VHI VHI Teachers Plan cover???

S

summersday

Registered User
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I am on teachers plan and a week ago was sent privately for an MRI and a CT scan for investigation of a cancer - this was in a public hospital but I was private. The MRI was fully covered , the CT i had to pay 120 as it wasn't covered. I've looked up the plan but can't tell what's covered and not covered as an outpatient. Could anyone clarify are blood tests, x rays, ultrasounds and other outpatients tests you might be sent for covered ??
 
Hi summersday,

Some tests or x-rays are paid for up front and are claimed as part of an outpatient claim.
The CT scan on Teachers plan is subject to the outpatient excess,which is 125 euro.
In other words, the first 125 is not allowable.
An ideal excess amount for outpatient expenses is 1 euro.
VHI have a list of approved scan centres, which you can request.
It is always wise to check with VHI as to what scan centres cover the relevant scan in question.
Radiology Consultant fees and pathology (bloods) fees are also part of your outpatient claim at renewal date.

Snowyb
 
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thanks but how can you tell what's covered? I've looked at the plan and am none the wiser. I'm glad to hear about the CT which I take it means if you've paid once then you won't pay again but how can you tell from reading the plan what's covered or not.
 
summersday,
On page 3 of your Table of Benefits for Teachers Plan, Section 9; B,C, D deals with diagnostic tests.

Cover as follows: Pathology / Radiology or other diagnostic tests 50% of agreed charges in an approved outpatient centre, up to a max of 500 euro per annum.

Radiology Consultant fees : €60 per procedure
Pathology Consultant fees: €60 per referral

SECTION 8 deals with MRI, CT and PET scans.

The information provided is not very clear.
A person could easily make a mistake, by having a scan done in a non-approved centre and then find out its not covered.
You would need to contact VHI and ask them to explain in detail in writing , as to what hospitals and scan centres are approved for each individual type of test.
Also, what type of cover applies, ie are they fully covered, 50% covered or not covered.
Which ones are payable up front and can be partially or fully refundable in an outpatient claim at renewal date.

You would need to know this kind of information in advance, in case you're referred for tests by a gp or consultant.
You can make better informed decisions as to where to go etc.


VHI need to put a user friendly info chart on their website, showing this information, like Laya Healthcare.
https://www.layahealthcare.ie/formembers/directpaymentcentresegmrictdexascans/

Snowyb
 
thanks, I find it so confusing. I know I'm going to be sent for more tests and it's a worry as to what will be covered and what will not! I wish it was all clearer as you said.
 
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