Quickest way to get an operation with no cover

I have a friend that needed an operation and her health insurance did not fully cover Blackrock Clinic. She was told to phone them anyway and when she said her health insurance did not fully cover the cost they told her don't worry and they waved the difference. I believe its worth a try.
 
+1 always worth trying.

wbbs said:
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.
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Another experience was to be entitled to private room, not getting it, getting MRSA, then getting an isolation room. The person sadly passing away (MRSA). Then being charged as a private patient.

It obviously not always that bad. Sometime it works out well. But for me I think the system is very broken.
 
laois1 said:
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.
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I think you're right on this. Doesn't the most basic level of private health insurance provide basic cover for all conditions in semi-private beds in public hospitals?
 
I wouldn't be so quick to offer to pay for it yourself. A back operation could run to thousands very quickly. Have you had a quote? You need to make sure you factor in all the costs - private bed per day, x-rays, scans, theatre staff, consultant surgeon, consultant anaesthetist etc etc.
Double check that a similar operation is not covered by your insurance. Ask your consultant is there something else that can be done with a code that is covered under your insurance? He/she may be able to do something if they are aware that that particular procedure is not covered. In short - fight for the right to use your insurance.
 
Agree with the above. There is likely an alternative procedure which should be offered to this patient which is covered. Advise researching the various operations possible for this condition. Ask the consultant about alternatives. As pointed out the costs old very quickly escalate particularly if complications arise and a longer admission is required. A relative recently had a fairly uncomplicated cardiac procedure done in the beacon, a day case. Price over 7 k. Lucky insurance picked up the tab.
 
Just to say that in post 10, dated 10th July, the OP says: by Monday job will be done.
 
The only info I can get is off people on here, so Thankyou. I have contacted hospital depts. but just getting no help. I cannot get any help from the hospital im going too. I can get a bed in another hospital from VHI but put on the waiting list for operation, and they wont/cant give me any indication when that will be.
I am self employed, i have been flat on my back in pain for a month, my 4 staff had to stay at home. I am due in too pay for operation in the morning, Desperation has set in.
 
seanie08, I'm sorry to hear about the hassle you've had. If you can hold off even a week more that may give you enough time to make sure you've exhausted all the options.

Some health insurance plans are very restrictive - can you tell us which plan you're on?

What is the procedure code?
 
Seanie08, is your operation done in Public Hospitals? Last month there was a posting about Aviva not covering treatment for Melanoma that was covered for public patients.
When you take out private health insurance, at the very least, you expect to be covered for all treatment available in the public system.
If this is not the case and insurers are opting out providing certain cover, this need to be highlighted and the HIA surely have a role here.
It's just not good enough to provide a comparison chart unless the treatment provided is similar.
 
Hi everyone im back, operation over pain gone. I had VHI first level plan one, procedure code 5728,double micro lumbar discectomy.
My surgeon and his team were the most professional group I have ever met. Now I have a small hole in my back a big hole in my bank balance. Cost= ONE night stay in hospital € 3250.00, Surgeon = €2000.00, Anesthetic =€ 700.00est. OUCH!!!!!!!!
But here is where im looking for advice???
I would describe my one night stay in hospital as disgraceful, a third world hospital managed by Basil Fawlty.
Just a quick idea, is that I filled in 5 different reports with different members of staff including a kitchen menu saying that I was lactose intolerant, everything I got on the first day was dairy based, We had travellers lamping rabbits in the hospital grounds at night, shinning there spot lights into the rooms, you couldn't make these things up.
There is a long list to go with these, then I was discharged, said goodbye to everyone and arranged a lift 60miles home.
When I got home I got a call to come back to the hospital, as they hadn't changed my dressing and needed to take the needle out of my arm that they fed the drips through.
A heated debate took place in which they told me to go to my GP and get him to do it.
I am livid! I intend to write to the hospital outlining the things I found wrong.
Is this the best way to approach it or is there some other way of going about it?
 
Good to hear you have it over you.

There should be a designated complaints officer, usually within the patient safety/quality department, that you could write to. Best to email them so you have a trail & do it ASAP so it's still fresh.

If you aren't happy with the response you could also contact a patient advocacy group. If you need to escalate further you could consider writing to JCI which accredits all private hospitals in Ireland.
 
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