Health Insurance

DUBLINIRL

I have health insurance and am wondering would that mean I am likely to be admitted sooner for treatment if I went to Beaumont Hospital A&E or is it first come first served with some allowance for severity of injury? I'm reading some people are waiting 24 hours for treatment.

Charles Babbage

No, health insurance is feck all use in A&E.

If you break your arm or something like that then you could go to a private injury clinic and get repaired, as long as you get your injury during working hours, which in fairness does cover most sports injuries and the like.

the_amazing_raisin

No use for A&E, you'll be in the triage queue same as everyone else

What it might given you access to is a private clinic. For example VHI have swiftcare clinics that can deal with non life threatening stuff. They're great for when young kids are sick and need a doctor, and they can also deal with sprains and fractures

Laya also have a couple of clinics and Irish Life have a deal with some private clinics around the place

Still stihl waters 3

Not much use after you get admitted either, you'll be seen on severity of case and you won't get private bed either

SuperBowserWorld

Nope.

Also, private clinics are fine so long as your emergency is convenient for the private clinic.

Shauna677

https://www.boards.ie/discussion/comment/120081953#Comment_120081953

it wont stop them from asking you for your private health insurance details though, unless you getting private room I wouldnt be signing no forms for them.

Shauna677

https://www.boards.ie/discussion/comment/120081972#Comment_120081972

A broken bone can wait until daylight hours. better than waiting up to 90 hours in an overcrowed public A&E.

SuperBowserWorld

https://www.boards.ie/discussion/comment/120081989#Comment_120081989

True

Still stihl waters 3

Even without insurance if you can afford to just go to a private A&E if its not too serious you're probably better off, I've needed 2 mri in the last few years and went to the Galway clinic both times, worth the money to not sit around for hours and end up waiting on a public waiting list for months

the_amazing_raisin

https://www.boards.ie/discussion/comment/120081989#Comment_120081989

I mean, it depends. If the bone is sticking out then you're probably better off going to the hospital

There's a lot of the time people end up in A&E when they don't need to be there. I don't think it's generally their fault, for example when you've a young kid who gets a fever over 40C then the HSE advice is to seek immediate medical attention

If that's after hours and you can't get the D doc then you're generally told to go to A&E

99% of the time, the kids fine and just needs a prescription dose of nurofen, but they won't be discharged from hospital until the doctor sees they're stabilised and they're taking up a bed

And then there's the 1% of times it's something more serious and they need urgent care

IMO the more people can seek care in clinics outside of hospitals, then the better off the health system is overall

The private clinics are good for this, when we had VHI we got great mileage out of the swiftcare clinics, better than the GP in many cases. It cost money, but absolutely worth it

Since we've moved insurer we tend to use the GP more because the paid clinics are too far away

Also used the CHI clinic a couple of times. It's a great facility but unfortunately it's very overcrowded a lot of the time

Gael23

No use for A&E but if you needed surgery for your broken arm you could be referred to an orthopaedic doctor in a private hospital for it

DUBLINIRL

https://www.boards.ie/discussion/comment/120081984#Comment_120081984

So this is something I've heard anecdotally.

How does this play out in reality when you present yourself at the intake desk?

the_amazing_raisin

https://www.boards.ie/discussion/comment/120088522#Comment_120088522

For me I've always given our insurance company and member number.

Apparently there's a form you may be asked to sign which basically says you won't be funded by the HSE and the entire cost will fall on your insurance

This doesn't seem to cost you anything but it does cost the insurance company a lot, which is why they're moaning about it

I've never actually been presented with the form, nor have I signed it. I've always gone into A&E as a public patient and only paid the public rate charges, which I then claimed back separately from my insurance

I've also checked my insurance claims and there's no big charges coming from hospitals, so I kind of feel like the whole thing was overblown a bit

Jim2007

https://www.boards.ie/discussion/comment/120081984#Comment_120081984

So why do you feel so strongly about helping to increase the insurance company’s profits or do you get some reward/discount for doing so.

