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Whats covered by health insurance

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  • 18-11-2009 1:40pm
    #1
    Vas_Guy
    Closed Accounts Posts: 436 ✭✭


    can anyone tell me what is coverded by VHI, Quinn Healthcare, Hiberian, during pregenancy if you want to go private with the consultant and semi prvate in the hospital and is a c section delivery coverded.

    i'm finding it hard to get information on what's coverded and what they pay for.

    Do the health insurers cover all costs?


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    #2
    Das Kitty
    Moderators, Arts Moderators Posts: 17,231 Mod ✭✭✭✭Das Kitty


    Depends entirely on your insurer / plan.

    On my plan I could get a couple of hundred back, tops.

    If you're insured, ring your insurer and see. If not be aware that you will need to be insured for a predefined period of time prior to pregnancy before they'll give you a cent towards it.


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    #3
    crazy cat lady
    Registered Users Posts: 1,196 ✭✭✭crazy cat lady


    Does anyone know if I can use my insurance to go to a semi-private ward after delivery if I have gone public all through the pregnancy?


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    #4
    Vas_Guy
    Closed Accounts Posts: 436 ✭✭Vas_Guy


    Das Kitty wrote: »
    Depends entirely on your insurer / plan.

    On my plan I could get a couple of hundred back, tops.

    If you're insured, ring your insurer and see. If not be aware that you will need to be insured for a predefined period of time prior to pregnancy before they'll give you a cent towards it.


    What is the best plan for maternity does anyone know.


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    #5
    cch
    Registered Users Posts: 318 ✭✭cch


    crazy cat lady wrote: »
    Does anyone know if I can use my insurance to go to a semi-private ward after delivery if I have gone public all through the pregnancy?

    Nope, definitely not, accommodation is one of the defining aspects of picking between public/semi-private/private.

    Saying that, when I was admitted with problems during pregnancy I got a private room with my insurance despite being semi-private. That's because I was a general admission on the gynae ward along with people who had hysterectomies, investigative procedures etc, i.e. no babies there!


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    #6
    Moonbeam
    Moderators, Education Moderators, Society & Culture Moderators Posts: 18,953 Mod ✭✭✭✭Moonbeam


    crazy cat lady wrote: »
    Does anyone know if I can use my insurance to go to a semi-private ward after delivery if I have gone public all through the pregnancy?

    Yes it can be possible but only if the hospital is not busy.
    vhi pay over the same for your semi private accommodation as they do for anyone elses.
    Tell them you have health insurance and what it covers and request it.


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    #7
    Moonbeam
    Moderators, Education Moderators, Society & Culture Moderators Posts: 18,953 Mod ✭✭✭✭Moonbeam


    Vas_Guy wrote: »
    What is the best plan for maternity does anyone know.
    You will need to go to each website and check out the policy options yourself,also remember you may need to have the insurance for 12 months before using it or before getting rpegnant.
    I find vhi have good cover,look at the family plan options.


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    #8
    implausible
    Registered Users Posts: 3,937 ✭✭✭implausible


    I have health insurance and have decided to go public. My reasons? The combined care scheme is very good, I'm delighted with it as my gp has a scanner in his practise. I don't feel the need to see a consultant every time I go to the hospital, I'm not a worrier by nature and I've faith in the midwives. Even with insurance, there is no guarantee that you will get the bed you've asked for, private/semi-private may not be available when you get there. My insurance covers me for private hospitals, but the nearest ones are Dublin/Galway-3hours away. Needless to say, when I noticed that, I changed my plan.

    On top of that, I was under the impression that the insurance covered everything-wrong! The insurance takes a few hundred off a bill of a couple of thousand.

    Now, I'm (obviously) no expert and I'm living in a part of the country where queues and waiting lists aren't mental, so feel free to correct me on any/all of the above. I just felt it wasn't for me and my doc concurred. But, everyone is different, this is just my slant on it:)


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    #9
    CathyMoran
    Moderators, Society & Culture Moderators Posts: 7,458 Mod ✭✭✭✭CathyMoran


    I got very upset with my health insurance over this one, have been with them all my life and they said that will not know what is and is not covered until after they get the bill...so I could end up with a massive bill...am disgusted.


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    #10
    cbyrd
    Registered Users Posts: 3,214 ✭✭✭cbyrd


    I have vivas family plan 2 (i think)but inever used it for any of my pregnancies. i've paid my taxes and i'm entitled to the care why should i pay anymore for it!!i know that there's benefits of going semi or private but for the money you pay out it's really not worth it last time i ended up in a semi private room as this was all that was available. :D happy days!! but i was only in for one night. There really isn't any benefit to going private..sure you have a lot less waiting time for your doc appointments but if she ends up having an emergency section your liable to pay up to 3 or 4000 euro.. and there may not be a private room when she's in hospital... you're much better off either semi or public if you want extra scans you can pay for them yourself they're only about €120.. public is free for all your antenatal visits to either hospital or gp.. and think of all the lovely money you'll have after baby comes to spend on him or her.. or yourself!!! Insurance companies will always find a way of not paying !! also there's no guarantee your consultant will attend the birth... and midwives have a better bedside manner!!:D but then i could be completely wrong as i've never gone private..:o :D


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    #11
    cch
    Registered Users Posts: 318 ✭✭cch


    Moonbeam wrote: »
    Yes it can be possible but only if the hospital is not busy.
    vhi pay over the same for your semi private accommodation as they do for anyone elses.
    Tell them you have health insurance and what it covers and request it.

    Yes it's possible, especially if you have a non-straightforward labour, but not something you can organise beforehand and be certain of getting, depends on who you're dealing with too. If you choose public expect a public ward.
    It's a bit like wishing for say chicken for dinner in there, if it happens great but no guarantee and has no impact on the care you receive, just a nice to have (but getting chicken is much more likely than getting a room!!)


