Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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UK health insurance draws one line through this subject, and everything else follows from it: screening is excluded, diagnosis is often covered. A routine mole map on someone with no symptoms is screening, and is self-pay. Investigation of a lesion that is changing, symptomatic or diagnostically uncertain is a diagnostic procedure, and is frequently payable subject to policy. The awkward consequence is that a policy can decline the map and then cover the excision that map produced.
The Line Insurers Draw
| What you are asking for | How it is classified | Usual position |
|---|---|---|
| Annual mole map, no symptoms, nothing changing | Screening / preventive | Excluded — self-pay |
| Assessment of a specific lesion that has changed | Diagnostic | Often covered, subject to policy |
| Excision of a lesion assessed as suspicious | Diagnostic / treatment | Often covered |
| Histology on that lesion | Diagnostic | Usually follows the excision |
| Removal of a confirmed benign mole for appearance | Cosmetic | Excluded |
| Surveillance after a confirmed melanoma | Follow-up of a known condition | Depends heavily on the policy and whether the condition pre-dates it |
The same distinction is the one the NHS applies, which is why the two systems tend to agree about what they will not do. Neither funds looking at skin where nothing specific is wrong.
Why the Split Feels Backwards
Patients frequently point out that the logic runs against the medicine, and they are right to.
Surveillance exists to find melanoma before it has declared itself. The whole argument for it is that early detection at lower Breslow thickness changes what treatment is required. By the time a lesion is unmistakably symptomatic, some of that advantage has been spent.
Insurance is built the other way round: it indemnifies against an event rather than funding the prevention of one. A person with no symptoms has no claim, however sensible the screening is.
Being straightforward about that is more useful than arguing with it. If you are in a high-risk group, the practical position is that the map is a self-funded decision, and what it finds is usually not.
Getting Pre-Authorisation, in Order
Where a lesion is symptomatic or changing and you want the investigation covered, the sequence matters. Authorisation obtained after the appointment is considerably harder than before it.
- Get a referral. Most policies require a GP or specialist referral before they will consider an outpatient claim. A self-referral to a private clinic often falls outside the terms even when the underlying problem is covered.
- Call the insurer before booking, with the referral in hand. Ask for pre-authorisation and note the authorisation number.
- Describe the clinical problem, not the service you want. “A mole on my back that has changed shape and colour over three months” is a diagnostic question. “I would like a mole map” is a screening request, and will be assessed as one.
- Check what the authorisation actually covers. Consultation, procedure and histology may be authorised separately, and histology is the one most often omitted.
- Check the excess and any outpatient limit. Many policies cap outpatient diagnostics annually, and a mole assessment may sit inside a limit already partly used.
The Policy Terms That Decide It
- Screening and preventive exclusions
- The clause that catches mole mapping. Wording varies, but the effect is consistent: investigations performed in the absence of symptoms are not covered.
- Cosmetic exclusions
- Catches removal of a lesion confirmed benign where the reason is appearance. This applies even where the removal is performed by a consultant surgeon in a clinical setting.
- Pre-existing conditions
- Relevant if you have had a melanoma or an atypical lesion before the policy started. Moratorium underwriting typically excludes conditions from the preceding five years until you have been symptom-free and treatment-free for a defined period.
- Chronic condition exclusions
- Most policies cover acute conditions rather than ongoing monitoring. Long-term surveillance after a melanoma can fall foul of this even where the original treatment was covered.
- Outpatient limits
- A capped annual outpatient allowance changes the calculation on a £100 consultation plus £180 histology, particularly late in a policy year.
Self-Funding and Claiming Back
Where a lesion turns out to be significant after you have paid privately, retrospective claims are possible but less reliable than pre-authorisation. What helps:
- An itemised invoice separating consultation, procedure and histology, since insurers assess the lines independently.
- The clinical justification in writing — what changed, over what period, and why investigation was indicated. A clinic letter describing the lesion as symptomatic or changing is doing the work here.
- The histology report, which converts a request into a documented diagnosis.
- Evidence of a referral where one existed, even retrospectively.
What does not help is describing the visit as a check-up. That is a screening word, and it closes the claim.
What It Costs If You Self-Fund
| Item | Price |
|---|---|
| Mole mapping — complete package | £300 |
| Consultation and single-lesion check | £100 |
| Mole removal | £350 |
| Each additional mole removed | £200 |
| Histological analysis | £180 |
Everything is quotable before you attend, which also makes it straightforward to submit. Each subsequent annual map is also £300 — the full breakdown is in mole mapping cost: what is included.
Appointments at 101 Harley Street: mole mapping or contact the clinic.
Where the NHS Sits
If a lesion meets the criteria for urgent referral, the NHS route is both free and fast, and it is the right choice — across London, 95.2% of patients start treatment within 31 days of a decision to treat. Insurance is not an improvement on that pathway.
Where insurance and self-funding genuinely change the timeline is routine dermatology, where the wait sits: between 45% and 56% of patients wait over 18 weeks depending on the London region, and 38.8% in Hertfordshire and West Essex. The criteria and the routes are set out in removal on the NHS.
Frequently Asked Questions
- Is mole mapping covered by health insurance?
- Generally not. A routine map on a patient with no symptoms is classified as screening, and screening and preventive services are excluded by most UK policies. Diagnostic investigation of a lesion that is changing or symptomatic is a different matter and is often covered.
- What counts as diagnostic rather than screening?
- A specific lesion with a specific problem — it has changed in size, shape or colour, it bleeds, itches or will not heal, or its diagnosis is uncertain. Screening is looking at skin where nothing in particular is wrong.
- Do I need pre-authorisation?
- Almost always, and it is far easier obtained before the appointment than after. Most policies also require a GP or specialist referral first; a self-referral often falls outside the terms even where the underlying problem would be covered.
- How should I describe it to the insurer?
- Describe the clinical problem rather than the service. “A mole that has changed shape and colour over three months” is a diagnostic question. “I would like a mole map” is a screening request and will be assessed as one.
- Is histology covered separately?
- It is often authorised as a separate line, and it is the item most frequently omitted from an authorisation. Worth confirming specifically rather than assuming it travels with the procedure.
- Can a policy decline the map but cover what it finds?
- Yes, and this is the common outcome. The map is screening and excluded; the lesion it identifies is a diagnostic problem and frequently covered. It feels contradictory but follows directly from how the policies are written.
- I have had a melanoma. Will surveillance be covered?
- It depends on whether the melanoma pre-dates the policy and on how the policy treats ongoing monitoring. Pre-existing condition and chronic condition clauses are the ones to read, and NHS follow-up runs in parallel under NICE guidance regardless.
- Can I claim it back afterwards?
- Sometimes, but retrospective claims are weaker than pre-authorisation. An itemised invoice, a clinic letter setting out what changed and why investigation was indicated, and the histology report all help. Describing the appointment as a check-up does not.
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