MIKEKC

https://www.boards.ie/discussion/comment/120088773#Comment_120088773

It's not about increasing the insurance company profits.You already pay for your hospital treatment through your prsi. If the insurance company costs are lower in theory the premiums should be lower

bladespin

https://www.boards.ie/discussion/comment/120088812#Comment_120088812

Funny how it doesn't really translate though, it is a bit of on Oirish thing though, it's just a matter of who pays the bill which in the end (either way) is yourself (the taxpayer and subscriber). Funny system where insurance is pretty much paying for most of what is already available for free and so much of what you can get privately isn't covered by most policies.

Jim2007

https://www.boards.ie/discussion/comment/120088812#Comment_120088812

You are paying for both right. And by not holding the insurance company responsible for its share you are going to increase your taxes or accept lower public services and the more people do this the more they will ultimately pay in taxes. The only one that gains by your approach is the insurance company. They are not reducing their premiums or giving you anything for that nice present you are giving them. It is one of the best legal scams I've heard of in years.

MIKEKC

https://www.boards.ie/discussion/comment/120088928#Comment_120088928

The advantage of insurance is you get immediate treatment . Not better. You hear of people waiting long periods for him and knee rep!acements Private insurance policies are being renewed this year without an increase.

Shauna677

https://www.boards.ie/discussion/comment/120088928#Comment_120088928

Im getting an orthopedic procedure carried

out in a private hospital this month. I saw the doctor to get the consultants appointment 3 weeks before christmas. I got my appointment to see the orthopedic consultant within a week and he basically asked me what date would I be available for surgery.

My doctor told me if i went under the public system, i would be waiting a minimum of two years.

Shauna677

https://www.boards.ie/discussion/comment/120088522#Comment_120088522

All the time. They will ask you.if you have insurance then try to get you to sign a form so they can bill private healthcare company.

Gael23

Yes but if you are treated as a private patient you will be seen by the consultant and not a registrar

bladespin

https://www.boards.ie/discussion/comment/120091783#Comment_120091783

That's a great turnaround, unfortunately over the past couple of years we've needed to seek a private consultation twice, one for myself and another for my son, neither of which is covered apparently, though I will say the turnaround for a private consultation is excellent, was seen within the week and the follow up was exemplary too, pity the insurance is rubbish.

bladespin

https://www.boards.ie/discussion/comment/120091174#Comment_120091174

If you present at an A&E you will get immediate treatment on public health too, it's the so-called 'elective' treatments that incur the wait, though how someone suffering arthritis and needing a new hip could be considered 'elective' is beyond me.

Also, it should be noted that if you have a life threatening condition, treatment will be pretty much immediate on public as well.

the_amazing_raisin

I will say the insurance is great for day to day care as well, a lot of them will cover a fairly significant percentage of GP or consultant fees

I think in general they're aiming to cover general healthcare, and things like specialist treatments or hospital care when you're abroad. The idea seems to be that if you have a life threatening emergency you still go to the hospital and get covered by the HSE

Shauna677

https://www.boards.ie/discussion/comment/120093161#Comment_120093161

Would you.not consider changing your policy, you would nearly want to.be paying €1400 a year for decent cover including day to day expenses.

In 2017 I was admitted to St Vincent’s in need of emergency surgery for bowel obstruction, and as I was in the middle of the most unpleasant vomiting imaginable a person with a clipboard came to ask me my health insurance details. I didn’t give them. I had a bit of a complicated recovery, and after surgery the clipboard person arrived again telling me I was being transferred to the private hospital, which was a complete lie. Regretfully I signed.

Furze99

https://www.boards.ie/discussion/comment/120089618#Comment_120089618

I always laugh too when I hear people with private health insurance doing their best to avoid their insurers from picking up at least part of the bill. They pay steep enough premiums.

My principal gripe with health insurance is that it's marketed like a pension as in 'invest now in your 20s/ 30s/ 40s etc and you'll benefit in your 70s and 80s etc'. But it's sold like car or house insurance, once your annual premium lapses that's it - your investment is gone poof. If you don't keep renewing with the increases they can screw out of the customer, then it's bye bye. Dishonest way of selling a product.

