Health Insurance

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.

Breezy_

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

As some say, that is why the public service is that way.

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.

Breezy_

https://www.boards.ie/discussion/comment/120101940#Comment_120101940

Hold up. Are you saying the hia is useless by letting their be 100s of policies and no one has any idea what they're actually covered for? You take that back. Its millions well speant, same as the energy and lottery regulator. They are all brilliant.

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.

cython

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

Would I pay the exact same premium as is paid on my behalf now? Perhaps not, I might well shop around for a cheaper one (we're offered a given plan that is procured at a company level to take or leave, vs some other employers who reimburse up to a value for it, so I've never had cause to go looking for the best value), but I would definitely not be without some form of health insurance so long as I could afford it at all, and that would have applied even before the implementation of Lifetime Community Rating. What speaks volumes for me regarding its value is the sheer number of HCWs across a variety of professions and disciplines (I know of dentists, doctors, nurses, OTs among others, all working for the HSE) who would not be without it - when so many working within the health service and system have insufficient faith in said service to leave themselves fully reliant on it and will pay out of pocket for additional cover, that's rather telling IMO.

Furze99

https://www.boards.ie/discussion/comment/120118945#Comment_120118945

Ah but would not all these dentists, doctors, nurses, OTs among others, be getting their health insurance as a condition/ perk of the job.

If you took away this entitlement, how many would pay out of their pockets?

In fact, there is a case for forbidding private health care for senior HSE employees including consultants and their families and likewise all elected TDs and senior civil servants. Such a policy would soon sharpen minds and we'd see big improvements in how the public system is run.

Greyfox

https://www.boards.ie/discussion/comment/120111553#Comment_120111553

156 a month is crazy money to have to pay

cython

https://www.boards.ie/discussion/comment/120120260#Comment_120120260

No, none of them to whom I'm referring would be in fact, as the HSE doesn't offer it - imagine the outcry were they to do so, after all, as it would be tantamount to admitting that the service they offer is not good enough for their own employees, whatever about the general public. Nice try though.

So as above, all of them pay out of their pockets, there is no such entitlement. In fact I don't imagine many, if indeed any, public service jobs include health insurance as part of the remuneration.

I don't know if your last paragraph is predicated upon your inaccurate assumption that they all get their insurance as part of the job, but regardless of that, plenty of the people you've proposed to exclude from purchasing a product are not in much of a position to improve the health service (what is a senior civil servant in the Department of Agriculture going to do about the HSE, after all? Or indeed opposition TDs? Should their children - since you specify families - who may have access to it in private sector employment be forced to decline it under your proposal too?), so it all seems a bit misguided.

griffin100

We have a basic enough family policy and we shop around every year and change plans when we get a better offer. It costs about €3k per year on average for the entire family.

Over the years it has provided for a private room in Holles Street for 2 of our 4 kids and my wife (the two other times we got a room in a different part of the hospital); it has allowed me to get an MRI for a potentially life shortening condition when the public waiting list was months long; and it covers my kids especially to go to the insurers clinic for a rapid examination and x-ray if needed if they have a sporting injury which means they are not clogging up hospital a&e for hours (happens a couple of times per year as they all play rugby or GAA).

But the biggest benefit we got was heart surgery for a condition my son had - he would have been waiting at least 3-4 more years on the public system but once he reached the age to get it done it was done privately. His entry into the hospital system when he had the heart condition was via a&e in Crumlin and all of his early years of assessments and tests were in the public system and the quality of care was second to none (the hours of queuing for every visit was the only issue). Once he was identified as a suitable candidate for the surgery he was transferred into the private system and all subsequent care was done privately.

Over the years I've probably paid €50k for private health cover. I think it was worth it but it's a lot. At this stage as I get older I'd be less inclined to let it go in case I need it at some stage.

Furze99

https://www.boards.ie/discussion/comment/120120646#Comment_120120646

Sure, that's how you'd put the burners under them. People act in their self interest mostly. We'd see dramatic improvements in the general health service if the people who make policy, carry out policy and work in senior positions all needed to rely on it. And their immediate families. We'd have the famous 'Slainte Health Care' in months not decades, if ever.

Shauna677

https://www.boards.ie/discussion/comment/120120596#Comment_120120596

You can get pretty good policy for approx €120 a month which will include very good day to day expenses such as a percentage back on GP fees, usually 50/%, consultant fees etc. Example would be Laya's Simple Connect, Simple Connect Plus, Connect Simplicity and Laya Inspire Plus. Im not familiar with the other healthcare companies.