Irish Life Health Do Aviva cover the cost of the melanoma drug Ipilimumab in Ireland ?

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Sodium13

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Hi does anyone know have Aviva covered the cost of the melanoma drug Ipilimumab in Ireland ?
We have got a refusal but are trying to appeal and would love to know if anyone has been in this situation with Aviva before and got it reversed.
Aviva cover it in the UK and VHI / Laya also cover it here. We only switched from VHI to Aviva 2 years ago supposedly on the exact same level of cover.
Can anyone update ? Please...
 
Isn't Ipilimumab now approved for use by the HSE? How can a private health insurer not cover for what is already provided for in the public system? This doesn't sound right...
 
Is it being used as part of an experimental therapy? They may not cover it if it's part of a clinical trial of some sort.
 
Yes Ipilimumab is approved by the Hse within the public health system and no it is not experimental therapy. This drug gives people fighting melanoma a good chance. Our case is that someone who has been paying for private health insurance for over 40 years has been refused this treatment by aviva. What is the point of paying for health insurance if you are refused a treatment that is accessible by public patients ?
Getting this diagnosis has been hard enough without Aviva kicking us in the teeth. We are not in the public system and Aviva won't cover .
Only changed over from VHI to Aviva 2 years ago on what we were assured was comparable cover.
Anyone with Aviva health insurance beware !
 
That is shocking. I would have assumed that if a Private Insurance company like Aviva are offering cover, that all treatments available to public patients are covered as standard. Isn't this the understanding of anyone who takes out private health insurance. Surely this is selling a product which does not do what it claims to do...
 
I second what thebadge21 has said. It's outrageous that a medical insurance provider offers less treatment options than the public system. Sounds like fraud to me! And who's left to cover the costs of this drug when the person is forced to use public healthcare? That's right, the taxpayer. Just what this country needs. Aviva are ripping us all off. And I'm guessing this story isn't the only one. I feel for you and your family having to deal with this when you should be 100% concentrating on fighting this horrible disease.
 
This item has been covered on the Joe Duffy Show yesterday and again today. Good points made such as what is the point of finding the cure for cancer if the private healthcare companies won't pay for them ! If Aviva have decided to deny access to new drugs that are proven to work against cancer , what disease or condition is next ? If they are trying to keep premiums down they should be honest that they are selling inferior cover. People pay their premiums to have peace of mind that if they are ever seriously ill and put their trust in their healthcare insurer. 1 person an hour in Ireland is being diagnosed with Skin cancer. I hope none of these poor unfortunate people have health cover with Aviva !
 
I'm confused, if the private insurer doesn't cover the drug, but the public system does, can Sodium not then get it under the public scheme? Isn't everybody entitled to the public system.

Sodium, I read your case in the newspapers and it's a total disgrace that Aviva would not pay for this. What's the point of insurance if you're not covered. Do you have it in writing from than that changing insurer ensured you would have the same benefits as you did with VHI. Is it written in their small print that they don't pay for this drug, what are their stated reasons for not providing it. It must be horrenoud to have cancer without the added stress of fighting Aviva, shocking behaviour. If it were an experimental drug etc I could see a reason for refusal, but not a drug with a proven record.
 
Thankfully the HSE have stepped in here and we are getting the treatment through the public health system.
Aviva decided not to cover the cost of this treatment in 2012 when HSE/VHI/Laya decided to cover it and did not inform or highlight this to their customers. We assumed that as we were paying for supposedly "better" private health cover that we would be covered for something that everyone can get through the public system.
Aviva's answer to this is that if we had asked they would have told us.
Bearing in mind to get an answer you need the consultants name, the specific hospital and the procedure code (and a crystal ball !) Finding out if you are covered for something at point of treatment is too late !
We tried to find out what else we are not covered for and they could not tell us. Also the treatments/procedures that they currently give cover for, could change !
The reasons they give for refusing the drug are economical - they are trying to keep their premiums down.
By paying handsomely for private Health insurance over the years , the last thing we wanted is to be a burden on an overstretched public system . What is the point?
 
Skin cancer survival rate soars in new drugs trial - please search for this article in the Irish Independent website - published yesterday 03/06/2014 .
Gives great hope to all with melanoma !
 
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