Can someone explain the HSE v insurance to me?!

araic88

I'm a bit confused by the health system (I think most people are though?!)

I have VHI insurance but don't expect to get much back at the end of the year from various visits.
I've been wondering though, if you have health insurance, does a hospital just charge the insurance company directly for surgery, scans etc. But what if you don't have insurance or a medical card -even though you're in a public hospital do you have to pay? I know major operations are really expensive (and that we're at least not the US where they apparently just don't treat people without insurance!)
Technically, even though I can "afford" VHI cover (though it would be useful elsewhere!), if I didn't have it would I actually just get the same treatment but probably have to wait longer / not get a private room if available etc. or would I have to pay for it?
I do wonder is VHI worth it! I kind of just have it "in case" something awful happens but if it really was serious, you'd hope you wouldn't be stuck on an overly long waiting list anyway.

Hal Emmerich

araic88 "But what if you don't have insurance or a medical card -even though you're in a public hospital do you have to pay"

Patients owe HSE 400 Million :eek:and they've spent 2.4million to debt collection agencies trying to get it.

Hospital Charges

Why are we still waiting

But for those referred by a GP to a specialist in the outpatients’ department of a hospital, it’s an entirely different story. That can take years.
The Health Service Executive (HSE) has refused to release data under the Freedom of Information Act on outpatient waiting lists at its hospitals but the head of the NTPF told a conference in March he understood there were about 200,000 people waiting for outpatient appointments, some for up to five years. Last month the HSE West confirmed that 27,344 patients were on the outpatient waiting list at University Hospital Galway and a further 7,455 were on outpatient waiting lists for Merlin Park University Hospital in the city.

5 years is a long time to put up with any ailment, this includes MRIs or Eye and Ear visits. One consultant visit can be from €150 to €250.

araic88 "I do wonder is VHI worth it! I kind of just have it "in case" something awful happens but if it really was serious, you'd hope you wouldn't be stuck on an overly long waiting list anyway."

If it was serious you wouldn't be on a waiting list (Hopefully it'll never get to that stage) but as you said in your post how much is it going to cost.

If it's just you and your young/healthy then there's not much point in Health Insurance but if there's kids and you can afford it then I'd get it.

HIA.ie

Susie564

I've been thinking or reducing my cover lately as my premium is quite expensive. I'm not sure it's a good idea, but I reckon lots of people are doing the same, or canceling their cover altogether. It's almost renewal time for me - so I'll have to decide soon

Traumadoc

Many people who were employed had health insurance to jump the queue, essentially if they had a medical condition financially it made sense to have insurance.
Now many people are unemployed so speed of delivery of non acute care is not the priority it once was, so why have insurance?

Delancey

Susie564 wrote: »

I've been thinking or reducing my cover lately as my premium is quite expensive. I'm not sure it's a good idea, but I reckon lots of people are doing the same, or canceling their cover altogether. It's almost renewal time for me - so I'll have to decide soon

All the health insurers have reported a drop in the number of subscribers , a situation I predict will worsen.

drzhivago

araic88 wrote: »

I'm a bit confused by the health system (I think most people are though?!)

I have VHI insurance but don't expect to get much back at the end of the year from various visits.
I've been wondering though, if you have health insurance, does a hospital just charge the insurance company directly for surgery, scans etc. But what if you don't have insurance or a medical card -even though you're in a public hospital do you have to pay? I know major operations are really expensive (and that we're at least not the US where they apparently just don't treat people without insurance!)
Technically, even though I can "afford" VHI cover (though it would be useful elsewhere!), if I didn't have it would I actually just get the same treatment but probably have to wait longer / not get a private room if available etc. or would I have to pay for it?
I do wonder is VHI worth it! I kind of just have it "in case" something awful happens but if it really was serious, you'd hope you wouldn't be stuck on an overly long waiting list anyway.

Short answers

Public Hospital

A&E €100 charge UNLESS referred by GP or have medical card

Admitted to PUBLIC BED PUBLIC HOSPITAL nightly fee of approx €150 I think up to a maximum of 15 nights in year UNLESS MEDICAL CARD OR INSURANCE - no operations charges/no surgeons charges/no scan charges

Admit to private bed - cant even estimate charges

Squiggle

Traumadoc wrote: »

Many people who were employed had health insurance to jump the queue, essentially if they had a medical condition financially it made sense to have insurance.
Now many people are unemployed so speed of delivery of non acute care is not the priority it once was, so why have insurance?

Will you not be seen quicker for an elective procedure if you have health insurance?

Gottalovegreys

drzhivago wrote: »

Short answers


Admitted to PUBLIC BED PUBLIC HOSPITAL nightly fee of approx €150 I think up to a maximum of 15 nights in year UNLESS MEDICAL CARD OR INSURANCE - no operations charges/no surgeons charges/no scan charges

75 euro a night for a public bed, up to a max on 10 nights per year.

