Health insurance for children - just another tax?

Sebastian Dangerfield

Unsure where to post this, so feel free to move it if in the wrong place.

My baby was in an accident which required her to be brought to hospital in an ambulance. She was in A&E for a couple of hours, thankfully nothing serious, and admitted to a ward for overnight observation. The next morning my wife was asked if the baby was covered by an insurance policy. She said she was, but on my work policy, so she didnt have the details. Not to worry, they said, we'll send it in the post.

Soon after, we got two letters. First was a bill for €100 for the A&E charge, which I paid immediately. This was followed by insurance forms.

I followed up with calls to ask for a receipt for the €100, so I could claim it back on the insurance. This was denied - I was told that the €100 was never actually due, because as soon as she was admitted to a ward, the €100 became null and void, to be either replaced with an €80 inpatients charge, or a bill to my insurance. Despite this they send me a demand letter every 10 days or so for the same €100 that has been paid, despite never having been due in the first place!

Anyway, the insurance point. In order to return my €100 - they have said they wont do so until the forms are returned - I either have to 1) complete a statement which says that a) if my insurer doesnt cover any of the €813 cost, I am liable for it, b) "I requested to be treated by a private consultant during my stay", and iii) even if I requested private care but got public care, I understand my insurer will still be billed for the former, or 2) choose not to avail of my insurance, and pay the €80.

They're essentially asking me to lie. I didnt ask for, nor were we offered, private care. We got the care available to us, which was public care in a multi bed ward, but it seems like we are being asked to restate history so that the public care I already paid for through my taxes, can be recharged to my insurance at an extortionate rate, which in turn I'll have to pay for again through increased premiums. It seems wrong.

Anyway, aside from wanting a rant, I was wondering if anyone has been caught out in such circumstances, either billed for an amount or been challenged on the "private care" point by the insurer?

Eggs For Dinner

You should rename your thread. The HSE, just another tax

Sebastian Dangerfield

Eggs For Dinner wrote: »

You should rename your thread. The HSE, just another tax

Very true. I pay insurance for the kids so they either get the best care available, or i get refunded costs if there is no choice of care. There was no choice, and it seems i cant recoup costs unless i decline public care, lie and say I asked for private care, and risk 10x the cost if for some reason the insurance doesnt cover it. So my premiums are essentially worthless.

Mods - on reflection I was venting frustration more so than looking for information, I dont think anyone can give much help. Feel free to delete

coylemj

OP, did your insurance company not advise you of this scam? If you go into hospital via A&E, all of the treatment is covered under the public system so if they hospital asks you if you have insurance, you say 'no'.

Because as you have found out, if you admit that you have insurance, the hospital will then retrospectively make you a private patient and bill the insurance company so you will end up paying twice, once via your taxes and the second time through your insurance. Of course the consultant will also bill you, even though at the time the treatment s/he administered was considered part of his/her public contract.

coylemj

Eggs For Dinner wrote: »

You should rename your thread. The HSE, just another tax

In this case I don't blame the HSE, I blame multiple ministers for health who, as a matter of public policy, have decided that private insurance is a pot of gold which should be used to subsidise the public system.

The attitude is that, regardless of how much tax you pay, if you also pay medical insurance then any treatment that you get in the public system should be paid for by your insurance. Even if you never set foot in a private ward and the consultant who treats you does so during his public hours.

Which is grossly unfair.

Sebastian Dangerfield

coylemj wrote: »

OP, did your insurance company not advise you of this scam? If you go into hospital via A&E, all of the treatment is covered under the public system so if they hospital asks you if you have insurance, you say 'no'.

Because as you have found out, if you admit that you have insurance, the hospital will then retrospectively make you a private patient and bill the insurance company so you will end up paying twice, once via your taxes and the second time through your insurance. Of course the consultant will also bill you, even though at the time the treatment s/he administered was considered part of his/her public contract.

I did get a circular to say that even if you have insurance, you dont have to sign the private care form and in turn keep premiums down. The form does seem to be optional also.

Choice is pretty simple - lie, sign the form, i get my 100 euro back, or choose not to use my insurance and pay 80 euro. Not life changing money either way, but I paid 600 euro to add both my children to my policy this year, and it seems pretty much for nothing, other than the State to extract more money for no additional service.

Ive also got a minor concern that something goes wrong with the claim and I have to foot the private bill. Insurer says Im covered over the phone, so probably not worth worrying about.

coylemj

Sebastian Dangerfield wrote: »

Choice is pretty simple - lie, sign the form, i get my 100 euro back, or choose not to use my insurance and pay 80 euro. Not life changing money either way, but I paid 600 euro to add both my children to my policy this year, and it seems pretty much for nothing, other than the State to extract more money for no additional service.

Your private insurance really comes into play for non-urgent procedures when you will be able to bypass the queues for public services and quickly get an appointment with a consultant followed by a private bed for treatment. If you are admitted via A&E the treatment you get is the same, regardless of insurance. But people like you are subject to the rigmarole that you are going through.