Why your insurance might not be as good as you thought it was…
You paid for a Mercedes, what you got was an old banger! “I work in the city, my company provides the best corporate health insurance around- I can see who I like”… possibly not! You will find that more and more Consultants, Surgeons, Anaesthetists, Physiotherapists and Osteopaths are choosing to no longer deal with certain insurance companies. Most insurance companies won’t even contribute their normal “cheaper” rate towards you seeing the specialist who you want to see, that is not on their list.
“Health Care Adviser” in a call centre calls the shots. You ring your health insurance claim hotline and after some brief questions and discussion on the phone the “adviser” in the call centre decides what you can and cannot have done. The expert view of your GP, Consultant or Physiotherapist whom you’ve seen and built a relationship of trust with, holds little sway over what the call centre decides they will or will not cover you for. You may even be transferred to another organisation who’s sole purpose is to ‘manage’ the usage of your insurance policy.
“The Computer says No”. You manage to get the desired test or treatment authorised by the call centre. You feel a sigh of relief, but the relief is short-lived as the adviser says “this specialist is not on our list, but we can recommend someone else”. Your Consultant or Physio recommended you to a particular doctor or specialist, because they thought carefully about matching you with the specialist who has the best expertise, bed-side manner and availability for your condition. The call centre then provides you with an option that is in the insurance company’s best interest, not in your best medical interest…the call centre have never even met you, let alone ever met the consultant or physiotherapist! It usually feels like a bonus nowadays if the consultant you wish to see is on your insurance companies list. Always push the company to let you see whom you’ve been recommended to see.
4 Treatments or less! Did you know that 3 of the biggest health insurance companies expects your physiotherapist to see you for 4 treatments or less (one company only authorises 3 treatments)? Insurance companies are holding physiotherapists and consultants to sessional averages, threatening de-registration should the physio or consultant not work within the limit set by the insurance company.
Your Policy says you have xxxx Pounds of Physiotherapy available, but the call centre only allows you £250. You bought your policy knowing that there was let’s say a £1,000 limit for physio, yet the insurance company will determine how much of it you can spend, that £1,000 limit could in fact be £250 or less.
Health Insurance and physiotherapy access can be a great addition to a policy but make sure you know your numbers and excess. Discuss your treatment with the physiotherapist, understand what they recommend, ask to be copied in on reports. It is always good to know what has been advised or requested. If you have unlimited access to physiotherapy and the physio asked for 10 sessions, why would someone you’ve never met only authorise 5?