diagnosis and tests. If you decide you wish the NHS to carry out your treatment and/or surgery, you can take the diagnosis and test results to your GP, who will refer you to an NHS consultant.
That can take some considerable time, as we explain on our Joint Reaction website page on private health insurance:
“If you switch mid-treatment, it is not possible to give you priority in the NHS over other NHS patients. You will also need to ask your General Practitioner to refer you to an NHS Service, which means potentially starting again regarding the waiting list.”
You may actually end up seeing the same specialist consultant you saw at Joint Reaction as most still work in the NHS and are very proud to do so. The difference is often a much longer wait of many months rather than weeks with more limited treatment options.
The NHS does not fund all types and duration of treatments and certain innovative surgical procedures that would be offered by Joint Reaction to private patients. For example:
- Via the NHS, you may not be given as many physiotherapy sessions and be given a shorter session time too, potentially extending your recovery time.
- Your Joint Reaction orthopaedic surgeon may also specialise in a new and highly effective surgical procedure that is not offered by the NHS, or a superior type of implant or joint replacement that the NHS does not currently provide.
By going private – either self-funding or using medical insurance cover – you can receive a rapid appointment and diagnosis and receive the very best care more quickly too.
Do you offer instalment payment plans for treatment and surgery?
All treatment plans and therefore costings, come after your initial consultation with one of our specialist consultants. If you are self-funding, you can book this first appointment as a ‘stand-alone’ for under £300. You’ll also need to pay for any diagnostic tests and scans that might be required and of course the hospital will provide a full costs breakdown before they book these for you.
You’ll receive your diagnosis at a follow-up appointment and at this point your consultant will create your personalised treatment plan.
- Payment options for treatments are provided by your chosen hospital and payable to the hospital direct. Most offer some sort of payment plan.
- Full payment is required for your consultant’s fees which are billed separately to any treatments.
For more details, see our page on “Fees and Payment Options”.
Talk to Joint Reaction first
If you’re in pain, the thought of a long wait for a consultation can be daunting. By cutting the time you need to wait to see a specialist consultant from multiple weeks to just a few days, Joint Reaction can help you get the accurate diagnosis and be potentially pain fee faster. Just get in touch.
IMPORTANT: This article on private medical insurance is for your information only. It is not intended as a substitute for professional medical advice or diagnosis. When you first meet your Joint Reaction consultant, they will discuss your current issues, plus past diagnosis or scans you may already have.
RESOURCES:
(1) https://www.aviva.co.uk/health/health-products/health-insurance/knowledge-centre/different-types/
(3) https://www.saga.co.uk/health-insurance/underwriting-methods
(4) https://www.moneysavingexpert.com/insurance/cheap-health-insurance/