Health Insurance - treatment cover

mood

I'm trying to find out if dermatology treatment is covered by any of the health insurers. Nobody will give me a straight answer as I am not an existing customer. I have never had (or luckily needed) health insurance but feel I should get it now. I may not need dermatology treatment but want to know if it is cover before I choose which company and plan to go with.

Can anyone tell me if they do or tell me where I could get this information?

seamus

http://www.hia.ie/

You'll basically have to trawl through mounds of policy documents to find out.

Health insurers deliberately make their policies obtuse and unclear to either scare you into buying more cover than you need or to avoid paying out on cover you thought you'd bought.

In most cases, if you have an existing medical condition, you will have to wait 12 months before any treatment for that condition is covered.

axer

seamus wrote: »

In most cases, if you have an existing medical condition, you will have to wait 12 months before any treatment for that condition is covered.

I think that may be 5 years. Trying to find info from insurance companies myself and it is a pain in the ass.

mood

axer wrote: »

I think that may be 5 years. Trying to find info from insurance companies myself and it is a pain in the ass.

One of the companies said it's five years until my asthma will be covered and it's the same with the three companies.

Getting any information is so hard!

Do they give a list of consultants/hospitals/clinics/procedures covered etc before you sign up?

axer

mood wrote: »

One of the companies said it's five years until my asthma will be covered and it's the same with the three companies.

Getting any information is so hard!

Do they give a list of consultants/hospitals/clinics/procedures covered etc before you sign up?

I think they tell you which are not covered e.g. blackrock clinic etc. Or some will have an excess or only cover a certain amount for those etc. Really depends on the plan but that type of info is usually easy enough to find.

dudara

Moved to Banking & Insurance & Pensions

dudara

NuMarvel

Aviva has a list of recognised in-patient and daycase treatments/surgeries/procedures on their website here (scroll down to Procedures Lists). I can’t find a similar list on Quinn’s or VHI’s website, but for the most part a treatment covered by one insurer will be covered by the others.

With regards to asking if particular ailments are covered, the insurer can't give a definitive answer without knowing more about the individual's circumstances. E.g. what treatment are they getting, what hospital are they going to, etc. However, if it helps the OP, consultants dermatologists are recognised by at least VHI and Quinn (and virtually certainly by Aviva), so the insurers must cover at least some types of dermatological treatments.

Details of the consultants and hospitals covered can usually be found on the insurer's website, and the hospitals covered will also be listed in the policy documents.

For consultants, you can check VHI's website here and Quinn's website here. I thought Aviva had a similar page on their website, but I can't find it at the moment.

Hospitals are listed on Quinn's website here, and on Aviva's website here.

VHI's hospital list can be found in the back of the policy documents of the plan you join. You can find their policy documents on their website here.

The hospital cover is based on the benefits offered by the plan you buy. However, the consultant cover is the same across all plans for any insurer. So if Dr J Bloggs is fully covered by VHI, he's fully covered no matter which VHI plan you buy (subject to the other rules like waiting periods, etc).

As others have said, bear in mind that as a new insurance customer, there is a no-cover period of at least 5 years from the date of joining for conditions that were present before joined. This is called the pre-existing waiting period, and it's longer than 5 years if you're 55 or older when you take out the cover.

You don't need to give medical information when you join, but if you go into hospital, your consultant fills in a section of the claim form and one of the questions they answer is when the illness or symptoms of the illness began. That second part is important, as many people think it's based on when they get the official diagnosis, which is not the case. It's instead based on your consultant's review of your medical history.

Hope that goes someway to clearing things up, and OP if you have more specific information about the type of treatment you may receive in the future, that should help the insurer give you a more definitive answer.

broker2008

NuMarvel wrote: »

Aviva has a list of recognised in-patient and daycase treatments/surgeries/procedures on their website here (scroll down to Procedures Lists). I can’t find a similar list on Quinn’s or VHI’s website, but for the most part a treatment covered by one insurer will be covered by the others.

QUOTE]

Those lists are out of date

NuMarvel

broker2008 wrote: »

Those lists are out of date

How so?

broker2008

The lists were valid until June 2010. I would not take anything from a website without checking with the various claims departments of the 3 insurers as they will be the ones paying or not paying the bills.

A friend of mine works in private hospital and she said that there are continual changes. An example would be a MRI SCANS where it was covered by direct settlement and is now no longer the case .

broker2008

You need to get a procedure code from the consultant, example, as per NUmarvel's link to see if an insurer covers it. There is usually no waiting period for the outpatient cover of visiting a consultant (if under 55/60). Some health plans offer money back on these visits. Plan B will require many many visits before you get any money back but plans with day to day cover will have no excess or a small amount of €25.

Aviva sell a plan for just day to day medical expenses, day to day a and day to day 50. VHI offer Healthsteps Silver and Healthsteps Gold although they went up in price recently. Quinn have none but incorporate cover within their hospital plans as Aviva & VHI do. HSF also offer cash plans that don't require inpatient cover.

(The Smart Plan from Aviva offers virtually no outpatient cover.)

NOt too familiar with dermatology procedures, but if you have something wrong that requires a procedure to be carried out in the future - then I would imagine its a preexisting condition and you will have to wait 5 years for cover.