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Exclusions Apply: How Health Cash Plans Supplement Your NHS Healthcare
In the UK, we’re in the privileged position of having a free national health service. But not all of our healthcare is free. Prescriptions, dental appointments, and eyecare come at an additional cost. If we require unexpected dental treatment, for example, the cost can take us by surprise.
Many people are turning to health cash plans to spread the cost of important healthcare services not covered by the NHS. Often confused with private health insurance, health cash plans are designed to cover more routine costs for essential healthcare that isn’t covered by the NHS as standard. You pay into your health cash plan monthly and, depending on your level of cover, you can claim a certain amount of your money back. Health cash plans are used to help people spread the cost of healthcare, as well as plan for the unexpected.
Here are some instances when health cash plans would be especially beneficial.
Dental treatments
Regular dental care is essential to your oral hygiene and can even prevent serious diseases, including mouth cancer. But because it can be expensive, a third of adults in the UK avoid going to the dentist.
Many people are turning to health cash plans to cover routine dental appointments as they’re a great way to spread the cost of these check-ups. With some patients requiring quarterly check-ups, this could save a substantial amount of money. But what about emergency appointments?
Emergency appointments with the NHS are charged at a flat fee of £23.80, while Electric Teeth estimates private emergency appointments can cost between £70–£150. Emergency appointments can cover issues like knocked-out, broken, or cracked teeth with temporary fillings or treatments. Many people will then need permanent fillings or other solutions following this, which depending on the treatment, can cost hundreds of pounds.
With health cash plans, you could claim up to 100% of this cost back, up to the limits of your cover level. This gives you peace of mind should you ever encounter serious dental issues, whether it’s an accidental emergency or a long-term problem!
Eyecare
A lot of eye-related care is not covered on the NHS, which is a source of frustration for those with sight issues. The health service recommends eye tests at least every two years, and the cost can range between £10–£25. This might not seem like a high cost to pay every two years, but unexpected eye tests can come at a time when you might not have the cash available. If you notice any changes to your sight, it’s recommended you get an eye test to see if you require glasses or changes to your prescription.
Glasses can be a big expense. Designer frames can cost hundreds of pounds and even budget frames don’t come particularly cheap. An Evening Standard review of the best online glasses stores, which included high street retailers like Specsavers, revealed that even the cheapest prices start at around £30. A health cash plan can put your mind at ease when it comes to both routine and unexpected appointments.
Therapy treatments
If you’ve suffered from chronic back pain, you’ll know that there’s only so much support you can get from the NHS. Physiotherapy is free to patients, but wait times can be as long as 12 weeks. If you’re suffering from chronic pain, that’s a long time to wait to see a specialist.
Private physiotherapy is covered by many health cash plans, but these solutions also cover additional therapies, including chiropractic. Patients can use these two therapies in conjunction.
Chiropody is also covered in many health cash plans. While this may not be considered essential for some, people who have diabetes or kidney problems will require special attention. Raised blood sugar can damage foot sensation, while diabetes can also restrict blood circulation in your feet. Equally, people who are physically active may require additional chiropody treatment.
Other therapy treatments included on health cash plans include:
- Osteopathy, a treatment similar to chiropractic but applied to the whole body
- Acupuncture, which can help with chronic muscle or joint pain
- Homeopathy, which some use to treat long-term illnesses including IBS and dermatitis.
Prescriptions
The most recent NHS data shows that 48% of UK adults take prescription medication weekly. This can vary from anti-depressants and chronic pain tablets to eye drops and hayfever medication. But, considering the essential nature of these medications, they are not free to the majority of adults in England.
Over a billion prescriptions have been issued per year since 2016–17, meaning most people will require multiple prescriptions a year – or even a month. At a charge of £9.15 per item, rising to £9.35 in April 2021, this cost quickly adds up. If you take an anti-depressant along with a painkiller for your back pain, aqueous cream for a year-round skin condition, and diabetes medication, you could be paying close to £40 a month. If you suffer from seasonal conditions, this cost will rise throughout the year.
A health cash plan can help you manage some of these costs, saving you money and making your essential medication more affordable.
While much of our healthcare is free to us, there are some things that we need to pay for that don’t always come cheap. When looking at the cost of regular dental check-ups, eyecare, and prescriptions, it’s easy to see why people might be concerned about the cost. But with a health cash plan, you can not only spread the cost of routine appointments and prepare for unexpected expenditures, but you can also save money.
