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BUPA
by lisa kellett
We've held a bupa family health insurance policy for over 10 years but here is why I'm changing health insurer:
1. I'm spending too long on the phone to advisors - my record is 40 minutes
2. Incorrect information sometimes given about providers - this seems to depend on which advisor you get to speak ... to.
3, SHORTFALLS ABOUT TO GET WORSE!! Beware - from the 21st May, BUPA are introducing a new schedule of procedures (this basically details how much they are prepared to pay the consultant for each procedure). Most of these limits have been static for 20 years - yes that's why some consultants charge more and you are left paying the shortfall. But things are about to get worse. From 21st May, many procedures have been "downgraded"by BUPA meaning limits will be cut further - some by 45% or more - leaving you to pay the difference. For example, if your consultant wants to see you for a follow up consultation at which he wishes to perform a soft tissue or joint injection - BUPA will only reimburse the consultant £50 from 21st May (down from £91). This is because BUPA will not pay a consultation fee alongside a pre-authorised procedure. Indeed, the consultant would be better off just charging for a follow up consultation (and no injection) since he/she could claim more from BUPA....but as a policyholder, that would deplete my outpatient benefit pot! I think that this is derisory to the consultant (I can pay more than £50 for a hairdresser's appointment!) and unfair to policyholders because we'll end up paying for a reduced level of cover and end up paying increased shortfall amounts to the consultant directly!
4. BUPA are trying to introduce an open referral system - ie, allowing the GP only to make a referral to an un-named specialist (e.g. an "orthopaedic surgeon". BUPA will then allow the patient a limited choice of consultant which undoubtedly will be based on cost. So if you need a hip replacement and the most experienced surgeon in your area is not on their list because he is not as cheap....you may have to see someone else. Since newly recognised (and hence, less experienced) consultants have to agree to charge no more than BUPA's fee limits in order to be "recognised", it seems that this is where BUPA may try to force patients to go.
In summary, the brand leader is compromising what it is offering. Yes, BUPA have made investment losses during the recession and may need to boost dwindling profit margins, but this is not the way to do it! If you've ever had a breakdown of your account, the amount that the consultant charges is usually a small fraction of the bill with the bulk of the overall amount being billed by the private hospitals themselves for use of the facilities/support staff. It is the latter that they should be trying to contain!
BUPA are not writing to patients to explain that they are effectively reducing the amounts they are prepared to pay out - they have written to the consultants themselves, so until you need to make a claim, you'll be blissfully unaware of all of this as you are paying your premiums each month.
For that reason, I'm about to make a change to one of the smaller insurers (probably WPA) who are not indulging in the same tactics.
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BUPA
by P Loxham
I have two procedures due, have been paying for years, I was told to pre authorise everything which I did and I have the pre- authorisation letters. I absolutely followed their procedures to the letter; they told me on the phone also that I was definitely covered for the procedure
Today i received a letter from BUPA, they are ... refusing to pay the first procedure that they authorised, notes 1 and 2 note 1 states " Under the terms of the scheme no benefit is payable" Note 2 states "under the terms of your scheme we are unable to pay this claim as prior pre-authorisation is required"
So after confirming tht my treatment was covered and having the pre-authorisation letter sitting in front of me the nice people from BUPA are trying to wriggle out of it.
This seems like a total rip off to me,
So now I'm supposed to have an operation in two weeks, I have the letter from BUPA pre- authorising but I daren't go through with it.
If you value your health I would AVOID
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BUPA
by jolley65
I have been with Bupa for the last 15 years, first in Spain with their sister company Sanitas and now here in the UK.
My experience has been positive and I have been very pleased with the care I have received from them.
Depending on the medical condition, once referred to the specialty (eg dermatology, gynaecology, etc.) the ... appointments are usually arranged within a few days and any tests (blood, ultrasound, MRI etc) then can follow quickly. Results will usually come back within a week and, if surgery is required, the waiting period is relatively short - in my experience less than a month.
There is an approval process depending on the insurance cover you take out but the authorisation can be done over the phone.
The Clinics and hospitals appear to be very well equipped, clean, and in my experience the nursing and other medical staff have been polite as well as professional in their approach.
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