Parents with NO Health Insurance

mky17

Just a question to parent who DONT have health insurance -

Im a mum of 3 and pay 120 a month on health insurance and while i really cant afford it i pay it beacuse im afraid not too. But anytime i need a doc/ specialist(which isnt too often) i either have to fork out 100 a pop or wait on a list whats the point and i dont have medical card as we both work - but anyways would really like to hear from parents who go without it.

Thanks

January

You may still be entitled to a medical card, even if both of you work. It's based on income and outgoings, so things like mortgage payments, creche fee's and travel to/from work are taken into account. Try www.medicalcard.ie you may even be entitled to a GP only card.

bookworms

Hi MKY17,

I am a mum of 2 boys with no health insurance. Simply cannot afford it. Luckily we are fortunate that myself DH and DS are in good health and rarely visit the doctor or hospital. (touching wood) You can claim tax refund on many GP visits, medications, certain dental and others at the end of a tax year, so in that regard you do get some money back.

However, if any of you have a previous medical condition, will the health insurer cover you again if you break your cover?

Nuna

As Janurary said you may be entitled to a GP only or Medical card even though you are both working - do look into this.

In relation to giving up the Health Insurance look into things first. If you go to www.hia.ie you can compare Health Insurance Plans for all the companies here. Also look at changing your children's cover to a lower level - the higher level ones allow for private rooms in private hospitals etc - there are no private children's hospitals though.

If your children end up in hospital the current Public in-Patient rate is €75 to a max of €750 in a year. The public waiting lists can also be extremely long, so if the admission is non urgent the child could be waiting 12 months or more (depending on how serious the illness is of course) where as a Private Patient gets on the list faster (as they see the consultant faster) and are usually admitted to hospital faster as well.

Depending on your Health Insurance plan you can claim money back for GP visits etc and if they pay say €25 of your bill you can claim tax back on the remainder, at the end of the tax year.

If you do stop your health insurance and a condition arises that is considered to be pre-existing to a health insurance company - you wouldn't be covered for semi-private treatment for that condition for 5 years.

Hope this is clear!

uck51js9zml2yt

i'm with quinn/laya and paying a fortune for it.

i was looking last night and they ar doign a new policy called health smart - there seem to be a few variations but it has as good a cover as i have on company care choice with a significant saving.

it also has a 1euro excess.

The cheaper policies with high excess arent always worth taking if you ebing stung for 250 euro and are saving less initially by going for the cheaper policy.

they also have a few months free at the moment on their policies.

gaeilgegrinds1

I completely understand if someone cannot afford it but IF you can I'd be loathe to give it up. The waiting lists are horrendous in this country, if your children get sick you don't want to be waiting. It's common now to put the children on grandparent's policies if parents cannot afford it.

BostonB

Has anyone actually had direct experience of these waiting lists. Have to say we've not had much of wait for treatment. other than when admin staff are inept with the paper work. You have to chase them constantly. We haven't seen any different in waiting times between public and private because generally its the same doc/consultant, same treatment, probably even the same ward. You just get billed more when you go private. (as a child). In my experience the finance staff could explain any diference between public and private when the child is in the hospital.

Perhaps the waiting list is just for certain consultants and treatments? Non critical?

planetX

I think the lists are different for children and that public and private makes no difference, it's only adults with private insurance that can skip queues. Definitely for serious problems there's no public/private divide for children. Damn right too.

Jamey_29

I thought there was no difference but tested the situation to get the fastest treatment I could. My Son had a cyst on his neck that needed checking out. Our GP sent off for a referral to a HSE consultant. I also asked the GP to send a seperate referral to a private consultant that turned out to work in both Crumlin & Beacon (I have VHI). I had an opointment in the private clinic in crumlin within 2 weeks. The consultant said it needed to be operated on and we could get it done in crumlin but would have to wait or get it done within a couple of weeks in Beacon. I went with Beacon and everything was done within a few weeks. Consultant was 150 euro and excess in Beacon was 200 euro i think. Four Months later the letter from the public clinic came back to me....this is 3 moths after he had his surgery all done. So for us anyway there was a big difference. I think we claimed 65 back from VHI for the consultant.

