Health Insurance Arthritis as Pre-existing Condition with Irish Life Health

[seakit]

Four years ago I retired to Ireland, where I have family. My sister put me on a family health insurance plan with Irish Life Health. Lately my left hip is giving trouble due to arthritis, needs a hip replacement operation. I’m concerned if any type of arthritis counts as a pre-existing condition or if they only consider the specific joint at this time. I had a replacement for a different joint nearly ten years ago in another country (unrelated health plan). The degeneration in my left hip is recent during the last two years, it’s entirely new. We asked Irish Life Health if this would be covered now but they simply recited ‘A pre-existing condition is... condition the signs or symptoms of which existed at any time in the six months before you took out health insurance..’ etc. Which doesn’t answer the question. Can anyone say if a hip op will likely be covered now or will I need to wait for the full five years? (thanks).

 

[snowyb]

seakit,

If your arthritis was a pre-existing condition before you took out health insurance in Ireland for the first time, then I would be inclined to think
that you would have to wait the full 5 years before a hip replacement would be allowed under health insurance.

I would recommend contacting the Health Insurance Authority for clarification, explaining your position.
I think it would hinge on whether your arthritis was a pre-existing condition when you took out health insurance in Ireland, mention this when
explaining your situation. This would become apparent to Irish Life, when the consultant fills out a medical report regarding surgery claim.
They would request certain details regarding underlying conditions relating to surgery to determine if relevant waiting periods have been served etc. They could refuse to pay out if it related to a pre-existing condition and the 5 year waiting time was not complete at the time of surgery.

https://www.hia.ie/contact/contact-details

As an aside, regarding Irish Life plans, most of them have a 2000 co-payment for hip or knee replacment surgery in private or hi-tech hospitals.
If you have surgery done in Blackrock Clinic Dublin, there is no charge. This hospital does not pass the 2000 charge onto the patient.
Just something extra to be aware of, if and when going for surgery.
There is no co-payment in any public hospital but the waiting lists are long - 1 to 2 years depending on the hospital.

Hope this helps.

Snowyb

 

[seakit]

Thanks for the information Snowyb. I'd suspected there might be an issue, and will follow up with the HIA. Also, turns out it's possible previous health insurance abroad could be taken into account, in which case I might be out of the waiting period sooner anyway. Yes, thanks for the warning about the 2k; we did know of it, someone suggested it's discretionary tho I'm willing to bet many hospitals will charge a discretionary fee! Not sure if Blackrock is practical, I'm down in the southeast, more likely to do the op in Waterford or Kilkenny.