Money-Go-Round: Will insurers prove themselves impotent? Medical Insurance In the wake of Viagra , insurers are scrambling to exclude impotence cover from their policies, writes Tom Tickell
TOM TICKELL
09/19/98
The Daily Telegraph London
Page 04
SUCH is the excitement about Viagra (at least among elderly men) that the Government felt obliged to announce this week that it will not be available on the National Health Service.
Money-Go-Round asked the private medical insurance companies whether they would pay claims by policyholders with prescriptions of this latest wonder drug. Perhaps surprisingly, two of the insurers said they may do so - but only on their most expensive policies. Meanwhile, other insurers are scrambling to exclude impotence from the cover provided by their policies.
Norwich Union and Clinicare are the companies that are willing to consider claims to pay for Viagra . A Norwich Union spokesman said: "We would not exclude claims for Viagra automatically on our Premier Care top-of-the range policy because this covers drugs prescribed outside hospitals.
"We will look at each case as it arises."
Clinicare's Carte Blanche policy will also pay for outpatient prescriptions, which might include Viagra if prescribed by a private doctor. A spokesman for the insurer said: "Carte Blanche will pay for drugs which alleviate chronic conditions, which other policies do not pay for.
"But doctors have to prescribe them for medical reasons. We aren't here to put nature into reverse by relieving impotence in pensioners. What's more, with all the worries over side-effects which apply to any new drugs, we'll go very cautiously."
Clinicare is hardly likely to face a flood of claims. Carte Blanche is a luxury plan at luxury prices. Typically, family policies cost between pounds 2,000 and pounds 3,000 a year, and you can only claim up to pounds 300 for prescribed drugs anyway.
Most medical insurers refuse to pay for drugs prescribed on an out-patient basis, that is, for people who do not stay in hospital overnight. This is likely to exclude most prescriptions of Viagra .
Bupa and PPP do not regard curing impotence as part of their policies' role. Bupa will pay claims for the cost of diagnosis but specifically excludes all the costs of treating impotence. PPP said: "We make a point of completely excluding impotence from our policies.
"It won't threaten your health and certainly looks like a chronic complaint, where there is no obvious cure.
"Medical insurance may cover most problems, giving you the security of a belt-and-braces approach. But belts and braces are hardly what you want if you have taken Viagra ."
Other insurers are following that lead. Guardian Direct is to withdraw cover for impotence from its policies next month, although staff claim that the decision was made before all the publicity about Viagra .
A spokesman for Telegraph Health Insurance stressed that any change of policy would simply raise costs for other policyholders. David Mutten of Provident Medical, which underwrites the scheme, said: "If we cover this risk, our subscribers would have to pay considerably higher premiums.
"We just do not think the potential benefit is worthwhile."
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