Health Insurance Insurance for child with existing condition

[Sar]

I have three kids under 5 - we all have full medical cards. One of my children has had ongoing respiratory problems and is under the care of a public consultant. She requires further investigations and possibly surgery at some stage, although I have no idea when this might be.

I am wondering if I should take out health insurance to cover her in case her condition is ongoing over numbers of years. I realise that she won't be covered for 3(?) years as it's an existing condition, but if her condition requires treatment for many years (I have no way of knowing yet) would it be worth having private cover?

I have no problems with the standard of care she currently gets when she is seen, but the waiting times for each investigation is long and appointments sometimes get cancelled.

Would I need to take out a policy for myself and her, or can I just get one for her?

 

[snowyb]

Hi Sar,

Firstly, there is a 5 year waiting time to serve for new customers, in relation to pre-existing conditions.
So, while any new conditions would be covered after 6 months on a plan, if they were connected to the
pre-existing condition, they would not be covered until the end of 5 years.

Secondly, VHI will insure a child on a plan and will include an adult as a non paying policy holder, so basically the adult holds the plan but only the child is covered.

There are no private children's hospitals in Ireland, but there are some hospitals that have private children's wards and offer certain procedures,treatment and surgery on a private basis.
Regarding your own child's ongoing situation, I'm not sure if her consultant has a private practice or if the type of medical treatment etc, she may or may not require, would be available on a private basis.
These are issues worth considering or asking her consultant about on a future appointment.

As an aside, while pre-existing conditions are not covered for 5 years, the likes of out-patient expenses are covered straight away. MRI, CT + PET scans are fully covered directly, other x-rays and scans are paid for by the patient and partially refunded after renewal date, depending on the level of cover on the plan.
Private consultant fees are also partially refunded at renewal date, according to the outpatient cover on the plan.
It may be an option to go private for tests and consultants visits to avoid some of the waiting. If the tests are done as an overnight stay in the hospital, this would not be covered for 5 years. Outpatient scans etc would be covered.

It is usually recommended that someone with ongoing health issues takes out a plan with no hospital excess. The following 2 plans with VHI are worth considering.

1. Company Plan Extra: child price 266 pa, good hospital cover, good x-ray cover, limited day to day expenses cover.
2. Company Plan Extra Level 3 : child price 352 pa, good hospital cover, x-ray cover and very good day to day cover.

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The only thing about these two plans is, they are both reduced at the moment, but will increase to full price from July 1st 2015. In order to avail of these prices, you would have to set it up with a starting date of June 22nd 2015 (Monday), as VHI only renew on certain dates. June 22nd is the last date to set up a new policy
this month. That's if you decide to take out insurance having weighed up the pro's and cons.
I'm not sure what children's offers, if any, are lined up for August 2015.

Hope this helps with your decision.
Snowyb

 

[Sar]

Thanks very much for this - really useful.

I spoke to VHI just now. Because her MRI has to be done under anaesthetic it's considered a day case and not covered straight away - the 5 year waiting time applies. Same would apply to CT scan/bronchoscopy (which we've already had done publicly anyway) They don't require overnight stays but they are done as an admission to the day ward which means they aren't covered straight away by VHI.

As far as I can see the only real benefit to taking out the plan now would be to switch to seeing the consultant privately. At the moment I don't have enough information to know if her health issues are likely to be ongoing so I think I might be better to wait and find out more about her condition before taking out the insurance.

Thanks again for your help.