Health Insurance Why would I need health insurance?

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confuseddotc

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Looking for advice please...

Am from the UK originally, and can't get my head around the system here...

Have had employer funded cover in the past, but now have to fund it myself, for simplicity this year, I kept with the same policy, but the renewal is due 1 Jan, and I'm looking at options and getting confused...

Items like this excerpt, from Governments White Paper on UHI add to the confusion...

"Ireland has both a national public health system and a voluntary private health insurance
system. In the case of the public health system, services are largely funded by general
taxation and are delivered by a single organisational entity, the Health Service Executive
(HSE). By contrast, private health insurance is provided by several, competing private
companies and is financed by individual insurance premiums.
While the national public health system provides universal coverage for hospital care, almost
45% of the population nonetheless purchase private health insurance, predominately for the
purpose of ensuring faster access to hospital care. While the State is making good progress in
reducing waiting times for public hospital services, these access times remain unacceptably
long and comparable waiting times for private treatment, while not measured nationally, are
accepted as being considerably shorter."

So, there's a public health system, but if you want to jump the queue and can afford it, you buy private cover....

So, a few simple questions... (I think)

If I go to A&E with an emergency, they ask me for medical card or insurance. If I have neither, do they refuse to treat me?

If something more serious/long-term is wrong, what then? Pick a number and wait? Or pay privately for treatment directly at that point?

It just don't seem to make sense to me..
 
Excellent question.

I would really welcome a reasoned argument why anybody, at any age, would ever take out private health insurance in the context of the Irish healthcare system. It has always been a mystery to me.
 
You basically have it figured out except for the A&E bit. A&E will treat you regardless, if you have private health insurance they will bill them otherwise you will just be treated under the public system, this is of course for emergencies.

However should you have anything other than an emergency like for example you needed a hip replacement then yes it's take a number and wait your turn in the public system or if you have private insurance then you go that way and get your new hip quicker. Or if you are suffering unexplained symptoms that necessitate a colonoscopy (again just an example), in the public system you wait and wait and hope you get it before anything serious takes hold, with private cover you just get referred to consultant and get the test privately.

Personally it will be one of the last things I drop even with the expense, the private system isn't even great not to mind the public.
 
I would really welcome a reasoned argument why anybody, at any age, would ever take out private health insurance in the context of the Irish healthcare system. It has always been a mystery to me.
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So you can pay for it twice, and still get restricted and sub-standard service?
 
So what happens if I slip and fall and need an emergency hip replacement/colonoscopy? (that was some fall!)... :)

I agree the private system isn't great. For example, my wife has seen a consultant around 3 times for a long-standing condition, and had two minor investigative procedures performed.

Each time, they send us the "claim form", multiple times, asking for policy numbers, each time we send it back, and wait for it to be sent back again. Even on stamps for us and them, it's such a waste.

I've a good mind to ring them (in response to latest letter received today), and tell them to go forth and multiply. Or, send them an invoice for my time responding to their incompetence.
 
Monbretia said:
However should you have anything other than an emergency like for example you needed a hip replacement then yes it's take a number and wait your turn in the public system or if you have private insurance then you go that way and get your new hip quicker. Or if you are suffering unexplained symptoms that necessitate a colonoscopy (again just an example), in the public system you wait and wait and hope you get it before anything serious takes hold, with private cover you just get referred to consultant and get the test privately.

Personally it will be one of the last things I drop even with the expense, the private system isn't even great not to mind the public.
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Ok, how much does a hip replacement cost? Or a colonoscopy? What if I just put aside a few bob to meet any such unanticipated expenses?

To be fair, I don't know anybody that can afford it that doesn't carry health insurance.. My problem is that I have never seen a convincing financial argument for carrying such insurance. It always comes down to an emotional argument - "I would give up anything but I won't give up de VHI". Okay, but why?

I suppose what I really want to see are some numbers/facts.
 
This article gives the costs for certain procedures in 2012 – I could not find any later.

“Operations for appendicitis or tonsillitis could cost around €5,000. A hip replacement could cost more than €16,000 while a pacemaker could cost over €30,000 and a heart bypass €40,000.

A day procedure in a private hospital for something as simple as getting a mole removed could cost up to €1,000.
 
Confuseddotc.

Maybe headline it .

Why should someone in employment take out Private Health Cover?

I wouldn,t mind getting some AAM views myself and I live here ?
 
I have found it important to have because of...

  • Anything related to elective surgery or scans.
  • What's the difference in waiting time between a cancer scan with private versus public systems? A matter of weeks versus months. This can be a life saving amount of time.
  • If you're struggling with a health issue that is seriously affecting your quality of life, jumping the queue with private health insurance can see you treated significantly (on a timeline of months or more) earlier.

I found it nice to have because of...

  • If you go to A&E you don't have to pay A&E charge of €100 (edit: should have said can claim it back)
  • Refunds towards GP visits, physio visits, dental visits, prescription glasses
Yes, you could set aside what you would have paid every year in health insurance premiums into an emergency fund, and down the line pay for scans, surgeries etc out of that fund. But how confident are you the fund would be enough?

