Health Insurance At what point does private health insurance simply become uneconomical?

Hi @arbitron,

I can't get my head around this, and find it quite hard to believe that the health insurers (per Insurance Ireland), pay the public rate for us, when we don't sign the form, whereas you say they are obliged to pay €800 per night? Why would the hospitals accept that lower rate when they have the Government law to back them up?

Would it not also be very strange that VHI wrote to all their customers, telling us what to do when asked to sign the form, and that would have gone against the legislation?

Sue Ellen said:
If you have health insurance and you do not sign the form, you will not have to pay the bill for your public treatment. Your health insurer will cover the public charge for your stay in the public hospital.
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arbitron said:
The law changed several years ago allowing public hospitals to charge insurers €800+ per night for private patients treated in public beds.
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I was totting up my receipts last week to put in my 6 monthly claim to my insurer. I estimate that last year, if I take the cost of the insurance v what I will get back, I lost around €2.5k in total for a family of 4. However the year before, I probably saved around €2k because of just the way various treatments were required and when.

So it is 6 of one and half a dozen of another to be perfectly honest. It's like an insurance, deep down you hope you never have to use it but I can name 2 families who ended up trying to raise money on Go Fund me after their house burned down and they had no insurance for that.
 
Peanuts20 said:
So it is 6 of one and half a dozen of another to be perfectly honest. It's like an insurance, deep down you hope you never have to use it but I can name 2 families who ended up trying to raise money on Go Fund me after their house burned down and they had no insurance for that.
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Not a very valid comparison imo. Public system is there and so too is the Cross Border Directive.
 
seanross said:
Isn't the A&E without a Doctor letter now the only Public Hospital bill?
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There are still other charges for private patients in public hospitals and long stay patients according to this:

Hospital Charges - HSE.ie

There are no hospital charges for public inpatient care or day service care. The removal of these charges was announced as part of Budget 2023 and came into effect on 17 April 2023. Inpatient and day service charges still apply for inpatient and day service care up until and including 16 April 2023.
www.hse.ie www.hse.ie
 
Sue Ellen said:
I can't get my head around this, and find it quite hard to believe that the health insurers (per Insurance Ireland), pay the public rate for us, when we don't sign the form, whereas you say they are obliged to pay €800 per night? Why would the hospitals accept that lower rate when they have the Government law to back them up?

Would it not also be very strange that VHI wrote to all their customers, telling us what to do when asked to sign the form, and that would have gone against the legislation?
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The form is a waiver that asks patients if they want to decline their public admission rights and be admitted with private patient status instead.

The €80 per night public rate was scrapped a couple of years ago. That insurance website is out of date.

If you have private insurance and decline to sign the form then you pay nothing and the insurer pays nothing.

If you do sign the form then the public hospital can bill the insurer up to €1,000 per night, depending on the hospital and the bed type.

Take St Vincent's Univesity Hosptal which has about 600 beds. Say 10% of them are taken up by private patients (in reality it's higher), then you have 60 beds per night x 365 nights x €800 = €17.5 million in revenue lost if they ignore the form. That is why hospital admin staff are pestering people in A&E for the forms and why the insurance industry are begging customers not to sign.

You can have 2 patients sharing the same public hospital room for a week with the same Vhi plan. Patient A signs the waiver form and Patient B does not. They get the same treatment but the Vhi pays €5,600 for Patient A and €0 for Patient B.

I am not arguing in favour of the current set-up, I am explaining the reason it works this way. It is a total farce but it would be completely irresponsible of any public hospital not to attempt to recover the money from the insurer.
 
arbitron said:
You can have 2 patients sharing the same public hospital room for a week with the same Vhi plan. Patient A signs the waiver form and Patient B does not. They get the same treatment but the Vhi pays €5,600 for Patient A and €0 for Patient B.
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Bonkers.

If you sign the form, you must get a semi-private or private room, and a consultant. Sure that's the whole point of the insurance.
 
Protocol said:
Bonkers.

