DEXA Scans Private Bone Density Tests
As an FCA-authorised expert that has helped arrange over 900,000 policies, WeCovr understands the UK private medical insurance market inside and out. This guide explains private DEXA scans for bone density and how they interact with your health cover, giving you the clarity needed to protect your future health.
Learn what a DEXA scan is and PMI coverage
A DEXA scan is the gold standard for measuring bone strength. It's a vital tool for diagnosing conditions like osteoporosis before a painful fracture occurs. But when it comes to paying for it, the lines between the NHS, self-funding, and private medical insurance can seem blurry.
This comprehensive guide will walk you through everything you need to know. We'll explore what a DEXA scan involves, who needs one, and the crucial question: will your private health cover pay for it? Understanding this is key to making informed decisions about your health and your insurance.
What is a DEXA Scan and Why is it Important?
A DEXA scan, which stands for Dual-Energy X-ray Absorptiometry, is a specialised, high-precision type of X-ray. Its primary purpose is to measure your bone mineral density (BMD), giving a clear picture of how strong and healthy your bones are.
Think of your skeleton as the scaffolding of your body. Over time, this scaffolding can lose density and become more fragile. A DEXA scan is like a structural survey that checks for any weaknesses.
The scan produces two main scores:
- T-score: This compares your bone density to that of a healthy young adult of the same sex. It's the most common score used to diagnose osteoporosis.
- Z-score: This compares your bone density to other people of your same age, sex, and ethnicity. It's often used for pre-menopausal women, men under 50, and children.
Here's what your T-score means:
- -1.0 or above: Your bone density is considered normal.
- Between -1.0 and -2.5: You have low bone mass, a condition known as osteopenia. This is a warning sign that you are at higher risk of developing osteoporosis.
- -2.5 or below: You have osteoporosis, meaning your bones are significantly weaker and more prone to fracture.
Maintaining good bone density is not just about avoiding broken bones. Strong bones support your muscles, protect your vital organs, and enable you to lead an active, independent life well into your later years.
Understanding Osteoporosis and Osteopenia in the UK
Osteoporosis is often called the "silent disease" because it develops without any symptoms until a bone breaks. It causes bones to become weak and brittle, so that a minor fall or even a sudden sneeze can cause a fracture.
According to the Royal Osteoporosis Society, an estimated 3.5 million people in the UK are living with osteoporosis. The condition leads to over 500,000 fractures every year – that's one every minute.
Osteopenia is the precursor to osteoporosis. It means your bone density is lower than normal but not yet low enough to be classed as osteoporosis. It’s a critical warning sign that you need to take action to protect your bones.
Key Risk Factors for Osteoporosis
While bone density naturally declines with age, certain factors can accelerate this process. Understanding your personal risk is the first step towards prevention.
| Risk Category | Specific Risk Factors |
|---|---|
| Non-Modifiable | Age: Risk increases significantly after 50. |
| Gender: Women are more at risk, especially after menopause due to the drop in oestrogen. | |
| Family History: Having a parent who had a hip fracture increases your risk. | |
| Ethnicity: Caucasian and Asian individuals are at higher risk. | |
| Previous Fractures: A fracture from a minor fall (a 'fragility fracture') is a major red flag. | |
| Medical Conditions | Rheumatoid arthritis, coeliac disease, hyperthyroidism, and some chronic kidney or liver diseases. |
| Conditions that cause long periods of immobility. | |
| Medications | Long-term use of high-dose steroid tablets (corticosteroids). |
| Certain treatments for breast cancer (aromatase inhibitors) and prostate cancer. | |
| Lifestyle Factors | Low Calcium & Vitamin D: Essential building blocks for bone. |
| Lack of Exercise: Particularly weight-bearing exercise. | |
| Heavy Drinking: Consuming more than 14 units of alcohol per week. | |
| Smoking: Smoking is directly toxic to bone-building cells. | |
| Low Body Weight: Having a BMI below 19. |
If several of these risk factors apply to you, it's wise to discuss your bone health with your GP.
How Does a Private DEXA Scan Work?
The good news is that having a DEXA scan is a simple, quick, and completely painless procedure.
What to expect on the day:
- Preparation: You'll be asked to avoid taking calcium supplements for 24 hours before the scan. You can eat and drink normally otherwise. Wear loose, comfortable clothing without metal zips, belts, or buttons.
- The Scan: You'll lie on your back on a padded table. A large scanning arm will pass slowly over your body. You need to stay still, but the process is non-invasive and you won't feel a thing. The machine doesn't touch you.
- Duration: The entire scan typically takes only 10 to 20 minutes.
- Areas Scanned: The most common areas measured are the lower spine (lumbar spine) and the hip, as these are common sites for osteoporotic fractures. Sometimes the forearm may also be scanned.
- Radiation Dose: A DEXA scan uses a very low dose of radiation. The exposure is less than you'd receive from a day's worth of natural background radiation, or about the same as a short-haul flight. It's considered extremely safe.