If you don't take out health insurance now, if in your 50s or 60s you sign up for it you will be heavily loaded.

More information here on charges for public hospitals in Ireland:
[broken link removed]
 
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Regarding the costs of various procedures I only have experience of two, hip replacement and heart bypass surgery for family member.

Heart bypass was maybe 12 yrs ago or more and bill was over 10,000 old pounds, all went well and was very short stay in hospital.

Hip replacement went horribly wrong and ended up over a month in hospital, bill was over 40k and as I understand was actually capped by the insurance companies who pay per procedure hence the hospital doing their best to turf out patient early to nursing home (at patient's cost) despite the catalogue of errors that caused the long stay.

While yes you could save and pay for some minor possibilities yourself, I imagine the cost of any really serious illness would be outside most of our ability to save for. Sad but true.
 
If you don't take out health insurance now, if in your 50s or 60s you sign up for it you will be heavily loaded.
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Health Insurance is universal. There is no age loading allowed!
 
I found it nice to have because of...

  • If you go to A&E you don't have to pay A&E charge of €100
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Are you sure ? I believe the cost is regardless of insurance cover but I presume you can claim half back.
 
44brendan said:
Health Insurance is universal. There is no age loading allowed!
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No longer the case I believe, unless this law didn't come into force:
http://www.irishtimes.com/news/heal...35s-signing-up-for-health-insurance-1.1858410

Over-35s who sign up for health insurance from next May will have to pay a loading of 2 per cent per year... The change means a 40-year-old buying health insurance for the first time after next May 1st will have to pay 12 per cent more than someone of the same age who is already insured. A 50-year-old will face a 32 per cent loading while the “age at entry” loading will be capped at a maximum 70 per cent for those aged 69 years and over.
 
odyssey06 said:
I have found it important to have because of...

  • Anything related to elective surgery or scans.
  • What's the difference in waiting time between a cancer scan with private versus public systems? A matter of weeks versus months. This can be a life saving amount of time.
  • If you're struggling with a health issue that is seriously affecting your quality of life, jumping the queue with private health insurance can see you treated significantly (on a timeline of months or more) earlier.
    [/]
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  • Thanks odyssey06, I think that is fair summary of the circumstances where access to private healthcare is highly desirable.

    The problem, I suspect, is that the proportion of health insurance premiums that fund these costs is relatively small. The proportion of health insurance premiums that fund costs that otherwise would be met by the State is, again I suspect, much higher. I have no particular knowledge about healthcare costs/economics so I am certainly open to correction on these points.

    It would be interesting to know what a health insurer would reserve to meet various claims, at various ages etc.
 
In relation to cancer treatment a friend of mine had the following experience. His wife attended her GP on a morning visit. GP done out a not for her to attend outpatients in local Hospital. She had a brain scan and arrangements were made for her to go to a Dublin Hospital that night. Was operated on the following morning at 8 am to remove a tumour. Had regular appointments and the normal treatments following such an operation. About a year later the tumour reappeared and all treatment was received as soon as this was noticed. They could be described as lower middle class. They had no cover but got no bill either for either operations/subsequent consultations or medications. I understand that cancer is deemed an exceptional situation but even with a "gold plated" policy I could not see how better treatment or the speed of it could have been improved. The woman has since died RIP.
 
The biggest advantage is to be seen for something quickly - not much waiting. I pay it and have used it on occasion but it's basically the same care you receive.
When I hear of cases though where something is covered in the public system but not in the private ( as in some cancer new drug treatments) or a case where a person with cancer had to wait for approval from their insurer to have a PET scan while in hospital and the public patient beside them was seen immediately - this makes me wonder why pay it. In going private you should be getting the same as the public system at least?? Also the rules and regulations with private health care can be mind blowing.
 
I think where you are considered an 'urgent' case the waiting times in the public system are not that much different than private.

But where your case isn't urgent but still serious (that includes potential cancer biopsies), or is greatly affecting your quality of life without being life-threatening, there is a significant difference in waiting times between the two systems.

If you are diagnosed with cancer, again with the treatment, there is not much difference and you may end up being treated in public system. But in getting to the diagnosis where you are not 'urgent', I stand over the weeks versus months claim.

For example, does anyone have concrete figures on waiting times for a hip replacement for public versus private?
 
odyssey06 said:
I think where you are considered an 'urgent' case the waiting times in the public system are not that much different than private.

But where your case isn't urgent but still serious (that includes potential cancer biopsies), or is greatly affecting your quality of life without being life-threatening, there is a significant difference in waiting times between the two systems.
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This.

I have a family member who is undergoing cancer treatment at present. They, having full private health insurance, had the scan within a week of attending their GP and started on chemotherapy. They found out later that by the time they would have had the scan in the public system, they were over half way through the treatment process.
 
Urgent is the most important word here, the public system is grand if you are treated instantly as an urgent case and I don't believe the care is any better private but it's getting access to the initial diagnosis if you don't appear 'urgent' is the issue.
 
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