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Health Insurance and Exclusions/Pre-existing conditions

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  • 18-01-2011 4:04pm
    #1
    axer
    Registered Users Posts: 5,517 ✭✭✭


    Hi,

    My german girlfriend has a rheumatoid condition and is living here. She currently has a medical card.

    I believe there would be a 5 year exclusion for pre-existing conditions. Does that mean she could not make any claim for anything under the insurance for the first 5 years? or how would it be determined whether something was related to a pre-existing condition?

    Just trying to figure out if there would be any benefit for her in private health insurance at all.

    Thanks for any/help advice.


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    #2
    Dinky22
    Registered Users Posts: 259 ✭✭Dinky22


    My understanding is that the VHI does not cover any pre-existing conditions for 5 years from the time that one takes out their insurance. When your girlfriend would see a rheumatologist here he/she would review her condition and would know that is was a pre-existing condition. If she was admitted into hospital the rheumatologist would have to fill out the back of a VHI Claim form and state when the condition occurred. I do not know about medical card requirements.


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    #3
    axer
    Registered Users Posts: 5,517 ✭✭✭axer


    Dinky22 wrote: »
    My understanding is that the VHI does not cover any pre-existing conditions for 5 years from the time that one takes out their insurance. When your girlfriend would see a rheumatologist here he/she would review her condition and would know that is was a pre-existing condition. If she was admitted into hospital the rheumatologist would have to fill out the back of a VHI Claim form and state when the condition occurred. I do not know about medical card requirements.
    Yep, thanks for the reply. I am just wondering where (if at all) the exclusions are limited e.g. god forbid my girlfriend broke her leg completely unrelated to her condition then I would assume this is covered. Just trying to figure out who decides and how clear it is. i.e will the health insurer refuse lots of claims saying it is related to pre-existing condition (much like in the USA).


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    #4
    Dinky22
    Registered Users Posts: 259 ✭✭Dinky22


    There is no reason that the VHI (I only mention them because I have insurance with them) should not pay for any claim that is not "pre-existing". They also have a rule that when you are a new customer that you have to wait something like 5 months (I could be wrong with this amount of time) before you can make a new claim. You should discuss your situation with the hospital consultant who will be filling out the back of the Claim form to ensure with him/her that is it not a "pre-existing" related condition. I know about the nightmares people have with US insurance companies. There are 3 private insurance companies here in Ireland - VHI, Aviva and Quinnhealthcare.


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