Private Health Care Dilemma
Discussion
I'll try to keep this brief 
I used to get free private health cover (Bupa) for me and my family (wife + 2 kids) through work. Obviously this was a taxable benefit so I had to pay the tax on the value of it at 40%. I didn't bother taking it up until about a year and a half ago as we were all healthy, had some faith in the NHS so I couldn't see the need to add around £1k to my tax bill. However I had a health scare and this spooked me a bit. The issue was dealt with in a fairly timely, efficient manner by the NHS and turned out to be not too serious, but it convinced me to opt into the health cover. Nothing like bolting the stable door after the horse has gone etc. Obviously as the condition I have got is now preexisting there's nothing the private cover can do to help with that.
Last year the company decided to buy us out of this benefit for a number of reasons so we got the cash equivalent added to our base salary and the option to continue buying the health insurance package through the company to get a good deal (much cheaper than going to Bupa direct). This was done through salary sacrifice so avoided paying NI on the extra salary but still declared as a benefit so taxed at 40%. Essentially meant that I could carry on with the health cover without any real change to my take home pay.
Fast forward to this year and we've had a email informing us that they've had to put the price of the health cover up by 37%
Reasons listed were that there was a lower than expected takeup of the new scheme and that it ran at a 23% deficit last year i.e. claims were 123% of the money coming in. Now I can only really see one thing happening here, folks such as myself are going think that's expensive, I won't subscribe for next year and then the take up will be even less, the deficit greater and soon we'll all be priced out of the scheme anyway.
So I really can't decide as to whether to carry on with it or not. As things stand it will cost me an extra £90/month in take home pay. If I don't carry on with it I'll have about an extra £85/month take home so I could essentially be £175/month better off. I spoke with the wife about it, she's not that bothered and has the belief that any health problems we may have can be dealt with through the health service.
I should always have the option to opt back in again at some point in the future provided the company keeps the scheme going but I could well see it disappearing anyway.
Thoughts?
I used to get free private health cover (Bupa) for me and my family (wife + 2 kids) through work. Obviously this was a taxable benefit so I had to pay the tax on the value of it at 40%. I didn't bother taking it up until about a year and a half ago as we were all healthy, had some faith in the NHS so I couldn't see the need to add around £1k to my tax bill. However I had a health scare and this spooked me a bit. The issue was dealt with in a fairly timely, efficient manner by the NHS and turned out to be not too serious, but it convinced me to opt into the health cover. Nothing like bolting the stable door after the horse has gone etc. Obviously as the condition I have got is now preexisting there's nothing the private cover can do to help with that.
Last year the company decided to buy us out of this benefit for a number of reasons so we got the cash equivalent added to our base salary and the option to continue buying the health insurance package through the company to get a good deal (much cheaper than going to Bupa direct). This was done through salary sacrifice so avoided paying NI on the extra salary but still declared as a benefit so taxed at 40%. Essentially meant that I could carry on with the health cover without any real change to my take home pay.
Fast forward to this year and we've had a email informing us that they've had to put the price of the health cover up by 37%
Reasons listed were that there was a lower than expected takeup of the new scheme and that it ran at a 23% deficit last year i.e. claims were 123% of the money coming in. Now I can only really see one thing happening here, folks such as myself are going think that's expensive, I won't subscribe for next year and then the take up will be even less, the deficit greater and soon we'll all be priced out of the scheme anyway.So I really can't decide as to whether to carry on with it or not. As things stand it will cost me an extra £90/month in take home pay. If I don't carry on with it I'll have about an extra £85/month take home so I could essentially be £175/month better off. I spoke with the wife about it, she's not that bothered and has the belief that any health problems we may have can be dealt with through the health service.
I should always have the option to opt back in again at some point in the future provided the company keeps the scheme going but I could well see it disappearing anyway.
Thoughts?
It all depends on the terms of the current scheme you are in. If it is a no excess, no limit policy covering the whole family then it's possibly still a good deal, as soon as you need that operation costing £5k you've more than got the value from it.
But, the PMI thing as a taxable benefit is rapidly losing value. A lot of employers are moving to high excess or limited claim policies, and as yours has already taken everyone out of the scheme anyway it looks like there is little benefit in carrying it on much longer as you will rapidly find it is no longer the good deal it was.
You should probably look at options to tailor your own policy to suit (there are price comparison sites for this) - perhaps there is better value for you doing it yourself either through adding an excess, limiting the cover or (as I did in the past) taking the kids off the policy. Kids are always a priority on the NHS, so I've always thought having them on PMI is a little overkill but I appreciate there is some value. I'd always advocate some form of PMI, especially as you age and even more so if you are active/sporty but again your circumstances dictate what is valuable to you.
