Funding your healthcare supplementing your state provision. This booklet is supported by sponsorship from Standard Life Healthcare

Transcription

1 Funding your healthcare supplementing your state provision This booklet is supported by sponsorship from Standard Life Healthcare

2 What is the Patients Association? The Patients Association listens to the concerns of patients and focuses all its work on what matters to them. We are the first port of call for many who seek help with their health care problems. We aim to empower them to make informed choices and speak up for themselves with confidence and conviction. The Patients Association, established in 1963, is a national voluntary organisation and registered charity. It is run by an elected Council and is completely independent of government and health service professionals, though we work with them for a better and more responsive service. The NHS exists for patients; it is there to serve them. It is not for the health managers and politicians to assume that they know what patients think. Instead, they should encourage patients to express their views and those views should determine the direction of policy and the way services are delivered. We represent all patients - and we are all patients sooner or later! Our Aims Listen to patients and encourage people to relate their experiences of healthcare to use through our Patientline, our Patient Voice magazine and by personal contact. Advise patients through our fact sheets, good practice material and self-help guides. Speak up for patients and support them in speaking up for themselves to government, the Department of Health, health professionals and managers. Campaign for improved health services from the patients point of view and for the development of a consumer-led health system in which patients are encouraged and enabled to make their own choices. What can we do for you? The Patients Association: Runs a free and confidential telephone advice service, the helpline, offering emotional support and practical guidance to patients. Provides a platform for patients to influence the health service agenda by contributing their views and experiences to our regular magazine, which is available free to all members quarterly, and Strategic Forum meetings for members. Produces reports on surveys of patients needs and concerns distributed freely to all members. 2

3 Makes the views of patients heard where it counts and runs full-scale campaigns on the issues that most concern patients. Runs conferences and seminars drawing participants from all areas of the healthcare industry to discuss, with patients, areas of concern to patients. These are available at reduced cost to members. Disseminates information that can help patients to take greater control over their own healthcare through its expanding library of booklets and leaflets. Uses the PA s own internet website to provide information on patients rights and responsibilities, run discussion groups and publicise its services. 3

4 Contents Funding your healthcare supplementing your state provision 5 Options for reducing medical insurance premiums 6 Treatment costs 8 4

5 The National Health Service, which for decades was a cause for national pride and internationally recognised as being the best system in the world, has had to face seemingly overwhelming challenges in recent years. And while it s still able to offer excellence in some areas accident and emergency, and pædiatric care for example many people are having to look to other ways of seeking and receiving treatment for non-urgent cases. And the range of insuring and funding options available these days reflects the demands of ordinary people who want greater control over their own healthcare. Funding your healthcare supplementing your state provision Your national insurance contributions pay for the National Health Service. Recent moves have been made to increase those contributions and thus inject more money into the NHS. But the fact remains that if you need treatment for something that isn t a life-threatening problem, you will have to wait, regardless of the effect on your quality of life. More people now are looking at alternative ways of securing treatment, to the extent that it s not uncommon for people to self-pay for certain operations out of their own pocket up to the level that they feel they can afford. Disposable income, savings, or bank loans can all be used to pay for treatment. For more expensive surgery, or longer-term treatment, Private Medical Insurance (PMI) offers a vast range of different types of insurance to suit most people on a variety of incomes. A. Private medical insurance (PMI) By paying a premium every month, or annually if you prefer, having PMI means that should you fall ill you will have access to prompt treatment. You will usually be able to choose where, when and by whom you are treated and the facilities will be of a high standard. 5

