Advertisement
If you have a new account but are having problems posting or verifying your account, please email us on hello@boards.ie for help. Thanks :)
Hello all! Please ensure that you are posting a new thread or question in the appropriate forum. The Feedback forum is overwhelmed with questions that are having to be moved elsewhere. If you need help to verify your account contact hello@boards.ie

Health insurance - waiting period question.

Options
  • 07-05-2013 6:01pm
    #1
    Johnny262
    Registered Users Posts: 6 ✭


    Hi There,

    Can someone please give me the definition of a Pre-existing Condition that the Insurance companies use ?

    I have a health issue but I've being told by my GP that their is "nothing wrong" with me. Does a Pre-existing Condition only apply to an illness you have been diagnosed with ? I'm wondering if I can truthfully say to an Insurance company that I dont have a Pre-existing Condition because my GP wasnt able to find a problem.


Comments

  • Options
    #2
    LostArt
    Registered Users Posts: 1,813 ✭✭✭LostArt


    Johnny262 wrote: »
    Hi There,

    Can someone please give me the definition of a Pre-existing Condition that the Insurance companies use ?

    I have a health issue but I've being told by my GP that their is "nothing wrong" with me. Does a Pre-existing Condition only apply to an illness you have been diagnosed with ? I'm wondering if I can truthfully say to an Insurance company that I dont have a Pre-existing Condition because my GP wasnt able to find a problem.

    From VHI's terms and conditions:
    When determining whether a medical condition pre-exists membership it is important to note that it is the date of onset of the condition that is considered rather than the date upon which the member becomes aware of the condition, as medical conditions may be present for some time before giving rise to symptoms or being diagnosed.


  • Options
    #3
    NuMarvel
    Registered Users Posts: 3,279 ✭✭✭NuMarvel


    Johnny262 wrote: »
    Hi There,

    Can someone please give me the definition of a Pre-existing Condition that the Insurance companies use ?

    I have a health issue but I've being told by my GP that their is "nothing wrong" with me. Does a Pre-existing Condition only apply to an illness you have been diagnosed with ? I'm wondering if I can truthfully say to an Insurance company that I dont have a Pre-existing Condition because my GP wasnt able to find a problem.

    They won't ask you when you're joining if you have a pre-existing condition or not. It only comes up when you're making a claim, and it's usually based on information supplied by your treating consultant at the time.

    So if a consultant treating you in the future says the treatment was connected to something that was present before you joined, then the insurer could refuse the claim.


  • Options
    #4
    Johnny262
    Registered Users Posts: 6 ✭Johnny262


    NuMarvel wrote: »
    They won't ask you when you're joining if you have a pre-existing condition or not. It only comes up when you're making a claim, and it's usually based on information supplied by your treating consultant at the time.

    So if a consultant treating you in the future says the treatment was connected to something that was present before you joined, then the insurer could refuse the claim.

    Thanks for your reply.

    What about getting medical tests done, does the insurance company not pay for them up front ?

    I need tests done that will cost a lot of money I'm wondering if I can get medical insurance just so I can get these tests paid for.


  • Options
    #5
    Johnny262
    Registered Users Posts: 6 ✭Johnny262


    LostArt wrote: »
    From VHI's terms and conditions:
    When determining whether a medical condition pre-exists membership it is important to note that it is the date of onset of the condition that is considered rather than the date upon which the member becomes aware of the condition, as medical conditions may be present for some time before giving rise to symptoms or being diagnosed.

    Not sure how anyone would know when a condition first started ? take cancer or heart disease. These diseases can take years to build up.

    How would anyone (doctors or otherwise) know when the condition first started ?

    Anyone could have a serious health conidtion they are not even aware of.


  • Options
    #6
    belcampprisoner
    Banned (with Prison Access) Posts: 698 ✭✭✭belcampprisoner


    you might get a medical card

    http://www.ms-society.ie/pages/living-with-ms/benefits-&-entitlements


  • Advertisement
  • Options
    #7
    NuMarvel
    Registered Users Posts: 3,279 ✭✭✭NuMarvel


    Johnny262 wrote: »
    Thanks for your reply.

    What about getting medical tests done, does the insurance company not pay for them up front ?

    I need tests done that will cost a lot of money I'm wondering if I can get medical insurance just so I can get these tests paid for.

    If they are tests that the insurer will be paying upfront for, then chances are they won't be covered because they are related to something present prior to joining. There might be some exceptions to that, but that's the principle in general. Situations where the insurer is paying upfront, are when the insurer will ask your treating consultant for details on why the tests were needed, when did symptoms begin, etc.

    If these are tests that your chosen plan will cover as part of the out-patient benefit, then you might get something back, but that's subject to the specific terms and conditions of your chosen plan. For example, is there an excess to reach first, how much of a refund is allowed, etc.


