Key Post: HSA Hospital Cash Plans

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Re: HSA / HSF / Bupa / VHI

Be very careful if you do so, as public (i.e non private-insured) patients do really get messed around in our system if they need elective treatment or surgery. I know people who have died after spending years on waiting lists for heart bypasses and the like.

Also, I understand that measures are to be introduced that will penalise people who opt out of private health insurance. Apparently, heavy surcharges will apply to people who haven't insured themselves previously if they haven't had insurance (or maintained it) before they reach a certain age.
 
Re: HSA / HSF / Bupa / VHI

If the ceiling on BUPA's Essential Plus scheme is c. €6,000 per annum does this *include* stay at hospital and any operations?

If it does, then I don't see how this would be anywhere near what would be required to pay for (as an example) a heart operation?
 
Re: Re: HSA / HSF / Bupa / VHI

Oh - maybe I'm mistaken. On looking at the [broken link removed] again I see the figures €55,000 and €65,000 mentioned. I've never been able to understand the VHI or BUPA contracts so I've never been sure exactly what's covered and to what extent and what's not! Is there no "VHI/BUPA health insurance contract details for dummies" summary available anywhere... :\
 
HSA / HSF / Bupa / VHI

Oh yes, I see that myself - it's point 8(g)

I wonder what would happen if someone's expenses were approaching or exceeded these levels; (or the appropriate level with VHI?)

Would Bupa and/or VHI tell the customer/patient, and the patient would then move to a public hospital?

Or would they charge you for the extra?

e.g. If the limit is €55,000 and cost of treatment in hospital and major operation came to €85,000 do you get a bill for €30,000 ??
:eek
Or do they tell you, so you get a chance to move to a public hospital?
 
Re: HSA / HSF / Bupa / VHI

Or do they tell you, so you get a chance to move to a public hospital?

I very much doubt that this would happen. Usually claims are only processed once treatment is completed but maybe long stays or certain procedures are dealt with differently.
 
Re: HSA / HSF / Bupa / VHI

I bet the hospital accounts depts are smart enough to keep an eye on long-stay/expensive patients and take action as they come close to their coverage thresholds.

So watch out for the bean-counter coming down to your semi-private room pushing you down the corridor to the public ward ;)
 
Re: HSA / HSF / Bupa / VHI

QUOTE:
"Usually claims are only processed once treatment is completed"

Have you ever heard what happens to someone if their hospital treatment exceeded the coverage threshold?

For example, if it exceeded the €55,000 threshold; have you ever heard of someone being given a bill for the excess amount?

It would be a concern receiving treatment in hospital if the claim is only processed afterwards; - for major surgery anyhow.

I wonder is there a risk of having to pay any excess out of your own pocket?

If there was any chance of this happening, I think many people would like to know they were coming close to their cover threshold so they could skadoodle out of there...
 
Re: HSA / HSF / Bupa / VHI

I bet the hospital accounts depts are smart enough to keep an eye on long-stay/expensive patients and take action as they come close to their coverage thresholds.

I doubt that myself but if anybody has any hard facts it'd be interesting to hear about them.

Have you ever heard what happens to someone if their hospital treatment exceeded the coverage threshold?

I haven't anyway.

I wonder is there a risk of having to pay any excess out of your own pocket?

I presume there is if there are payment thresholds specified by the insurance cover.

If there was any chance of this happening, I think many people would like to know they were coming close to their cover threshold so they could skadoodle out of there...

Money is usually the last thing on one's mind when in hospital! :\
 
HSA / HSF / Bupa / VHI

QUOTE:
"Money is usually the last thing on one's mind when in hospital!"

Though if I was a patient I think I would prefer to know if my treatment was approaching or going to exceed the threshold.

Would this not give me the option of moving to a public ward/public hospital, and receiving additional treatment above this threshold free of charge?
(bar the c.€300/€400 public hospital charge)

It's a bit of a concern as to what would happen as some treatments can be incredibly expensive. The last thing you would want to have to do after major surgery (for example multiple organ transplant) is have to sell your home...
 
