Insurance companies we work with - and how to make your claim

Every insurance company works slightly differently but this is our typical step by step guide for your private medical insurance to cover the costs of your procedure:

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1. Referral

You might need a letter from your GP - some policies require this, some don't. If you cant get to see your own GP, usually an online referral from an online GP is enough.

 

2. Finding the right surgeon 

Finding the right surgeon for you is usually done via personal recommendation, your own online research or after talking to your GP. Once you have decided who you want to be referred to, call your Medical Insurance Company, and check that the surgeon you want to be referred to is on their list - most are.

 

3. Authorisation from your medical insurer

Your insurer will then give you an authorisation number, and explain to you what cover your policy provides - whether it is the whole process from consultation to operation to post op follow up including any tests that might be required (most policies) or whether there are any excesses or exclusions - just like car insurance. Make sure you understand these.

 

4. Contact the surgeon

Then find the surgeon's contact details - often best done online as well. Then call his or her secretary, explain that you want an initial consultation to discuss tonsil problems, and tell her the authorisation number.

 

5. The initial appointment
At the appointment, bring your authorisation number as if you are being seen at a Private Hospital, they will want this. All appointment costs should be covered by your insurance.

 

6. Costs, practicalities and procedure
Following the appointment, if you decide you want to be treated, call the surgeon's secretary. All of the costs, Surgeon, Anaesthetist, Hospital, Consumables are usually covered by your Insurance. You may have to pay for painkilling tablets to go home with. Antibiotics aren't required. The secretary will offer some dates, choose the one that suits you best, and tell your employer you will need time off work, sick leave, for however many days the surgeon has advised you. For example with laser surgery for tonsils, if it's local anaesthetic no time off is needed - it can be done in your lunchtime. General anaesthetic needs at least 3 days off - the day of surgery, and at least 2 days post op, although you can work from home during those days. Other techniques usually require more time off, up to 3 weeks.

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7. After your operation
From an admin perspective, payments will be dealt with between the surgeon's office and your insurance company. Personally, remember you are not allowed to drive a motor vehicle of any sort for 24 hours after a general anaesthetic - for local anaesthetic there is no restriction. Post op follow up will be arranged by the Hospital, this is covered by your insurance as well. It usually takes place 4 weeks after the operation, and is a one-off, after which you are usually discharged.

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If your considering a tonsillectomy or similar treatment and have medical insurance, we hope this overview helps - but as always please check procedures with your medical insurer in the first instance.