Probably an obvious question to most, but I'm new to Irish healthcare, so can someone explain (ideally with examples) about excesses and shortfalls, how they are applied, and in what order?
For example if I have 10 treatments costing a €100 each and have a €200 excess and €40 shortfall for this treatment what happens?
Is the excess applied to each treatment (so I get nothing in this case as each treatment individually is less that €200 excess?) or is the excess for the year of cover (in which case I can apply for cover for the 2nd - 10th treatment)? Does it matter if the treatments are related? I.e. would an insurer expect me to claim 10 physio treatments for one leg injury as 10 separate claims, or as 1 claim?
Similarly with shortfalls.
As I see it, depending how you understand this, I could pay:
€1000 - I pay 10 * €100 full amount as no individual treatment below excess.
€600 - The insurer will pay €60 per claim minus the excess, meaning they pay (€60 * 10) - 200 = €400. So I'm left with €600 to pay.
€520 - I pay full price of €100 for first two treatments as below excess and eight treatments at forty euro excess only: (2 * €100) + (8 * €40) = €520
€240 - I pay the excess and the shortfall on the total amount.
How would this work out differently if this was definitely one treatment?
For example if I have to stay for 10 nights in a hospital costing a €100 each and have a €200 excess and €40 shortfall per night what happens?
Sorry if that's not the most clear but as you can see I'm very confused about all this!
For example if I have 10 treatments costing a €100 each and have a €200 excess and €40 shortfall for this treatment what happens?
Is the excess applied to each treatment (so I get nothing in this case as each treatment individually is less that €200 excess?) or is the excess for the year of cover (in which case I can apply for cover for the 2nd - 10th treatment)? Does it matter if the treatments are related? I.e. would an insurer expect me to claim 10 physio treatments for one leg injury as 10 separate claims, or as 1 claim?
Similarly with shortfalls.
As I see it, depending how you understand this, I could pay:
€1000 - I pay 10 * €100 full amount as no individual treatment below excess.
€600 - The insurer will pay €60 per claim minus the excess, meaning they pay (€60 * 10) - 200 = €400. So I'm left with €600 to pay.
€520 - I pay full price of €100 for first two treatments as below excess and eight treatments at forty euro excess only: (2 * €100) + (8 * €40) = €520
€240 - I pay the excess and the shortfall on the total amount.
How would this work out differently if this was definitely one treatment?
For example if I have to stay for 10 nights in a hospital costing a €100 each and have a €200 excess and €40 shortfall per night what happens?
Sorry if that's not the most clear but as you can see I'm very confused about all this!