Is Fibromyalgia Covered by Insurance?

Fibromyalgia can be extremely painful and challenging. It is a pain syndrome of chronic widespread musculoskeletal pain and fatigue, and although not life-threatening, it can be life-altering. As well as pain in the muscles, ligaments and tendons, cognitive abilities can also be affected with many patients reporting having ‘brain-fog’, where they find functions such as concentration and memory to be impaired.

There is no cure for fibromyalgia, but it is important to seek medical attention if you experience widespread pain that lasts for more than three months, as there are treatments available. The syndrome is becoming more well-known and awareness is also increasing, leading to more research and interest in finding answers to the root cause of the condition.

Fibromyalgia and Health Insurance

Health insurance, or private medical insurance, gives you a choice of care in the UK, rather than using the NHS. All insurance policies differ, although they tend to cover most in-patient treatments, such as tests and surgery, and also day-care surgery. 

Some policies extend to out-patient treatments, such as specialists and consultants, however your healthcare insurance won’t usually cover private treatment for pre-existing medical conditions or chronic illnesses.

UK residents get free treatment on the NHS and tend to buy private medical insurance to avoid long waiting lists for treatment on the NHS or if they want access to specialist treatment that isn’t available on the NHS.

For those who suffer from a chronic pain condition such as fibromyalgia or CRPS, it is important to check with health insurance companies before signing up to a policy whether your condition is covered and what level of treatment is included in your plan. Because there is no objective test for fibromyalgia and diagnosis is based largely on self-reported symptoms, many insurers specifically exclude fibromyalgia from coverage.

Fibromyalgia and Critical Illness Cover

Critical illness insurance provides additional coverage for medical emergencies like heart attack, stroke, or cancer, and cover can be helpful if you don’t have enough money saved to fall back on in the event that you fall ill unexpectedly and cannot work. Having mild fibromyalgia should not prevent you from getting critical illness cover, with some alterations to the normal terms. However, fibromyalgia income protection specifically is generally difficult to obtain.

Can I Claim Compensation for Fibromyalgia?

Although you might not be covered by critical illness insurance unless it is particularly disabling, if your fibromyalgia symptoms were caused, or were made worse as a result of another person’s negligence, then you may be eligible for a fibromyalgia compensation claim. Whether you were involved in a car accident that wasn’t your fault, had an accident at work, or had a slip/trip, you may be able to claim compensation for your losses.

In order to claim, you will need to be able to demonstrate that the negligence was the cause of your fibromyalgia symptoms. Additionally, the value of your claim will depend entirely on the severity of your symptoms and the effect it has had on your ability to work.

Medical experts will be instructed to assess your symptoms and provide their opinion on the effect your accident has had on your quality of life, and how that is likely to change in the future. If you’re looking to make a claim, the general rule is that you must claim within three years of knowledge of the negligence which caused your symptoms, however, there are exceptions to this rule.

If you are suffering from fibromyalgia, CRPS, or any chronic pain condition as a result of an accident that was not your fault, and even if you have an existing claim, get in touch with Brian Barr Solicitors to see if we can assist. It is simple and hassle free to move your claim to Brian Barr Solicitors who are experts in dealing with chronic pain litigation. Call us today on 0161 737 9248 or visit our website to find out more. 

We do not endorse any research, studies or sources mentioned within our blogs and comments. The blog is for information purposes only as we are not medical professionals. We do not endorse any medical advice provided and would strongly recommend anyone seeking medical advice to contact their local healthcare provider before any changes to treatment and / or management of your condition is undertaken.