UK Keratoconus Self-Help and Support Association

Hi All, I was diagnosed with KC at 18, I'm now 32 and have been struggling with lenses for years. I went to see a consultant in Manchester privately who told me I need a graft. I was really please to hear this as I've wanted it for years, he also said that I shouldn't be driving - this horified me. I am lucky enough to have provate medical cover at work but when I spoke to them (Remedi) and gave them the code for the op (C4630) they said that it was a transplant and that my medical insurance didn't cover transplants. Has anybody else had this problem? If so, did you manage to convince them?

I don't want to go off sick on the basis that my sight is not sufficient to drive to work, so I am considering paying for the op privately but will no doubt be put off by the cost, does anybody have an idea on how much it costs? Has my employer got a duty of care?

Many Thanks,
Craig

Hi Craig,

Your employer certainly has a duty of care towards you... but not necessarily a duty to pay for your operation.

I'm slightly surprised that your insurance company aren't playing ball - I'd check the policy exclusions carefully with your HR dept. at work, as usually, the operation is something that they will pay for - but not the non-surgical route. Certainly, BUPA were very happy to pay for my graft.

My graft was in Jan 2002, and probably cost about £5,000 at the time, with further costs for the very regular follow-up visits (say £800 a year for the first two).

Best of luck with your struggles; keep us up to date of your progress.

Hi All, Quick update on this. I received an estimate from my consultant of £4k which inludes all op costs pre-consultancy and 6 months worth of after care.

If anybody has healthcare provided by a company called Remedi then I'd be sure to check the policy exclusions. Remedi aren't actually a health insurance company, they solely administer a companies budget for employees healthcare and they also negotiate preferential rates with local hospitals within the facinity of the employer. It is therefore my employer who sets the policy about what is included or excluded from the cover.

An update on my plight ... HR have suggested that I meet with the occuptional health team (who defined the Remedi policy) to see whether my KC has been impacted by the use of a PC at work. If this can be proven then my employer may contribute to the cost of the graft. I'll post another update when I have an outcome. If anybody else is with Remedi or is in a similar situation please get in touch.

Cheers,
Craig

Very best of luck to you, Craig.

If their definition of proof is that your KC has got worse since you've been using a PC, then they're likely to pay up (in the fear that you'd sue them otherwise).

If they want medical proof that the KC was caused by the PC then you'll be very lucky to get a penny out of them.

In a meeting with HR, I'd be careful to point out that your work will probably improve following a graft, and that BUPA and Axa PPP to my personal knowledge do indeed cover this.

As I said before, I don't think that they have an obligation to fork out the cash, but if they did, they need to know that they would benefit.

All the best,