Health Insurance Do Private Health Insurers cover the public bed charge?

[Leabharlanna]

Hi,
I wonder if someone could answer this query for me please.

Suppose you hold PHI and have to attend A&E. You are admitted to hospital and are assigned a public bed. Under the new rules introduced in 2014, you may be asked to sign a Private Patient Insurance Form (waiver form) by the hospital. If you sign, then your PH Insurers may be charged up to €813 a night although you have not availed of any private accommodation. If you elect to go public, then you will be charged the public bed charge of €80 a night (max of €800).

My query is, in the case of you deciding to go public, will all PH Insurers cover the full public bed charge?

Many thanks for any clarification about this confusing matter.

 

[Brendan Burgess]

Yes, but...

I have a large excess on my policy. I presume that it would be deducted.

So I could end up paying €813 for a public bed.

Brendan

 

[snowyb]

Brendan,

That large excess on your policy doesn't apply to any public hospital, only private or hi-tech hospitals.
So, if you were admitted to a public hospital, and asked to sign a public waiver form which allows the public hospital to charge 813 per night,
you can decide to either go in as a public patient(don't sign the form) or use your health insurance(sign the form) or say I will sign the form when
I get a private room.

Leabharlanna,
Yes, the health insurance providers will cover the 80 euro cost per night if you don't sign the form.
I'm not sure what way it works in practise, as far as I know when you receive the bill from the hospital you can pass it onto
your provider.

Its a personal choice to sign or not to sign and its easier said than done when you're in an A + E dept under all kinds of pressure.
There's all kinds of stories about people being hassled and bullied to sign the form and even receiving the form in the post after leaving
hospital. The CEOs have raised this with the Minister for Health recently, to try sort it out in some shape or form.
But the providers will definitely pay the 80 per night bill, its in their total interest, keeping their costs down.

Snowyb

 

[Brendan Burgess]

So, if you were admitted to a public hospital, and asked to sign a public waiver form which allows the public hospital to charge 813 per night,
you can decide to either go in as a public patient(don't sign the form) or use your health insurance(sign the form) or say I will sign the form when
I get a private room.

Hi snowy

That's great thanks.

I had always meant to check it out and never got around to it. If I were being admitted, it would be too late to be asking about it.

Brendan

 

[Leabharlanna]

Thanks Snowyb, I couldn't see it anywhere in the documentation provided by my health insurer.

 

[BazzaDP]

All Health Insurers cover the public bed charge for public hospitals for public wards, without an excess for health insurance plans (so cash plans not included).

All plans work on having the hospital bill the insurer directly. The one exception I'm aware of was very cheap Glo Health plan that was launched a few years back and worked on a charge back method so member paid and claimed back - can't remember the name and dont think it's sold anymore (especially as Glo Health are now part of Irish Life Health).

So you SHOULD give your health insurance details to the hospital to get this €80 a night charge paid for you. You will be treated as a public patient, and put on a public ward, but your health insurance will cover the small €80 a night charge that you would normally be expected to pay (public healthcare is not completely free but is heavily subsidised so this is a small charge). Getting this €80 a night charge paid for you is a benefit of having insurance.

However, just by giving your insurance details does not mean you need to sign the waiver form. This means you wish to be treated as a private patient and this will automatically mean the charge increases to €813 a night - even if you will most likely end up in a public ward since there are so few actual private rooms in public hospitals. Your insurance will also cover this charge, and also without an excess in public hospitals, so you might be tempted to sign, but this has been blamed by the insurance companies as one of the reasons for recent rises. They are advising to only sign this form if you will get the extra benefit of a semi-private or private room (note not all plans cover private rooms in public hospitals without extra charges for you).

Previously your health insurer was only charged the semi-private or private rate if you got a semi-private or private room. Now you are charged if you agree to be charged, and the room you get is incidental.

It's very confusing and many people assume you have to sign the form if you don't want to be charged and want your insurer charged. Or assume not signing means you pay the bill and claim it back from your health insurer. This is not the case.

 

[Leabharlanna]

Thanks for all the helpful responses. I agree that many people are confused. It would really help if PH Insurers would explicitly clarify the position in their policy documentation and web site.