Health Insurance 20% shortfall on specified orthopaedic procedures.

RedOnion said:
2nd hand parts obviously! ;)

I'm not sure that one can 'shop around'.

One angle that I looked at previously was:
Person without health insurance, and limited means to pay privately. To get a hip replacement as a public patient, there are a few steps, and a delay at each one:
1. Your GP refers you.
2. Eventually you get x-ray appointment.
3. Then there's a waiting period to see the consultant.
4. Once you've seen the consultant, you're then in the waiting list for operation.

What we had looked into doing was presenting to consultant as a private patient to speed up steps 1-3 above, but then going back to the public system.

Ultimately, this wasn't followed in the case I was looking at, so I'm not sure whether or not it would have been any benefit.
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It won't make much difference, paying the private fees for an xray and Consultant is the easy part.
The current waiting time for public health joint replacement will prob be years long after the turmoil of Covid.
 
Saavy99 said:
It won't make much difference, paying the private fees for an xray and Consultant is the easy part.
The current waiting time for public health joint replacement will prob be years long after the turmoil of Covid.
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Yes, this was pre-Covid.

The waiting period to see consultant as public patient was > 1 year in the case I looked at.
 
Saavy99 said:
76,000 waiting for surgery in Oct 2020
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Not quite accurate, unless I've misread. The list awaiting surgery is much smaller. The 76k are awaiting an outpatient appointment. Not necessarily surgery.

It's in the article, c 2,600 are awaiting knee or hip replacement surgery.
 
RedOnion said:
Yes, this was pre-Covid.

The waiting period to see consultant as public patient was > 1 year in the case I looked at.
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Notional treatment purchase fund has the waiting times for everything up.
These times are actually mostly not accurate and cannot be trusted.
They have times up for initial appointment...surgery waiting etc.

There are many articles exposing how they manipulate this if one searches but for example it's about a 5/6 year wait online for hip replacement...that's if they are to be believed.

Which they can't be and so one would end up between 8-10 years and they could be dead by then.

What a country.
 
RedOnion said:
Not quite accurate, unless I've misread. The list awaiting surgery is much smaller. The 76k are awaiting an outpatient appointment. Not necessarily surgery.

It's in the article, c 2,600 are awaiting knee or hip replacement surgery.
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Well.....the most likely scenario is they will all need surgery actually.......so in summary

The waiting list figures are a waiting list for to be then put on the waiting list.

The waits in dublin and cork and not as bad as limerick.
Look at the site but remember many have to wait years before their initial appointment......then....their imaging...
Then diagnosis to then...be put on the waiting list for the procedure.

(1-5 years) is the wait for outpatients appointments.

You can also look up the number of surgeons in the country and how often they operate and how long it would take to clear the lists and the answer is years.

So they outsource it. And....delay and manipulate the lists.

In the past if someone waited 3-5 years the ntpf paid for them to be seen privately. Not sure if this happens still
 
Curlyfella said:
www.irishexaminer.com

More than 4,100 people waiting for cataract procedure

Of those waiting in November, the majority (3,529) were waiting one year, 572 were waiting more than two years and 52 people were waiting more than three years for the procedure
www.irishexaminer.com www.irishexaminer.com

www.irishexaminer.com

More than 21,700 people waiting to see respiratory consultants

Waiting lists shot up during pandemic
www.irishexaminer.com www.irishexaminer.com
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Healy rae was criticized by martin in the dail about his cateract bus but he's the only td who has put any incentive into helping people access treatment.

The treatment is available down south but they are rationing it and making the lists longer so people take out insurance.....hence this forum!
 
podgerodge said:
Just jumping on this subject, does anyone know the potential impact in terms of cost of the 90% only cover on a few policies for "Blackrock Clinic, the Mater Private and the Beacon Hospital, certain Special Procedures" - how much this 10% shortfall could actually be? It can be easy to move to a policy from 100% to 90% and think that's not much, but how much is it!

Edit - RedOnions' useful Blackrock link is very handy. But I'm confused about one thing, for a parent on Health Plus Extra (like a lot of people!), Blackrock states: "
In Patient Stay (per diem)You are covered. A shortfall of 55% applies for each night of your stay but this fee is waived by Blackrock Clinic. A €200 fee applies per night of your stay

So they waive the shortfall of 55% but charge €200 per night. Not sure which is better, but this is a bit confusing.

And for my own Laya policy:
CategoryCover Information
Day Case / Sideroom ProcedureYou are covered. A once off excess payment of €100 applies.
Non-Cardiac ProcedureYou are covered. A shortfall of €175 applies for each night of your stay but this fee is waived by Blackrock Clinic. A once off excess payment of €150 applies.
Orthopaedic ProcedureYou are fully Covered.
In Patient Stay (per diem)You are covered. A shortfall of € 175 applies for each night of your stay. A once off excess payment of €150 applies.
Cardiac ProcedureYou are fully Covered.

I'm confused by above from Blackrock. The above, but I must be reading it wrong, suggests that for non-cardiac they WAIVE the €175 per night shortfall, but if I have an in patient stay a shortfall of €175 applies per night. Do these 2 statements not contradict? Then I thought ahh, the waiving is for NON cardiac, so maybe that's it. But then at the bottom, they say cardiac covered ?!
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I can just give you information on the Mater Private. A family member had to pay the 10% shortfall. It cost approximately €300 per night for 2 days stay for 2 admissions for cancer treatment. So a total of around €1200 for 4 nights stay. This was in September 2020.
 
thanks Megan. Just goes to show, these 10%, while appearing a bit inconsequential, are not when you look at your figures.
 
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