Health insurance cover for blood test done by a GP

Bob24

I had a blood test done by my GP recently and VHI didn't cover any of it (the GP gave a receipt with two separate items for the consultation itself and the blood test; and VHI only paid me what they usually do on the GP consulatation part but 0 on the bloods part).

I checked the policy details (I am on a "Company Plan Plus Level 1") and I can't see anything about blood tests. But I am surprised it is not covered whatsoever as I think my plan is a mid-range one.

Is this standard practice for health insurrances not to cover this type of small investigative action which can be done by a GP but adds an extra cost to the consultation?

coylemj

How much did the GP charge for the 'consultation' - sticking in a needle and drawing a sample of blood? And how much for the blood test itself?

I'm in a similar 'Company Plan Plus' scheme but my GP practice only charges €20 for a blood test for which VHI refuses to reimburse a cent.

Incidentally, your GP practice doesn't pay a penny for that blood sample to be analysed, the HSE does it for free so you've been rightly screwed by being charged twice.

uck51js9zml2yt

coylemj wrote: »

How much did the GP charge for the 'consultation' - sticking in a needle and drawing a sample of blood? And how much for the blood test itself?

I'm in a similar 'Company Plan Plus' scheme but my GP practice only charges €20 for a blood test for which VHI refuses to reimburse a cent.

Incidentally, your GP practice doesn't pay a penny for that blood sample to be analysed, the HSE does it for free so you've been rightly screwed by being charged twice.

The gp pays for the courier to take the sample to the local hospital in addition to the costs attached to taking the sample and doing the paperwork that goes with it.

dev100

coylemj wrote:

Incidentally, your GP practice doesn't pay a penny for that blood sample to be analysed, the HSE does it for free so you've been rightly screwed by being charged twice.

The doctor has to pay the courier and he has to pay himself his/her staff , rates ,taxes and mortgages etc . The doctors time doesn't come free .... if he or she had 15 to 20 people to take blood samples from every day and each patient took 10 min that time is a cost on the doctors business and they would be financially at a loss

Bob24

coylemj wrote: »

How much did the GP charge for the 'consultation' - sticking in a needle and drawing a sample of blood? And how much for the blood test itself?

I'm in a similar 'Company Plan Plus' scheme but my GP practice only charges €20 for a blood test for which VHI refuses to reimburse a cent.

Incidentally, your GP practice doesn't pay a penny for that blood sample to be analysed, the HSE does it for free so you've been rightly screwed by being charged twice.

The consultation part was their regular 65 euros (which I know is on the expensive side but the practice is just next door to where I live and I trust them) and they charged 35 for the blood test. I am OK with having a separate charge (although I find it too pricey) as I didn't go there just for the bloods and had a few other small things I wanted reviewed.

I'm just wondering why it is not covered by the health insurer whatsoever and if it is common practice for most plans across the industry.

coylemj

Calliope Better Cloud wrote: »

The gp pays for the courier to take the sample to the local hospital in addition to the costs attached to taking the sample and doing the paperwork that goes with it.

OP was charged €35 for the blood test itself, the GP could send every sample to the local hospital in a separate taxi and still make a profit. Then there's the consultation fee...

dev100 wrote: »

The doctor has to pay the courier and he has to pay himself his/her staff , rates ,taxes and mortgages etc . The doctors time doesn't come free .... if he or she had 15 to 20 people to take blood samples from every day and each patient took 10 min that time is a cost on the doctors business and they would be financially at a loss

Ok, let's take the 'consultation fee' (€65) alone and disregard the charge for the blood test....

If the GP works 48 weeks a year, 5 days a week and takes 20 blood samples a day, at €65 a pop that would work out at €312,000 gross per annum for less than three and a half hours work per day based on 20 blood samples at 10 minutes each.

Gael23

None of them seem to cover bloods. I have a medical card so I can claim the blood test fee as a GP visit as I don't have to pay for the consultation.

Geuze

My GP charge 50 + 10 for bloods, but you bring it yourself to the hosp lab.

eddiem74

My GP if he draws the blood during a consultation it's covered in the cost of that, 55.

If I come to the nurse in the surgery, it's 20.

50% reimbursement for bloods from Irish Life Health formerly Aviva.

Oops69

Yet again more naivety from people who haven't a clue what expenses are involved in running business and have all the time in the world to check they're entitlements .

Nonoperational

coylemj wrote: »

OP was charged €35 for the blood test itself, the GP could send every sample to the local hospital in a separate taxi and still make a profit. Then there's the consultation fee...



Ok, let's take the 'consultation fee' (€65) alone and disregard the charge for the blood test....

If the GP works 48 weeks a year, 5 days a week and takes 20 blood samples a day, at €65 a pop that would work out at €312,000 gross per annum for less than three and a half hours work per day based on 20 blood samples at 10 minutes each.

My goodness what a load of nonsense.

wordofwarning

Oops69 wrote: »

Yet again more naivety from people who haven't a clue what expenses are involved in running business and have all the time in the world to check they're entitlements .

OP probably has a GP that has patient books that are full to the brim of medical card patients. He saw OP coming and gouged him for the cost of that blood to make up for the loss of revenue that the GP has from medical card patients.

