Pregnancy - Health Insurance

borus22222

Dear All fellow forum members,

My wife(Kerry girl) and I moved from UK to Ireland last year. We settled just fine in Dublin, last week we good a fantastic news that she is pregnant - due end of April. I started reading about the medical cost of and the health insurance and the more I read the more confused I am. I'm structural engineer and this system is bloody complicated. We have been paying private health insurance for all those months, so I thought that finally there will be use of it. I know that we can go public and there should be no cost related. So, in I have few questions:

1. What is the major difference between going private, semi-private, public in case of medical service. Sharing the room with other patients ? (but there is no guarantee of private room anyway) . Being seen by other consultant every time? Is there a risk my wife would get lees experienced doctor to look after her? What is the difference private vs semi-private in real life?
2. We probably going to choose Coombe hospital. What is average cost of all consultants’ costs + delivery? My wife has a Laya Healthcare cover as follows:

Maternity in-patient hospital delivery/homebirth costs Full cover for 3 nights in a public hospital (Up to €3,200 per year towards costs)
Maternity out-patient consultations Up to €300 per pregnancy subject to out-patient excess
Post natal home nursing if Hospital stay less than 3 nights Up to €1,600 for 2 nights

So what I would like to know is how much outside of her cover cost I should expect ?
Can someone write down what were their total costs so I can run simulation based on her cover

3. What about cost of any complications, C -section etc – is going non public imply risk that I might end up paying few thousands?
4. Laya advised that they only cover 3 days whereas apparently Combe hospital likes to keep first time mothers for 4 days – is that true?
5. Can I start public and switch to private at later day?
6. I know that there is an option of claiming through the tax form which should be few quid back. Assuming I go private can I claim all outstanding cost or is there some exceptions?
Thank you in advance for answers/ help.

Bart

uck51js9zml2yt

She will give birth in the exact same birthing rooms as public patients.
There is no guarantee your consultant won't be on holidays or on a day off.
We had 2 public in the rotunda and couldn't fault it.
There is also a minimum time for to have health insurance before she can avail of maternity cover.
Public system is free.

My wife was also given a semi private root on pure first.

One thing I did see however was the lack of medical staff in maternity hospitals at weekends. It was worrying as though management think babies aren't born at weekends!

judeboy101

borus22222 wrote: »

Dear All fellow forum members,

My wife(Kerry girl) and I moved from UK to Ireland last year. We settled just fine in Dublin, last week we good a fantastic news that she is pregnant - due end of April. I started reading about the medical cost of and the health insurance and the more I read the more confused I am. I'm structural engineer and this system is bloody complicated. We have been paying private health insurance for all those months, so I thought that finally there will be use of it. I know that we can go public and there should be no cost related. So, in I have few questions:

1. What is the major difference between going private, semi-private, public in case of medical service. Sharing the room with other patients ? (but there is no guarantee of private room anyway) . Being seen by other consultant every time? Is there a risk my wife would get lees experienced doctor to look after her? What is the difference private vs semi-private in real life?
2. We probably going to choose Coombe hospital. What is average cost of all consultants’ costs + delivery? My wife has a Laya Healthcare cover as follows:

Maternity in-patient hospital delivery/homebirth costs Full cover for 3 nights in a public hospital (Up to €3,200 per year towards costs)
Maternity out-patient consultations Up to €300 per pregnancy subject to out-patient excess
Post natal home nursing if Hospital stay less than 3 nights Up to €1,600 for 2 nights

So what I would like to know is how much outside of her cover cost I should expect ?
Can someone write down what were their total costs so I can run simulation based on her cover

3. What about cost of any complications, C -section etc – is going non public imply risk that I might end up paying few thousands?
4. Laya advised that they only cover 3 days whereas apparently Combe hospital likes to keep first time mothers for 4 days – is that true?
5. Can I start public and switch to private at later day?
6. I know that there is an option of claiming through the tax form which should be few quid back. Assuming I go private can I claim all outstanding cost or is there some exceptions?
Thank you in advance for answers/ help.

