# Can you be both a public and private patient?



## Sue (26 Dec 2012)

I have private health insurance and have attended consultants privately.I am also attending a number of consultants as a public patient in a public hospital.Now a consultant who I see privately and who works in that public hospital has referred me for a procedure as a private patient in that hospital.Will this compromise my position as a public patient?.
 I am am confused by this.The HSE site says everyone is entitiled to be a public patient.I have multiple health issues at the moment and I am really struggling financially.I am just able to keep up my health insurance and am afraid to stop it as it covered surgeries for me.Has anyone been in this position and can they advise me?.I would really appreciate it.Thank You.


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## browtal (26 Dec 2012)

It would make sense to speak with the consultant who referred you.
You should tell him what you wish for.  If you are concerned about not being covered by your health insurance why not contact them and they will advise you.
Everybody is entitled to public treatment in a public bed the main problem is the delay that often occurs in getting such appointment or getting the initial appointment to refer you to hospital for the treatment. 
Regards Browtal


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## amtc (27 Dec 2012)

I've posted on this before - 


My dad has a clot on his right leg which is now in his lung and as he came in through A&E is a public patient on that leg. 

He was referred by our GP for a lesion on his left leg privately - been back twice - 180 each time - I suggested today that he try and get both treated together, 

my original post here was critical of the public health system, but now he is in it, the standard of care he gets and more importantly the information flow (i.e. we now can talk to teh doctor rather than the secretary) is second to none.

I should say my father has private health insurance but my mam retired last week (she paid it)


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## Slim (27 Dec 2012)

The HSE does not allow a la carte patient status. If you are admitted as a private patient, you or your insurer will be billed. You cannot, as far as I know, be a public patient seeing a consultant privately. You can take your chances as a public patient, that you will see your preferred consultant but you will not skip waiting lists etc...


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## Sue (27 Dec 2012)

Thanks for the replies.I know my question is confusing.What I mean is I am currently seeing a consultant in a public capacity in a public hospital.I am also attending a consultant in a private capacity and he has refered me to the same public hospital for a procedure he will perform and I will be admitted as a private patient and that is fine.But will this affect me attending the public consultant as a public patient?.


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## STEINER (27 Dec 2012)

If you have 2 different health issues then its ok for you to use a public consultant for one issue and a private consultant for the 2nd issue.

If you have one health issue, choose either private or public for treatment, even if you use one for a 2nd opinion.  Don't attend 2 consultants for one health issue unless you wan't a second opinion.


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## Sue (27 Dec 2012)

Hi Steiner, Yes I have two completely different health issues and just worried that if the public hospital now knows I have health insurance that they would try to make me go private for the other issue.I can't afford to go private for both.


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## AlbacoreA (28 Dec 2012)

We had experience of this with a family member. They had attended one consultant privately, and had treatment privately. Then had another consult and treatment publicly. Got a bill for private, queried it, and they changed it to Public. Then had a third treatment via a consultant they see in the public clinic. Had treatment, at all stages hospital staff were told they were public patient. 

But accounts want to put it through as private on the insurance. We've spent 2 years arguing with them, as they insist they were a private patient. Even though they see the consultant as a public patient, the admission letter was to a public ward etc. They have no record of a request from the person for private treatment, and give a different reason each time why it was private. In the end the insurance was sent a letter explaining the situation and asked them to sort it out. 

Maybe I'm wrong but it seems to me, that for all the players involved, consultant, hospital, insurer are all better off if its done privately. The only person that's worse off is the subscriber with increasing premiums. As such (in my experience) you're on your own getting these things corrected. 

So my advice is get everything in confirmed in writing, and the names and details of everyone who is informed that's its a public treatment, not a private one.


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## browtal (28 Dec 2012)

Sue, 
if you are covered for one complaint why do you think your private health insurance would not cover you for both?
I have some knowledge of the health cover in private and public service.
If I can help please email me privately 
Browtal


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## AlbacoreA (29 Dec 2012)

As far as I know, the main thing private insurance wouldn't cover is private consultant visits rather than to any of the team in the public clinic. In hospital treatment would be covered. Well depending on your plan.


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## Time (29 Dec 2012)

You could see him publicly for his clinics and then go private for any hospital stays. I did this before for a knee problem, once he mentioned surgery I dropped the hint I had insurance. Operation was done a week later.


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## AlbacoreA (29 Dec 2012)

Consultant Clinics would be the big cost. 200 per visit. Which is reason enough to go public.  

Depends on what it is though.


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## Time (29 Dec 2012)

Exactly. 200 a visit is a lot of money to find. 

I see the HSE now send you a "your on a waiting list" letter when referred from a GP.


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## becky (29 Dec 2012)

The issue here is that the OP is happy to stay private but is afraid of hassle if they preset later as a public patient under another consultant.  He could look to having the procedure in a private hospital but chances are only a percentage is covered.

If the OP has to go to the other consultant as a public patient make it clear you are now public.  Income collection is a big issue for public hospitals.

Make sure that you tell them you are a public patient to that consultant and if you have any hassle, write to the Finance Manager of the hospital.  His/her name will easily be got.


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## AlbacoreA (29 Dec 2012)

Hard to know what is covered. Tried to get a straight answer from the VHI before, about which procedures are covered and which aren't because the policies have general sweeping statements and lack specifics.


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## Slim (30 Dec 2012)

In a nutshell, if you want to attend the hospital as a public patient, you may do so but cannot choose which consultant you see each time. However, most hospitals don't have so many consultants so you may very well see your 'private' consultant by chance and I am sure he can swing that if he wishes. However, if you are admitted, the hospital will try to bill the insurer if they realise you have cover. Going public means you cannot choose your consultant and you will be on a waiting list for any procedure.


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## Time (30 Dec 2012)

> However, if you are admitted, the hospital will try to bill the insurer if they realise you have cover.


They can only do this if you are admitted as a private patient.


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## Slim (30 Dec 2012)

Time said:


> They can only do this if you are admitted as a private patient.


You are correct but if they smell Health insurance they will try to sign you up to private!


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