Trying to get radiotherapy for Dupuytren’s disease through private insurance? This step-by-step guide explains how to check coverage, get a referral, secure consultation approval, and apply for treatment authorisation.
If you have private medical insurance and want treatment with radiotherapy for Dupuytren’s or Ledderhose disease, it can be confusing to work out how the referral and approval process actually works.
Many patients get stuck at different points—uncertain about whether they are covered, who they need to see, or when to apply for authorisation. This guide explains the process step by step so you know exactly what to do.
Step 1: Check whether your insurer is likely to cover radiotherapy
Not all insurers cover radiotherapy for Dupuytren’s disease
- Bupa, Vitality, and WPA → usually cover radiotherapy for Dupuytren’s and Ledderhose disease
- Aviva → usually cover Ledderhose disease, but not Dupuytren’s
- AXA → generally do not cover benign radiotherapy
Action point
Before doing anything else, check which insurer you are with and whether they are likely to cover treatment.
If your insurer does not cover this treatment, it is usually not a good use of time trying to pursue it through insurance, as it is very unlikely to change the outcome.
Step 2: Get a referral for an initial consultation (not treatment)
You only need approval for the consultation at the start
A common mistake is trying to get treatment authorised before being seen. This isn’t possible, because the treatment plan depends on a proper clinical assessment.
What you need first is approval for an initial consultation only.
Where does the referral come from?
- Usually your GP
- Sometimes another specialist
- Some insurers offer their own GP service you can use
Action point
Request a referral for an assessment of Dupuytren’s or Ledderhose disease and suitability for radiotherapy.
Step 3: Attend the consultation to assess stage and treatment options
Treatment decisions depend on stage and activity of disease
At the consultation, your hands (and feet if relevant) will be examined to:
- Confirm the diagnosis
- Assess the stage and activity of the disease
- Decide whether radiotherapy is appropriate
For some patients, it will be too early for treatment. For others, it may be too advanced. Radiotherapy is only suitable at specific stages of the disease.
Why this step is essential
Until this assessment is done:
- We don’t know if radiotherapy is appropriate
- We don’t know what areas need treatment
- We don’t know what treatment plan is required
Action point
Attend the consultation before applying for any treatment authorisation.
Step 4: Apply for authorisation for radiotherapy treatment
Only apply once a treatment plan has been agreed
If radiotherapy is recommended, you then contact your insurer to request approval for treatment.
They will usually ask for:
- A clinic letter explaining the diagnosis and treatment plan
- Radiotherapy codes (provided by the treating team)
- Occasionally, a form for treatment authorisation
What usually happens
If:
- your insurer covers the treatment, and
- your case fits standard criteria
…then approval is usually straightforward.
Action point
Submit the clinic letter and required details to your insurer after your consultation.
Expert Non-Invasive Treatment for Dupuytren’s and Ledderhose Disease Across the UK
Dr Richard Shaffer set up Dupuytren’s UK in April 2011 to provide non-invasive treatments for people who suffer from benign conditions such as Ledderhose disease and early-stage Dupuytren’s contracture in the Guildford area. Today, Dupuytren’s UK offers this service to patients throughout the UK.
When might insurance not cover treatment?
Two common reasons for refusal
- Your policy specifically excludes Dupuytren’s or Ledderhose disease (often as a pre-existing condition)
- The disease is not at the stage where radiotherapy is normally used
Action point
Check your policy details if you are unsure, particularly for exclusions.
What does “experimental” actually mean?
This is an insurance decision, not a clinical one
You may be told that radiotherapy is “experimental”.
In practice, this does not mean that the treatment doesn’t work. It usually reflects the insurer’s internal policy about what they choose to fund.
Action point
Do not assume “experimental” means ineffective—seek a clinical opinion.
Who should you be referred to? This is a critical step
Hand surgeons treat late disease – radiotherapy specialists treat early disease
Dupuytren’s disease is often referred to:
- Hand surgeons
- Plastic surgeons
These specialists focus on advanced disease, particularly where contractures need to be released.
However, if your disease is early, the key decision is:
- observe, or
- treat with radiotherapy
Radiotherapy requires a different specialist
If you are considering radiotherapy, you need to see:
- a radiotherapy specialist, or
- a radiation oncologist
These are the only clinicians who can assess suitability for and deliver radiotherapy.
Action point
If you have early Dupuytren’s disease, make sure your referral is directed to a radiotherapy specialist, not a hand surgeon.
Summary: The 4-step process
You can follow this pathway
- Check your insurer covers radiotherapy
- Get a referral for an initial consultation
- Attend the consultation to assess suitability
- Apply for treatment authorisation if appropriate
