Pre-existing condition - new to Ireland

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pink78

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Hi All,

I am moving to Dublin from the US this summer with my son. I am trying to organize things now and I am having a hard time figuring out health insurance. I do not start my job until September so I need to get something prior to that. My issue is my son has a pre-existing condition and attends UV light therapy 3 times per week. From my reading he would not qualify for treatment under a private plan for five years because it is a pre-existing condition. Am I correct? Is there anyway around this? When i start working in the fall and get public health insurance does this waiting period apply within the public system? Also, worst case would I be allowed to bring him to the hospital and pay for the treatments myself? Any insight would be much appreciated.

Also - I am shocked by the prices of healthcare in Ireland. I looked up the prices of the plans and the top plan would be about €3200 per year for the both of us. In the US I was self-paying €9800 per year for a bottom of the barrell plan and when I was on a plan through my job it was €8000 per year and that was with the company paying half. There were still long waiting lists and God forbid you needed to see a specialist.

Thanks in advance for the help!
 
Hi All,

When i start working in the fall and get public health insurance does this waiting period apply within the public system? Also, worst case would I be allowed to bring him to the hospital and pay for the treatments myself? Any insight would be much appreciated.


Note that there is no such thing as "public health insurance" in Ireland.

Everybody who lives here is entitled to (more-or-less) free healthcare.

The main exceptions are:

GP fees = 50 approx
A&E fee = 100 euro approx (except if referred by a GP)
Hosp = 75 per night

These are free to the 30-40% of the population who have a medical card.


The main reason people choose to buy private health insurance is to get faster access to consultants / hosp, i.e. to skip the public patients who are on a waiting list.

(This is clearly medically immoral, but that's the system in Ireland.)

Yes, you can choose to become a "private" patient and use your insurane to pay the GP, consultant and/or hosp costs.

You can also choose to pay these out of pocket.

You get 20% tax relief on most out of pocket medical costs.
 
Also - I am shocked by the prices of healthcare in Ireland. I looked up the prices of the plans and the top plan would be about €3200 per year for the both of us. In the US I was self-paying €9800 per year for a bottom of the barrell plan and when I was on a plan through my job it was €8000 per year and that was with the company paying half. There were still long waiting lists and God forbid you needed to see a specialist.

Thanks in advance for the help!

I assume you mean that you are shocked that health ins is so cheap in Ireland compared to the USA???

Yes, that is true.
 
find out from your future employer if they have any concessions, as some companies have special exemtions from the pre-existing waiting periods
 
Ok. Thanks for the information. I've also done some more research myself.

So everyone is entitled to free healthcare. When I start working I will pay a small amount into the system and I will pay those fees that you outlined above. If I qualified for a medical card (unemployed, lone parent, ect...) I would avoid those fees.

I have the option to purchase private insurance for quicker access to healthcare.

I pretty much understand the basics now.

Now specific to my situation which seems so complicated - if I purchased private healthcare, my son's treatments wouldn't be covered for 5 years because it is pre-existing. I would have to pay out of pocket for that. In fact nothing would be paid for except an emergency during the waiting period of 26 weeks (as an example). But the private insurance would allow me to book him in to be seen by the doctors right away even though I have to pay for it? That seems like the only advantage right now.
During the private insurance waiting period are you allowed to use the free system?

Could I do the following;

Use the free system for GP appoinments, ect...
Enroll in the cheapest private plan available for the sole purpose of getting past the 5 year waiting period and to book appoinments fast just for my son's pre-existing condition treatment which I will be paying for.

The issue is when his condition flares up he has to be seen right away and begin treatments right away. So I think I am going to have to go private.

Any thoughts are appreciated. Thanks.


And yes I meant cheap in regards to the price.
 
Just to note that even going private doesn't guarantee that you'll be seen immediately - it all depends on the type of treatment and the current waiting lists.

For example, there can be a waiting period of a couple of months for a colonoscopy for private patients (it can be much longer for public patients).

If you enrol in the cheapest private plan, and later decide to upgrade it, you will have to serve another waiting period before the additional benefits can be used/claimed. I've just downgraded my cover to exclude private hospitals and was told that should I decide to upgrade again, I'll have to wait 2 years before I'll be covered for private hospital care.
 
Have you checked to see where this "UV light therapy " is available and how much it costs in Ireland........and if there is much of a waiting list. It might give you some idea of what to do
 
Yes I get that - I should have said shorter than not right away :)

Ok, I think my best bet is to find out about the specific treatment first and then try to determine the best course of actions. Thanks!
 
pink78 - my OH used to have to get the UV light therapy done for a condition. He recalls it was in the range of 60/70 euro per session to have it done privately and that the wait times were no more than a few days at a time. This was a number of years ago so things may have changed but it might be worth googling private hospitals in Ireland to find out what the situation is.
 
OP,

I am pretty sure that during the 5 year waiting period before health insurance companies will insure pre-existing conditions, you cannot have any treatment or investigations/consultations for that condition.

My own example is that I suffered from chronic uveitis/cataracts and have undergone prettyy major eye reconstructions over the years to the point where i am almost blind in the eye. Although now declared discharged from hospital and abel to self-refer back to a consultant, if i have any flare ups before I have my VHI for 5 years, i will remain not covered for those conditions.

Is there a way of contacting the major insurance providers here in Ireland and discussing if there are any relationships between Irish and US insurers? It may be that once you have continuous medical insurance some might allow for the treatment to be covered. I know this can be done within the Irish insurance markets.
 
I am pretty sure that during the 5 year waiting period before health insurance companies will insure pre-existing conditions, you cannot have any treatment or investigations/consultations for that condition.

