Question about the Health Insurance in England (knows nothing about it. HELP!)

My dutch boyfriend and I (american) are researching the possibilities of moving to England. We currently live in the Netherlands (me for the last 3yrs on a "green card"). My boyfriend has a rare syndrome called Kallmann's. He requires testosterone regularly to keep from getting sick. For a 3mos. supply here in the Netherlands, the cost is a couple thousand euro and luckily enough our insurance here, pays for it all. I really need to find out what the insurance covers that we would have if we moved there to see if his meds would be covered 100% or partially or not at all. This is of course a large financial responsibility that cant be gone without so we need to consider this when making our decision on if we can afford to move there or not. I'd appreciate any links, or answers or tips to finding out this information that I need. Thanks!

Nikki

The UK doesn't really use insurance plans as we have a National Health Service (NHS) which provides free healthcare for all (it's paid for by our taxes).

- Doctor's appointments, emergency care and hospital treatment are all free.

- If you live in Scotland or Wales, then all prescriptions are free.

- If you live in England, then prescriptions are £7.40 per item on the script - so it doesn't matter if you get a 1-month, 3-month or 1-year supply of a particular drug, it still costs £7.40. But if you have two (or more) different drugs on a prescription, you have to pay £7.40 for each one. Some groups of people in England can get all their prescriptions for free though (people with certain medical conditions, anyone under 18 or over 60, people on government benefits etc.).

- Private health insurance is available in the UK, but in general most people don't need to take out insurance as they can be treated on the NHS for free.

Private care/insurance is usually only useful if you want to skip NHS waiting times for operations/appointments with consultants, if you want elective surgery (such as cosmetic surgery), or if you need a drug that is not provided by the NHS (I would imagine that you could get his testosterone prescriptions on the NHS though). You do usually need to get a referral from an NHS doctor first though before you can get private treatment.

Hi Nikki
 Welcome to UKY 
Here's a thread that talks about what the NHS is and how it works
http://talk.uk-yankee.com/index.php?topic=72432.0

Thanks ladies! That was very wonderful information. I didnt realize that's how the NHS worked. I've never lived in a country that had that system before so it's definitely  not the first thing that comes to mind when one is preparing and researching.

The UK doesn't really use insurance plans as we have a National Health Service (NHS) which provides free healthcare for all (it's paid for by our taxes).

- Doctor's appointments, emergency care and hospital treatment are all free.

- If you live in Scotland or Wales, then all prescriptions are free.

- If you live in England, then prescriptions are £7.40 per item on the script - so it doesn't matter if you get a 1-month, 3-month or 1-year supply of a particular drug, it still costs £7.40. But if you have two (or more) different drugs on a prescription, you have to pay £7.40 for each one. Some groups of people in England can get all their prescriptions for free though (people with certain medical conditions, anyone under 18 or over 60, people on government benefits etc.).

- Private health insurance is available in the UK, but in general most people don't need to take out insurance as they can be treated on the NHS for free.

Private care/insurance is usually only useful if you want to skip NHS waiting times for operations/appointments with consultants, if you want elective surgery (such as cosmetic surgery), or if you need a drug that is not provided by the NHS (I would imagine that you could get his testosterone prescriptions on the NHS though). You do usually need to get a referral from an NHS doctor first though before you can get private treatment.

Could you possibly give me an idea of how long the waiting times are? Do the waiting times apply to normal house doctors or only specialists?? And are the waiting times in general longer then a week or are you talking about possible months depending on teh specialty or even house doctor?

Could you possibly give me an idea of how long the waiting times are? Do the waiting times apply to normal house doctors or only specialists?? And are the waiting times in general longer then a week or are you talking about possible months depending on teh specialty or even house doctor?

Waiting times vary from area to area.
I live in Sheffield and my partner has waited almost 3 months for an appointment with a Cardiologist, while somewhere else in the country it could be less.  Waiting times also depend on how severe your GP ranks your complaint. If they feel its VERY serious, youll more than likely get a referral for a specialist right away. In my partners case, his problem is more of annoyance than life threatening. We just want a confirmation of the diagnosis that the A&E (ER) doctor gave us a few months back.

Like Kerri said, waiting times do depend on where you live

I can get into my GPs surgery (as long as you're not picky whom you see) usually within the same day if I call in the morning - seeing a specific doctor is usually a 3-4 day wait

I had to wait 3 weeks for one ultrasound to be done, but then I had another one which the GP considered urgent and had marked *urgent- will take waiting list cancelling* - and had an appointment within 2 days

I had about a 7 week wait for an endoscopy to be done

I had a 4 month inital wait to see a Rhuematologist (and now when I get the letters to make my 6 monthly appointments, I usually have about a month to wait)

I'm sure everyone else can kind of post the same types of experiences - It does depend on urgency and whether or not its really necessary to see a specialist consultant, rather than just the GP
 

What most people don't realise is that there are waiting times for a good reason.  Basically, the hospitals are inundated.  The hospital I work at (won't say which it is) is constantly working at full capacity, and sometimes well over 100% bed limit.

There are different types of wait lists, and basically the entire country is now working to what is called the 18-week referral to treatment rule.  What that means is that you should have had a definitive first treatment (whether that is surgery, ambulatory care, or even a prescription) from the hospital provider within 18 weeks of the date of the referral from your GP.  Bear in mind that this does not include a visit to Outpatients Departments (unless there is some treatment done in the outpatients i.e. something for a skin condition or a prescription etc).  This is for FIRST treatment, so if you go to outpatients and the consultant needs you to have an MRI and then realise you need surgery, this ALL needs to be done within 18 weeks of the referral.

Also, keep in mind there is the Urgent Referral system which is monitored by the Care Quality Commission, at that says that if your GP has any inkling that you may be presenting with some sort of symptom that may indicate even a hint of cancer (or indeed any noncancerous breast symptoms), you must be A) Seen by a specialist within 2 weeks of the referral B) Treated within 31 days of seeing a specialist C) Treated within 62 days of the referral.

Why do we wait so long while the US doesn't?  Money.  Plain and simple.  The divide of health inequalities in America is massive, clearly showing that the haves get treated quicker and better than the have-nots, and in most cases the have-somes (i.e. basic health insurance packages) get seen somewhere in between.

It's not a reflection on how the care is administered, it's merely a reflection on how the system favours one group over another

I seem to have gone into the rant zone so I close my comment now

We do wait in the US. Trust me, we do, and it has little to do with what kind of insurance you have.

A developmental pediatrician wait can be a year long. GI can be 3 months for non-urgent needs. That's with state insurance. Other waits tend to be about 1-2 months. I live in an area with tons of hospitals and doctors so it's not like there's a limited service availability.

Of course, if you're rolling in money, you can get seen immediately, but you can do the same in the UK