Dealing with Glaucoma in UK

Private cover doesn't provide anything for pre existing conditions except to get you back to the baseline when you signed up to the service. But it is worth having for when new conditions occur.

@AnotherUKYankee This is a little concerning, since i am getting treated for Galucoma here in the US  -  when i move to UK would this be considered as pre-existing condition? Will private insurance reject coverage? I will be having private insurance form my employer and was relying on that.

@jimbocz I will take up this offer, we really like (from little i have researched) Twickenham and Richmond. I will surely connect with you and might bug you with some Qs.

@Nan D. Not finding ambulances when needed is such a scary prospect, it would never happen in the US.

@phatbeetle Thanks for those charity links, I will take a look.

@KFdancer "doctors office (called surgeries here)" -- wow, thanks for clarifying this. Reading through some of the responses I was so confused, someone said "I dropped off samples at surgeries" !!
No wait doc visit!! I wish i can do my Glaucoma visits online! On an average i wait about 2 hours everytime i see my doc here in US.

@Aquila Thanks for sharing your experiences, very helpful. "Also, it may be helpful to have your current doctor write a letter regarding your condition to give to your new doctor in the UK " -- This is a brilliant suggestion, I should work with my doc here in Stanford to write a letter to Moorfields doc.

You may also hear  a pharmacy called a "chemists". But not always.  They are identifiable by the green cross sign.

About ambulances in the USA.  While not to that degree (since most towns/cities run their own ambulance service, from what I have seen), there are places where it does take some time to get one. Especially in rural areas. And the inner-city areas (read that "crime-infested ghetto) of some large cities. And God forbid you need an air ambulance in the USA! Unless you have stellar insurance, are independently wealthy, or can sell a kidney .....  If you are air-ambulanced in the UK it's free. So there is that. 

You asked someone else about pre-existing conditions, but I'm going to chime in here anyway. When we were looking, if we hadn't had any treatment in 3 years, they would cover us. But we were taking out a personal policy. If you're going to be put on an employer group policy it may be a different situation. (And depend on which insurance they offer.) Your employer's benefits person should be able to get you that information.

Good luck!

Indeed - if you will be getting private insurance through your employer, it's best to ask them about the specifics of the policy and pre-existing conditions.

As a general rule of thumb, most private policies will not cover any condition that has been diagnosed prior to taking out the policy. BUPA, for example, specifies that the policy is designed to cover conditions that are diagnosed once the policy is in place, but nothing before. It even specifies that chronic conditions may be excluded (or not fully covered) as well because:

These conditions aren’t covered because health insurance is used to treat acute conditions where you can receive treatment in a private healthcare facility to restore your health back to how it previously was. You can however, sometimes claim for unexpected flare ups of chronic conditions.

https://www.bupa.co.uk/health/health-insurance/understanding-health-insurance/private-health-insurance-exclusions

So definitely figure out the exclusions for the policies you're looking at.

@girish also know that if you need to pay out of pocket to see someone, it's not SUPER scary costs.  Probably £250 or so for an initial appointment.  Then they can refer you down the NHS path with a plan/diagnosis if needed to help push you along in the queue.  I really wouldn't worry too much. 

You won't have difficulty or be denied having your continuity of care.  The bigger "risk" is potential wait times to get on a routine schedule.  But that can be overcome with a good GP or going direct if need be. 

Random fun fact.  It may be exactly the same in the USA.  But Air Ambulances here have a doctor (usually a trauma surgeon) on board.  I think that's pretty badass.  They will get a person stabilized in situ before taking them by air or land to the hospital.  Also if you are not well enough or unable to drive, regular GP's will do housecalls.

They typically release you quite quickly after giving birth here.  But that's because you get loads and loads of home visits after birth.  I had issues with both pregnancies so started with 2 visits each day and then they dropped to 1 visit a day when everyone was comfortable to do so.  Fantastic breastfeeding support, etc.  None of this making new mothers leave the house and go sit in a waiting room at a doctors office.  For all it's faults, when the NHS is shining in her glory.  WOW, does she shine! 

There's a bit of a learning curve though.  You have to learn the system and know what is/isn't reasonable to ask of it. 