I have not heard of this. I had a pre existing condition when I signed up to VHI - had investigatons/treatments both private and public during the 5 years, and after the 5 years was up I was covered. Perhaps it is different for different health insurers but it sounds a bit odd - in theory someone could die if they ignored their pre-existing condition for the 5 years while waiting for cover!
 
I have not heard of this. I had a pre existing condition when I signed up to VHI - had investigatons/treatments both private and public during the 5 years, and after the 5 years was up I was covered. Perhaps it is different for different health insurers but it sounds a bit odd - in theory someone could die if they ignored their pre-existing condition for the 5 years while waiting for cover!

I wasn't aware of that Truthseeker....i thought that a pre-existing condition had to have no treatment for 5 years before it was covered. I stand corrected so!
 
I wasn't aware of that Truthseeker....i thought that a pre-existing condition had to have no treatment for 5 years before it was covered. I stand corrected so!

Dont stand corrected - Im only offering my opinion - not fact!! It would be wise to check the specifics of pre existing conditions with each health insurer being considered as rules may differ for different ones.
 
I get UV light treatment on the public health system in Ireland. In Dublin, there is
a dedicated centre is based on St Vincents Hospital, which I am very impressed by. I don't know what facilities exist ourtside of Dublin.

Please PM me if you would like to discuss this more privately.

Regardless of whether you get private health insurance, you should immediately go to a GP , explain the details of your sons medical condition and ask for an emergency referral to a public consultant . There will be a waiting list for an initial consultantion so do it immediately. Once you are a patient of a consultant, you should be able to assess UV treatment quickly in a flare-up situation.
 
Another thing,
When checking out private health insurance plans, check if they will cover the cost of UV light treatment.
It may not be covered, or may only be covered for a % of the cost.

Private health insurance in Ireland does not cover the full cost of visiting a GP or consultant. They primarily cover hospital in-patient treatments. Some cheaper plans do little or no cover for doctors visits or out-patient treatments, and some more expensive plans only cover some of the cost.

The irony is that is an operation costing €20K would completely cure your condition, it would be covered, but ongoing out-patient treatment is treated differently.

All the more reason to make every effort to get your son an appointment with a public dermatology consultant as soon as you can.
 
OP,

I am pretty sure that during the 5 year waiting period before health insurance companies will insure pre-existing conditions, you cannot have any treatment or investigations/consultations for that condition.

My own example is that I suffered from chronic uveitis/cataracts and have undergone prettyy major eye reconstructions over the years to the point where i am almost blind in the eye. Although now declared discharged from hospital and abel to self-refer back to a consultant, if i have any flare ups before I have my VHI for 5 years, i will remain not covered for those conditions.

Is there a way of contacting the major insurance providers here in Ireland and discussing if there are any relationships between Irish and US insurers? It may be that once you have continuous medical insurance some might allow for the treatment to be covered. I know this can be done within the Irish insurance markets.

If you have a pre-existing condition when joining any insurance company, then the insurance comp will not pay out anything related to that condition, if you have treatment for it. They do not stop you having treatment for the condition, either as a private/public patient. Once the 5 years has passed, then they will pay the costs of the treatment related to the condition.

AFAIK, there is no agreement between international insurance companies when moving from one country to another
 
Hi OP,

I think you got a bit confused over the term "private". As explained, there is a general public health service here and that is free (except as outlined above GP, dentist, etc). So if you get a referral from your GP to see a specialist or some sort of treatment (like UV) you can opt to either go down the public system (which depending on the type of treatment you need might take a long time) or you can opt to go as a private patient. In that case the referral gets sent to the consultant in his private office and then you have to pay for it. So it's usually at the time of referral that you tell your GP if you want to go private. If in this case you have private health insurance, you can claim some or all of this back (depending on the treatment you're receiving). But in your case you have to sit out the waiting time of 5 years before you can claim anything back.
If you want to get private health insurance here, the best place to check it out and compare prices is here. www.hia.ie
I have private health insurance and where it has come in handy so far is when I needed an MRI - had that within a week (can take up to a year in the public system) and I regularly see a consultant and can claim a good bit back for that, too. But make sure you check the various plans properly, a lot of them only cover hospital treatment and very little outpatient treatments (such as GP, consultants, physiotherapy, etc). So the plan I'm on covers this, but most plans don't or have such high excesses that you'd have to get very very ill to ever spend more than the excess!
 
One other thing to think about if you go public is the possibility that you may need to satisfy a residency requirement (usually one year) if hospitalization is needed, as the rates are much higher for non-EU residents. Also if your son needs a special treatment, check if the treatment is available anywhere near where you live.
 
pre-existing condition

I lost my left foot in an accident in 1995. I did not have any health insurance then. Took out first health insurance policy in 2001, and have continueous cover since. I now need to get a new prosthesis, which will cost about €6000. My health insurance company say they will contribute €500 towards it. I now wonder if indeed there is any point of paying astronomical costs for private health insurance, when they will only contribute a paltry sum towards medical costs
 
I lost my left foot in an accident in 1995. I did not have any health insurance then. Took out first health insurance policy in 2001, and have continueous cover since. I now need to get a new prosthesis, which will cost about €6000. My health insurance company say they will contribute €500 towards it. I now wonder if indeed there is any point of paying astronomical costs for private health insurance, when they will only contribute a paltry sum towards medical costs

I sympathise with you on your injury. Insurance seems by its nature to set out to indemnify the insured against largely unforeseen events, so they are ubnlikely to insure against predictable replacements.
 
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