Sources
Preventive treatment reduces diabetic retinopathy complications
Early treatment with anti-VEGF injections slowed diabetic retinopathy in a clinical study from the DRCR Retina Network (DRCR.net). However, two years into the four-year study its effect on vision was similar to standard treatment, which usually begins at the onset of late disease. The intermediate findings published today in the JAMA Ophthalmology. The study was supported by the National Eye Institute (NEI), a part of the National Institutes of Health.
“While it is possible that preventive injections of anti-VEGF drugs may help protect vision in the longer-term, we saw no effect on vision at two years,” said Raj Maturi, M.D., Indiana University, the protocol chair for the study. “These 2-year results suggest that close monitoring and routine treatment when complications develop are key to preventing vision loss from diabetic retinopathy.”
An estimated 30 million Americans have diabetes, which can cause blood vessel abnormalities, including the growth of new blood vessels in the eye, called diabetic retinopathy. In the early stages of diabetic retinopathy, called non-proliferative diabetic retinopathy (NPDR), changes in the eye’s blood vessels are visible to clinicians but generally do not affect sight. In the advanced stages, people can develop proliferative diabetic retinopathy (PDR), where retinal blood vessels grow abnormally, and/or diabetic macular edema (DME), where fluid leaks out of the retinal blood vessels. Both can lead to vision loss and blindness. Treatment, such as with anti-VEGF drugs, can slow or prevent vision loss in people with PDR or DME, as long as treatment occurs promptly.
In this study, participants with NPDR were randomly assigned at baseline to receive either injections of Eylea (aflibercept) or a sham injection. They were examined at one, two, and four months, and then every four months for two years, receiving Eylea or sham injection at each visit. The researchers tracked their visual acuity and the severity of their diabetic retinopathy. If disease progressed, regardless of whether they were in the treatment or sham group, participants were given Eylea more frequently as is given in standard practice. If their condition did not improve with additional anti-VEGF treatment, participants could be given treatments such as laser photocoagulation or surgery if necessary.
The study included 328 participants (399 eyes). In two years, the rate of PDR development was 33% in the control group, compared with 14% in the treatment group. Likewise, the rate of development of DME affecting vision was 15% in the control group, compared with 4% in the treatment group. However, loss of visual acuity was essentially the same between the two groups at 2 years, suggesting that standard treatment at the appearance of PDR or DME affecting vision is sufficient to prevent further vision loss at this time point.
“We have a really good treatment for these diseases, so we can manage vision complications that may arise as disease progresses for many eyes,” said Adam Glassman, Jaeb Center for Health Research, director of the DRCR.net coordinating center. “When evaluating new preventative treatment strategies, it is important to compare them directly to the standard treatment after disease worsens, as we have done in this study.”
“Although we did not see any difference in visual outcomes at two years, the four-year follow-up is going to be very important,” said Jennifer Sun, M.D., M.P.H., Joslin Diabetes Center, Harvard Medical School, chair of Diabetes Initiatives for the Network. “We look toward the four-year data to see whether reducing rates of diabetic retinopathy worsening will lead to long-term improvement in visual outcomes.”
Helping childhood-onset lupus patients stay healthy as adults
Southwestern researchers have identified factors that put patients with childhood-onset lupus at elevated risk for poor outcomes, such as end-stage renal disease or death, as they transition from pediatric to adult health care. The findings, published online in Seminars in Arthritis and Rheumatism, emphasize the precarious nature of this period and shine a spotlight on areas prime for intervention to help protect these vulnerable patients. CREDIT UT Southwestern Medical Center
UT Southwestern researchers have identified factors that put patients with childhood-onset lupus at elevated risk for poor outcomes, such as end-stage renal disease or death, as they transition from pediatric to adult health care. The findings, published online in Seminars in Arthritis and Rheumatism, emphasize the precarious nature of this period and shine a spotlight on areas prime for intervention to help protect these vulnerable patients.
Patients with chronic diseases that used to be fatal early in life now often survive to live long lives. However, says study senior author Bonnie Bermas, M.D., professor of internal medicine at UTSW, while pediatric patients often have significant support in managing their conditions as children, they are expected to take much more responsibility for their health care as they transition to adult care.