After the scan, a radiologist or specialist will analyse the images and prepare a report detailing your bone mineral density and T-scores. This report is then sent to your referring doctor or consultant to discuss with you.
Getting a DEXA Scan: NHS vs. Private Routes
There are two main pathways to getting a DEXA scan in the UK: through the NHS or by arranging it privately.
The NHS Pathway
To get a DEXA scan on the NHS, you will almost always need a referral from your GP. The NHS follows specific guidelines, set by the National Institute for Health and Care Excellence (NICE), to decide who is eligible.
You are likely to be referred if you:
- Are over 50 and have had a fragility fracture.
- Are under 40 and have major risk factors (e.g., long-term steroid use).
- Have a medical condition known to affect bone health.
- Are undergoing treatment that can cause bone loss.
The main drawback of the NHS route can be waiting times. While urgent cases are prioritised, non-urgent referrals for diagnostic tests can sometimes involve a wait of several weeks or even months, depending on local demand.
The Private Pathway
Opting for a private DEXA scan offers speed and convenience. You can often self-refer to a private hospital or clinic, although some may still prefer a GP's letter.
The primary benefits are:
- Speed: You can typically book an appointment within days.
- Convenience: Choose a time and location that suits you.
- Peace of Mind: You don't need to meet strict referral criteria. You can have a scan for your own information, for example, to establish a baseline bone density reading.
The main consideration is the cost. A private DEXA scan typically costs between £150 and £400, depending on the clinic and location.
NHS vs. Private DEXA Scan: A Comparison
| Feature | NHS Pathway | Private Pathway |
|---|---|---|
| Referral | GP referral is mandatory | Self-referral is often possible |
| Eligibility | Must meet strict clinical criteria | Open to anyone willing to pay |
| Cost | Free at the point of use | £150 - £400 (self-funded) |
| Waiting Time | Can be weeks or months | Usually a matter of days |
| Purpose | Primarily for diagnosis based on risk/symptoms | Diagnosis, screening, or peace of mind |
Does Private Medical Insurance Cover DEXA Scans?
This is the most common question we receive, and the answer requires a clear understanding of how private medical insurance (PMI) works in the UK.
The fundamental principle of standard UK PMI is that it is designed to cover the diagnosis and treatment of new, acute conditions that arise after your policy has started.
Crucially, PMI does not cover pre-existing conditions or the management of chronic conditions.
A DEXA scan is a diagnostic test. Therefore, whether it is covered depends entirely on the reason for the scan.
When a DEXA Scan is LIKELY to be Covered
Your insurer is likely to approve cover for a DEXA scan if it is part of the diagnostic process for a new, eligible medical condition.
Example:
- You are 58, have a PMI policy, and have never had bone issues.
- You trip over a rug at home and suffer a painful wrist fracture.
- Your orthopaedic consultant, whom you are seeing via your PMI, is concerned that the severity of the fracture is unusual for such a minor fall.
- The consultant refers you for a DEXA scan to investigate whether undiagnosed osteoporosis could be the underlying cause.
In this scenario, the DEXA scan is a necessary step to diagnose the cause of your acute problem (the unexpectedly severe fracture). Therefore, it would very likely be covered under the outpatient diagnostic benefits of your policy, provided you have sufficient cover.
When a DEXA Scan is UNLIKELY to be Covered
A DEXA scan will almost certainly not be covered by standard PMI if it is for:
- Routine Screening: You have no symptoms but want a scan due to your age or family history. This is considered preventative and is excluded.
- Monitoring a Pre-existing Condition: You were diagnosed with osteopenia or osteoporosis before you took out your policy. A scan to monitor the condition's progress would be excluded.
- General Health Checks: If the scan is part of a general "health MOT" without a specific medical problem being investigated, it won't be covered.
The Golden Rule: Always Get Pre-Authorisation Never assume a test will be covered. Before you book a private DEXA scan, you or your specialist must contact your insurance provider to get a pre-authorisation code. They will assess the clinical reason for the scan and confirm whether it meets the terms of your policy. Failing to do this could leave you responsible for the full cost.
As an expert PMI broker, WeCovr can help you understand the nuances of different policies and their rules around diagnostics before you buy.
How to Choose the Right PMI Policy for Diagnostic Cover
When choosing a private medical insurance UK policy, the level of cover for diagnostic tests is a key differentiator. These tests fall under your "outpatient" benefits.
Policies are generally structured in three tiers:
- Basic/Inpatient Only: These policies cover you only when you are admitted to a hospital bed. They typically offer very limited or no cover for outpatient diagnostics like DEXA scans.
- Mid-Range: These policies offer a set limit for outpatient consultations and diagnostics. For example, you might have a limit of £1,000 per policy year. This would usually be sufficient to cover a DEXA scan and the related consultant appointments.
- Comprehensive: These policies offer the most extensive cover, often with "full cover" for outpatient diagnostics, meaning there's no set monetary limit (though "fair and reasonable" cost clauses apply).