6 With some exceptions and limits, which should be clearly identified when you take out a policy, and depending on the type of policy you take out, your insurer will pay for all in-patient, daypatient and out-patient treatment and surgery. B. Cash plans Cash plans pay out useful cash sums for a range of routine, (and some non-routine) medical bills such as dental and optical expenses. You can also get cash sums for each night you have to stay in hospital, regardless of whether you are being treated privately or on the NHS. This is useful if you find that staying in hospital actually costs you money for example for childcare, pet care, or housekeeping help while you are away. Options for reducing medical insurance premiums PMI was for years seen as an expensive perk, exclusively for those on high incomes, but these days you can contribute to claims costs to help reduce the monthly premiums. And it is now easier through certain insurers to switch PMI companies for lower premiums or to access better benefits or service. Most fully comprehensive PMI plans give you a choice of excess, usually between 100 and 500 of any claim or the total cost of claims in a year. This represents for many people an affordable contribution towards claims, and in return gives a useful reduction in premiums. There are high excess policies available where you can undertake to pay for a much higher proportion of any claim or claims in a given period, from 1,000 to as much as 5,000 or more. This will reduce your premiums by a large amount, and it s clearly beneficial to have some PMI cover because some expensive treatments such as those for heart and cancer can run to tens of thousands of pounds. Switching PMI insurers is another option if you already have PMI and want to save money or improve benefits. Until recently it has not always been possible to transfer insurers without needing new medical underwriting. But recent innovations mean that in certain cases you can switch to a new insurer and carry your existing medical underwriting terms with you. 6

7 Self-pay Many people decide to pay from their own funds if they need surgery for which they would otherwise have to wait. A joint replacement, such as a knee or hip, or a hernia repair might not be life-threatening, but pain and discomfort for the months it might take to come to the top of the waiting list make using rainy day or `Health Fund savings particularly appropriate. There are back-up insurance packages available that cover you for higher-cost treatments if you undertake to fund up to a certain amount yourself often described as `shared-risk. These are special types of high excess medical insurance that sometimes also offer wide-ranging support and advice. It s also important to know that many private hospitals offer fixed-price packages which include every planned aspect of your stay in hospital and your treatment afterwards to make it easier for you to budget. You should be aware though, that fixed price packages do not include the cost of dealing with any complications that arise or any additional procedures or services that are unexpectedly needed. Building a health fund Some people decide not to pay out for medical insurance, assuming they might never need it. But many of these still want the reassurance of having resources to draw on should they fall ill. And some people build up a health fund to help them cover the cost of treatments up to a certain level and have PMI to cover the rest. Regular savings, maybe using a tax efficient savings plan, can be a useful way of doing this with the added benefit of having the cash available for eventualities other than illness. An independent financial adviser would be able to help you. Self-pay back-up Some PMI providers offer a form of high excess policy, often described as `shared risk medical insurance. This is like a mixture of self-pay and insurance. If, for example, you decide to take care of medical bills up to a limit of say, 1,000, 2,500 or even 5,000 (maybe paying for these from your health fund) you can take out low cost, high excess back-up insurance to cover anything over that amount. But these plans are more than simply high excess because they will also help you shop around helping you choose the best facilities and the best value for money for any part of the treatment that you may be funding yourself. 7

8 Treatment costs Many of the procedures for which there are long NHS waiting lists are routine, and don t cost as much as you might think if you decided to opt for private treatment. For example, a specialist consultation would be about 100, and the removal of an ingrowing toenail 700 or so. A little higher up the list, a hernia operation could be 1,600, or varicose vein stripping would cost in the region of 1,600 for one leg or 2,600 for both. Cataract removal would cost you around 2,800 and removal of an appendix, (appendicectomy) about 2,200. It s easy to find out these prices if you call the hospitals concerned and let them know what you want. As many hospitals now provide fixed-price packages which include everything from hospital accommodation and surgeons and anaesthetists fees, to consultations and follow-up treatment budgeting is easy. Some of the higher-priced procedures can be out of reach of selfpay for most people. For example, a knee replacement could cost 9,500, a heart bypass around 13,000, and treatment of breast or prostate cancer might reach 25,000 or even more. You can decide your own funding threshold, the limit up to which you feel you can pay for your own treatment. If you feel you want more comprehensive cover in case you need more expensive treatment, that s when to consider sharing the risk and taking out a back-up insurance. The information on these pages has been made available with sponsorship from Standard Life Healthcare, one of the country s leading private medical insurance providers. More information can be found at: 8