Imagine selling a pension like that - sorry you missed your payment, so xyz€ in your account is now ours!

Shauna677

https://www.boards.ie/discussion/comment/120092289#Comment_120092289

Im truely shocked to read this.

witchgirl26

https://www.boards.ie/discussion/2058278709/health-insurance

A&E is always on a need first. So if you're waiting with something minor & something major comes in, it doesn't matter what insurance you do or don't have, that will take precedence. It's all about the severity which is why you're triaged - it's an assessment of where you'll be in the queue.

https://www.boards.ie/discussion/comment/120088522#Comment_120088522

So my experience is that they will ask you at the desk in A&E for insurance details. While it makes no difference in A&E, it is more that if you're admitted, it'll mean that your costs are billed back to your insurer.

thebiglad

https://www.boards.ie/discussion/comment/120093630#Comment_120093630

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POBox19

https://www.boards.ie/discussion/comment/120088522#Comment_120088522

A visit to a public hospital A&E costs €100 per day. If you provide your insurance details to the hospital they will charge the company directly for you. The company should advise of how much they paid on your behalf later. If a doctor has written a referral for you to go into A&E the charges are waived.

https://www.boards.ie/discussion/comment/120093735#Comment_120093735

It’s the A&E attendance fee that’s waived if a GP has sent you with a letter from her/him

cython

https://www.boards.ie/discussion/comment/120093676#Comment_120093676

Having accompanied my mother to A&E shortly before Christmas (and given she was admitted on the back of it and was recovering from emergency surgery less than 12 hours later, I'll not get into questions about the necessity of her being there!) and needing to answer questions on her behalf with the desk clerk due to pain making this difficult for her, she certainly wasn't asked about insurance in A&E, and it was only in the subsequent days that anyone broached the subject with her. That was in James's, but obviously it may vary from hospital to hospital.

https://www.boards.ie/discussion/comment/120093735#Comment_120093735

As another poster mentioned, the €100 A&E is per attendance, not per day (thankfully, given the current trolley crisis!), and I don't believe that any of the insurers offer direct settlement of that (nor should they, or it would be almost certainly be abused by some!). At best you might be able to claim back a percentage of the fee from an insurer once you've paid it yourself. It is worth noting, however, that if you are admitted to the hospital as a result of attending A&E then the €100 fee is (rightly, IMO) waived, regardless of whether or not you had a GP referral.

The only daily fee applies to inpatients who have been admitted, and is €80 up to a maximum of €800 (10 nights) in a calendar year, and this is unaffected by whether or not you have a GP referral, but is covered for medical card patients. Most insurers will cover this via direct settlement. As of April this charge is being removed for all patients, however, which will doubtless make it more difficult for public hospitals to broach with patients the matter of private payment by insurers for public treatment, since there will be nothing to settle with insurers in most instances of treatment in public hospitals.

I can see both sides of the matter of hospitals seeking payment for the full whack from insurers to be honest, but I'd fall on the side that most people with health insurers are also paying their fair share in tax, PRSI, etc., so why should they be expected to be a source of even more funding for the health service when they're unfortunate enough to require treatment by having their insurers foot the whole bill? Were the HSE operating on a shoestring and making best use of a very meagre budget whereby the money would likely make a material difference, I'd happily and unequivocally advocate for insurers coughing up, but the fact of the matter is that there is an immense culture of fiduciary waste within the HSE management, and any patient's insurance cover will be but a drop in the ocean in the face of it. That is not to criticise the frontline staff, who predominantly do trojan work within a limited system, but there are too many surplus management layers being paid bloated salaries with the result that a frankly whopping budget just can't deliver the service it should.

Furze99

https://www.boards.ie/discussion/comment/120094240#Comment_120094240

And just how much PRSI did you pay last year? And then consider that this covers several areas of public expenditure: your state pension, unemployment benefit if you're unlucky to lose your job and a range of other payments and benefits. Compare that to your private health insurance premium, then try rocking up to your insurer and demanding a pension when you're due one..