However that all said...from experience. If dropping the Health cover is a must there is a way around speeding things up for your kids.
You get a private consultant referral....then go public for the treatment. Its usually the initial exam that cause the most delays. Then if there is something serious going on with it will get treatment ASAP. You just dont get the 65 euro or whatever it is now back.

This is just my opinion...

Moonbeam

The only experience that we has was 16 months v about 8 weeks to get the babies eyes tested.
I have heard and read so many stories about crazy waiting lists for kids to get their tonsils out too.
The only time it seems to make a huge difference is for initial consultants visits.

January

18 month waiting list to get a heart murmur checked out in Temple Street... not sure about private because can't seem to get through to the secretary to check.

Diddler1977

Jamey_29 wrote: »

However that all said...from experience. If dropping the Health cover is a must there is a way around speeding things up for your kids.
You get a private consultant referral....then go public for the treatment. Its usually the initial exam that cause the most delays. Then if there is something serious going on with it will get treatment ASAP. You just dont get the 65 euro or whatever it is now back.

This is just my opinion...

This not allowable. You can go public to private but not private to public in relation to consultation and then treatment.

Jamey_29

U can of course...in these situations alot of consultants see both Public & Private patients and once ur in the door ur choices for treatment are discussed. I've seen this done more than a few times. Of course u cant do this for the likes of maternity...

planetX

January wrote: »

18 month waiting list to get a heart murmur checked out in Temple Street... not sure about private because can't seem to get through to the secretary to check.

for a child?:eek:
That's disgraceful.

BanzaiBk

Jamey_29 wrote: »

U can of course...in these situations alot of consultants see both Public & Private patients and once ur in the door ur choices for treatment are discussed. I've seen this done more than a few times. Of course u cant do this for the likes of maternity...

???
As a secretary of a consultant (public servant alert) this is not at all possible in the way you describe.

kelle

When my daughter needed grommets I was pleased to have VHI as we were able to get a private consultant's appointment 2 months after referral from our GP, then the op was another month later.
The public waiting list was 12 months just to see the consultant. I dread to think how much school she could have missed out on!

How Strange

BanzaiBk wrote: »

???
As a secretary of a consultant (public servant alert) this is not at all possible in the way you describe.

I had to see a gastroenterologist recently which I did privately so I paid €150 and he recommended a colonoscopy. I asked if I could go public or private and he said it was my decision. I went private as I have health insurance but it seemed to me that I could've gone public and jumped the queue by paying for a private consultant appointment.

username123

BanzaiBk wrote: »

???
As a secretary of a consultant (public servant alert) this is not at all possible in the way you describe.

You can, Ive done it more than once. In fact, I thought thats what you were supposed to do.

Maybe the consultant you work for doesnt do it but many do.

mky17

Now im totally confused - however thanks anyhow all - keep them coming - i like the idea of paying for 1st visit to consultant(as this isnt covered anyway) and going public then....still afraid to drop it....

deisemum

My family don't have health insurance and my children are teenagers. The 16 year old only saw his GP recently and the last time he saw a GP he was around 2 or 3 years old and my 14 year old was 2 the last time he saw his GP so health insurance would have been a big waste.

I think it would be better to personally save the money and keep it for such a rainy day, then if you need to see someone privately at least you'll have the money to access treatment and if you don't need to use it then you still have it.

One thing I'd recommend take out is the €8pa insurance that you can take out for children once they start childcare or school. It will cover medical attention if they have an accident though not illness.

I've been seen a lot quicker on the public system than going private with my older child a while back. I had expected to be seen privately within a week or two, not 4 months where as I was seen on the public system within 5 days and my son had excellent public treatment.

EraseAndRewind

My son was very unwell with his tonsils and needed them removed -we have both vhi and medical card for him

He was getting sick and missing school constantly our GP referred us to a specialist through the public health system -when he saw my son he agreed that the tonsils needed to be removed urgently but the waiting list was 4 years

We reminded him that we also had Vhi and were told that he could get them out in 3 weeks

He is a completly different child since they have been removed but if we had to have gone on the public waiting list he would be still waiting

BanzaiBk

How Strange wrote: »

I had to see a gastroenterologist recently which I did privately so I paid €150 and he recommended a colonoscopy. I asked if I could go public or private and he said it was my decision. I went private as I have health insurance but it seemed to me that I could've gone public and jumped the queue by paying for a private consultant appointment.