Random fun fact.  It may be exactly the same in the USA.  But Air Ambulances here have a doctor (usually a trauma surgeon) on board.  I think that's pretty badass.  They will get a person stabilized in situ before taking them by air or land to the hospital.  Also if you are not well enough or unable to drive, regular GP's will do housecalls.

They tend to be funded by charities.  https://www.airambulancesuk.org/

You can fund raise for them or just donate what you can, no matter how small as it all adds up.

For emergencies in the Lake District you may now be attended by a jet powered paramedic.

If i stay in Kingston (thats where we are planning to stay) can i not visit NHS in Kent for eg?

Only hospitals in England, as that is where you will be living. Since devolution, the four nations have their own NHS. e.g. if you lived in Wales and wanted a hospital in England, you would need to get approval from NHS Wales, who would have to fund your treatment (pay NHS Engalnd). The 4 NHS bill each other. For a minior accident when visiting you can use their NHS and they will then bill your NHS (all the time you are legally in the UK).

Choice is limited for some conditions.
https://www.nhs.uk/common-health-questions/nhs-services-and-treatments/can-i-choose-where-to-receive-treatment/

As said, find a job where they provide private healthcare for their employees and their partner and children.

Paying for private healthcare directly in Europe, doesn't seem to be anywhere near the cost of that treatment in the US. Have a look on the internet to get some idea of the prices.

Also be aware that not every treatment is paid for by an NHS and not all NHS offer the same treatment for free. Sometimes you have to pay privately for the treatment you need, either in the UK or another country.

We took out private insurance when we arrived back in England and have used it several times. Cost was £80/month for both of us and includes dental and vision. 5 years on and it is £120/month but we are now in our late 60s. The policy we have has moratorium underwriting and the only pre-existing condition either of us had was my atrial fibrillation. To keep costs low it only pays for specialists if the wait to see the specialist or have a operation on the NHS would be longer than 6 weeks. As it happens I was seen by a heart specialist very quickly, was very impressed with all the tests and appointments and rather than put me on any medications told me I was a good candidate for cryogenic ablation and would have probably have been seen within 6 weeks except we were going on a Norwegian cruise and they were very flexible in the timing of the surgery, waiting until after we had returned.

Our insurance includes 5 video same day GP appointments per year for each of us. when I hurt my knee in October 2020 I took a photo of it, booked an appointment, uploaded the photo and the GP asked me a bunch of questions then said he would refer me to a specialist. Within the hour I had the referral letter in pdf format. I looked up the specialists online that practiced at our closest private hospital before calling the insurance company. This was in Covid times so the agent had no issues with the NHS waiting time being greater than 6 weeks, and he asked me review the bios and choose a specialist. I had an appointment a few days later, MRI same day as the appointment and diagnosis of a badly torn cartilage. Surgery and follow up appointments all went well.

Moratorium underwriting is a process by which insurers determine the terms of health insurance, where they exclude all pre-existing conditions from the last five years for a period of two years. After that, the list of pre-existing conditions is reconsidered, and insurance policy exclusions may change.

@girish also know that if you need to pay out of pocket to see someone, it's not SUPER scary costs.  Probably £250 or so for an initial appointment.  Then they can refer you down the NHS path with a plan/diagnosis if needed to help push you along in the queue.  I really wouldn't worry too much.

I think for most fully self-funded private appointments, approximately £300 is the max. My MIL's quote for a private consultant rheumatology appointment (southwest England) was about £150 (not including any further actions like testing or treatment). When I looked for an equivalent in London, estimates were about £270-£280 (also, just for the appointment only).

You won't have difficulty or be denied having your continuity of care.  The bigger "risk" is potential wait times to get on a routine schedule.  But that can be overcome with a good GP or going direct if need be.

Exactly! I think the key word here is routine. In my experience, the longest wait times are for routine things that don't have a clinical urgency. If you need a surgery (or other treatment or procedure) within X days or harm will occur, it would be rare to not receive that intervention within that timeframe.

Of course, there will be horror stories of people who have received substandard care (and they are certainly not excusable or acceptable!), but for the majority of people, there aren't significant problems accessing the care needed in a clinically appropriate timeframe.