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    #12
    Vas_Guy
    Closed Accounts Posts: 436 ✭✭Vas_Guy


    cbyrd wrote: »
    I have vivas family plan 2 (i think)but inever used it for any of my pregnancies. i've paid my taxes and i'm entitled to the care why should i pay anymore for it!!i know that there's benefits of going semi or private but for the money you pay out it's really not worth it last time i ended up in a semi private room as this was all that was available. :D happy days!! but i was only in for one night. There really isn't any benefit to going private..sure you have a lot less waiting time for your doc appointments but if she ends up having an emergency section your liable to pay up to 3 or 4000 euro.. and there may not be a private room when she's in hospital... you're much better off either semi or public if you want extra scans you can pay for them yourself they're only about €120.. public is free for all your antenatal visits to either hospital or gp.. and think of all the lovely money you'll have after baby comes to spend on him or her.. or yourself!!! Insurance companies will always find a way of not paying !! also there's no guarantee your consultant will attend the birth... and midwives have a better bedside manner!!:D but then i could be completely wrong as i've never gone private..:o :D

    If your private under a consultant they will be the ones doing the section, not the sho or reg.

    As far as i know if you go private under the consultant in their rooms you can only go private or semi private in the hospital


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    #13
    houseman
    Registered Users Posts: 38 ✭houseman


    CathyMoran wrote: »
    I got very upset with my health insurance over this one, have been with them all my life and they said that will not know what is and is not covered until after they get the bill...so I could end up with a massive bill...am disgusted.

    I was the same with quinn. So what i did was phoned up the private and semi private clinics in holles st and asked them whats covered by my plan and most importantly, whats NOT covered. they were really helpful.
    Private - even with my medical insurance would have cost thousands but semi-private is 500 euros and 100 euro each per scan for a max of two scans.
    - which i think i am prepared to pay.
    Id phone the hospital first - rather than the insurers.


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    #14
    eimsRV
    Registered Users Posts: 224 ✭✭eimsRV


    Just wanted to share my experience here.

    I went private in Holles Street, I have VHI Company Plan cover.
    I had to pay €4000 to consultant. She was excellent. As I had problems with pregnancy I was seeing her monthly, then weekly. Everytime I went I had a scan in the consultancy room. the first time I went to see her I was given a list which included what was covered by the 4k I paid, what else I'd have to pay and what Vhi and Quinn pay cover/contribute towards.
    The only other thing I had to pay was for the anomaly scan, which I think was €130.

    I ended up having an emergency section (the consultant carried this out) I didn't have to pay anything for this. Also the baby needed to spend 3 weeks in intensive care, this was all covered under my policy. All bills were covered by VHI, no issues at all. I really didnt have to worry about that side fo things!

    The first night I was in a ward which women who were in for gynae procedures, they didnt put me in with other mammies and babies as I didnt have my dd with me. Thought that was very sensitive. Then the 2nd night I got a room in Merrion Wing, the consultants seem to book their patients in there. Again this was all covered by VHI for 5 nights.


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    #15
    blackrovers
    Registered Users Posts: 88 ✭✭blackrovers


    hey i just wonderin would i be better off reducing my plan down to the very basic because my insurance has gone from 556 to 820. thats after tax etc is deducted. my only medical visits is that i have to get a pint of blood taken off me ever 3months as i have high count in my blood and that was covered on my last plan which was the teachers plan with hibernian. is there anyone out there in a similiar situation and could anyone give me some advice? thanks


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    #16
    Das Kitty
    Moderators, Arts Moderators Posts: 17,231 Mod ✭✭✭✭Das Kitty


    blackrovers wrote: »
    hey i just wonderin would i be better off reducing my plan down to the very basic because my insurance has gone from 556 to 820. thats after tax etc is deducted. my only medical visits is that i have to get a pint of blood taken off me ever 3months as i have high count in my blood and that was covered on my last plan which was the teachers plan with hibernian. is there anyone out there in a similiar situation and could anyone give me some advice? thanks

    Are you pregnant?

    If not you might be better off asking this question in a more suitable forum.


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    #17
    LegacyUser
    Registered Users Posts: 166,026 ✭✭✭✭LegacyUser


    Hi, I'm with hibernian, and we just found out my girlfriend is pregnant. She doesn't have health insurance. This might be a stupid question, but does my health insurance entitle her or my future baby to anything? thanks!


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    #18
    houseman
    Registered Users Posts: 38 ✭houseman


    Hi anon,
    i asked the same question as well and sadly no, your girlfriend needs her own healthcare.


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    #19
    Chill.ie (Conor)
    Closed Accounts Posts: 60 ✭✭Chill.ie (Conor)


    Hi Guys,

    One of the staff in here wrote a good blog on the different health Insurance options, what is covered under each policy and who offers the best value. Worth checking out. http://tinyurl.com/ya2upl8


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    #20
    alibabba
    Registered Users Posts: 1,240 ✭✭✭alibabba


    Moonbeam wrote: »
    Yes it can be possible but only if the hospital is not busy.
    vhi pay over the same for your semi private accommodation as they do for anyone elses.
    Tell them you have health insurance and what it covers and request it.

    My wife rang the hospital today, asked them if she could use her health insurance to go private/semi private with the acomm & public with the delivery. they said no, its either public or private.


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    #21
    Moonbeam
    Moderators, Education Moderators, Society & Culture Moderators Posts: 18,953 Mod ✭✭✭✭Moonbeam


    If you go semi private it is possible to get a private room and health insurance covers it.
    I do not know anything about public but I suppose maybe they are so busy there is never the space to give it as an option.


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