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Health insurance - pre-existing medical condition

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  • 03-08-2017 10:13am
    #1
    hkjohn
    Registered Users Posts: 379 ✭✭


    Anyone here have problems with their health insurer refusing to cover pre-existing medical conditions?

    FWIW, I'm with Irish Life who've just sent me a letter saying that they will not cover me for a problem I recently saw a consultant about as it was "a pre-existing condition".

    Problem is

    1) I have never previously suffered from the condition (and certainly not within the parameters the company outlines in their website glossary)

    2) I have to date not submitted any claim regarding my expenses for the two specialist's visits

    and

    3) The specialist who dealt with the problem has also not sent them any information to say that the condition is pre-existing either


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    #2
    sabrewolfe
    Registered Users Posts: 52 ✭✭sabrewolfe


    Easy enough to get sorted. To prove it wasn't a pre-existing condition just get a copy of your GP referral letter that was sent to the consultant to arrange the appointment. This will prove to them when the condition was first recognised or suspected.

    If your GP did not refer you and you made your own appointment the consultants secretary can give you a letter proving date of first appointment.

    Once this is forwarded to health insurers they will have to take this into account and realise the waiting period for pre existing conditions does not apply


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    #3
    hkjohn
    Registered Users Posts: 379 ✭✭hkjohn


    Cheers for the clarification, SW


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    #4
    Shazamm
    Registered Users Posts: 241 ✭✭Shazamm


    sabrewolfe wrote: »
    Easy enough to get sorted. To prove it wasn't a pre-existing condition just get a copy of your GP referral letter that was sent to the consultant to arrange the appointment. This will prove to them when the condition was first recognised or suspected.

    If your GP did not refer you and you made your own appointment the consultants secretary can give you a letter proving date of first appointment.

    Once this is forwarded to health insurers they will have to take this into account and realise the waiting period for pre existing conditions does not apply


    But they go on the basis of medical advice on the likelihood of when it began?


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    #5
    Mrs OBumble
    Registered Users Posts: 25,734 ✭✭✭✭Mrs OBumble


    Shazamm wrote: »
    But they go on the basis of medical advice on the likelihood of when it began?

    Thread is three years old, so the OP is at least 60% through their waiting period now.

    But you're right, its pre existing, not pre- symptomatic or pre-diagnosed. Once you get to a certain age, almost everything is pre existing.


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    #6
    Shazamm
    Registered Users Posts: 241 ✭✭Shazamm


    Mrs OBumble wrote: »
    Thread is three years old, so the OP is at least 60% through their waiting period now.

    But you're right, its pre existing, not pre- symptomatic or pre-diagnosed. Once you get to a certain age, almost everything is pre existing.

    You certainly put it best.
    Its a total cop out


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    #7
    Jim2007
    Moderators, Business & Finance Moderators Posts: 10,045 Mod ✭✭✭✭Jim2007


    Mrs OBumble wrote: »
    Thread is three years old, so the OP is at least 60% through their waiting period now.

    But you're right, its pre existing, not pre- symptomatic or pre-diagnosed. Once you get to a certain age, almost everything is pre existing.

    Healthcare coverage is a strange sort of a subject.....

    The US thinks universal coverage is not possible despite the fact that it is the only first world country to have failed to do so...

    In other countries they believe public healthcare is the only way, where as others go the opposite way...

    More claim there is too many administrators and not enough doctors while more claim doctors are doing too much admission.

    In Switzerland we don’t have a public healthcare service and the department of health has a staff of less than 500 people. Health insurance is mandatory, but there is no concept of a pre existing condition... yet I’ve never heard of an insurance company getting into difficulties! We’re closing down hospital capacity due to a lack of demand while suffering from a chronic lack of GPs.

    It’s an industry in desperate need of wide spread factual information for public decision making.


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    #8
    coylemj
    Registered Users Posts: 25,357 ✭✭✭✭coylemj


    Jim2007 wrote: »
    In Switzerland we don’t have a public healthcare service and the department of health has a staff of less than 500 people. Health insurance is mandatory, but there is no concept of a pre existing condition... yet I’ve never heard of an insurance company getting into difficulties!

    You mentioned a hefty monthly premium for medical insurance in a previous thread and if there's no public health service, it means it's not a destination (like the UK) for medical tourism.

    And given the high cost of living, Switerland is not a retirement destination either so the local insurance companies don't have much to worry about in terms of new customers arriving to the country with pre-existing conditions.


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    #9
    Jim2007
    Moderators, Business & Finance Moderators Posts: 10,045 Mod ✭✭✭✭Jim2007


    coylemj wrote: »
    You mentioned a hefty monthly premium for medical insurance in a previous thread and if there's no public health service, it means it's not a destination (like the UK) for medical tourism.

    And given the high cost of living, Switerland is not a retirement destination either so the local insurance companies don't have much to worry about in terms of new customers arriving to the country with pre-existing conditions.

    The point I was making was that we don’t have any kind of credible metrics to judge the healthcare industry on.

    And pre-existing conditions is a big issue in Switzerland because unlike say Ireland, it does not act as a deterrent for switching insurance companies. So shopping around when it comes renewal time is definitely a thing. I’m a diabetic, if I have any other serious issue during the year it’s likely the payout will very likely exceed the premium, so if I switch the new company will be immediately on the hook for it and they can’t reject my application.

    Medical tourism is definitely not as bad as most countries, but the fact that we don’t have waiting lists etc means people are motivated to hop on a train to cross the border for treatment. Some EU citizens do it another way - register as seeking employment, get their treatment and be gone before the first health insurance bill hits them three months later.


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    #10
    coylemj
    Registered Users Posts: 25,357 ✭✭✭✭coylemj


    Jim2007 wrote: »
    .... pre-existing conditions is a big issue in Switzerland because unlike say Ireland, it does not act as a deterrent for switching insurance companies. So shopping around when it comes renewal time is definitely a thing.

    But the blocker on pre-existing conditions in Ireland only applies if you are taking out medical insurance for the first first time or after a break of 13 weeks or more in cover. People with cover can happily shop around at renewal time. The only stumbling block is that if you purchase a policy with a higher level of cover, there may be a waiting period before you can claim under the enhanced cover.


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    #11
    Shazamm
    Registered Users Posts: 241 ✭✭Shazamm


    They are refusing cover for any conditions now and putting it down to a pre existing condition in the hopes peopel will accept it and its working


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