We have indeed already been through all this. The documentation makes it clear that if the need for, say, a hip replacement is causing pain and mobility issues, it will be done on the NHS at no charge. The "My Choice" option is for people who have been diagnosed as needing a hip replacement at some unspecified time in the future but who have not yet met the NHS criteria (which includes pain even at rest, and mobility issues). I don't see why this is so difficult to understand. Can you enlighten me, perhaps? Just because somebody "needs" something, such as a vasectomy reversal, circumcision for religious reasons or surgery for cosmetic reasons, it no longer follows that the NHS is willing to pay for it.