choice of clinic/procedure

Seanachai

I don't have health insurance and I am considering signing up, I was wondering if I became ill in the future could I then choose the clinic I want to go to and also shop around for the best procedure or will I be restricted by the terms of the policy?

coylemj

The insurance company you go with will have a list of approved clinics and hospitals where they provide full or partial cover, depending on which plan you're on. But the decision as to which hospital or clinic you go is is usually down to the consultant you get referred to by your GP - most consultants operate out of one and possibly two centres so for example you can't just go to any old consultant and say that you want your procedure to be carried out at xxx clinic because he/she may not practise there.

So if you are in need of some class of a procedure and want to nominate the clinic where you want to be treated, the first thing to do will be to find out which consultants in that clinic have the speciality you will need, then tell your GP to refer you to one of those consultants.

If you suddenly get seriously ill and require immediate treatment then you will go in to your local A&E and be treated there under the public system.

Seanachai

Okay, it's good to know I'll have a choice to nominate a clinic at least

coylemj

Why would you select a clinic first i.e. before you decide which consultant to see? Surely you should be finding the skill and experience (and listen to the recommendation from your GP) first, then go along with wherever they happen to practise?

Seanachai

coylemj wrote: »

Why would you select a clinic first i.e. before you decide which consultant to see? Surely you should be finding the skill and experience (and listen to the recommendation from your GP) first, then go along with wherever they happen to practise?

Gallbladder problems run in my family and on the advice of doctors/consultants so far most of my relatives have has their gallbladders removed completely. From the research that I've done and from speaking to other people there are less invasive procedures such as shock wave therapy that can avoid the need for surgery. I'd like to be able to pick a clinic that offers the conservative options. I'm thinking of this down the line as I want to be able to eat fats without vomiting like currently happens to my uncle.

okiss

In regards to health insurance I would look up the hia.ie website.
I would look for health insurance that would cover you for a semi private room in a private hospital and one that would cover your for caridic/cancer treatments in the high tech hospitals ie mater private, the blackrock clinic.
To keep the cost down be willing to pay an excess - you pay x amount toward the cost of a day case or per night/per stay in hospital.

I would look into having as many hospitals as possible available on your policy. Some of the cheaper policies will only cover public hospitals and/or very few private hospitals or the high tech hosptials.

One policy that I found to be good is Laya Flex 500 explore. It costs €661.50 a year. You are covered in private hospitals, high tech hospitals along with public hospital. You pay €150 towards a day case in a private or high tech hospital - you have cover for the blackrock clinic and the mater private for this.
If you have to spend some time in hospital you pay €500 excess per claim if you stay in a semi private room in a private hospital. You have full cover for public hospitals including private room. Note private rooms are very hard to get in a public hospital.

In regards to picking a clinic/procedure you need to be aware of the following.
Most private consultants could work from 1 or 2 clinics - one clinic could be in public hospital and one private or both could be in private hospitals/clinics.

If you doctor/consultant says you need to have a procedure done ask them for a procedure code for this with what ever insurance company you are with ie laya. If you ring your insurance company they will tell you if the procdue is covered, were it is covered and let them know the name of your consultant also.

On the hia.ie website I would also look into the consumer information at the bottom of the home page as it explains waiting periods. All health insurance policies have a waiting time for pre- existing conditions.