VHI - are the advantages only a better hospital room ( considering cancelling )

mr_happy

We are a family of two adults early 40s and one kid.

Is it dangerous not to have medical insurance?

We will be looked after anyway?

NuMarvel

Not to be too pedantic, but the benefits of private health insurance is that it will cover some or all of the costs of receiving private healthcare. What's exactly covered depends on the plan you hold.

The main advantage of being a private patient is that in general it gives you quicker access than you would get being a public patient. As a private patient you'll see the consultant quicker, and you have a wider choice of hospitals to be admitted to which means shorter waiting times for admission, depending on what kind of treatment you need. The downside of all this is that you pay handsomely for the privilege of being a private patient (hence health insurance), whereas going publicly is effectively free (€75 per night for a max of 10 nights per year is the ceiling, including consultant costs before and after admission).

All of the above is on a general basis. There will be exceptions where there is little or no difference between public and private waiting times, I think neurology is one example. And the obvious exception is emergency treatment, in which case you'll be admitted as soon as is possible.

The National Treatment Purchase Fund seems to have made progress in reducing the waiting times to be admitted into hospital for non-emergency treatment, but they themselves say that the current bottleneck in the system is with people waiting to visit a consultant once referred by their GP. The NTPF has instigated some pilot programmes to tackle this, but there's nothing on a national level.

As such, my outlook is that health insurance is still a necessity, (but not one I'd go hungry for!). If the new Government can do something to tackle the waiting times for consultants, then I think this would reduce the necessity of health insurance, which is something I'd like to see.

In the meantime, as you would do with your car insurance or home insurance, always shop around on your health insurance, even if it's just to see if your own insurer has a better value plan. There is a bewildering array of plans on the market, but if you use the Health Insurance Authority's website, you'll be able to make a bit of sense of it. And it's no harm to check their latest news section every so often to see if there are any special offers running (usually reduced/free child rates).

broker2008

One claim for any of you will make it worth it. Work out what is important to you, Aviva and Quinn have loads of alternatives. Ring them both and them them what you are looking for and then look at hia website to compare against what you have.

twowheelsonly

Pretty much as the others say..
If push comes to shove and something serious happens that requires urgent consultation then it will stand to you by speeding up the process.

IMO though Maternity Cover is a total waste of money - that's basically a slightly better room (sometimes!!!) and an extra slice of toast. You'll be seeing the consultant, getting scans etc regardless of your status. if there's any inherent problems with the pregnancy then you'll be looked after in identical fashion.

broker2008

I met a lady today who told me she was in Holles Street, armed with private insurance and was told that there was no private room available. She told them she was checking out and within 10 minutes had the private room. 3 nights at close to a grand per night.....

jimoc

there was an article a couple of weeks ago in the Independent I think, that considered whether health insurance was worth it any more.
One thing it did mention was that for a child going to hospital it was basically useless, since there's no private childrens beds in this country even with insurance you still have to wait for a public bed.

Traumadoc

Unless your child is waiting to have an operation, such as tonsillectomy.

The private insuranse will allow you to jump a two year queue.

It's morally objectionable - rich get better faster care, but that's the way it is.

NuMarvel

jimoc wrote: »

there was an article a couple of weeks ago in the Independent I think, that considered whether health insurance was worth it any more.
One thing it did mention was that for a child going to hospital it was basically useless, since there's no private childrens beds in this country even with insurance you still have to wait for a public bed.

The paper is incorrect in stating that. Certainly, there are no private children's hospitals, and there are few if any private beds in the public children's hospitals. However, general public or private hospitals can take children as private patients for the more routine operations.

For example, a young relative of mine needed an operation to do with gromits and she had a choice of being admitted as a private patient to either a public or private hospital. And in a previous job, I often came across cases of children being admitted to private hospitals for tonsillectomies or the like.

