The true cost of going abroad
Long waits for NHS procedures mean more people go private. Those going further afield can recoup the costs, explains Teresa Hunter
Lengthy NHS waiting lists are driving more people to opt for private treatment abroad as a way to hasten an operation that will end pain or get them back to work.
The little-known fact is that much of the cost can be claimed back.
The numbers of patients waiting more than six months for treatment soared 40pc in September to nearly 152,000 compared with the same month in 2016, according to the latest figures from NHS England. More worryingly, 21,000 waited up to nine months – a 59pc surge.
Many are cashing in their Isas or pensions in order to buy private treatment.
While private medical insurance now protects only one in 10 adults, “self-payers” are rising by between 10pc and 20pc year on year, depending on region, with London seeing a 25pc annual increase.
But many could hold on to their savings by travelling abroad for an operation. Not only is treatment typically up to 20 to 40pc cheaper than paying privately at home, you can claim money back from the NHS, too. If you pay privately for treatment here in Britain you cannot recoup that expense.
This explains why the numbers going abroad for medical care have skyrocketed, up from 48,000 in 2014 to 144,000 last year, according to the Office for National Statistics.
Many patients are unaware they can claim the cost back from the Government. Family doctors, too, are similarly in the dark. An NHS spokesman said it could not provide any data about patients claiming refunds from the health service for operations abroad.
Keith Pollard, chief executive of Treatment Abroad, said there was widespread ignorance of what could be available.
“The average GP has no idea about the various options and the way they could be funded,” he said.
“But he or she should know. If patients are told that they face a long wait for an operation, the doctor should sit down with them and talk through a range of options, which may include going abroad.”
Medigo, another firm specialising in overseas treatment, said inquiries from UK patients about treatment abroad were 52pc higher than a year ago.
There are two ways to claim the cost of an overseas operation, one of which requires pre-approval by the NHS, and largely avoids having to pay upfront. The other option is to claim when you return after, hopefully, being successfully treated.
Telegraph reader Kevin Brady, 60, has successfully claimed the cost of a new knee – despite being told by his GP there was “no chance” the NHS would help towards the cost of an operation abroad.
Mr Brady said: “I am working, so time is of the essence. I had put up with agonising pain as long as I could, but I couldn’t go on any longer. I was then told I would have to wait six months for an operation.
“I paid to see a consultant here in the UK, who said a new knee would cost about £12,000 to have it done privately, at my local hospital.
“I was happy to pay. But the first date I was given was nearly three months away. Even paying privately I couldn’t get the operation as quickly as I wanted. That was when I started seriously looking abroad.
“I contacted a hospital in Lithuania. They quoted me €7,000 (£6,207), but they could fit me in within weeks. It was the time, rather than the money, which was the deciding factor for me.”
Mr Brady, of South Stifford, Essex, had heard that in certain circumstances it might be possible to get some help towards the cost of the operation, but when he asked his GP, she laughed, and said: “No chance”. So he didn’t pre-apply for funding, accepting he would probably have to pay the entire bill himself. But on his return he had one last shot at help, and was delighted when his application was successful.
Each new knee or hip costs the NHS between £5,000 and £10,000 depending on region, patient condition and how long they may need to be admitted to hospital. A private operation will cost between around £9,000 and £15,000. Treatment abroad is usually cheaper.
Only treatment costs can be claimed. Applications must include consultants’ reports about the urgent need for treatment. If treatment cannot be provided within an acceptable time-frame, known as “undue delay”, this is grounds for a claim.
Getting the green light before travel
If you wish to receive treatment in a state hospital in another European Economic Area (EEA) country or Switzerland, you can apply for the cost to be paid by the Department of Health, via the S2 route.
Where successful, you will be given an S2 form, which lasts for three months and will cover the cost of treatment as if you were a resident of that country. The drawback is that you will have to wait up to 20 working days for application approval.
Claiming on your return
Under the EC Directive route, you pay for your treatment in either a private or state hospital in another country, and then claim it back on your return to the UK. If your application is approved you will be reimbursed fully, without any deduction. However, you can only claim back as much as the treatment would have cost the NHS. If the treatment is more expensive, you’ll have to cover the additional costs yourself. Even with this option, some specialist treatments require pre-approval. Check before you travel.
You can request a review if your application is turned down and you have additional evidence that you believe can support your claim. If you have no additional evidence, you can appeal against the decision.
What can go wrong?
It is easy to find stories on the internet of operations abroad that have not ended well. However, according to the latest Treatment Abroad Medical Tourism Survey, due to be published in December, 71pc of those who travelled abroad recently for medical treatment said they were “very satisfied”.
Scarlett Mcnally, consultant orthopaedic surgeon and council member of the Royal College of Surgeons, said: “Patients considering going abroad for surgery must thoroughly research both the hospital and surgeon. Patients should also keep in mind that following their surgery they will not have access to the same surgeon who performed their procedure, as is expected in the UK. This can cause problems if there are complications, or a revision is needed, due to differences in surgical techniques.”