Quickest way to get an operation with no cover

seanie08

Registered User
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13
Im self employed, I have basic VHI cover. I have been out of work for 4 weeks and urgently need a back operation.
I have my MRI scan completed and paid for, I have seen the surgeon and paid him, for the consultation, he booked me in for surgery straight away in a private hospital,and then I found out my VHI covers nothing only a small refund for both expenses so far.
So do I now go to a public hospital and get put on a waiting list for months or try somehow to pay for the surgery myself?
Im in serious pain and need to get it sorted.
 
Forget about a public waiting list, you could be years waiting.

The only way forward is to show up with a few tesco bags full of cash. Sad but true.
 
If you have the operation code - call VHI and see where do they cover - most surgeons operate in several hospitals, it may be covered in one of them..... been there, do not envy you! best of luck....
 
How come VHI don't cover it? I had a long debate one day with them trying to find out what operations they cover, they didn't have a specific list to offer. Just replied with the routine operations, in certain area's. Is their actually a list of which plans cover which operations?
 
Thanks everyone it looks like the credit union will be getting a call.
You get a procedure code to check with your health insurer, and this tells them what sort of operation it is. I had a look at my cover and it is very vague as too what exactly they do cover.
I had too pay €200 for scan and get €40 back, one Consultant fee for 10min cost €280 and I get €60 back.
 
Thanks everyone it looks like the credit union will be getting a call.
You get a procedure code to check with your health insurer, and this tells them what sort of operation it is. I had a look at my cover and it is very vague as too what exactly they do cover.
I had too pay €200 for scan and get €40 back, one Consultant fee for 10min cost €280 and I get €60 back.

So what have you got to loose exactly by trying to go public??? Until you actually try, you have no idea how long the wait be... If it works you've saved a bit, if not you can still go private.
 
Thanks everyone it looks like the credit union will be getting a call.
You get a procedure code to check with your health insurer, and this tells them what sort of operation it is. I had a look at my cover and it is very vague as too what exactly they do cover.
I had too pay €200 for scan and get €40 back, one Consultant fee for 10min cost €280 and I get €60 back.

The charges for scans and Consultants is to be expected on some plans.

But you said it didn't cover the operation. Have you checked that specifically?
 
Forget about a public waiting list, you could be years waiting.

The only way forward is to show up with a few tesco bags full of cash. Sad but true.

Years may be an exaggeration.

Months, maybe.

Maybe weeks, it's hard to know.

Note that thousands of people get treated each day in the public system.
 
Hi. Your VHI probably covers this operation, just not in certain private hospitals, possibly black rock clinic, mater private etc. it will likely cover for you in a semi private or private bed in a public hospital. The waiting list for this may not be as long as you think as you are still a private patient. Ring your consultants secretary and ask which other hospitals they work in then call their private secretary in that hospital and ask about the waiting list. I would expect several years wait if you were a public patient but not with semi/private insurance.
 
Ps. Check your plan details on hia.ie. it will tell you the level of in patient cover you have.
 
Thanks everyone, I checked with VHI and the operation is not covered. I checked with surgeons private secretary and was told that if I was marked as a priority case it would still be months, but no exact time.
And as I have been laying on my back for a month waiting for things to happen, in pain , I guess I may pay up.
Just for anyone else that happens to be paying insurance, i have paid this for 25 years, no claims, so just find out EXACTLY what you are covered for.
On the bright side by Monday evening I will have operation over and on the way to recovery, Happy days.
 
I checked with surgeons private secretary and was told that if I was marked as a priority case it would still be months, but no exact time.

Well it's not the way I would approach it... the surgeon's private secretary is not the public service... and I would be sure how motivated she be to get you fast tracked on the public service, if you're a potential fee payer! What does your GP say to all of this I wonder?
 
Years may be an exaggeration.

Months, maybe.

Maybe weeks, it's hard to know.

Note that thousands of people get treated each day in the public system.

In our experience months is normal even up to a year for some situations. Sometimes the public is quicker, sometimes a lot slower. Its impossible to know.
 
Well it's not the way I would approach it... the surgeon's private secretary is not the public service... and I would be sure how motivated she be to get you fast tracked on the public service, if you're a potential fee payer! What does your GP say to all of this I wonder?

I also would be wary of taking the work of secretary and even docs/consultants at face value, in particular with waiting lists. We were once delayed months because a secretary couldn't/wouldn't send a fax until I said I'd hand deliver the fax.
 
Well it's not the way I would approach it... the surgeon's private secretary is not the public service... and I would be sure how motivated she be to get you fast tracked on the public service, if you're a potential fee payer! What does your GP say to all of this I wonder?

I'd also add that even if you go public, but have insurance they'll find a way to charge your insurance or you directly. I had 2 yrs of arguing that a specific treatment was done on the public system, only for them to charge the insurance anyway. They changed their reason for doing this about a dozen times. I gave up arguing, because the insurer had no interest in avoiding charges.
 
...Just for anyone else that happens to be paying insurance, i have paid this for 25 years, no claims, so just find out EXACTLY what you are covered for.....

its very hard to get a list of specific treatments that are included as the policies aren't very specific. As a result its very hard to argue when they say a treatment isn't included.
 
I'd agree with the above. Don't take secretaries word for it. What is the procedure or code ? It must be something hi tech or new or specialised? There may be an old fashioned or alternative procedure available which would be covered. The majority of inpatient procedures are covered on all plans. Without knowing specifics it's hard to comment further.
 
Well isn't that just depressing, you pay for years and then you haven't cover for the thing you need. How can any of us know what possible treatment we are going to need, it would be impossible to go through the policies to see what is not covered if we don't know what illness we will get or procedure we will need. Makes you really wonder about the point of it all.
 
In our experience months is normal even up to a year for some situations. Sometimes the public is quicker, sometimes a lot slower. Its impossible to know.

Absolutely, I was quoted 2-3 years for a dental operation on the public system. Going private i.e. a large amount of cash, it was done the following week.
 
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