Health Insurance Help me understand private health insurance in Ireland

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Curly Wurly

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I'm going to be asking some very basic questions in this thread. Please forgive my innocence.
I have lived in the UAE for more than ten years. When I left Ireland I was in my 20s, fit as a fiddle and had no dependents. So frankly I never accessed healthcare when an adult in Ireland. In the intervening years I have aged, built a family, and during this time my employer has provided me and my family with health insurance which we use more and more with every year that passes.

In the UAE there are hospitals and clinics galore. You can access any number of GPs or specialists (e.g. dermatologists, pulmonologists, oncologists, endocrinologists, neurologists, ophthalmologists, cardiologists, ENTs) within literally a few hours of looking and you don't need to be referred to specialists by GPs. This is because the supply of medical professionals is abundant. If I need an MRI or CAT scan, or need hernia or any other type of surgery, it can be arranged within a few days. There is an abundance of choice and no waiting lists.

Now back to my insurance. It is wonderful. It fully covers pretty much everything both in the UAE and globally: dental, consultant visits, vaccinations, medically necessary surgeries, private rooms when an in-patient. And again, all of these services are accessible within hours, or at most a week within the UAE. And the direct billing network is vast and efficient.

My question is, when I return to Ireland with my family, I'd like to know what I can expect from private health centers / hospitals in terms of the immediacy of access to health services, and moreover, what can private health insurance in Ireland offer that would be comparable to what I have access to in the UAE?

Are all the complaints one hears of in Ireland related to public health only? Is there an abundance of private clinics in Ireland? For example, my friends in Ireland tell me you are lucky to have on GP "who will take you" - but if I exclusively go the private route, surely this wouldn't apply and you could access a GP or specialist in short order?

Thanks
 
Hi Curly Wurly (always loved them straight out of the fridge when I was a kid and calories didn't matter :) ),

This link to the Health Insurance section of AAM might give you some reading material which might help.

This previous thread might show you some comparison between our cover here and the NHS (UK).

There are companies out there such as www.totalhealthcover.ie which you can investigate and see if their fee based service might be worth using.



I would only have basic knowledge of the system here but feel free to shout if you need anything else and if I can't answer others here may be able to help.
 
Which GP you sign up with is not really related to your insurance status.

If a GP is full, they aren't taking any more patients.
 
Health insurance in Ireland doesn't really provide quicker access to GPs.

It provides faster access to diagnostic tests and hospitals.
 
Make sure you get PHI as there is loading after a certain age. There is a waiver for people returning to Ireland. Citizens Advice website is excellent and will have the details.

Lots of GPs are no longer taking new patients, nothing to do with being private.
 
When I got sick in 2007 we had the creme de la creme of PHI, paid for by wifes employer 100% and was/is a taxable benefit. If you pay it yourself for a family you get tax relief €200 per Adult and €100 per child to a max of €600 annually.

Even the best wouldn't cover 100% of costs for example consultants charge €200 per visit phi might cover 75% of that but normally you pay in full and claim back the €150 the balance will be tax deductible at 20% basic tax rate.

So, expect to pay but not get 100% of anything back.

Serious illness, as I said I got sick had phi but treated in a public hospital, they billed something like €300k but treatment was the same if I walked off the street, but the public system is in my opinion better than private care as experienced medical people are within the public system and seem more dedicated. But impossible to get into and post pandemic going to get worse.

I spent 3 nights on a trolley and still got charged. But the public system saved my life.

Everything here is more expensive and you will pay more and sometimes upfront, my daughter recently went for 2 MRI scans eventhough she has full cover each visit cost €250, consultant €200 we paid and today I claimed back 75% of everything which is the max .

Dental and other bits are available but beware not all dentists, etc will wait for payment same scenario as above.

I would love to say you don't need it , but unfortunately you do and our premiums are now just short of €10k for 2 adults and 2 students.And embedded in that is an equality charge so that older people can afford phi. The market was opened to competitors but VHIs age profile and by extension risk was higher so the younger population subsides.

Welcome home........

Hope this helps
 
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There is a post here which may help you.

Key Post - A guide to private health insurance

Specialist intersts Maternity cover (thanks to huskerdu for this summary) Here is a summary of what PHI covers for Maternity in Ireland. If my figures are incorrect or out-of-date, please let me know. If you decide to see a consultant privately for ante-natal care, the cost will be...
www.askaboutmoney.com

Here is a basic summary ( which is a bit of a generalisation but I think gives a good overview)

Health insurance in Ireland was originally intended and is still primarly focussed on covering staying in hospital and the costs of surgery and in patient treatment
The very basic plans cover you to be a private patient in a public hospital
The mid range plans cover most private hospitals
The expensive plans cover what are called "hi tech hospitals"

This list from the VHI is a useful list of all hospitals and contains their categories which will give you an indication of the more expensive ones


Private 1 are cheaper private hospitals. Private 2 are more expensive, Private 3 are the most expensive

PHI does not always cover the cost of visiting a consultant as an outpatient. Some plans give you some part cover, but AFAIK, none cover the entire cost.