I moved over with multiple health problems (including a pre-cancerous condition), and never faced any huge hurdles in accessing care through the NHS. If anything, the NHS was more aggressive about monitoring (and eventually treating) me than my US doctor. I've never had private insurance, and the only time I was tempted to self-fund a private appointment was recently - and even then, I was able to get an NHS appointment moved up due to my GP writing a letter, so didn't need to go private anyway.

And when I got severe COVID in the first half of 2020, considering the state of COVID medical care (when we knew nothing about this virus and doctors were essentially making it up as they went), I think I had the best care that could be offered at the time.

(It's not my intention to dissuade you from purchasing private insurance - if you want to get private insurance, totally go for it! Just thought I would chip in a bit more with some of the positive experiences I've had. Hope you can sort out what works for you!)

MP's (Members of Parliment, sort of like a congressperson) also have surgeries.  Not sure anyone else does?  I wouldn't be that surprised if anyone who had open office hours where anyone can drop in might call it a surgery. 

It used to confuse Americans when I would talk about someone going to theatre, meaning the operating theatre!
It's a whole different language. 

Thanks folks. Our son’s recovery has been remarkable and he is very much a changed person since his brush with death. He has done major renovations to his house and is overall much more positive and upbeat these days.

That's so great to hear, I'm so happy for him.

And with his sister talking about moving back to this very town (where she was born) then our family may be together in the same place for the first time since 1999 when our daughter left for college in another State.

Fingers crossed it all works out, that sounds like it would be amazing for all of you!

Maybe this will be of help?

https://www.nhs.uk/nhs-services/hospitals/guide-to-nhs-waiting-times-in-england/

It appears to be what they plan. I've no idea if what they plan is what is actual reality, but it is a start?

The first office refused to take us on their roster because  we were both American and Irish, and not Scottish with a work history. They kept insisting that we had to have a work history or pay the requisite fee to the government as we were foreigners. In Scotland, if you live in the country with the intent that you will remain permanently, you are entitled to medical care regardless of your prior work history there. And, if memory serves (and it's getting fuzzy now), as EU, we should have not had to pay any more than a citizen paid for care. 

The EU Directive said only EEA/CH citizens who are worker qualified persons can have what a citizen of that member state can have, for themselves and all the thier family members..

The 2004 Directive states that those who are only students or self sufficient qualified persons must not be "an undue burden" to that member state and these must have Comprehenisve Sickness Insurance for themselves and every family member they brought with them (even if that non-EEA/CH family member is working). Do you remember how you looked into if your health cover was viewed as a CSI and bought (?) a CSI for your US citizen daughter?

Things have, of course, changed with Brexit.

Completely changed. There are no more "EU rights" in the UK. NHS England have also instructed their OVMs to take an EHIC for A&E for those who are visitiing, to claim those costs back from an EU country.  Not sure what NHS Scotland is doing. Some EEA countries have negotiated a deal for limited NHS treatment for their visiting citizens. Those arriving at the NHS with status under the Withdrawal Act, will need to prove to the NHS that they are living in the UK to avoid being charged (with 50% added), just as British citizens and those with ILR have to do.

Some EEA countries have negotiated a deal for limited NHS treatment for their visiting citizens.

We went to Spain in March and our EHIC had expired so before we left we applied for and received a UK Global HI Card (GHIC), free of charge, good for 5 years. It can be used in all of the EU. It is also valid in Switzerland under certain conditions and in Norway a UK Passport gets you treatment for essential healthcare. 

https://www.gov.uk/global-health-insurance-card

You can use a GHIC or an EHIC if you’re travelling to an EU country.

Visiting Switzerland
There are different rules for using your GHIC or EHIC card in Switzerland.

To use your GHIC or EHIC in Switzerland, you must be one of the following:

a British national
a Swiss national
an EU citizen
a refugee
a stateless person
the dependant or survivor of someone with one of these nationalities or statuses
Visiting Norway, Iceland or Liechtenstein
You cannot use a GHIC or an existing EHIC in Norway, Iceland or Liechtenstein. You’ll need travel insurance with healthcare cover.

You can use a UK passport to get medically necessary healthcare in Norway (for example emergency treatment, or to treat a pre-existing condition).