# Cover after an operation?



## tomobrien (10 Feb 2014)

My elderly mother recently had an emergency operation in St. Vincents Public Hospital, the need for which arose from underlying, ongoing health issues which were also being treated in St. Vincents Public.

Post-op she went to ICU for about a week during which we were told that we might need to plan for her not recovering: the load from the operation + the load from her other health issues might well overcome her in perhaps a few days, maybe a couple of weeks. 

She was discharged from ICU a couple of days ago and brought to a more general ward which we felt unsuitable, not least health-wise (in her weakened state and due to her illness she is immuno-compromised)

She was moved to a private room in St Vincents Public where she now resides.

Mam has VHI HealthPlus Extra (how very positively loaded with words is _that _title). It provides full cover for _day care / side room semi-private and private accomodation_ in Public 1 & 2 hospitals, St. Vincents Public being a 1.

Further down on her policy it talks of covering convalescent care for a couple of quid a day.

My question:

Is my mothers accommodation post-op covered under a hospital stay. Or would it be considered convalescent care?


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## arbitron (10 Feb 2014)

Hi tomobrien,

It sounds like your mother has been transferred to Vincent's Private as an in-patient admission to recover from her operation.

They are probably referring to her stay as convalescence in a general sense, but strictly speaking it is different, as convalescent care takes place in a convalescence home.  The convalescence home stay is what her policy is referring to.

From what you say above it sounds like she is covered, but it would certainly be worthwhile calling the Vincent's Private billing office to double check for peace of mind - they will be used to dealing with these queries.


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## amgd28 (10 Feb 2014)

Arbitron
The patient is in St Vincent's public, in a private room:


> She was moved to a private room in St Vincents Public where she now resides.



OP - you mother will not need to pay for anything so long as she is still in St Vincent's Public. 

The hospital will charge the insurer for the number of nights your mother was in a private bed. In any given calendar year, the insurer will only reimburse a maximum of 180 days.
The insurer will query from the consultant when the patient was "fit for discharge" and seek to only pay up to that date, even if there were no alternative accommodation for your mother to be discharged to.
Even if the consultant said your mother was fit for discharge, say today, and your mother remained in the hospital for another 2 weeks, your mother would not be charged for the shortfall.

The only situation where your mother may have a financial exposure would be if the doctors had certified her as fit for discharge, and an alternative accommodation was found and your mother/family refused to move out of the bed. This occurred in St James' hospital but even at that they waited for 4 years before bringing it to a head..


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## tomobrien (10 Feb 2014)

Thanks arbitron, I wasn't too sure who to check with as VHI won't discuss the details of the policy with me since I'm not listed as one permitted to discuss her account.


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## arbitron (10 Feb 2014)

tomobrien, my apologies I misread your post - amgd28 is correct.


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