Bart

Not much difference apart from convienence and comfort. UNLESS there are complications. Then you are at the mercy of the gods in the public system. Mid wife led is the buzz in public but I've yet to hear of a midwife perform a successful emergency c section in Ireland or successfully repair a second degree tear with no complixations. You don't want some registrar whose on 36 hrs no sleep taking care of your wife whom they've never met before when things go south.

uck51js9zml2yt

judeboy101 wrote: »

Not much difference apart from convienence and comfort. UNLESS there are complications. Then you are at the mercy of the gods in the public system. Mid wife led is the buzz in public but I've yet to hear of a midwife perform a successful emergency c section in Ireland or successfully repair a second degree tear with no complixations. You don't want some registrar whose on 36 hrs no sleep taking care of your wife whom they've never met before when things go south.

It was a midwife in the rotunda who copped our second was having breathing problems and transferred him to neo natal.
It was a midwife who was instructing the doctors on our first.

They often have more experience than the doctors.
My wife had a gp in the a&e who couldn't do an ultra sound! They do their maternity training in the hospitals

mirrorwall14

Public patient in the Coombe on my third pregnancy now. Could not fault the care. I’m high BMI, asthmatic, rhesus negatives and have had multiple issues across pregnancies including bleeds, suspected IGUR and pregnancy hypertension. I do have very good private health insurance which we did not avail of except for physio

Positives: prenatal care excellent (exception below-physio). Never concerned that I wasn’t being cared for in public. Zero expense. No excess. Multiple scans (for medical reasons) all covered. I’m going for my fourth big scan in a weeks time on this. I think I had 6-7 on my last.

Negatives:
Post natal wards can be chaotic. Wait times in clinic can be long however this pregnancy is much better than 2015! Physio delays totally unacceptable, I have SPD. It would be 4 weeks before they would see me one on one. I went privately myself. Need confidence to speak up in appointments as they can be quite fast.

(trigger warning) miscarrying my second at 7 weeks was awful there. No real care or compassion

Sheepdish1

Have health insurance but decided to stay in public in rotunda as I was quite happy with the care.

For second pregnancy I had anatomy scan done privately in the beacon and paid for it along with blood tests.

Was semi private on first pregnancy and found the waiting times much less, leather couch smaller rooms etc. Less people and more comfort. I think I saw the same few doctors but it is quite long ago so can’t be sure.

Had planned section 2nd time and was very happy with care I got from doctors nurses etc.

I found the difference for me was the room I was staying after delivery in had 8-10 patients instead of 4/6 but I can’t fault the care that I got as I found the nurses and doctors very helpful also along with cleaning and catering staff.

I would have felt very isolated and lonely in private room as I like to be around people even if it is chaotic and liked being able to chat to people but that is not for everyone I would imagine! Can be very noisy at night time with babies crying! Also much larger flow of visitors but they were very strict on visiting hours!

No complications in the second pregnancy so can’t advise on that.

I would imagine with semi private you are more likely to meet same doctor through out prenatal care but medical care during the delivery could be the same for everyone in the fact who needs doctor gets seen by doctor but I could be wrong.

I can’t imagine that consultants or doctors can prioritise private patients as opposed to public patients. They all seem extremely busy and I would guess they go where called most urgently. The hospital you are going with clarify this for you.

Maybe call private , semi private and public and find out exactly what the difference is 😊

judeboy101

Nia Moldy Switchblade wrote: »

It was a midwife in the rotunda who copped our second was having breathing problems and transferred him to neo natal.
It was a midwife who was instructing the doctors on our first.

They often have more experience than the doctors.
My wife had a gp in the a&e who couldn't do an ultra sound! They do their maternity training in the hospitals

Hope you weren't private for any of those.

Cash_Q

borus22222 wrote:

4. Laya advised that they only cover 3 days whereas apparently Combe hospital likes to keep first time mothers for 4 days – is that true? .

Congratulations on the impending arrival.

I'm public in the Coombe. That's the first I heard of this. There is an early release scheme whereby you can be home within 12-24 hours if you live within certain areas. Even without the early release scheme we were told that standard stay for vaginal birth is 3 nights, caesarean 5 nights.

We were told at antenatal classes to be careful of how overnight stay is counted e.g. if you are admitted for induction and stay a night or two before the birth and then have 3 nights stay after the birth, there will be charges for nights exceeding your cover.

