Maternity cost vs Health Insurance

turniton

Hi Guys,
here the most confused daddy of the week (or year)..
Me and my wife are early 30s, don t have a GP currently or Health insurance. Not Irish but have been living here for + 7years. always worked and paid our tax.

Now. we are pregant... as x citizensinformation.ie:
"
The combined medical services are provided by your family doctor (GP) and a hospital obstetrician.
The GP provides an initial examination, if possible before 12 weeks, and a further 6 examinations during the pregnancy, which are alternated with visits to the maternity unit/hospital. The schedule of visits may be changed by your GP and/or hospital obstetrician, depending on your individual situation.
If you have a significant illness, e.g. diabetes or hypertension, you may have up to 5 additional visits to the GP.
After the birth, the GP will examine the baby at 2 weeks and both mother and baby at 6 weeks.
Charges

The mother is entitled to free in-patient, out-patient and accident and emergency/casualty services in public hospitals in respect of the pregnancy and the birth and is not liable for any of the hospital charges"


So, when the Health Private insurance kicks in?.. I mean.. I m Italian and back in Italy women do montlhy visit to a Gynecologist (which I suppose the Health Insurance call "Consultants' fees)

I m just trying to understand which plan works better for us and when to get it!

NuMarvel

The information you've taken from the Citizens Information website is what is available to everyone ordinarily resident in Ireland, which I believe would include you and your wife and this stage.

As a very high level overview, health insurance in Ireland is (or at least is meant to be) an optional add on to the public system. All residents in Ireland are entitled to certain health services at no or minimal cost. The reason health insurance has such a high take up in Ireland is because many public services have long waiting lists to see a consultant or get into hospital.

Any health insurance plan you purchase now won't cover this pregnancy anyway, as they all have a one year exclusion on covering maternity related hospital stays.

She can still attend as a private patient of the obstetrician and the hospital, but you (and she) will be liable for the full costs, which will run to at least a couple of thousand euro. You can claim tax relief on some of this, and the out-patient cover on any health insurance plan you take out may cover a portion as well, but you would still be looking at being out of pocket by a significant degree.

sillysocks

If you go through the public system when pregnant you pay nothing. There are no consultant fees, and per your link you get doctor visits free too (I think a lot of doctors don't hold you to only the visits listed above, they will cover any pregnancy related visits but that can vary from doctor to doctor).

On the public system you normally just get hospital appointments for a consultant clinic, which means there are numerous other doctors under the consultant on in the clinic and you'd normally only see the consultant if there's an issue or specific need to. Appointments are normally given at same time for everyone and its first come first serve which can mean a bit of a wait at appointments. You also only get a public room in hospital after having the baby. The length of appointment wait and size if public room can vary greatly from hospital to hospital.

If you choose to go private to have the baby you should see the consultant for each visit, you would be entitled to a private room after the birth (if one is available), and would normally get a specific appointment time. Health insurance normally only covers a fraction of the consultants charge regardless of policy and depending on the policy it should cover the private room stay. From hearing friends I would think there'd be a shortfall of maybe around 2k between insurance and consultant fees (I'm sure someone else could give a better idea on figures)

Hope that info is all correct, that's my experience from having my last baby in public system, and from hearing about others using private consultants.

I have quite good health insurance but opted for the public system for both pregnancies. I found the care both times to be excellent and never felt badly treated because I was public. Longest ive been at appointments is probably 1.5 hours for the wait and time spent with doctors etc. and the public ward I was in only had 4 beds so wasnt too bad at all. I'm outside of Dublin, I think there might be a bigger divide between public vs private within Dublin.

Hope that helps!

turniton

thanks NuMarvel,
so, if I go with a private insurance. I ll have to wait a full year before being able to claim any money.

so we could (will) go public, pay for private visit to a obstetrician and claim some of those money back?

Tipsygypsy

For any private insurance I'm aware of you have to have had the cover for a certain period (year in some cases) BEFORE you get pregnant. I doubt that any of them will refund you anything if you only join during the pregnancy.
I think in this case you will have no choice but to go public - which includes the combined maternity scheme that you mentioned - all pregnancy related visits to GP are covered and care in maternity hospital.

Or pay the full fees for private care yourself (which would be CRAZY expensive)

NuMarvel

sillysocks wrote: »

Health insurance normally only covers a fraction of the consultants charge regardless of policy and depending on the policy it should cover the private room stay. From hearing friends I would think there'd be a shortfall of maybe around 2k between insurance and consultant fees (I'm sure someone else could give a better idea on figures)

I can't believe I forgot about that. DOH!

turniton wrote: »

thanks NuMarvel,
so, if I go with a private insurance. I ll have to wait a full year before being able to claim any money.

so we could (will) go public, pay for private visit to a obstetrician and claim some of those money back?

With health insurance, the one year waiting period means that they don't cover any maternity treatment or admission that takes place in that year. That doesn't usually apply to any out-patient (consultant) visits, but you're still spending alot of money to get a small amount back. In your current circumstances, taking out health insurance just for the pregnancy would cost you more than simply going private yourself. And going private yourself could easily set you back four to five thousand euro, when you add up the various consultants and the hospital charges.

Another thing to consider is that Dept of Health guidelines state that swapping between the public and private systems for maternity isn't allowed. So once you start seeing an obstetrician privately, your wife might not have a choice but to use a private or semi private room once she needs to go into hospital. Those are only guidelines though, so I'm not sure how strictly they are enforced on the ground. It might be no harm to ring your local maternity hospital/unit to see what they do in practice.

I hope that helps. Or at least, I hope I haven't added to your confusion!

uck51js9zml2yt

Also bear in mind that there is no guarantee the consultant will be available when your wife gives birth and she will give birth in the same area public patients will (Mt Carmel excluded).

As was also said private/SP beds are only given if available otherwise she will be in a public ward.

We went public in 2010, got the best of care and got a SP bed after he birth as a public patient.

The only difference is pre natal visits and having to wait with the masses for an appointment.

We found in the rotunda if you got a morning appointment to get there at 7 am to be first in the queue when the office opened at 8.

You may not get as many scans in public but they can be got privately. Its a lot cheaper than going SP/Private.

Moonbeam

The irish maternity system is unique.
It is extremely busy and over crowded but the midwives are amazing.
It is not usually to see a Gynecologist in Ireland during pregnancy but you see an Obstratician at your hospital appointments.
public,semi private and private are your options.
There is a difference between Mount Carmel and the public hospitals and there is a difference between private and public but you need to work out if the cost difference is worth it to you.
The maternity hospitals have websites which explain the main benefits of each type of care.

turniton

Just wonna say thanks to everybody for taking the time..
We also talked to a friend that has 2 babies and she s always been happy about her GP.
We manage to get the same GP and have an appointment shortly.

I m thinking also to go this saturday to the maternity unit and as the clueless guy that I am, ask all
the basics questions to them!

thanks again

January

I'd try and make an appointment with the maternity unit, they probably wouldn't take too kindly to you just turning up! Ask away here if you have any more questions.

turniton

thanks January, i ve actually just google it and called them!
i had a feeling that being saturday, it could have been worse than usual

uck51js9zml2yt

turniton wrote: »

thanks January, i ve actually just google it and called them!
i had a feeling that being saturday, it could have been worse than usual

weekends are usually skeleton staff. Was in the rotunda on Monday. Only 2 doctors for the whole building. don't have a baby at weekends