Comparing Outpatient Cover Levels
| Level of Cover | Outpatient Diagnostics (e.g., DEXA) | Typical Use Case |
|---|---|---|
| Basic | No cover or very limited (e.g., post-op only) | For those wanting cover only for major surgery. Not suitable for diagnostics. |
| Mid-Range | Capped, e.g., £500, £1,000, or £1,500 per year | A good balance of cover and cost. Sufficient for most diagnostic pathways. |
| Comprehensive | Full cover (no annual monetary limit) | For those wanting complete peace of mind and access to extensive diagnostics without financial caps. |
When comparing providers, it’s essential to look at these outpatient limits. An experienced PMI broker can be invaluable here. WeCovr's team can compare the small print from all the best PMI providers to find a policy that matches your specific needs and budget, saving you time and potential confusion.
Lifestyle and Prevention: Protecting Your Bone Health
While insurance is a safety net, prevention is always the best medicine. You have significant power to influence your bone health throughout your life.
1. Champion a Bone-Friendly Diet
- Calcium: This is the primary mineral in your bones. Adults need 700mg per day. Rich sources include milk, cheese, yoghurt, fortified plant-based milks, leafy greens like kale (but not spinach, as its calcium isn't easily absorbed), and fish with edible bones like sardines.
- Vitamin D: This vitamin is essential for your body to absorb calcium. The best source is sunlight on your skin. From October to March in the UK, the sun isn't strong enough, so the NHS recommends everyone considers a daily 10-microgram supplement. Oily fish, red meat, and fortified cereals are also good food sources.
To help you keep track of your intake, WeCovr provides all our health and life insurance clients with complimentary access to CalorieHero, our AI-powered calorie and nutrient tracking app. You can use it to monitor your daily calcium and Vitamin D consumption easily.
2. Embrace Weight-Bearing Exercise
Your skeleton strengthens itself in response to impact and resistance.
- Weight-Bearing Exercise: Activities where your feet and legs support your body weight are best. This includes brisk walking, jogging, dancing, tennis, and stair climbing. Aim for at least 30 minutes, five times a week.
- Resistance Exercise: Activities that make your muscles work against a force help to strengthen both muscles and bones. This includes using weight machines at a gym, lifting free weights, or using resistance bands.
3. Make Smart Lifestyle Choices
- Stop Smoking: Smoking reduces the blood supply to the bones and slows down the production of bone-forming cells.
- Moderate Alcohol: Regularly drinking more than the recommended 14 units per week is linked to an increased risk of osteoporosis.
- Maintain a Healthy Weight: Being underweight (a BMI below 19) is a significant risk factor for poor bone health.
By adopting these habits, you can build a strong "bone bank" in your youth and slow down the rate of bone loss as you age, significantly reducing your risk of future fractures.
As a WeCovr client, you can also benefit from discounts on other types of cover, such as life insurance, helping you build a comprehensive financial safety net for your family.
Real-Life Scenarios: When is a DEXA Scan Covered?
Let's look at some practical examples to make the insurance rules clearer.
Scenario 1: Sarah – LIKELY COVERED
- Situation: Sarah, 55, took out a comprehensive PMI policy last year. She has no history of bone problems. While gardening, she slips and fractures her ankle. Her private consultant is surprised by the break and wants to rule out an underlying issue. He refers her for a DEXA scan.
- Outcome: Sarah calls her insurer for pre-authorisation. Because the scan is to investigate the cause of a new, acute injury that occurred during her policy term, the insurer approves it under her outpatient diagnostics benefit.
Scenario 2: David – NOT COVERED
- Situation: David is 62. His mother had osteoporosis, and he's read about the risks. He feels perfectly fine but wants a DEXA scan for peace of mind and to get a baseline reading.
- Outcome: This is a preventative screening test. It is not investigating a new symptom or condition. Standard private health cover does not pay for screening, so David would need to self-fund the scan.
Scenario 3: Mary – NOT COVERED
- Situation: Mary, 68, was diagnosed with osteopenia seven years ago, long before she bought her current PMI policy. Her GP recommends a routine two-yearly DEXA scan to see if her bone density has changed.
- Outcome: This scan is for monitoring a known pre-existing and chronic condition. All UK PMI policies exclude cover for pre-existing conditions and the long-term management of chronic issues. Mary's insurer would decline cover, and she would either use the NHS or self-fund the private scan.
Frequently Asked Questions (FAQs)
Is a DEXA scan itself considered a pre-existing condition?
Do I need a GP referral for a private DEXA scan if I'm using my PMI?
What happens if my DEXA scan reveals osteoporosis? Will my PMI cover the treatment?
Can I get private health cover if I already have osteoporosis?
Navigating the world of private medical insurance can be complex, but you don't have to do it alone. Understanding what is and isn't covered is the key to finding real value and security in a policy.
Ready to find a private health cover plan that protects you and your family? The friendly, expert team at WeCovr is here to help. We compare policies from across the UK's leading insurers to find the right cover for your needs and budget, all at no cost to you.
Get your free, no-obligation quote from WeCovr today and take the first step towards peace of mind.
Related guides
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
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Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
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Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
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