CXL paid for WPA medical insurance

[gr1ffiths]

Latest update....

Phoned BUPA and they rang me back after speaking to the policy operations department and they have said that they do not cover this treatment. a member of the complaints department phoned me back and basically confirmed that they do not pay for this treatment because of NICE guidelines etc etc.

So, I guess the fight begins... Should I know ask my consultant to write a letter saying that treatment would be the best option etc?? and does that letter get sent to them directly?? I will also draft a letter covering what has been said in previous posts in the mean while.

The woman also denied that BUPA had paid for CXL treatment from 2009 onwards... stating the NICE guidlines statement.

[longhoc]

Hi... yes, if you can, speak to your consultant and ask if s/he would be able to write a letter about you, your situation and the indication for crosslinking. Same suggested word pattern as already given in this thread. Ask for the letter to be sent to you not th insurer. Include the letter from the consultant with your letter, take copies of everything.

Please do let me know if you need any assistance with any of this. More than happy to help where I can.

Kind regards

Chris

[gr1ffiths]

Hi... yes, if you can, speak to your consultant and ask if s/he would be able to write a letter about you, your situation and the indication for crosslinking. Same suggested word pattern as already given in this thread. Ask for the letter to be sent to you not th insurer. Include the letter from the consultant with your letter, take copies of everything.

Please do let me know if you need any assistance with any of this. More than happy to help where I can.

Kind regards

Chris

Excellent Chris, Will draft a letter this weekend and speak to consultant as well. Many thanks!!

[sushila]

Hi,
Just thought I would let you all know,just heard from BUPA,and they have refused to pay for the treatment.The reason is still to do with NICE guideline and medical evidence which in their view the "quality and efficacy" of the procedure is not proven.I am absolutely devastated. This apparently has been looked at by the Medical director in BUPA .
They said that the past funding they have approved in the past has been in error!!!!!....not once but several times!!
Chris, I would like to take this further and really would appreciate some guidance on what my next step should be. I am still thinking of taking this to Watchdog.
I was told by the person I spoke to who is the customer relations manager that their were only 2 cases in the past that he was awrae of that they provided funding for.
If anyone has more information with regards to this,please let me know Any help will be hugely appreciated !

[gr1ffiths]

Hi,
Just thought I would let you all know,just heard from BUPA,and they have refused to pay for the treatment.The reason is still to do with NICE guideline and medical evidence which in their view the "quality and efficacy" of the procedure is not proven.I am absolutely devastated. This apparently has been looked at by the Medical director in BUPA .
They said that the past funding they have approved in the past has been in error!!!!!....not once but several times!!
Chris, I would like to take this further and really would appreciate some guidance on what my next step should be. I am still thinking of taking this to Watchdog.
I was told by the person I spoke to who is the customer relations manager that their were only 2 cases in the past that he was awrae of that they provided funding for.
If anyone has more information with regards to this,please let me know Any help will be hugely appreciated !

Sad times Sushila... I'm in the process of appealing to BUPA's good side. but it doesn't sound likely from what you have said.

I can't believe an insurance provider won't stump up for a relatively cheap procedure to potentially save themselves further expense, it'll be a damn sight more expensive if grafts are needed in the future. It makes no sense!!!

Come on BUPA sort yourselves out!!

[dalbeath]

So what was their justification for paying for 2 cases in the past but not paying for yours?

[sushila]

They told me it was a mistake!!...made twice!!! Might have been more cases but I am not sure.Does anyone else know how many cases BUPA have funded.I am going to contact WATCHDOG ! I know I might not get anywhere since BUPA is a big organisation and they have probabaly covered themselves, but I do feel that it is very unfair. They will fund this procedure IF it was a clinical trial ,but not otherwise. From my point of view what they are saying is if you want to take a risk with a procedure that is still being trialed,we will fund it BUT a procedure that is offered as the only alternative to halting progression by a leading consultant and is readily avaialable if you go for it privately is " inadequate in terms of Quantity and Quality ". I am absolutely amazed !!! Sorry about the rant...feeling very frustrated , angry and annoyed and I know I need to calm down!! ......I know I may loose this battle at the end of the day but I do feel an injustice has been done here.

If anyone has any advice or suggestions as to what I should do, please let me know !! This site has been an absolute godsent for me.Just to share things with people who will understand!

[sushila]

Hi Dalbeath, I am also going to take this up with the financial Ombudsman. Would you mind telling me what I need to do to do this since you have already entered thius process.
Many Thanks,
Sushila

[longhoc]

Hi Sushila

Sorry to read you're getting nowhere with this provider.

More than happy with assisting in taking this matter to the Financial Ombudsman Service.

Would you like me to send you a draft of the template for you to review and if you're okay with it we can get the ball rolling..?

Best wishes

Chris

[sushila]

Hi Chris,

Yes please, that would be very helpful. Really appreciate your help with this.

Thanks,

Sushila