Not sure how to best utilise my health insurance

Tiddlypeeps

I'm going to have to go to A&E. Can anyone tell me if I would be better off going to a private hospital or a public one? I'd rather not subject myself to the waiting times of the public hospitals in my condition if I can help it but I have no idea what it will cost me to go to a private one, if anything. Beacon Hospital is pretty close to me so I was thinking that would be my best bet.

I'm with VHI, and my plan is Company Plan Extra Level 2. Here is a pdf of what I should be covered for: https://www.vhi.ie/pdf/myvhi/TOBCPEL2XS%20V10%20Jan13.pdf
I read it one way and it seems like I'll pay €75 either way regardless of public or private and I read it other ways and it seems like I'll pay hundreds. Very confused.

I think I will probably need an MRI and Beacon Hospital is listed under their approved centers. https://www.vhi.ie/pdf/products/mridirectory.pdf
Not sure what category 1 or category 2 means tho, one says full cover on my plan and the other say €125 excess. Since that hospital falls under both I'm not sure which applies.

I know it totally depends on what is actually wrong and what treatments I'll need etc. but since I don't know lets just assume for now I'm only looking for the cost of the diagnoses. Emergency room, a few scans and a talk with a doctor or consultant.

peteb2

So why would you have to go to A & E? Why would you not be going to your doctor and just be referred on in the normal manner?

Tiddlypeeps

peteb2 wrote: »

So why would you have to go to A & E? Why would you not be going to your doctor and just be referred on in the normal manner?

That's not really a helpful response. I'm not in a position to wait for a doctors appointment and then wait for an appointment for whatever they refer me onto. At best that would be weeks. I didn't come here looking for medical advice and that's banned by boards anyway. I'm just trying to get an idea of the cost of private health care with my insurance plan.

Since posting I have discovered that VHI have a clinic in Dundrum which is pretty close by that deal with emergencies. It's says they provide "treatment and advice to patients who suffered unexpected urgent illness or injury that does not pose a serious danger to their health but require urgent treatment."

That sounds like exactly what I need so I think I'll give that a go.

caitrionaanne

Martin00 - Do you work for Laya or something?? You have posted more or less the same thing on most of the health insurance posts!!! If this is their form of advertising, id be stayin away!!! haha

caitrionaanne

Tiddlypeeps - I see you have gotten sorted but i have had simaliar scenarios in the past. If you go to private a&e, i think the fee is €140 in the Beacon. Health insurers seem to only refund the public a&e's partially if you have that benefit on your policy. The VHI Swiftcare clinics are great but you will pay extra for xrays and that if needed. Hope you got on alright

peteb2

Tiddlypeeps wrote: »

That's not really a helpful response. I'm not in a position to wait for a doctors appointment and then wait for an appointment for whatever they refer me onto. At best that would be weeks. I didn't come here looking for medical advice and that's banned by boards anyway. I'm just trying to get an idea of the cost of private health care with my insurance plan.

The purpose of the question was to elicit exactly why you would approach it in that manner. Reason being that health insurance policies arent really geared to deal with you going through A & E. Because generally they will refund a portion of the amount. But when you go through A & E the inevitability is that you will end up through the public system and not benefit from having health insurance.

it was also to figure out whether you were actually talking about a real life situation or something hypothetical for the future.

I actually have a chronic illness. I went to the doctor who referred me on to a consultant for a test. I requested to go private. Took a week for me to get an appointment. So no need for the drama of saying you can't wait..........if there's nothing wrong with you.

Tiddlypeeps

peteb2 wrote: »

The purpose of the question was to elicit exactly why you would approach it in that manner.

As I said already that is unhelpful and irrelevant to the questions I asked. I was not asking if I should go to A&E or not.

Reason being that health insurance policies arent really geared to deal with you going through A & E.

You could have just said this to begin with. That would have been a helpful response. It would not have changed my mind about seeking immediate treatment, but it may have effected where I chose to go.

But when you go through A & E the inevitability is that you will end up through the public system

How does this work? Surely if I had gone to A&E in a private hospital like the Beacon then that is where I would be treated? Why would they send me on to a public hospital?

I actually have a chronic illness. I went to the doctor who referred me on to a consultant for a test. I requested to go private. Took a week for me to get an appointment. So no need for the drama of saying you can't wait..........if there's nothing wrong with you.

I don't really appreciate being called dramatic for not being able to wait a week to see a doctor when you have no idea what the issue is. Why would I want to go to A&E if there was nothing wrong with me

I do not want to give any more personal information than I strictly need to and I have no idea why you feel the need to become antagonistic because I won't give it.

The_Morrigan

OP ring VHI and ask them what you're covered for. I've had to ring them before to get them to explain what I was entitled to claim etc.
You are paying them a lot of money for cover make them work for it.

peteb2

I'm not being antagonistic. Some people tend to just go to A & E as opposed to their doctor. A & E is for just that, accident and emergencies. You want a diagnosis go to a GP.

Generally when someone mentions A & E they mean a regular hospital and not the Beacon A & E. But why don't you just ring the Beacon. Seeing as they are fully private and reliant on income and not government subvention they will be more than happy to let you know what is covered by your plan.

Addle

I would have thought that if someone had time to go online and make enquiries, they had time to go to a GP.

Tiddlypeeps

Addle wrote: »

I would have thought that if someone had time to go online and make enquiries, they had time to go to a GP.

A lot of minor injuries and a lot of infections are not life threatening but need to be seen to asap because they get progressively worse the longer they are left. And there is almost nothing a GP can do for anything that won't go away on it's own or get better with antibiotics or other drugs except refer on. An extra day or two/week or two can make a pretty large difference when something is likely to get progressively worse in a short space of time.

The reason I had a couple of hours to come on here was because if I went straight to Tallaght hospital A&E I was likely to be sitting in the really uncomfortable waiting room in significant pain for 6 to 12 hours. Or I could go straight to a private hospital and be seen to within an hour. That's a pretty big difference when it means sitting around in an uncomfortable environment in agony, so was worth taking the time to find out if I could afford to avoid the public waiting room.

Anyway I got treated in the end. The swiftfcare clinic was really fast, I was seen to straight away. The price was a bit higher than I expected since they don't offer anything off the cost of an xray to policy holders, but was worth not having to wait around in A&E for as long as I would have otherwise had to.

There aren't any public facilities like swiftcare for minor injuries (At least not that I'm aware of, please correct me if I'm wrong). The only option if you can't afford it is A&E. So claiming A&E is only for people who are literally about to die is really unhelpful. Those people are always rushed to the front of the cue anyway, so it's not like minor injuries and other urgent but not life threatening illnesses are causing deaths. If they are then the triage nurse would have a lot to answer for.