PHI usually does not cover medication unless it is part of treatment as an in- patient in a hospital. Some plans offer a small part payment as an out patient benefit.The health systems pays for expensive medication over €114 a month.

The most important thing to note is that a private patient is a private patient of a consultant. It has little to do with the size of the room you end up in. Most consultants work in the private and public health systems.

You pay for PHI to skip the queue in the hospital, if you need surgery or to gain access to private hospitals,

It works like this

-You are concerned about an issue with your elbow and you visit your GP who agrees that you need to see an elbow consultant (You pay the GP).
- There is a 18 month waiting list to see the elbow consultant in the public system so you go private.
- The GP also thinks that you would benefit from a particular elbow painkiller which is €200
- You pay the pharmacy €114 for the painkiller and the state pays the rest ( once you have a DPS card which anyone can get)
- You visit the elbow consultant in their private offices and pay them €200 for the visit
- The consultant orders an MRI, which is probably covered by your PHI as long as you use a clinic covered by your policy and your consultant orders it for the reasons covered by your policy.
- The consultant recommends surgery and books you into a private hospital where they work
- Assuming you are covered for this hospital, the hospital bills your PHI company directly.

- After the surgery, you have another out patient visit to the consultant which you pay another €200

At the end of the year, if you plan covers a part payment for GP And consultant visits, you make a claim
Some polices cover part payment of physio etc also

You can also get a tax credit of 20% on all health expenses that you could not claim back.
 
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huskerdu said:
PHI does not cover medication unless it is part of treatment as an in- patient in a hospital.
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This is not quite correct.
Some private health insurance do offer cover for medicines prescribed while not an in patient.
E.g. my Irish Life 4D Health 2 plan covers €15 of up to three prescriptions per policy year.
 
becky said:
PHI Private Health Insurance. It's the term we use in the hospital.
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I could see how it would work that way too :)

I suppose it more matters if you are talking to anyone in the financial/insurance side as in brokers etc regarding buying that type of cover as in financial business terms PHI would be taken to be permanent health insurance.
 
Paul O Mahoney said:
the public system is in my opinion better than private care as experienced medical people are within the public system a
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A client of mine who is a hospital consultant has the most basic of packages. His reasoning is that he will only need it if he's very sick and if so, he wants to be in a public ward where there are nurses coming in and out all the time. That way, if something happens to him, they'll notice quickly. If he's in a private room, he could be dead and they wouldn't know!
 
becky said:
PHI Private Health Insurance. It's the term we use in the hospital
Click to expand...

Steven Barrett said:
A client of mine who is a hospital consultant has the most basic of packages. His reasoning is that he will only need it if he's very sick and if so, he wants to be in a public ward where there are nurses coming in and out all the time. That way, if something happens to him, they'll notice quickly. If he's in a private room, he could be dead and they wouldn't know!
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Exactly unless you smuggle in a quarter bottle of wine, and you have a private party with calvita cheese and cream crackers. Listening to Amy Winehouse with no immune system and after getting high dose chemotherapy that made you glow in the dark.

But its true I had a bad turn one night my temperature went to 103.5 essentially my body shut down to heart and lung function, I somehow pressed the button and I can't remember after that.
 
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Steven Barrett said:
A client of mine who is a hospital consultant has the most basic of packages. His reasoning is that he will only need it if he's very sick and if so, he wants to be in a public ward where there are nurses coming in and out all the time. That way, if something happens to him, they'll notice quickly. If he's in a private room, he could be dead and they wouldn't know!
Click to expand...
Like other insurance (home buildings/contents, car - even if I just renewed on comprehensive because the price difference with third party fire and theft was marginal) I'm leaning towards this bare bones/worst case scenario approach to private health insurance. Also because somebody else (employer) will not be paying for it from next week! :) I just wish that I didn't have to pay for stuff that I can/will never use (maternity, gender reassignment - unlikely at this stage - etc.), stuff that is useless in the first place (all "alternative" treatments) and other non essential bells and whistles (I don't really want to talk to my health insurance provider about financial/legal advice thanks very much).
 
ClubMan said:
Like other insurance (home buildings/contents, car - even if I just renewed on comprehensive because the price difference with third party fire and theft was marginal) I'm leaning towards this bare bones/worst case scenario approach to private health insurance. Also because somebody else (employer) will not be paying for it from next week! :) I just wish that I didn't have to pay for stuff that I can/will never use (maternity, gender reassignment - unlikely at this stage - etc.), stuff that is useless in the first place (all "alternative" treatments) and other non essential bells and whistles (I don't really want to talk to my health insurance provider about financial/legal advice thanks very much).
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Well you have to pay for maternity cover under common risk rating rules.

I think there are plans out there that don't cover alternative treatments or offer much out patient benefits \ have very high excess
 
Steven Barrett said:
A client of mine who is a hospital consultant has the most basic of packages. His reasoning is that he will only need it if he's very sick and if so, he wants to be in a public ward where there are nurses coming in and out all the time. That way, if something happens to him, they'll notice quickly. If he's in a private room, he could be dead and they wouldn't know!
Click to expand...
Your client will likely not to be placed on a waiting list, perk of the job.
 
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