Health Insurance Advice needed for health policy for 40 year old with autoimmune disease

I am a 40 year woman with an autoimmune disease diagnosed in 2017 and have never had health insurance. I paid out of pocket for that private diagnosis and have since transferred onto the public system and have a medical card.
Once you have one autoimmune disease you are almost certain to get another and I have been having some joint pain recently which I'm fairly certain will result in another diagnosis.
I would like to get some health insurance under my belt before I am diagnosed with anything else but I am completely clueless. I have spent all weekend trying to make sense of all the plans but I'm none the wiser.
Consultant fees and possible scans like MRIs etc would be the big things for me.
Can anyone be so good as to point me in the direction of a plan that would be useful for me, I see a lot have things like maternity or fertility which are of no interest to me, is there a way of getting a plan where you don't have these.
Appreciate any help.

Hi,

Sorry to hear about your illness. As you have already been diagnosed will it not exclude you therefore for this and any associated illnesses no matter which policy or company?

Unfortunately you will also have to pay the Lifetime Community Rating charge. Presumably you have been looking at the www.hia.ie site.

Do you feel that you will not get the treatment that you require with just the medical card?

The illness I have been diagnosed with is IBD and I attend a public hospital for that.
The illness I believe I am developing is arthritis which is separate to IBD though both are autoimmune diseases.
There is a 2 year waiting list to see a rheumatologist so even with the 26 week waiting period I could still be seen potentially quicker than going on a public waiting list.

I think it's 5 yrs though not 26 weeks for existing conditions and I know in theory the arthritis is a new condition but you'd want to be sure the health insurer sees it that way, the definition is usually did the condition exist in the months before taking out the policy.

Maybe try ringing one of the companies like Cornmarket or Dermot Goode's company (can't remember name), think that company charges for the advice but it might be worth it anyway to get some good basic knowledge of what policy would suit.

Thanks for the replies.
So in theory once you're diagnosed with an autoimmune disease any other autoimmune disease you may develop will still be treated as a pre existing condition even if separate from your original diagnosis I might be better served saving for any upcoming treatment, no sense in paying premiums each month just to be told I can't have treatment when I need it. At least I can claim 20% back in tax.

Monbretia said:

I think it's 5 yrs though not 26 weeks for existing conditions and I know in theory the arthritis is a new condition but you'd want to be sure the health insurer sees it that way, the definition is usually did the condition exist in the months before taking out the policy.

Maybe try ringing one of the companies like Cornmarket or Dermot Goode's company (can't remember name), think that company charges for the advice but it might be worth it anyway to get some good basic knowledge of what policy would suit.

Click to expand...

Dermot Goode's company is https://www.totalhealthcover.ie/

From Citizen's Information it does appear to be 5 years:

Pre-existing conditions​

The health insurance company may refuse to cover you in respect of pre-existing conditions for longer periods after you join. So, for example, if you have diabetes, the insurance company may refuse to provide you with any cover for diabetes for a specified period but must cover you for any other illnesses once the initial waiting period has expired.

For policies taken out since 1 May 2015, the maximum waiting period for pre-existing conditions is 5 years.

Any waiting period for a pre-existing condition may switch from one Irish insurer to another. If the switch takes place within 13 weeks, the completed waiting periods will not have to be served again. Therefore, you can normally move from one Irish insurer to another without loss of cover.

For contracts taken out before 1 May 2015, longer waiting periods for pre-existing conditions could be applied to people aged 55–59 (maximum 7 years) or aged over 60 (a maximum of 10 years).

I understood that the IBD wouldn't be covered for 5 years and that wasn't a problem as I attend a public hospital for that and am happy with the care I get there once I got in the door so to speak. I suppose that's the advantage of having health insurance is no waiting to get seen when something does arise as opposed to getting care once you get a diagnosis.
I guess the risk I would be taking would be whether an insurance company would not cover anything IBD for 5 years (which is fine) or any anything autoimmune for 5 years, which would include any of the 80 different types of autoimmune diseases that exist.

health insurance in Ireland is primarily based on paying for hospital stays and surgery .
if you are diagnosed with rheumatoid arthritis or any other similar form of arthritis, you are likely to be treated with long term medication . Your costs will be €114 per month for medication under the DPS and 2 rips to a consultant per year .
Most health insurance policies pay a portion of consultants fees.
The medication will not be covered under health insurance but you can get a tax credit.

it might not be worth your while payong €1000 for health insurance if all you will get back is €100 per consultant and €40 per physio visit .
I would recommend that you spend your money on a private visit to a consultant and also get a referral to a public clinic so you can go to the public clinic when you finally get to the top of the waiting list.
I attend the public rheumatiogy clinic in St Vincent’s and I’m happy with the care I get

Thanks that makes sense and is what I did with my first diagnosis.
I have a medical card so I don't pay for medication, its really just getting a diagnosis and the waiting time to get it.
I think I'll do some saving and get on the public list, thanks for the advice

I can understand why you might want to get health insurance and if you want to, now is a good time - before the community rating gets more expensive for you and before your health disimproves.

Just be clear way you are getting health insurance. It will mean you can avail of private treatment if you need to go to hospital and if you ever need surgery.

However, purely for outpatient treatment, it will cost you a lot more than paying privately to see a consultant.
If you are going to see a consultant privately, go to one who works through a public hospital.

If you see a consultant in a private hospital . you will be pushed to get xrays and blood tests at the private hospital rates which are much more expensive than the private rate in a public hospital.
If you need regular blood tests, get your GP to do them and send the results tot the consultant, which is a lot cheaper.

I think others have replied correctly on cover for a diagnosis you think is coming......if there are signs or symptoms of a condition present prior to joining , that condition will fall into the 5 year pre existing clause. You don't have to have been given a medical diagnosis. The symptoms is enough to exclude it from cover.

Also just because auto immune diseases tend to follow each other, it does not mean all autoimmune would be excluded from cover - as previously mentioned, only those where you are displaying signs and symptoms (or have a diagnosis of already)