Mucco

Gottalovegreys wrote: »

75 euro a night for a public bed, up to a max on 10 nights per year.

This is correct.

In theory, you should get equal care whether you're public or private, just not a private room etc.... In practice - the VHI pays the doctor a fee for service, whereas the public system is salary. Therefore, you'll more likely see the consultant and so on. Not that this means that the care is any better. It usually also means you can jump the queue, though it shouldn't.

There's actually a perverse incentive for doctors to maintain large waiting lists so that people pay for insurance and then the doctor gets paid more!

Do a personal risk assessment. If you're young and healthy, you're unlikely to need hospital care.

Susie564

Mucco wrote: »

Do a personal risk assessment. If you're young and healthy, you're unlikely to need hospital care.

Surely the point of any type of insurance is to help with the unexpected. If you get diagnosed with any sort of condition and try to get health cover afterward - good luck.

I'm attending a public clinic at the moment and some of the more junior doctors leave a lot to be desired - I wonder how one or two of them even made it through med school??? It can be really difficult to get to see the consultant himself.

The only thing I've found my health insurance useful for is getting scans done privately - I'm not waiting 6mths to 1yr for scans (I think that it's an absolute scandal that anyone should have to wait for diagnostic scans). And on my current policy I get €30 back for every doctor/dentist visit, which I've had a lot of this year, but I normally wouldn't have more than two/three a year. But it is an expensive policy and I'm not sure I can really afford it.

stargazer 68

Mucco wrote: »

This is correct.

In theory, you should get equal care whether you're public or private, just not a private room etc..../QUOTE]

You dont automatically get a private room with insurance either - only if there is one available.

Squiggle

Susie564 wrote: »

The only thing I've found my health insurance useful for is getting scans done privately - I'm not waiting 6mths to 1yr for scans.

You could always pay for the scan yourself and be seen just as quickly!

Susie564

Squiggle wrote: »

You could always pay for the scan yourself and be seen just as quickly!

Well, I do pay for the scan - but at the end of the year I get that money back.

Squiggle

Mucco wrote: »

You dont automatically get a private room with insurance either - only if there is one available.

+1. The main advantage of health insurance, that I can see, is for elective procedures where you will be seen quicker. That said you could always pay for any treatment you need though I shudder to think of the cost of say a hip replacement op :eek:.

stargazer 68

Squiggle wrote: »

+1. The main advantage of health insurance, that I can see, is for elective procedures where you will be seen quicker. That said you could always pay for any treatment you need though I shudder to think of the cost of say a hip replacement op :eek:.

Well a knee replacement done privately is 15,000!! :eek:

Susie564

I agree with you Squiggle - I dread to think how much you would have to pay out for a relatively "minor" op like that. But this year I've paid out about €2000-2500 on health related stuff, of which I hope to get at least half (if not a bit more) back from my insurer. Which makes it worth my while to have insurance this year, but last year and many previous years I have not claimed anything. You never know when you might need that insurance - that's the decision I'm trying to make at the moment - as my policy expires in July.

Susie564

Plus, people hear "elective" and they think it's something you always have a choice over or it's cosmetic - people are left waiting sometimes in awful pain for long periods of time for elective procedures.

Squiggle

Dovies wrote: »

Well a knee replacement done privately is 15,000!! :eek:

Just got weak at the knees reading that.

Squiggle

Susie564 wrote: »

I agree with you Squiggle - I dread to think how much you would have to pay out for a relatively "minor" op like that. But this year I've paid out about €2000-2500 on health related stuff, of which I hope to get at least half (if not a bit more) back from my insurer. Which makes it worth my while to have insurance this year, but last year and many previous years I have not claimed anything. You never know when you might need that insurance - that's the decision I'm trying to make at the moment - as my policy expires in July.

Might be worth your while check the Health Insurance Comparison section on hia.ie and remember you are entitled to any corporate plan that is offered by the Insurers. HFS health plans might also be worth checking out.

Bella mamma

Squiggle wrote: »

Might be worth your while check the Health Insurance Comparison section on hia.ie and remember you are entitled to any corporate plan that is offered by the Insurers. HFS health plans might also be worth checking out.

Agree.

Corporate plans only.

No excess (out of pocket expense before you claim).

I have Quinn's Company Care Choice, paid €660 last year (would be higher this year). No excess and can claim straight off, don't have to wait til a yr is up. €300 for dental a bonus. I couldn't find any plan better than this. Anyone?

OMD

You have to look at your own risk. Really if you are aged between 20 and 40 you should on average have no real health care needs in that time (apart from maternity or GP visits for pill). Really if you have children it is pretty pointless having insurance for them.