This page will give some useful information if you wish to use your Private Medical Insurance.


Utilising Private Medical Insurance

Steps for Using Private Health Insurance

Why is involving my GP important?

Aside from the fact that most Private Medical Insurance Companies require a referral from your GP before they will agree to cover consultations and treatment there are a number of other reasons why having the input of your GP is important in your care.

  • They coordinate your care.  Your family doctor will have access to your complete medical record, and will be aware of any conditions that may impact on your treatment.  They will include this on your referral letter, so that the specialist you are seeing can give you the best care possible and may not have to repeat any tests or procedures that your child has already had.
  • They will be able to help you identify who the best person to look after your child is.

    What does this mean?
    If a child needs to be treated for an Inguinal Hernia, there are many surgeons who could do this.  However if your child also has another medical problem, this may mean that they need to be looked after in a specialist centre.  This may cut the number of consultants who can manage your child dramatically.  Your GP will be able to help you identify who can provide this care, and potentially cut down the number of appointments that you need.

  • They will be involved with care after you see your specialist.  In some cases it is only important for your GP to be aware of what treatment that your child has had.  This may change how they are managed in the future.  In other cases your may need ongoing medication.  Often it will be your GP who prescribes this.  It is important that you involve your family doctor so they are up to date about your child's care as possible, and they are therefore in the best position to support you and your child in ongoing care.
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Fees & Pre-Authorisation

If you have pre-authorisation from your Private Medical Insurer, my fees will be in accordance with their approved fees.  Where appropriate I will submit invoices directly to the relevant insurance company.

If you do not have pre-authorisation and your Private Medical Insurer refuses to cover your treatment, then it is your personal responsibility to cover my fees in full and any hospital invoices.  This is why pre-authorisation is so important.

Note:  Private Health care is a contract between the patient and a medical practitioner.  Private Health Insurance is a contract between yourself and your insurer.  The General Medical Council (GMC) recommends invoicing patients direct to ensure patients understand this, and we advise that it is your responsibility to check what your PMI policy does or does not cover, prior to undergoing investigations or treatments. Any policy excess or costs not covered by your policy will remain your responsibility to pay.



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