Private Health insurance, Consultant fees

Outkast_IRE

Basically my mother has private health insurance, she found out she had cancer and the health insurance covered the hospital stay and treatment.

However she has been to her various consultants at least 7 times this year with followups so far, and the charges range between 100-150 which she has been paying herself each time.

There will be more follow ups later in the year. That's a lot of money to pay out it adds up quickly.

Is she entitled to claim any of this money back and if so how.

Her insurance is with the vhi and is plan b or whatever they are calling it now.

LostArt

Yes she is, check her plan under the outpatient section for the returns allowed for consultant fees. An excess will also apply.

Bakemate

She should really change plan if she's on Plan B, or HealthPlus Access as they call it now, to a plan which will give her more money back for consultant's fees with a low outpatient excess. Currently she only gets €39 back per visit and that's only once she's exceeded the €300 excess. She can only count the amount Vhi give her towards a consultant visit, to exceed the excess, not the actual cost of the visit. If she was on a plan with a €1 excess and 50/75% back, it would be well worth her while financially. e.g. http://www.hia.ie/ci/comparison/step3?67&198&current=67/

Outkast_IRE

Not so sure its that simple.
She usually ends up in hospital about once a year for up to a week. This is fully covered to her current VHI plan, however on the plan you linked to there is a shortfall of 175 per night. That would add up quickly.

LostArt

What hospital does she attend?
The shortfall on laya's plan only applies to certain hospitals, The VHI plan also has shortfalls from my reading of the comparison

Outkast_IRE

LostArt wrote: »

What hospital does she attend?
The shortfall on laya's plan only applies to certain hospitals, The VHI plan also has shortfalls from my reading of the comparison

Cork, Bons Secours

LostArt

Ok so if you look at the comparison you'll see full cover on the Laya plan for a semi private room in a private hospital (Bon Secours) and €50 shortfall for a private room

coylemj

OP's mother is fully covered for hospital stays so that is not the issue, it's consultant visits when she's not in hospital that's the problem.

OP, you could consider upgrading her to a plan with better consultant benefits but there would probably be a waiting period based on her age i.e. you can't just upgrade when you take ill and start claiming straight away, the additional benefits under a new plan are subject to a waiting period.

Outkast_IRE

Thanks to the advice here I have made the first steps towards her and my father changing over to Laya Company Care Plus No Excess plan.

They were paying over 3000 to VHI for plan B no excess.

They will now be on Laya Company Care Plus No excess for less than 2500, which from my research is practically the same as plan B but allows you to claim 50% back on most medical expenses with a €1 excess.