HSA / HSF / Bupa / VHI

Tommy, you said before:

"I understand that measures are to be introduced that will penalise people who opt out of private health insurance. Apparently, heavy surcharges will apply to people who haven't insured themselves previously if they haven't had insurance (or maintained it) before they reach a certain age."

Do you mean surcharges might be levied by the state on persons receiving public health care?

Can you elaborate on this at all?
 
Re: HSA / HSF / Bupa / VHI

I'm not an expert on this but I understand that the measures will mean that someone who joins VHI or BUPA for the first time at say age 45, 50 or 55 will pay a loading to reflect the higher risk of their age profile and the fact that they did not contribute to the private health insurance system when they were younger, and when their risk profile was lower..

Afaik, it has nothing to do with people receiving public health care.

If you need to know more, enquire with the Dept of Health or either of the two private health insurers.
 
Re: HSA / HSF / Bupa / VHI

There's some information about this included in the VHI's response to the white paper on private health insurance published on 16th September 1999 (!) which is available here.
 
HSA / HSF / Bupa / VHI

ClubMan,

I'm just after re-reading the terms on the Bupa site i.e. item 8(g) which mentioned the €55,000 & €65,000 limits.

[broken link removed]

After reading this again (all of item 8) , I think item 8 actually refers to benefits *not* covered.

At the beginning of item 8 it states:-
"We will not pay benefits for any of the following"

Then at point 8(g) it states:-

"Treatment you receive outside Ireland"

which seems to indicate that the insurance does not cover this, though there are various scenarios in which the insurance will cover treatment received abroad. These are all listed in 8(g).

Point 8(g) also goes onto to state:-

******************************************
We will only pay benefits up to an overall total per episode of illness of €55,000 for Essential, Essential Plus and Gold Scheme members and €65,000 for members of the Health Manager scheme for the cost of all treatment
received outside Ireland each year. These limits apply to each person per episode of illness. This exclusion or the benefit limits of €55,000 or €65,000 will not apply to treatment that we have agreed you may receive in a BUPA Ireland participating hospital in the UK because the treatment was not available in Ireland.
******************************************

So, I think this €55,000 / €65,000 threshold only applies to certain treatment received outside Ireland and received in certain circumstances. As far as I can tell it does not apply to treatment received in Ireland.

I can't seem to locate any similar threshold for hospital treatment received *in* Ireland.

Can anyone else.....?
 
.

The above "Smilie" is supposed to be an "8" with a ")" after it.

Not sure where the smilie came from.....!
 
Re: HSA / HSF / Bupa / VHI

someone who joins VHI or BUPA for the first time at say age 45, 50 or 55 will pay a loading to reflect the higher risk of their age profile and the fact that they did not contribute to the private health insurance system when they were younger, and when their risk profile was lower..
Click to expand...

A bit like motor insurance in reverse then!!
 
Re: HSA / HSF / Bupa / VHI

A bit like motor insurance in reverse then!!
Click to expand...

Yeah - What's the odds that most actuaries are over 45? Ensuring that they get the best rates for health insurance & car insurance!
 
re: dental cover

I intend having cosmetic dentistry to the value of €2000 done in the future. Is it worthwhile joining up with HSA or HSF for this alone?
 
Re: re: dental cover

For what it's worth such treatment may qualify for [broken link removed].
 
Re: re: dental cover

Is it worthwhile joining up with HSA or HSF for this alone
Click to expand...

The HSA coverage ceilings are quite low in each cover area (€100-€200), so it is unlikely that it would be worthwhile joining just to cover some dentistry. But if you have your dentistry expenses, plus a few GP visits, plus a few perscriptions, plus a consultant visit, it is likely that it would be worth your while joining.

I don't know the HSF coverage, so I can't really comment on this. I'm not certain that HSA covers cosmetic procedures (dentistry or otherwise) so you should double-check before proceeding.
 
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