Just to be clear, I'm not trying to scare-monger (honest!). I think the paper is correct stating that private health insurance doesn't make a difference for admission to the children's hospitals (Crumlin, Temple Street and so on), but it's not correct in implying that children will only ever be admitted to public beds.

okiss

Don't cancel your private health insurance if at all possible. If you cancel your insurance and need it later you will have a waiting period before you can make a claim. As you get older this waiting period increase and for a pre-existing condition it can be 5 years plus. At the moment you will be waiting months to see a consultant as a public patient and a long time after that if you need surgery.
I would look up the www.hia.ie and consider the following re your health insurance.
a) Your child does not need cover in the high tech hospitals ie mater private, blackrock clinc ect - they can be on a different plan to you - get a plan that has a €1 excess for gp visits each so you can make a claim with just one doctors visit. Check this out for you and your partner also.
b) Due to your age I would look for cover for high tech cardiac or high tech special procedures - ie heart bypass or major surgery in the mater private. Even if you had to pay an excess of ie €150 it worth it to have this cover if required.
c) If you are willing to pay an excess of €50/€125 it will bring down your cost.
You pay the first €50 or €125 of your claim and the health insurer pays the rest. Check this excess is per visit as some times it is per night. Spending an extra €100 a year more is worth it in this case as €125 + per night can add up.
d) Always look for the amount of money shortfall if you agree to a plan with an excess. Vhi have recently said they will cover 80% of costs with some plans ie operation cost €10000 they will pay €8000 leaving you with €2000 to pay.
I hope this is of help.

mr_happy

Thanks for all the advise.
I will weigh up our options.

broker2008

You can always reduce the level of cover, you could have 2 adults and a child covered for a little over €1,000. Don't let your cover lapse for more than 13 weeks or you will have to reserve your waiting period again unless out of the goodness of their heart, an insurer waives it.

Mucco

Does anyone know where current waiting list info is available?

I can't see the private hospitals being any better than public in terms of quality of service, so insurance is all about queue jumping.

Here's an example for heart bypass from UK

NuMarvel

The National Treatment Purchase Fund operates the National Patient Treatment Register, and their statistics can be found here. According to their most recent report, the median waiting time for admission to hospital is 2.3 months, with just under 20,000 people waiting more than three months to be admitted. That breaks down as 11,000 waiting 3 to 6 months for admission, 7,000 waiting 6 to 12 months for admission, and less than 1,000 waiting more than 12 months.

According to a report in today's Irish Examiner, there are another 30,000 people waiting less than 3 months for hospital admissions.

None of these figures include the time that people wait to see a consultant once initially referred by a GP. There doesn't appear to be any national figures on those patients.

Mucco

Thanks, that's what I was looking for

imokyrok

NuMarvel wrote: »

The National Treatment Purchase Fund operates the National Patient Treatment Register, and their statistics can be found here. According to their most recent report, the median waiting time for admission to hospital is 2.3 months, with just under 20,000 people waiting more than three months to be admitted. That breaks down as 11,000 waiting 3 to 6 months for admission, 7,000 waiting 6 to 12 months for admission, and less than 1,000 waiting more than 12 months.

According to a report in today's Irish Examiner, there are another 30,000 people waiting less than 3 months for hospital admissions.

None of these figures include the time that people wait to see a consultant once initially referred by a GP. There doesn't appear to be any national figures on those patients.

The main problem is actual initial consultation rather than the referral on into hospital. With VHI you can get an appointment with any consultant within a couple of weeks. With public consultants you can easily wait 18 months and more. I have VHI but even with it have gone public to avoid the out of pocket expenses at times. And that difference in waiting times has been a common experience for me.

I've often wondered if one could pay for the initial consultation and then get referred on into the public system for investigations etc. I've never been able to discover if this is possible.

NuMarvel

imokyrok wrote: »

The main problem is actual initial consultation rather than the referral on into hospital. With VHI you can get an appointment with any consultant within a couple of weeks. With public consultants you can easily wait 18 months and more. I have VHI but even with it have gone public to avoid the out of pocket expenses at times. And that difference in waiting times has been a common experience for me.

I've often wondered if one could pay for the initial consultation and then get referred on into the public system for investigations etc. I've never been able to discover if this is possible.

I checked this with the Dept of Health last year. Their response was that you can see a consultant privately and then ask to be put on a public hospital waiting list (if admission is needed), but your placement on the waiting list will be where you would be if you were a public patient all along, i.e. where you would be had you waited X months to see the consultant in the public system. Basically, you don't get to skip the public hospital queue, which I think is only right and fair. Why should someone get quicker and free public healthcare just because they paid the consultant?

The exception to this are what the Department refers to programmes of care that includes elements of both in-patient and out-patient care (e.g. maternity). In those cases, you can't switch between the public and private systems.

I don't know how to attach the documents that the Department sent me, but if you want to ask them for copies, the reference numbers are Circular 1/91 and Circular 5/91.