Studies have shown that patients with chronic diseases such as HIV and sickle cell disease tend to have poor outcomes during this time. As an adult rheumatologist who cares for young adult patients with childhood-onset lupus erythematosus, an autoimmune disease, Bermas says she has witnessed a similar phenomenon. However, it’s unclear what factors put young lupus patients who transition to adult care at higher risk.
To explore this question, Nicole Bitencourt – a former UTSW pediatric and adult rheumatology fellow who is now on the faculty of the University of California Los Angeles Medical Center – along with Bermas and her UTSW colleagues used medical records to identify childhood-onset lupus patients who transitioned to adult care between 2010 and 2019. These 190 patients were seen at two different rheumatology clinics: One is a safety-net hospital that mainly treats patients with public insurance; the other is a university hospital that primarily sees patients with private insurance.
The researchers followed patients for an average of nearly 3.5 years and looked at three major outcomes: time to the first hospitalization following a patient’s final pediatric rheumatology visit; time to end-stage renal disease, a condition in which severe kidney failure necessitates dialysis; and death.
Of the 190 patients, 11 percent developed end-stage renal disease and 5 percent died during the follow-up period. Out of 114 patients with hospitalization data, 53 percent were hospitalized as young adults.
The research team found several factors linked with these poor outcomes. End-stage renal disease and death were associated with having public health insurance, a history of Child Protective Services involvement, and an unscheduled hospitalization during the final year of pediatric care. A shorter time to hospitalization in adult care was linked with a pediatric outpatient opioid prescription and Black race or Hispanic ethnicity.
Bermas, the Dr. Morris Ziff Distinguished Professor in Rheumatology, notes that these findings could help health care providers better target childhood-onset lupus patients who might be at higher risk of poor outcomes during their transition to make sure they have the support and resources needed to stay healthy after they become adults.
“Transitioning to young adulthood has its own challenges, but these patients are struggling with a chronic disease on top of that. We’re asking an awful lot of these patients to navigate the medical system, often with little support,” says Bermas. “By identifying those patients who may need more help, we can improve outcomes and even potentially save lives.”
‘DIY’ type one diabetes treatment demands clearer guidelines for patient benefit
Type one diabetes patients need a more open approach from their doctors, supported by clear professional guidance, to unregulated ‘Do-It-Yourself’ (DIY) artificial pancreas systems (APS) if they are to reap the potential treatment benefits, according to a new article.
Frustrated by slow progress in managing type one diabetes, some persons with the condition have created DIY systems. These use a smartphone or mini computer to link a continuous glucose monitor and insulin pump so that their bodies’ glucose levels can be frequently adjusted and maintained in real-time.
Globally, there is an almost complete lack of guidance – legal, regulatory, or ethical – for clinicians, leading to doctors being cautious about discussing DIY APS with patients, let alone recommending or prescribing them.
Experts at the University of Birmingham today published their findings in Medical Law International – calling for greater trust and transparency between adult patients and clinicians around the potential benefits and risks of using DIY APS.
Muireann Quigley, Professor of Law, Medicine, and Technology at the University of Birmingham, commented: “Clinicians are encountering more patients considering using DIY systems. However, lack of clear guidance means even specialist doctors are not starting conversations with their patients for fear of potential regulatory and legal ramifications.
“This approach undoubtedly threatens to undermine trust and transparency, making the goal of shared decision-making harder to achieve. Analysing professional guidance from the UK regulator – the General Medical Council – nothing within it should be interpreted as preventing clinicians from starting discussions about these systems.”
The team argues that the current cautious approach to discussing DIY APS means patients and clinicians cannot have open and honest discussions about the potential benefits and risks of using DIY APS, potentially damaging the doctor-patient relationship.
They note that, although the GMC advises clinicians to exercise caution before prescribing unapproved medical devices, they are not precluded from doing so – provided that doctors determine that DIY APS is both necessary to meet their patient’s needs and there is sufficient evidence of effectiveness to justify their decision.
Dr. Joseph Roberts, Research Fellow in Law and Philosophy at the University of Birmingham, commented: “If doctors are to take shared decision-making seriously, then, at the very least, they ought to be free to initiate conversations with their patients about DIY APS. For them to be able to do this, and given the increasing use of DIY APS technology, guidance on clinicians’ ethical and professional obligations has become an imperative – something which is needed sooner rather than later.”