New member 'bubbles' & 'dent' any advice welcome

[longhoc]

Hi there Hayley

Private Medical Insurance (PMI) policies and what they'll cover for Keratoconus is a mixed bag unfortunately. It's a complex topic and each situation is different because a) each policy provider is different and b) your own circumstances vary too. But briefly as a general rule, here's what's likely to be covered and what's not

Typically Covered (but pre-authorisation is essential):

* Intacts
* Grafts (DALK or PK)
* Wedge sections where there is a clinical need e.g. >20D correction
* Cataract removal e.g. post graft due to lens fogging complications
* Treatment of acute hydrops during the initial occurrence and any complications
* Consultations with ophthalmologists

May be Covered:

* Crosslinking. This is the big one as far as most people with Keratoconus are concerned and alas the one with the most uncertainty. Some PMIs will cover the procedure without any hassles at all. Some will initally decline and relent if you kick up a fuss -- especially if the indication for the treatment is supported by the ophthalmologist. Some will play hard ball and fight all the way.
* LASIK or similar -- usually requires evidence of contact lens intolerance

Not Covered:

* Keraflex
* Intraocular Contact Lenses (ICLs) -- apart from a very few extremely limited exceptions
* Any sort of lens used for the palliative improvement of Keratoconus e.g. scleral, hybrid, RGPs, soft lenses for Keratoconus. A huge contention for people with Keratoconus because our lenses are not "nice to haves" for cosmetic reasons; they are an integral part of our treatment. But they're not covered so if you have to go private because your NHS provision doesn't offer what you need, it's Pay as You Go.

I work in insurance, been a while since I had any direct involvement in General Insurance which is what this sort of policy is, but I know the contractual, legal and consumer protection frameworks that apply so if there's anything you need to know, give us a shout.

Best wishes

Chris

[GarethB]

The level of cover also depends on if the private health care is taken out by an individual or if it is taken out by an employer.

Employers negotiate all sorts of additions & omissions to get themselves the best rate.

If I stay in the UK my employers healthcare excludes anything to do with KC, probably because we have the NHS, but the same employer but private healthcare if I moved to Belgium, France, Germany or Netherlands would cover all aspects of KC.

[Hayley]

I have an appointment at the end of the month at a private clinic in Guildford to see if I am suitable for CXL and an intac in one eye, I am going to try to get Bupa to pay for this as my partners health insurance is quite comprehensive... I will let you know how I get on with that!
Meanwhile I'm going to read about peoples experiances with having CXL and Intacs done, I'm quite nervous about the prospect, but if it means no more rigid lenses then its definately worth considering for me.
Thanks for everyones inputs, Hayley x