As regards waiting times, if you're living in certain areas you can avail of the midwife clinic where you're generally seen at your appointment time. It's been a different midwife for me every time but they are lovely.

Ring the hospitals and see what's covered and what each consultants fees are.

Some insurers require you to be their customer for a minimum period before maternity care is covered.

lazygal

I'm private. I didn't realise the benefits until I had unexpected complications on my first and ended up with a c section. Then having my consultant deliver my baby and getting the private room paid off. Went private on number two. Consultant again delivered my baby in a an emergency and I got a private room.
I wasn't happy with the parts of the public system i had to deal with. I'm going private again on this pregnancy. I've had complications again and extremely glad I'm with my consultant who's aware of everything and provided significantly more continuity of care than I have seen those in the public system get.
I know plenty of people who were happy with the public system but going private was 100% the right choice for me and worth every penny.

uck51js9zml2yt

judeboy101 wrote: »

Hope you weren't private for any of those.

Public but as it happened my wife got a semi private room after the birth of our first.
As for the maternity a&e. Its the same for public and private.

bovril

I would suggest getting all your questions together and then doing an online chat with laya and they can answer all your questions. You can then save the conversation. If you're going semi private/private and you need to be admitted before birth and kept longer after birth for medical reasons then it's usually covered under the insurance once your Dr signs it off as a medical requirement. This was the case for me anyway but just to be on the safe side ask laya about your policy.

The care you'll receive between the two/three systems will be the same standard. You might and I say might have less of a wait at appointments if you go semi private or private. It's mostly about increasing your chances of a private room and continuity of care (same Dr each appointment with private).

judeboy101

Nia Moldy Switchblade wrote: »

Public but as it happened my wife got a semi private room after the birth of our first.
As for the maternity a&e. Its the same for public and private.

That explains your experience then . Maternity a&e ain't the same. We were always told in the goonge if we had to present that they were to contact our consultant who would then arrive or one of their team.

jlm29

It varies from case to case really. I’ve gone private on all three of mine, and I’d do it again if the situation arose.
I’ve had three very straightforward pregnancies, but for two of the three deliveries I’ve bedn glad to have a doctor who knows me well present, for different reasons.

You can (or at least I know in a lot of places you can, I assume it’s the same everywhere) switch from public to private later in the pregnancies if needs be.
Do check the wait times on your policy though to make sure you’re covered

jlm29

Also, if you go private and there are complications, c-section etc, they should all be covered by your insurance.

catrionanic

We have decent cover with Laya but are still going public. We were so happy with the service on our first baby, when we also went public, that we didn't see the real point in going privately. Certainly when I've spoken to midwives etc about it, they've seemed to be of the opinion that the care is largely similar, it's just that the waiting times are shorter at appointments (although I'm doing Domino scheme this time anyway so virtually no waiting), and more chance of a private room.

As much as I'd love a private room, with the Domino scheme you're discharged 6-12 hours after the birth so it would hardly matter.

Millem

Neve had a baby in the coombe.
Always had health insurance. First as public/domino in holles street, second private in rotunda.
If you can afford the €3k (average consultant fee in coombe) pay it!
It wouldn’t even consider anything else if I have baby number 3.

lollpop

I've had two babies in the coombe. I had health insurance but went public both times. I had a medical condition which meant I was high risk and I saw the most senior consultants by going public.

#1. Appointment waiting times and the room you get post delivery are the main differences. The coombe is one of the better hospitals for the rooms post labour though. The public wards have 6-8 beds. Both times I was there I was in a 6 bed. The first time there were 3 beds occupied so it was only half full. The second time there were 5 beds occupied on one night, 4 beds the other nights. For the actual birth, all patients have the same room, regardless of public, semi or private. It's a private room with en suite. The delivery rooms in the coombe were renovated a couple of years ago and so are quite modern.

#4 No, the coombe dont keep first time mothers for 4 nights as standard. The time you stay depends on your birth and any complications. E.g. you need longer if you are sectioned. On my first, I stayed 3 nights post delivery but that was because my baby was ill, otherwise I would have been out after 2. On my 2nd I stayed 2 nights, again baby needed to stay otherwise I would have been out same day. Double check this with the insurer too. Normally they say something like we pay 3 nights unless more is medically required, so if doctor says you need more then they pay more.
#5 No. Coombe dont generally allow this.
#6 You get 20% of whatever the insurance doesn't pay. So if you have to pay 2k of your own money then you get 20% of this back(400 euro).