You jump the queue of course to see the consultant. If you use your health insurance to pay for inpatient stays (policy depending) you are treated as a private patient and thus are subject to the private patient waiting list. Had you elected to go public you would have been placed on the public list. Usually private patients see the doctor within 2 months. My list at the moment is just over 10 weeks privately and 18 months publicly.

username123 wrote: »

You can, Ive done it more than once. In fact, I thought thats what you were supposed to do.

Maybe the consultant you work for doesnt do it but many do.

You've done what exactly? Paid to see a consultant privately for a sooner appointment or 'went public' for procedures? There are 2 lists - public and private. You can of course see a consultant privately and elect to go public with treatment but you will always be placed on the public treatment lists. That's just how bed management works.

Of course any emergency or high importance procedures will always be dealt with as speedily as possible regardless of your admin. category. I spend week after week chasing up beds and daycase slots for both public and private patients. Next week for example I have 2 patients in for scopes who were only seen publicly last week but are considered to be emergency category patients.

'Skipping the queue' so to speak doesn't really work nowadays as it used to.

Penny Dreadful

deisemum wrote: »

My family don't have health insurance and my children are teenagers. The 16 year old only saw his GP recently and the last time he saw a GP he was around 2 or 3 years old and my 14 year old was 2 the last time he saw his GP so health insurance would have been a big waste.

I think it would be better to personally save the money and keep it for such a rainy day, then if you need to see someone privately at least you'll have the money to access treatment and if you don't need to use it then you still have it.

One thing I'd recommend take out is the €8pa insurance that you can take out for children once they start childcare or school. It will cover medical attention if they have an accident though not illness.

I've been seen a lot quicker on the public system than going private with my older child a while back. I had expected to be seen privately within a week or two, not 4 months where as I was seen on the public system within 5 days and my son had excellent public treatment.

The problem with this is if you need surgery. The cost for an anaesthetist alone is huge and anyone would need a huge amount of savings to cover the cost of private treatment. Then if you happen to be unfortunate enough to require a longer stay in the hospital, ICU care, etc your bill will rocket.

Personally giving up my private health insurance would be one of the very last things I'd do. I think it is very important to have it.

username123

BanzaiBk wrote: »

???
As a secretary of a consultant (public servant alert) this is not at all possible in the way you describe.

BanzaiBk wrote: »

You can of course see a consultant privately and elect to go public with treatment but you will always be placed on the public treatment lists.

Sorry, you seem to be contradicting what you said earlier.

I have paid to see a consultant privately but then been placed on a public list by him for treatment. More than once, with different consultants.

The bottle neck is usually the public wait to see the consultant, not the wait for treatment having seen him. So if you can afford to pay a consultant privately it is worth it to see him in (to use your example) 10 weeks, rather than 18 months.

BanzaiBk

Patients who step down from private to public are subject to a block of paused weeks on the waiting lists to readjust waiting times to reflect their admin. category.

username123

BanzaiBk wrote: »

Patients who step down from private to public are subject to a block of paused weeks on the waiting lists to readjust waiting times to reflect their admin. category.

But you are allowed to mix private and public which was the original point raised. And a block of paused weeks is nothing compared to an 18 month wait to see a consultant in the first place.

It is probably of more value to not have health insurance because if you save enough to see a consultant privately, you can then request to be treated publically - and if its an emergency - you will be treated quickly anyway.

So going on the information in this thread, what exactly is the point of health insurance? I mean I have it, I feel like I need it, but if you can skip the bottle neck on the consultants visit and then request public treatment - why do we have it? What am I missing?

ulinbac

I would never give up my vhi. You might think that you haven't used it for years but it will be needed some day. The public waiting list for my back surgeon is up to 3 years where I waited approx. One month for private. I am currently in a private hospital and will be for up to a month. I have been told that my bed for the month alone is 16k excluding treatments. I was admitted within 2 days of getting unwell.

Those that think they could just pay it when it comes up could be faced with a hefty bill that is not easy to pay.