OP pick up the phone and start calling around for a GP who does not attempt to gouge their private practice patients. According to the Indo (not a great source though...) GPs charging up to €20 is considered excessive.

http://www.independent.ie/irish-news/health/gps-defend-bloodtest-fees-for-medical-card-holders-35422803.html

Rocket19

It would be covered under your outpatient benefits under your policy docs. Would fall under radiology/pathology.

Most insurers don't cover much in the way of bloods/scans. Usually 50% of the cost of the test (or the full amount depending on your plan) will be offset against your outpatient excess.

Bob24

Rocket19 wrote: »

It would be covered under your outpatient benefits under your policy docs. Would fall under radiology/pathology.

Most insurers don't cover much in the way of bloods/scans. Usually 50% of the cost of the test (or the full amount depending on your plan) will be offset against your outpatient excess.

Thanks I didn't notice that section as it doesn't specifically refer to bloods.

It says:

Pathology/Radiology or other diagnostic tests (refer to Section 8 for out-patient MRI benefits) - 50% of agreed charges in an approved out-patient centre. Contact us for details of eligible diagnostic tests.
€500 per year

So I guess it requires pre-agreement and you need to go somewhere within their network ... which seems pretty useless for bloods.

Addle

Best check if procedures are covered prior to making appointments/paying for them.

Bob24

Addle wrote: »

Best check if procedures are covered prior to making appointments/paying for them.

Sure for specific procedures which require prior appointment it makes sense (and usually I think whichever private healthcare institution carries out the procedure won't do it before they have talked to your health insurrance anyway).

But when you go for a GP appointment and based on the symptoms your describe the GP tells you they need to do a blood test to check something, you're not gonna tell them you want to come back for another appointment after having had time to check with your health insurance if they cover bloods.

coylemj

Rocket19 wrote: »

It would be covered under your outpatient benefits under your policy docs. Would fall under radiology/pathology.

Most insurers don't cover much in the way of bloods/scans. Usually 50% of the cost of the test (or the full amount depending on your plan) will be offset against your outpatient excess.

It's not covered under radiology/pathology, both of those involve a specialist whereas a blood test is just a printout of a few indicators that goes to your GP to read. The OP already told us that the VHI refused to reimburse him for the blood test. I'm on a similar plan and they refused me a claim for a €20 blood test last year.

So while we can discuss how much our various GPs charge for blood tests, the fact is that OP is not going to get a cent from the VHI for the €35 he paid for the blood test.

Rocket19

coylemj wrote: »

It's not covered under radiology/pathology, both of those involve a specialist whereas a blood test is just a printout of a few indicators that goes to your GP to read. The OP already told us that the VHI refused to reimburse him for the blood test. I'm on a similar plan and they refused me a claim for a €20 blood test last year.

So while we can discuss how much our various GPs charge for blood tests, the fact is that OP is not going to get a cent from the VHI for the €35 he paid for the blood test.

That's not the case. Radiology/pathology benefits have nothing to do with seeing a specislist. They cover general costs such as x-rays and blood tests. Obviously I cannot comment on your specific plan, but what I outlined above would usually be the case.

coylemj

coylemj wrote: »

It's not covered under radiology/pathology, both of those involve a specialist ......

Rocket19 wrote: »

That's not the case. Radiology/pathology benefits have nothing to do with seeing a specislist.

Really? My VHI plan includes the following benefits ....

• Referrals to consultant pathologists - €100 per visit
• Consultant radiologists, per procedure - €100

Rocket19 wrote: »

They cover general costs such as x-rays and blood tests.

They don't, routine blood tests and x-rays do not come under either of those categories. I get any required x-rays in St. Michael's in Dun Laoghaire and they don't cost me a cent. For blood tests, my GP practice now give me the bag for the sample bottle(s) with the appropriate boxes ticked, I make an online appointment with the blood testing people in St. Vincent's, I go along, they take the samples, send the results back to my GP and that doesn't cost me a cent either.

If your GP charges you for blood tests, I don't believe there is any VHI plan which will reimburse you for that charge. Unless they really push the boat out and add on a 'consultation' fee which you may be able to claim.

Dingle_berry

There's a lot of misunderstanding of blood tests on this thread and in general I find.

You should never pay your GP for blood tests, certainly not routine ones. You might pay a GP for the cost of taking the sample, transporting the sample, receiving the report and interpreting it. The costs of testing, forms and sample containers are paid by the HSE.

All medical (diagnostic/hospital) labs fall under the medical speciality of pathology. That's how they might appear on a private hospital bill. Or it may be broken down by speciality (biochemistry, hematology, microbiology, histopathology, immunology, etc.)

Private health insurance won't cover the cost of GP pathology because it's publically funded. The GP is charging you business expenses and/or for their expertese.
And, AFAIK, in Ireland a diagnostic test can.only be requested by a clinician and can only be reported to a clinician - so you do need the GP.

And to nit pick a blood test is not "just a print out" any more than histology report is! Specialist work goes into that print out and ensuring that those numbers are accurate.