MIKEKC

https://www.boards.ie/discussion/comment/120093161#Comment_120093161

It's very important when taking out cover to study the policy . There are hundreds of them. Of course some cover May be very expensive. The insurance certainly isn't rubbish. You just haven't a policy that covers your needs

Strumms

My father has several medical issues and for many years has had the best health insurance that money can buy…

Problem is its been a lottery though as to whether he sees any benefits of that policy on admission to hospital. More often then not he doesn’t…which used not be the case..

he is supposed to get a private room on admission, on occasion he does or will be moved to one as they become available….but last time he was a few days in a general ward and then into just a semi private room just him and another individual which was a bit awkward as the guy was a bit of a head melt motormouth and wouldn’t STFU for the entire duration… he enquired from the guy what insurance he had… “ ohhh none “ was the response. A shortage of beds led him to being facilitated a semi private ward…So a guy not paying a cent, ends up with levels of care and comfort that my Dad pays almost a couple of grand for…yet my Dad per his policy should be entitled to a private room…he pays for it….yet cannot in many instances, attain it.

Smee_Again

https://www.boards.ie/discussion/comment/120093735#Comment_120093735

The fee for A&E is €100, this is waived if you are referred by your GP and/or admitted. Once admitted the daily fee is €80 for a max of 10 days in any 12 month period.

cython

https://www.boards.ie/discussion/comment/120094451#Comment_120094451

How much PRSI I did or did not pay is none of your business, obviously, but rest assured it was more than a lot of people. As for your persistence with a pension analogy, my PRSI today is paying for the state pension of current retirees, not towards my own, and this perpetual payment of current pensions from current workers' pockets is widely acknowledged as a ticking time bomb with population aging and living longer on average (as you ought to know if you're so fixated on pensions) with many commentators skeptical about it still even existing when I eventually reach retirement age. That is part of why I pay into a pension scheme, which incidentally is completely separate from my health insurance, from which I have (rationally enough) zero expectation of a pension. And I'm fortunate enough that my health insurance is paid on my behalf with my employment, so I could either opt out of that scheme and save a little in BIK, or avail of it for the cost of that same little. On balance most years I get more out of it than the BIK costs, so it works for me.

Thanks for missing/overlooking/ignoring the majority of my post to demonstrate your fixation on pensions though, it's very helpful.

Jim2007

https://www.boards.ie/discussion/comment/120094240#Comment_120094240

They are not the source of more funding for the health services, they are the source of more profits for the insurance company. The insurance company does not give you any reward for saving them money now does it? No matter who ends up footing the bill for treatment, you still end up paying for both. And if most people with insurance do this, then taxes go up and the company still gets to keep your money.

POBox19

I stand corrected.

sugarman20

https://www.boards.ie/discussion/comment/120094240#Comment_120094240

So because the HSE is badly managed the health insurance companies shouldn't pay for the services being provided to their customers? That's a truly bizarre way to look at it.

cython

https://www.boards.ie/discussion/comment/120094748#Comment_120094748

If those patients with insurance agree to have their insurers billed for their treatment in full, then they absolutely are the source of more funding for the health service, with the insurers being the providers of that funding. If they refuse this billing, then granted, they could be deemed a source of more profits for the companies. Whether they reward their customer base as a whole (since premiums are pretty much uniform for a given policy save for community ratings coming into play) for not agreeing to the claim, or penalise them for agreeing to it (by means of increasing premiums year on year), is a matter of semantics really. However I do have an objection to seeing money that is taken from my earnings on a mandatory basis being squandered, and I've no interest in putting more money on the plate of those responsible, regardless of whether it's my money or that of a private company. At the very least I can invest in the company and see some benefit from their profits increasing if I really wanted to, but I see zero benefit from the HSE pissing away money.

https://www.boards.ie/discussion/comment/120094804#Comment_120094804

If that's your interpretation of my comments, then so be it, but be assured it is no more than that, and not what was said.

