Question re: insurance

LegacyUser

Hey guys,

I'm getting a procedure done in about 8 weeks (circumcision for health reasons). I have insurance and it covers the procedure. However, I am an 18 year old student living away from home but I am under the 'family package' or whatever it is called.
I have not told my parents I'm getting it done... is it going to somehow show up?! I have no idea how insurance works, literally. Do I have to initially pay and then I get the money back on the insurance or does the insurance pay off the bat?

Thanks guys!

Ickle Magoo

Moved from PI...

Although the procedure is personal in nature, this is the best forum for advice on insurance.

All the best. :cool:

Random

this is an example about how vhi deal with it

http://www.vhi.ie/claims/howto_claims.jsp#hospital

...
We pay all hospitals directly
Vhi Healthcare has direct payment agreements with all hospitals. This means that you won’t have to settle the bills yourself before making a claim.

Instead, you simply complete the relevant section of your claim form at admission to the hospital:

* Don’t forget to bring your Vhi policy number for any planned admissions. Your policy number can be found on your Vhi card.
* We will take care of your treatment costs.
* We will send you a claims statement later to confirm the benefit paid.
* All our members should review their claims statement to ensure the bills are consistent with the treatment received, and to contact us in the event of any discrepancies.
...

coylemj

An itemised statement will be sent to the policyholder which I guess is one of your parents, it will probably just outline the bare details of the treatment and may or may not mention the word circumcision.

There will be a charge for the hospital/clinic, the anaesthetist and the surgeon and all of these will appear as line items on the statement. Talk to the surgeon and ask him/her if they can send a bill to the VHI with a reasonably vague description of the procedure, then you can tell your parents it was an ingrown toenail!

broker2008

The health insurers will only deal with the policy holder but you could try and flag with them to see if there is anything they can do like suppress the bill but I have my doubts.

An alternative would be to take out your own policy in your own name with VHI (leaving the current policy in place) and quote the new policy number to the hospital. They will pay the claim out under the new policy as there will be no waiting period. You may have to pay adult rates for the privilege though. You then cancel the policy once the procedure is over so it would cost you in the region of €70 for cover for the month to save the embarrassment to bring up with your parents. If that doesnt work, get a friend's parents to add you onto their policy again for the duration of the procedure, before and after, with any of the 3 insurers or tell your folks !

NuMarvel

may_as_well_ask wrote: »

Hey guys,

I'm getting a procedure done in about 8 weeks (circumcision for health reasons). I have insurance and it covers the procedure. However, I am an 18 year old student living away from home but I am under the 'family package' or whatever it is called.
I have not told my parents I'm getting it done... is it going to somehow show up?! I have no idea how insurance works, literally. Do I have to initially pay and then I get the money back on the insurance or does the insurance pay off the bat?Thanks guys!

I'm guessing from these two statements that you haven't spoken to your health insurer yet? Your doctor may have told you it's covered, but before going for the treatment, definitely check it with your insurer. You're not obliged to, but they are the best people to tell you if you're covered or not.

When you ring them, they'll need to know the name of the hospital you're going to, the consultant carrying out the treatment, and maybe the procedure code. That's a code the insurer has assigned to each procedure, the consultant's secretary should be able to give it to you. They should also take you through the claims process, but generally, just fill in part of a claim form in hospital and the hospital takes care of the rest.

At the same time, ask them what will be written on the claims statment that will be sent when the claim is paid. I some minor surgery last year and next to the consultant's name, all that was on my statement was Surgery. The statement also listed the hospital and consultant's names, and the amounts paid, but nothing more specific than that. Your insurer might have a different process though.

If they do print details of the surgery, ask if there's any way that the claims statement can be sent to you in this case, or if there's another way around it. Maybe they can set you up on a dummy policy for the purpose of the claim. Don't worry about being embarassed talking to them; your insurer has to be told by your consultant what procedure was carried out when he/she sents in the claim, so they'll know in any case.

By the way, all of this is assuming you're going as a private patient. If you're going publicly (i.e. you haven't had to pay the consultant for the visits), then the only charge is the hospital charge of €75 per night. That bill can be sent directly to whatever address you give them, and you can pay that yourself if you're embarassed about the procedure.

looder

If you put a college apt address on the hospital claim form, the benefits statement from the insurer will be sent to that address.

Also, ring your insurer to make sure it's covered.

NuMarvel

looder wrote: »

If you put a college apt address on the hospital claim form, the benefits statement from the insurer will be sent to that address.

Also, ring your insurer to make sure it's covered.

The VHI claim form asks for the policy holder's address, presumably one of the OP's parents. A different address to the one on the VHI's records would probably result in a call by the VHI to the policy holder to confirm the correct address, and possibly result in the hospital admission coming to light.