Health Insurance

No use for A&E, you'll be in the triage queue same as everyone else

What it might given you access to is a private clinic. For example VHI have swiftcare clinics that can deal with non life threatening stuff. They're great for when young kids are sick and need a doctor, and they can also deal with sprains and fractures

Laya also have a couple of clinics and Irish Life have a deal with some private clinics around the place

Nope.

Also, private clinics are fine so long as your emergency is convenient for the private clinic.

A broken bone can wait until daylight hours. better than waiting up to 90 hours in an overcrowed public A&E.

No use for A&E but if you needed surgery for your broken arm you could be referred to an orthopaedic doctor in a private hospital for it

For me I've always given our insurance company and member number.

Apparently there's a form you may be asked to sign which basically says you won't be funded by the HSE and the entire cost will fall on your insurance

This doesn't seem to cost you anything but it does cost the insurance company a lot, which is why they're moaning about it

I've never actually been presented with the form, nor have I signed it. I've always gone into A&E as a public patient and only paid the public rate charges, which I then claimed back separately from my insurance

I've also checked my insurance claims and there's no big charges coming from hospitals, so I kind of feel like the whole thing was overblown a bit

Im getting an orthopedic procedure carried

out in a private hospital this month. I saw the doctor to get the consultants appointment 3 weeks before christmas. I got my appointment to see the orthopedic consultant within a week and he basically asked me what date would I be available for surgery.

My doctor told me if i went under the public system, i would be waiting a minimum of two years.

Yes but if you are treated as a private patient you will be seen by the consultant and not a registrar

If you present at an A&E you will get immediate treatment on public health too, it's the so-called 'elective' treatments that incur the wait, though how someone suffering arthritis and needing a new hip could be considered 'elective' is beyond me.

Also, it should be noted that if you have a life threatening condition, treatment will be pretty much immediate on public as well.

Would you.not consider changing your policy, you would nearly want to.be paying €1400 a year for decent cover including day to day expenses.

I always laugh too when I hear people with private health insurance doing their best to avoid their insurers from picking up at least part of the bill. They pay steep enough premiums.

My principal gripe with health insurance is that it's marketed like a pension as in 'invest now in your 20s/ 30s/ 40s etc and you'll benefit in your 70s and 80s etc'. But it's sold like car or house insurance, once your annual premium lapses that's it - your investment is gone poof. If you don't keep renewing with the increases they can screw out of the customer, then it's bye bye. Dishonest way of selling a product.

Imagine selling a pension like that - sorry you missed your payment, so xyz€ in your account is now ours!

A&E is always on a need first. So if you're waiting with something minor & something major comes in, it doesn't matter what insurance you do or don't have, that will take precedence. It's all about the severity which is why you're triaged - it's an assessment of where you'll be in the queue.

So my experience is that they will ask you at the desk in A&E for insurance details. While it makes no difference in A&E, it is more that if you're admitted, it'll mean that your costs are billed back to your insurer.

A visit to a public hospital A&E costs €100 per day. If you provide your insurance details to the hospital they will charge the company directly for you. The company should advise of how much they paid on your behalf later. If a doctor has written a referral for you to go into A&E the charges are waived.

Having accompanied my mother to A&E shortly before Christmas (and given she was admitted on the back of it and was recovering from emergency surgery less than 12 hours later, I'll not get into questions about the necessity of her being there!) and needing to answer questions on her behalf with the desk clerk due to pain making this difficult for her, she certainly wasn't asked about insurance in A&E, and it was only in the subsequent days that anyone broached the subject with her. That was in James's, but obviously it may vary from hospital to hospital.

As another poster mentioned, the €100 A&E is per attendance, not per day (thankfully, given the current trolley crisis!), and I don't believe that any of the insurers offer direct settlement of that (nor should they, or it would be almost certainly be abused by some!). At best you might be able to claim back a percentage of the fee from an insurer once you've paid it yourself. It is worth noting, however, that if you are admitted to the hospital as a result of attending A&E then the €100 fee is (rightly, IMO) waived, regardless of whether or not you had a GP referral.

The only daily fee applies to inpatients who have been admitted, and is €80 up to a maximum of €800 (10 nights) in a calendar year, and this is unaffected by whether or not you have a GP referral, but is covered for medical card patients. Most insurers will cover this via direct settlement. As of April this charge is being removed for all patients, however, which will doubtless make it more difficult for public hospitals to broach with patients the matter of private payment by insurers for public treatment, since there will be nothing to settle with insurers in most instances of treatment in public hospitals.

I can see both sides of the matter of hospitals seeking payment for the full whack from insurers to be honest, but I'd fall on the side that most people with health insurers are also paying their fair share in tax, PRSI, etc., so why should they be expected to be a source of even more funding for the health service when they're unfortunate enough to require treatment by having their insurers foot the whole bill? Were the HSE operating on a shoestring and making best use of a very meagre budget whereby the money would likely make a material difference, I'd happily and unequivocally advocate for insurers coughing up, but the fact of the matter is that there is an immense culture of fiduciary waste within the HSE management, and any patient's insurance cover will be but a drop in the ocean in the face of it. That is not to criticise the frontline staff, who predominantly do trojan work within a limited system, but there are too many surplus management layers being paid bloated salaries with the result that a frankly whopping budget just can't deliver the service it should.

The fee for A&E is €100, this is waived if you are referred by your GP and/or admitted. Once admitted the daily fee is €80 for a max of 10 days in any 12 month period.

So because the HSE is badly managed the health insurance companies shouldn't pay for the services being provided to their customers? That's a truly bizarre way to look at it.

Not always, illnesses can and do appear at any age. Many young people in their 20s 30, 40s and beyond are always very reliefed to have health insurance policies n place when accidents, illnesses/cancers etc strikes. The security of having it in place is more vital than ever now given the state of the public service.

The public service has been abysmal for generations. Its not a recent occurrance.

A health service that was buillt without a proper foundation rather something that wss developed in an ad hoc fashion. It has multiple issues and unless the powers that be will do something to sort this poisoned chalice once and for all, the private health care service

will continue to grow and flourish.

Kind of my point, you're sold a policy that promises to cover your needs, the average joe has no way to decipher the flannel contained in the policy notes (I'm quite familiar with other insurances and still find it extremely confusing), so yeah, it is rubbish really and needs to be cleaned up.

100% correct, I recently checked with Laya (my insurer) about policies that better suited my needs, they directed me to their website to 'explore' the different policy types/levels etc, explore being the perfect word, a little more and I'd need a machete to cut through the jungle there were that many and each had different levels, it's ridiculous, to expect the average person to navigate that level of BS in simply wrong, should be like car insurance, 3 levels and you get what you pay for.

Mine is also paid by my employer currently but I would (& have in the past) pay it myself if it wasn't. I've received a large amount of benefit from it over the years that makes it worth while to have. I don't pay for a massive premium but it gets me what I need. It has helped with GP visit costs, enabled me to get a hurt knee seen to quickly & easily - out of the public system through one of the private a&e type places so I wasn't clogging up the main public service for something minor. It helped pay for my semi-private maternity which was important to me as it meant I was able to schedule my apps & scans to suit my work & my other half being able to join me for ones needed. And with my son on it, it's helped with some of his costs including getting in to get an asthma diagnoses quicker than the public system (again going through the private setting so not skipping any public queue in a public hospital).

I can't see employers cutting health insurance. Maybe moving to providing a discount rather than paying the full but realistically it is now expected from most and I've seen some stats showing that employers who had this had lower days off than prior to giving employees access to private health insurance.