  • Options
    #8
    Johnny262
    Registered Users Posts: 6 ✭Johnny262


    belcampprisoner wrote: »
    you might get a medical card

    http://www.ms-society.ie/pages/living-with-ms/benefits-&-entitlements

    I have a medical card but I have to wait a year just to see a consultant. I saw a private consultant who wanted me to have a few tests done which would of cost over a thousand euro which he admitted may not of even found the cause of my health issue. So I didnt get them done.


  • Options
    #9
    Johnny262
    Registered Users Posts: 6 ✭Johnny262


    NuMarvel wrote: »
    If they are tests that the insurer will be paying upfront for, then chances are they won't be covered because they are related to something present prior to joining.
    There might be some exceptions to that, but that's the principle in general. Situations where the insurer is paying upfront, are when the insurer will ask your treating consultant for details on why the tests were needed, when did symptoms begin, etc.

    If these are tests that your chosen plan will cover as part of the out-patient benefit, then you might get something back, but that's subject to the specific terms and conditions of your chosen plan. For example, is there an excess to reach first, how much of a refund is allowed, etc.


    I was told by my GP that gave me a blood test that their is "nothing wrong" with me even though I know for a fact their is. I wonder can that be used as proof that I dont have a pre existing condition ?


  • Options
    #10
    coylemj
    Registered Users Posts: 25,437 ✭✭✭✭coylemj


    Johnny262 wrote: »
    I was told by my GP that gave me a blood test that their is "nothing wrong" with me even though I know for a fact their is. I wonder can that be used as proof that I dont have a pre existing condition ?
    Johnny262 wrote: »
    I saw a private consultant who wanted me to have a few tests done which would of cost over a thousand euro which he admitted may not of even found the cause of my health issue. So I didnt get them done.

    Two questions....

    1. How did you get to see that consultant if your GP said there was nothing wrong with you - you normally need a GP letter of referral to see a consultant.

    2. Did you ask the consultant if he was prepared to medically certify the necessity for such a test if an insurance company was going to be paying for it?

    I ask the second question because the insurance companies don't put up with consultants sending people for unnecessary tests so when the consultant said he 'wanted you have a few tests done', he may have been humouring you based on the fact that you were a cash customer but he may not have been prepared to certify the necessity for such tests in order that they be paid by a third party.


  • Options
    #11
    Johnny262
    Registered Users Posts: 6 ✭Johnny262


    coylemj wrote: »
    Two questions....

    1. How did you get to see that consultant if your GP said there was nothing wrong with you - you normally need a GP letter of referral to see a consultant..
    I put pressure on my GP to write me a referral letter but they even said in the letter that they thought their was nothing wrong with me. I think the GP wrote the letter because he wanted to get rid of me as I was a medical card patient and I was I was going to the surgery a lot for an issue they couldnt find the cause of.

    coylemj wrote: »


    2. Did you ask the consultant if he was prepared to medically certify the necessity for such a test if an insurance company was going to be paying for it?
    He said he wanted me to have certain tests done including an MRI but I told him I had no insuranace and would need to know the cost of the tests he told me it would cost around 1000euro so I didnt get them done. He also said the tests he wanted me to have done first may not have found the cause of the problem so he would of needed to do further tests which would of cost me thosands of euro.


  • Advertisement
  • Options
    #12
    LostArt
    Registered Users Posts: 1,813 ✭✭✭LostArt


    Johnny262 wrote: »
    Not sure how anyone would know when a condition first started ? take cancer or heart disease. These diseases can take years to build up.

    How would anyone (doctors or otherwise) know when the condition first started ?

    Anyone could have a serious health conidtion they are not even aware of.

    Your gp/consultant will give the insurers an indication of the start of the condition. This is the general market practice.


  • Options
    #13
    coylemj
    Registered Users Posts: 25,437 ✭✭✭✭coylemj


    Johnny262 wrote: »
    He said he wanted me to have certain tests done including an MRI but I told him I had no insuranace and would need to know the cost of the tests he told me it would cost around 1000euro so I didnt get them done. He also said the tests he wanted me to have done first may not have found the cause of the problem so he would of needed to do further tests which would of cost me thosands of euro.

    He was fobbing you off in that case, same as your GP did. An MRI doesn't cost €1,000. I had an MRI in St. Vincent's Private in 2006, I had to pay on my credit card and then claim it back from the VHI, it cost less than €300.

    Euromedic in Dundrum will do an MRI on a GP referral letter but you will still need a specialist to look at the scan results.


  • Options
    #14
    NuMarvel
    Registered Users Posts: 3,279 ✭✭✭NuMarvel


    Jumboman wrote: »
    The MRI was just one test he wanted me to do he also wanted to do another test which involved putting a camera inside me, this would of being in The Beacon which I think is the most expensive hospital in the country.

    You? I thought it was Johnny262?

    And didn't you also start a thread claiming health insurance is a rip off?

    This is getting more confusing the more it goes on.


Advertisement