BanzaiBk

Apologies if I gave the impression that you could not mix public and private care, that's not what I meant at all. I just meant that there are penalties imposed on people who step down categories and if you do step down categories you've outlaid money for only a negligible benefit. Sorry, my phrasing was confusing.

For parents who are reading this and are at pains about their health insurance or lack of it, generally I would say don't worry too much. GPs can urgently refer cases for public treatment as soon as possible. Serious cases will not be left lagging on waiting lists if your GP has any cop on at all. Pediatric lists move quite quickly and are dealt with as a matter of urgency. Community outreach clinics are a good way too of accessing consultants and their most senior associate doctor quickly.

Health insurance is handy for covering day-case procedures, inpatient stays, being reimbursed for medical imaging costs etc IF you are a private patient. There is a lot of confusion for people who have health insurance, especially recently with a lot of people stepping-down their cover to new packages which are attractively priced but cover very little with high excesses. When I get new prospective private patients I spend a good chunk of time explaining what costs they are now liable for. Out of 15 calls last week only 2 elected for private treatment.
As a private patient, health insurance DOES NOT cover the majority of 'outpatient' fees; consultants fees, any kind of plain x-ray films, ultrasounds, CT imaging, technician-lead testing, some blood testing ranges etc. You have to pay on the day for these or you are billed for them. At the end of your insurance year you present your bills to the company to be reimbursed. As a private patient, some policies do cover some MRI scans in some MRI centres. If you have a medical card but you are a private patient your medical card does not cover any imaging or testing.

How Strange

BanzaiBk wrote: »

You jump the queue of course to see the consultant. If you use your health insurance to pay for inpatient stays (policy depending) you are treated as a private patient and thus are subject to the private patient waiting list. Had you elected to go public you would have been placed on the public list. Usually private patients see the doctor within 2 months. My list at the moment is just over 10 weeks privately and 18 publicly

It may vary from consultant to consultant but I went to my gp on a Monday, got my referral letter, rang the consultants secretary on Tuesday, had my appointment for the next day which I paid €150 for, had my procedure on Thursday the following week which I did privately through my health insurance. The cost was approx €800. Thats the cost of my annual insurance policy.

Compare that to a public patient who probably wouldn't see a consultant for at least 2 months then has to be referred for a colonoscopy if you're referred straight away so another few months waiting. If I'd had cancer or a serious illness it would've been fairly advanced at that stage. Thankfully I'm fit and healthy but as least I know it for sure.

My husband had his wisdom teeth taken out privately last year usung his vhi so again he benefitted from private insurance. That's why I wouldn't cancel my health insurance for our family unless I absolutely had to. I think you could probably go onto a hospital plan with little or no day-to-day benefits which would be cheaper.

BanzaiBk

I'm glad you were happy with your treatment.

username123

BanzaiBk wrote: »

Apologies if I gave the impression that you could not mix public and private care, that's not what I meant at all. I just meant that there are penalties imposed on people who step down categories and if you do step down categories you've outlaid money for only a negligible benefit. Sorry, my phrasing was confusing.

For parents who are reading this and are at pains about their health insurance or lack of it, generally I would say don't worry too much. GPs can urgently refer cases for public treatment as soon as possible. Serious cases will not be left lagging on waiting lists if your GP has any cop on at all. Pediatric lists move quite quickly and are dealt with as a matter of urgency. Community outreach clinics are a good way too of accessing consultants and their most senior associate doctor quickly.

Health insurance is handy for covering day-case procedures, inpatient stays, being reimbursed for medical imaging costs etc IF you are a private patient. There is a lot of confusion for people who have health insurance, especially recently with a lot of people stepping-down their cover to new packages which are attractively priced but cover very little with high excesses. When I get new prospective private patients I spend a good chunk of time explaining what costs they are now liable for. Out of 15 calls last week only 2 elected for private treatment.
As a private patient, health insurance DOES NOT cover the majority of 'outpatient' fees; consultants fees, any kind of plain x-ray films, ultrasounds, CT imaging, technician-lead testing, some blood testing ranges etc. You have to pay on the day for these or you are billed for them. At the end of your insurance year you present your bills to the company to be reimbursed. As a private patient, some policies do cover some MRI scans in some MRI centres. If you have a medical card but you are a private patient your medical card does not cover any imaging or testing.

Very informative post, thank you.