Medical insurance with medical card

sicguy

I'm planning on getting health insurance and I'm not really sure where to start.

I've been quite ill for most my life and have a medical card but have decided that with the problems I have now and will possibly face in the future that I should get insurance as well.
I have a very rare condition and several other less rare problems, I'm on a lot of medications and will probably be for life.
A lot of my needs are covered by the medical card so I'm not sure how to go about getting insurance.

I realize I'll have to pay for several years to cover my existing conditions but I'm not sure what difference my medical card will make, I've looked through the vhi plans and most cover things I won't need as my medical card covers them(gp visits, meds, ect) so would it be a tailored plan I'd be buying or would it be just say plan b but I'd just be using the medical card for the day to day things instead of the insurance?

Also would I be paying the same as everyone else or would I be paying a considerably larger amount because of the severity of my pre existing conditions?

On account of the rareness of both my conditions and the test/treatments is there a particular insurer I'd be better go with such as vhi, from what I've read I'm led to believe that the others may be harder to deal with if you don't fit in a particular box or if you have a lot of medical problems.

Apologies for all the questions but I don't have much experiance of health insurance and I'm finding it hard to find relevant information, also I'd prefer to know as much as possible before contacting any of them.


Thanks for any info

NuMarvel

Hi sicguy.

First off, the Health Insurance Authority is a body set up by the Govt to monitor the health insurance market and they have guides about taking out health insurance. Their website is www.hia.ie. I'm mentioning this first so that you can use their guides in case anything is missed here.

As you've stated, a pre-existing waiting period applies to any hospital treatment related to your existing illness. However, you won't be charged anything extra because of this; under Community Rating you'll pay the same adult rate as everyone else on the product you choose.

In terms of joining, it's relatively easy. You just need to fill in an application, and that's it, you've joined. You're only asked basic questions, like name, address, date of birth, preferred method of payment, etc. You're not obliged to delcare your illness.

That said, to ensure that you have the appropriate cover for your illness, do tell the salesperson you're talking to so that they can be sure you're on the right plan. The more information you have about the type of treatment you get, the better, because then you can be sure that a particular hospital and/or consultant is covered.

As for the specific type of plan, that depends on your particular circumstances. The guides HIA guides I mentioned above do a good job of breaking down the various items to think about, but in summary, I think it would be:

What hospitals do you want cover in? The most popular plans from all insurers give access to both public and private hospitals as well as day-case cover in the high tech hospitals (Blackrock Clinic & Mater Private). Personally, this suits me as it gives me a good range of options, without breaking the bank. For you, it may be too much as the treatment you require may only be available in public hospitals, or it may be too little as you may need better cover in those hi-tech hospitals. So think about where you want to be covered.

What kind of accommodation do you want in hospital? Most hospitals offer a choice of semi-private (shared) rooms with up to 6 beds and private, single rooms. Is your condition so that you would need a private room? Bear in mind as well that hospitals nor insurers can guarantee that private room.

Out-patient cover: Your medical card already covers GPs and prescriptions, but do you want cover as well for private consultant visits, lab tests, physiotherapy, alternative therapies etc?

Another consideration in your case may be access to treatment abroad. All insurers offer access of some description, some confined to the EU and some with access worldwide.

In terms of your actual treatment itself, the list of covered procedures published by each insurer applies to all of their plans. The main difference is where you are covered, i.e. do you have the right plan for the hosptial you are in. Also, most consultants have signed up to full cover agreements with all insurers, but if you have a specific consultant in mind, check before signing on the line.

I think that's enough from me for now, there's alot there to digest. I hope it helps to some degree and if you want more info on anything, just shout.

sicguy

Thanks NuMarvel for an extremely helpful post.

You've covered a lot of items I was unsure about, I guess its just a matter now of finding what best suits me.

My condition would mean I'd be supposed to be in a private room and most of my cover would be for public hospitals but I've always been in a ward and while I know I can't be guaranteed a single room, at least it may give me a better chance.
Also I do have to attend private hospitals/clinics every so often and at the moment its covered by a public number so that could involve waiting anywhere from a few months to over a year.

As some of the tests/treatments would be covered by both my medical card and the insurance is there a standard procedure for deciding which system would cover what?
As in if I have to get certain tests that are both covered by the med card & the insurance, would I just decide or once I have insurance would it automatically be used in clinics/hospitals for everything it covers?

I don't imagine having insurance would have any bearing on being re-reviewed for the medical card.

Also I would be curious as to whether anyone thinks its a good Idea to have both the card and insurance? I've spoken to some who see it as pointless as I have a med card but I find those same people have little experiance of the public medical system.

One of the main reason I intend getting it is that its fairly likely I'll have a lot more illness in lifetime and I want to have the best change possible of both surviving and also having as good as possible chance of getting treatment when and if I need it, also I need a back up if I ever loose the medical card.

Does anyone have anyone have any recommendations as to which company to go with, I would be inclined to go with vhi as I need a certain amount of leeway because of the rarity/tests/treatments involved, but maybe the other two would be just as good for my needs.

Another list of questions

Again any info appreciated
Thanks