Gatica

I had large fibroids and a breech baby. Went through pubic midwife clinic for my care up until week 36 when they needed to check regularly if she was still breech, so transferred back to the hospital and our assigned consultant's team. I got scans in addition to the midwife appointments at the hospital every 4 weeks, every 2 week after week 32. No extra cost, couldn't fault the care.
There was no continuity of care, that was the down-side. However, I felt that 3k was too much to pay just for seeing the same person again. The delivery room was fine when we went it, once I was pushing, I didn't care anyway. The consultant on duty supervised the delivery of our breech baby with a reg getting hands on experience. I don't think it could've gone any better, had I hand-picked the consultant. Of course, we could've been unlucky and the consultant on duty that day may have had 0 experience with breech deliver and made a balls of it, but also, I could've picked the consultant, and they could've been on holidays when I went into labour 3 weeks early. Things can go wrong or right one way or the other.

salmocab

We went private in the Coombe both times, for medical reasons my wife wanted to see the same consultant each time. The upside is appointments etc are with the same consultant with less queuing etc. she had an emergency section both times as we knew we probably would and neither time was our consultant there as it was out of hours and they use a call system. Everything was great but it’s a lot of money (think it was 3200). We had specific reasons for using it but otherwise we would have stayed public as ultimately the care is just as good.

Neyite

judeboy101 wrote: »

Not much difference apart from convienence and comfort. UNLESS there are complications. Then you are at the mercy of the gods in the public system. Mid wife led is the buzz in public but I've yet to hear of a midwife perform a successful emergency c section in Ireland or successfully repair a second degree tear with no complixations. You don't want some registrar whose on 36 hrs no sleep taking care of your wife whom they've never met before when things go south.

Sorry, but that's absolute nonsense. If you have complications then the medical care you get on the public system is the same as you would get privately. If you have any complications or even if you have an existing health issue you are usually excluded from the midwives scheme and put on the consultant's ante-natal visits.

Midwife led care is predicated on the fact that you will have a straightforward birth with no complications. If you have any complications or if your baby is breech or whatever, you swap over from midwife led to the team with the experience to deliver safely. You are not going to have midwives performing c-sections!

I had my baby on a weekend, transverse, induction failed, heartbeat distress and emergency c-section and the whole process could not be faulted in terms of medical care for either of us in the public system. And while it was possibly a registrar who sewed me back up, my incision was absolutely perfect and the scar line can barely be seen.

My ante-natal visits were with a professor and a consultant due to a very minor endocrine thing with a lot more visits and very good care there as well. And my baby needed checking out in NICU - thankfully nothing but they investigated absolutely everything to make sure he was ok. And his file was reviewed by his own paediatrician GP afterwards who concurred that they looked into everything.

And it was all free on the public system.

The only downside I had going public was being on a public ward, that did suck. But even paying for private care, the rooms are subject to availability so there's no guarantee you'll get one. There's no guarantee that your consultant will attend the birth either. They may be off duty or already dealing with a delivery. I know of someone who went private three times and each time the consultant missed the delivery.

lazygal

Maybe it depends on the hospital. I felt very much under cared for on the few times I dealt with the public system in Holles St. Had to constantly explain things despite people holding my chart, there seemed to be no one point of command and I had to keep asking for things rather than the nurses and midwives being proactive. Found things dramatically different when my consultant came in and on the private ward afterwards. My consultant will deliver this baby in two weeks. Friends went with her and she attended all deliveries.

annoyedgal

I've gone public twice in holles st and was impressed with the standard of care. Straightforward pregnancies so can't comment on having any complications.
Post natal wards are busy no question. Didn't bother me and was nice to chat with other mums on my second when felt more relaxed than first time!
Had lots of help establishing breastfeeding on public ward.
If i go again I'll be public all the way again. Couldn't justify the expense but might feel differently if i had complications.

borus22222

Thank you for all your responses. We decided to go semi-private as we can afford that kind of expense. I don't particularly like how the system is organised but "it is what it is".