Private Insurance questions

Hi Mark

No I don't have private cover so can't really answer your questions but also note if I did have cover what was in the terms and conditions at the time of signing up may no longer be the terms & conditions of the policy now. You are going to have the direct these questions to the provider.

I did have a workplace pay-in scheme which covered things like teeth and eye costs (glases as test are fee for us) plus other things like if you had a stay in hospital.

When I took the policy I specifically checked my pre exisiting condition was covered and yes but they got taken over and I was issued the new booklet which stated pre-existing conditions excluded - When I asked the rep about these changes was told your condition would be covered - can I have that in writting - no. So when I worked out the money I was getting back for the eyes and teeth I was paying in was less than i was getting back and now coupled with the fact I may struggle to get the other benefits as I was not going to take a verbal confirmation I cancelled the policy.

The work scheme I have won't even cover a C-peptide test - expect them to wriggle out of everything they are able to come up with any excuse for and then you won't be disappointed when they do ... most exclude pre-existing conditions and if they can link a claim to one in any way they will do

Markca91 said:

Hello,

I am 29 years old and I have type 1 diabetes. I was diagnosed 3 years ago. My HBA1C is 41. I am working hard to keep it in good range.

I have my own business so I was thinking about getting business insurance (Axa or Bupa) for myself and a few of my employees.

I am aware that Diabetes will be outside of scope of insurance. That part is clear and out of the question. What worries me though is that in future, if I need some help from the insurance, they might try to push it towards diabetes. For example, if I have heart issues, they might connect it to diabetes. If I had eyes issues, they might connect it to diabetes. Therefore, I am a bit worried that I will be paying insurance for nothing - that when I need it, they will be able to reject me based on connecting it all to diabetes.

My questions:

1. If you have private insurance do you feel that they are fair and that I am worrying for no reason?
2. Do you have any suggestions or tips that I should be aware of?
3. Which insurer would you suggest?
4. Does it matter at all if my blood sugar is controlled well (ie if I have good control of my blood sugar, is it less likely that they can say that something is diabetes related)?

Thanks!

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Mark, as someone who used o work for a medical insurance provider, with all the benefits that bestowed, I'd like to be able to say no lines would be drawn between your diabetes and other medical conditions, however, that likelihood would increase where your diabetes maintenance has been a bit iffy. If you have kept yourself in good order it's a bit harder for them to do, if they wanted to.

The specific cover you could secure will depend of a large number of factors, including how much you are willing to pay in premiums.

In terms of whether it would be right for you, it would be prudent to consider what you feel you might claim for. Emergencies are covered under the NHS. Unless you were to cover a lot of employees, cover for your diabetes is likely to be a pipe dream, and even if you did manage to get a degree of cover, it wouldn't cover your maintenance, so insulin, test kits, pumps etc. It would only cover investigations and likely diagnostics, if you were being covered before diagnosis.

If you are thinking of instances such as a cancer diagnosis, PMI can be very useful - not only for the initial surgery, but for the follow up stuff. A colleague of mine found herself being paid a not insignificant sum for each radiography session she attended, as those had to be done in an NHS hospital. She saved those payments for a good holiday when she was better.

If you are thinking of fixing orthopaedic issues - football or rugby type stuff, like ligament repairs or shoulder surgery, then it could be worthwhile saving a sum to potentially cover those eventualities.

Are you a member of any professional bodies, or groups? Those sort of groups can acquire affiliate cover, and once the group gets larger, individuals joining tend to garner benefits from the larger group.

Just briefly, if you are considering paying for insurance for select employees, do they want it? They would be taxed on it as a benefit in kind, so they might prefer to have a modest pay rise.

PMI is often a very emotional purchase. It's profitable because most folks don't claim or if they do their claims are modest.

If you do go ahead, I suggest you select cover where you disclose your medical history up front, as that can quash delays at the point of any claim.

Markca91 said:

Wow, thank you for such a detailed answers!

@ROE100 , I am not really expecting to get any coverage regarding diabetes, that is as clear as night and day. I am just hoping that when I need something else, that it doesn't get excluded as well on the basis that diabetes could have caused it...

@jonathan183 that is terrible Would you be able to share which company is it? If you don't feel like doing it publicly, could you send me a private message? It would really help me!

@AndBreathe Thanks for such a detailed answer! Your first few sentences cover the most of my concerns. Based on your experience, would you say that managing diabetes definitely can determine what later gets attributed to it? Does it mean that for as long as my HBA1C is in "normal" range I should be able to get most of the things that are not pre-existing conditions?

Honestly, I am working very hard towards having glucose in range and I plan to continue doing so. It will get easier and easier with future technology and I don't have issues with eating the right food. That is why I am worried that even if I do all the right things, injustice can be made and my claims could get denied with an excuse.

I am not part of any sport clubs, and I only do gym and running for training. I don't think that it is likely I will ever get injured from any team sport, as I don't really play them.

Regarding the other employees, we are a small team and I will definitely speak with everyone regarding their preferences.

Thank you for the pro-tip regarding disclosing everything upfront, I will do that

Do you have any suggestion on which company should I chose?

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I would suggest that having your control in a good place will help with many things. On any given event, it will depend on the event and your control at the time.

I would suggest if you have a small team, it could work out expensive, depending on ages and so on, but that's entirely up to you.

In terms of selecting a company, that can be a bit of a minefield, and again can be a costly step. Costly from the point of view that, purely for example, many folks head to BUPA, just because they've heard of them.

In your shoes, I would find myself a specialist medical insurance broker. They are out there. They can save yo a LOT of money, even if you end up paying them a fee for their services. They can also guide you on the levels of cover you might need, and even if you really need full cover, or if you would be well served by having a plan that kicks in only if the NHS waiting time for your needs is more than 6 (or whatever) weeks.

I'd rather not disclose m former employer as, like ALL forms of insurance and companies, they have their pros and cons.