It is dangerous for a privately insured patient to assume his/her insurance covers everything. Very often it does not and this impacts on the consultant surgeon.
Short term issues
Private medical insurance is designed for short-term injuries or illness i.e. an injury that suddenly happens and in most cases treated/cured relatively quickly. For example: a broken hand can be treated relatively quickly whereas a diabetic problem may not.
Consider it this way. Private medical insurance is in place to cover elective non-urgent operations such as knee replacement. A heart attack will be treated at an NHS level. In any event, if the condition was known before the policy was taken out, it will not be covered. Further, it does NOT follow however that if the injury is short-term and treatable under private medical insurance cover, all parts of the treatment will be covered.
It will depend on the type of policy held by the patient. And basically, the higher the costs of the cover, the more items are covered regardless of a financial limit. The lower or budget type cover may set a financial limit on how much can be paid out under the policy or, for example, may exclude consultation fees.
How does this affect the consultant?
Is this relevant to the consultant surgeon?
In this writer’s view whilst it may impact on the consultant surgeon it will be a very sad day when a consultant even stops to consider if he/ she will treat a patient based solely on the type of insurance coverage. In such a case they would remain an MHM client.
That said what is the impact on the consultant surgeon?
For one thing, a budget type policy could easily lead to shortfalls, excess or the non-payment of consultation fees. This, in turn, in order to avoid a financial loss on his part, will lead to a requirement for the consultant to have such amounts collected from the patient.