But, the PMI thing as a taxable benefit is rapidly losing value. A lot of employers are moving to high excess or limited claim policies, and as yours has already taken everyone out of the scheme anyway it looks like there is little benefit in carrying it on much longer as you will rapidly find it is no longer the good deal it was.
You should probably look at options to tailor your own policy to suit (there are price comparison sites for this) - perhaps there is better value for you doing it yourself either through adding an excess, limiting the cover or (as I did in the past) taking the kids off the policy. Kids are always a priority on the NHS, so I've always thought having them on PMI is a little overkill but I appreciate there is some value. I'd always advocate some form of PMI, especially as you age and even more so if you are active/sporty but again your circumstances dictate what is valuable to you.
Private is good to sort out self-contained issues - like knee operations. When you start to involve many departments - surgeon/anaesthetists/dietitian/physio/hostital-stays, then it starts to get complex on private. On the NHS - all these depts tend to work as one. On private they all need paying for separately, and some are even not covered, so you go without. This is where the American system also falls down.
fatboy b said:
Private is good to sort out self-contained issues - like knee operations. When you start to involve many departments - surgeon/anaesthetists/dietitian/physio/hostital-stays, then it starts to get complex on private. On the NHS - all these depts tend to work as one. On private they all need paying for separately, and some are even not covered, so you go without. This is where the American system also falls down.
This is the opposite to my other half's experience...19 years of the NHS f
king around. False diagnoses,different departments not looking at notes, contradicting medication prescriptions, the works. All through one GP and one hospital.Finally, new GP and a chance encounter lead to an NHS referral to specialist at the local Nuffield. Everything is planned centrally - the op, aftercare, physio, everything. The difference in care is night and day, without discussing the extreme difference in speed.
That's all covered by the NHS. My circumstances have changed and I've just taken out Aviva cover through my employer (was powerfully built previously) for the whole family. Pre-existing covered, but limits on chronic conditions. Local Nuffield is on the list as an approved supplier.
Sorted.
Today - it seems one's in it 'for the money', the other is in it 'to save money'.
One you pay for the privilege, fair enough, but please don't forget us long termers who over their lifetimes have 'paid a lot into' for the privilege of the other.
Private is fine until you have a serious issue, then try and continue with your policy. Good luck with that!
I know of two people locally now queuing at the GP practice who had spent bucketloads over the years on private.
I'm at an age where I get free prescriptions. Ha ha ha. The reality is different!
I do my very best to keep away from docs unless absolutely necessary. In fact, the only item I've had in 6 years of 'free' prescriptions is one lot of antibiotics. So the 'Free' can be dependent entirely on what that prescription is.
A guy I know who had a similar health problem to my current one, he suggested I get xyz. It had really helped him and to be fair it is recommended. He's not retired so cost him the £8.40.
I go to my GP and ask for similar. Sorry says GP, that item is now silver lined, whatever the f. that means? It's been wiped from prescriptions (by our local NHS authority, possibly not by others). GP suggests 'You can, of course, buy the item from a local pharmacy without a prescription.' Ok. 38 quid! 'The recommendation is you have 3 of them. Righty o' that'll be 114 quid then. Free? Ha ha ha.
Edit to add
Just noted the 'Bloody red tape' thread (about private health care) - worth a read too!
One you pay for the privilege, fair enough, but please don't forget us long termers who over their lifetimes have 'paid a lot into' for the privilege of the other.
Private is fine until you have a serious issue, then try and continue with your policy. Good luck with that!
I know of two people locally now queuing at the GP practice who had spent bucketloads over the years on private.
I'm at an age where I get free prescriptions. Ha ha ha. The reality is different!
I do my very best to keep away from docs unless absolutely necessary. In fact, the only item I've had in 6 years of 'free' prescriptions is one lot of antibiotics. So the 'Free' can be dependent entirely on what that prescription is.
A guy I know who had a similar health problem to my current one, he suggested I get xyz. It had really helped him and to be fair it is recommended. He's not retired so cost him the £8.40.
I go to my GP and ask for similar. Sorry says GP, that item is now silver lined, whatever the f. that means? It's been wiped from prescriptions (by our local NHS authority, possibly not by others). GP suggests 'You can, of course, buy the item from a local pharmacy without a prescription.' Ok. 38 quid! 'The recommendation is you have 3 of them. Righty o' that'll be 114 quid then. Free? Ha ha ha.
Edit to add
Just noted the 'Bloody red tape' thread (about private health care) - worth a read too!
Edited by dandarez on Thursday 8th December 18:05
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