Customers of Bupa could be left shouldering costs of routine operations, as the
Bupa patients could see payouts slashed by a third
The health insurer Bupa is cutting the cost it will pay for routine procedures, but this means customers could be left to pick-up part of the bill.
Customers of Bupa could be left shouldering costs of routine operations, as the private medical insurer is cutting the amount it will pay in reimbursement for procedure costs.
Under the new Bupa schedule, reimbursements are being cut by up to 60% and overall pay outs to patients are set to fall by a third, according to reports in the Sunday Telegraph.
If the consultant's fee or surgery costs rise above the amount an insurer is willing to pay, it is patients that are left to pick-up the rest of the bill. It's been estimated by the Federation of Independent Practioners that Bupa patients will now face an average shortfall of £213 which will have to be paid out of their own pockets.
Fee readjustments
The news provider reports managing director of Bupa, Natalie-Jane Macdonald, as saying: "If consultants readjust charges in line with our reimbursement schedules, there should not be any shortfalls."
It's been claimed, by Geoffrey Glazer, chairman of the Federation of Independent Practioners, that 70% to 80% of consultants currently charge within the Bupa reimbursement schedule, but the changes are expected to bring this number down.
Some procedures will be harder than others. For example, the amount Bupa will reimburse for a routine hip replacement is falling by £55 from £837 to £782. But if complications arise during the operation, patients see their cover drop by £685 from £1,725 to £1,040.
Manage consultant costs
The battle between health insurers and consultants over the fees charged by the latter has intensified in recent years. Insurers say that extortionate charges by consultants are pushing up the cost of cover for customers.
Ms Macdondald added: "Our focus is on making sure our members can afford subscriptions into the future, particularly as they get older... We have a duty to make sure doctors' charges are competitive."
Customers worried about being hit with shortfall costs can use one of 10,000 consultants who are guaranteed to fall within the Bupa reimbursement schedule.
Quick tips
- If you are a Bupa customer worried about the changes, consider a consultant under the insurer's guarantee
- Cash plan cover is a cheaper way of covering the costs of private medical treatment
- Compare the market by shopping around for the best value health insurance
If you are worried about cost of an operation, check with your insurer before undergoing a procedure