If you sign the form, you must get a semi-private or private room, and a consultant. Sure that's the whole point of the insurance.
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It is indeed bonkers.

Unfortunately chances of getting a semi-private/private room are slim to none because they are generally for very sick people and rightly so.
 
arbitron said:
If you do sign the form then the public hospital can bill the insurer up to €1,000 per night, depending on the hospital and the bed type.
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:oops:

arbitron said:
You can have 2 patients sharing the same public hospital room for a week with the same Vhi plan. Patient A signs the waiver form and Patient B does not. They get the same treatment but the Vhi pays €5,600 for Patient A and €0 for Patient B.
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Absolute madness and very much Irish style.

arbitron said:
I am not arguing in favour of the current set-up, I am explaining the reason it works this way. It is a total farce
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Thanks for the explanation and you are right it is a total farce and I would definitely side on the health insurers approach.
 
I'm not interested in getting small amounts of money back off visiting a GP.

I don't care about nice food or a private room.

I would be happy to pay a high excess, perhaps 20K per annum or perhaps even more if the price is right.

I just want the security that I'll be seen immediately if something bad happens.

Is there a policy for me? If there isn't, why not?
 
Nermal said:
I just want the security that I'll be seen immediately if something bad happens.
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That is what happens currently, if you are in an emergency situation you will be seen immediately. The greater the emergency, the more effort is made. I have seen it in action for my child and it is impressive.

The problem is the A&E are getting overwhelmed with the volume of patients, there are too many patients for the system to process and we hear horrible stories of A&E waits, deaths, missed opportunities to save lives, 3rd world conditions etc. My elderly mother spent 5 days in A&E several months ago. It was torture, there was no kindness, dignity, or an environment conducive to rest and recovery. Thankfully she was discharged and with her private health insurance was accepted into a private hospital several days later (as her medical issues had not been fully resolved after the A&E stay). She then spent her last days in an environment that was calm and peaceful and with great medical care.

Now my mother dying was something bad happening to her but the public system no longer met her needs and we were able to leverage her private insurance. But a point I also made was she could have paid cash, she had the savings; it is not an option that I have heard many people discuss but some do not pay health insurance, but keep a cash reserve to pay as they go in the private system.
 
Clamball said:
it is not an option that I have heard many people discuss but some do not pay health insurance, but keep a cash reserve to pay as they go in the private system.
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I was talking to a doctor recently about a claim on private medical insurance for rare cancer treatment that was €300,000.

This is several lifetimes of premiums.
 
My mother in law in the couple of years before she passed in 2014 spent two months in the Blackrock Clinic, a month each time
Each bill was over €30k, which in total, I'm presuming is more then she probably paid in health insurance premiums in her whole life

I've heard it suggested here a few times that with the rising cost of health insurance would it not be better to save the yearly premiums
and use them when and if needed to pay for you medical needs, personally I think this is madness
It's called insurance but really it's assurance, you are more then likely going to need it at some stage in your life and maybe many times and it's when you see the costs of the procedures you realise that you'd never be able to afford it without the help of the health insurance policy

And then there's the little thought process that goes on when you have savings and a big bill is on the horizon
Are you going to be willing to let go of those savings or will you try and reduce the costs or hold on to them for some other reason??
 
Clamball said:
That is what happens currently, if you are in an emergency situation you will be seen immediately. The greater the emergency, the more effort is made. I have seen it in action for my child and it is impressive.
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Exactly. I had a friend, with no health insurance, flown by air ambulance from Waterford to Cork for cardiac treatment as cath lab was closed at the weekend in Waterford University hospital.
 
JoeRoberts said:
What other options would have been available for her care other than the Blackrock ?
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Can't really answer that, she was 83/84 at the time and was having problems with her heart and wasn't responding to medication
Mrs C brought her to Blackrock A&E and they admitted her for observation in a private room because of her health insurance
Would she have got the same service in the public system, I'm guessing not but she did mention that the food was terrible in Blackrock
 
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