Shauna677

https://www.boards.ie/discussion/comment/120093630#Comment_120093630

Not always, illnesses can and do appear at any age. Many young people in their 20s 30, 40s and beyond are always very reliefed to have health insurance policies n place when accidents, illnesses/cancers etc strikes. The security of having it in place is more vital than ever now given the state of the public service.

Charles Babbage

https://www.boards.ie/discussion/comment/120093630#Comment_120093630

Did it ever occur to you that the premiums are so steep because people are paying for things they shouldn't be paying for?

If people take the piss then the premiums go up and none of us will be able to afford them.

Shauna677

https://www.boards.ie/discussion/comment/120096394#Comment_120096394

The public service has been abysmal for generations. Its not a recent occurrance.

A health service that was buillt without a proper foundation rather something that wss developed in an ad hoc fashion. It has multiple issues and unless the powers that be will do something to sort this poisoned chalice once and for all, the private health care service

will continue to grow and flourish.

mohawk

https://www.boards.ie/discussion/comment/120096326#Comment_120096326

GP has sent a private referral off for our toddler. The issue is time sensitive as in needs to be treated before he reaches a certain age for greatest chance of success. The waiting lists are so long on public system that he won’t be treated in time. Honestly, I make no apologies for having private insurance and using it to get my toddler treated faster.

bladespin

https://www.boards.ie/discussion/comment/120094490#Comment_120094490

Kind of my point, you're sold a policy that promises to cover your needs, the average joe has no way to decipher the flannel contained in the policy notes (I'm quite familiar with other insurances and still find it extremely confusing), so yeah, it is rubbish really and needs to be cleaned up.

Furze99

https://www.boards.ie/discussion/comment/120094594#Comment_120094594

"And I'm fortunate enough that my health insurance is paid on my behalf with my employment"

That's grand for you. But answer honestly, would you pay that annual premium every year if it had to come directly from your own bank account. Just like paying the ESB or house insurance?? And what if you can't afford to pay this year or next after say 20 years of payments, would you be happy to be told you'll have to pay substantially increased premium if you want to re subscribe and wait for a year etc etc. Private health insurance companies have ordinary people over a barrel and taking them for the maximum they can get away with.

We pay into a private pension scheme as well but at least I can look that up and see the value in it, whether rising or falling. With health insurance, you're effectively only as good as your last premium. If employers had sense they'd cut this cost off their bottom line, and let their employees decide what to do with their money and pay their own way. Ditto with pensions for that matter.

bladespin

https://www.boards.ie/discussion/comment/120102553#Comment_120102553

100% correct, I recently checked with Laya (my insurer) about policies that better suited my needs, they directed me to their website to 'explore' the different policy types/levels etc, explore being the perfect word, a little more and I'd need a machete to cut through the jungle there were that many and each had different levels, it's ridiculous, to expect the average person to navigate that level of BS in simply wrong, should be like car insurance, 3 levels and you get what you pay for.

Count Dracula

I pay 156 per month which works out around a 5er a day. the guts of 1800 a year.

I hate money, but your health is your wealth.

witchgirl26

https://www.boards.ie/discussion/comment/120102644#Comment_120102644

Mine is also paid by my employer currently but I would (& have in the past) pay it myself if it wasn't. I've received a large amount of benefit from it over the years that makes it worth while to have. I don't pay for a massive premium but it gets me what I need. It has helped with GP visit costs, enabled me to get a hurt knee seen to quickly & easily - out of the public system through one of the private a&e type places so I wasn't clogging up the main public service for something minor. It helped pay for my semi-private maternity which was important to me as it meant I was able to schedule my apps & scans to suit my work & my other half being able to join me for ones needed. And with my son on it, it's helped with some of his costs including getting in to get an asthma diagnoses quicker than the public system (again going through the private setting so not skipping any public queue in a public hospital).

I can't see employers cutting health insurance. Maybe moving to providing a discount rather than paying the full but realistically it is now expected from most and I've seen some stats showing that employers who had this had lower days off than prior to giving employees access to private health insurance.