Health Insurance How can I get treat privately for Eye issue? I am being herded to Public all the time.

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Gnobak

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I have had private healthcare for 25+ years but am very healthy and have never been to hospital and am pretty clueless about how it all works.

3 years ago I had an issue with my eye. I went to Specsavers and they sent me into Mater A&E straight away.
I ended up in Eye A&E and gave them my private healthcare details.
I was seen to and started some treatment which meant having a procedure done every 3-4 months.

After 18-20 months a friend mention his wife having the same procedure and said it was being done in the Mater Private and then I realised that I was being seen to in Public all that time! Why did they not use my details to switch me???

At the next consultation I said I had no problem with the level of medical care I had received but what was the deal with switching to Private and they said it would just mean a nicer waiting room, it was the same staff, and didn't offer to switch me over. I just left it, but why would they not offer to switch???

There had been 2-3 occasions when appointments were not set up, or a bit delayed which annoyed me, so I was thinking Private would have been better overall.

The treatment ended Sep 2024.

The other Monday I had an eye problem again. This time I went to the Affidea clinic so I could get referred in. Which they did. I went straight to the public A&E and told them I had private healthcare, they did a quick inspection and rang the Eye A&E who sent me home but would ring me the next morning.

They rang and wanted me to come in Wed morning. I asked them if it was Public and they said yes and I said I wanted Private and they said the cost was all covered by Irish Life. But I said should I not be going to the Mater Private and they just repeated that I should go to the Mater Public and the cost is covered.

So I have provided or asked for Private cover 4 times now and get fobbed off. Even if I just get a nicer waiting room that's fine. Surely I'm paying for it?

Is there something I'm not understanding?

I can think of 2 benefits to me going private:
- I wouldn't have to wait in a room with druggies and drunks and the smell of urine, most likely, although I am exaggerating a bit
- Their admin staff might not drop the ball. On my very first visit I was told they had to make an appointment for me as a matter of urgency and they never did. I rang them up and they realised their mistake.. I was completely forgotten about. This is not nice when thinking you could lose your eyesight.

Anyway, sorry for rambling but there is probably something going on that I just amn't aware of.
 
Most A&E is public. There are private A&Es in some places like the Blackrock Clinic and the Beacon but check if they do eyes.

I went to the Eye & Ear A&E a few times and the wait was very long but they are clearly the specialists.

You can see an eye consultant privately although it is difficult to get an appointment.

I used these guys. But my Laya scheme does not cover them. I presume if I needed anything major, they would refer me to the Beacon or somewhere.

https://vistaeyeclinic.com/contact-us/
I rang them once and got an appointment that afternoon. While I was waiting in reception, someone else rang and the next appointment was in 4 weeks. I asked about this and the receptionist told me I had been very lucky in that there was a cancellation.
 
Both myself and my wife have had eye problems since last November. Our doctor always refers us to the A & E in Adelaide Road. We often wait for several hours there before being called in to see a doctor. There has never been a mention of going private from anybody.

I have to say that I feel that I am in the best place albeit the bedside manner of the nurses/doctors in the A & E needs to be worked on. They are very busy and see multiples of people every day. I sometimes feel like a piece of meat being moved around. I feel that I would have a more comfortable experience going private.
 
The public and private are very alike once you're in the system. The problem is the entry point, whether it's A&E (up to 25hr wait) or being pushed up by a private doctor. It appears to me that there are no private specialists in that area or they are obliged to deal with people by need.
 
Thanks. I think I'll just have to tackle the most senior person I see on my next visit.
Maybe it is the case that all the staff including all the Admin are shared across public/private and the waiting room is literally the only difference, in which case maybe I'll just go with the flow.
 
I think you should talk to your GP to get a referral to a private consultant . Once you are a patient , talk to that consultant about how to make a private appointment to get whatever you need done .

I doubt if an admin person or doctor in the public A&E is going to do that for you or has any role in making appointments for the mater private hospital which is a completely different hospital
 
I agree with Huskerdu, looking at the mater private website there are a raft of ophthalmology specialists. Check them out you may have come across one or two of them in the public system. Go to your gp and ask for a referral to one of them, he will give you a letter. Then phone and get an appointment, you can even book an appointment on-line.
Best of luck
 
In the same boat, paying for private healthcare doesn't seem to matter a jot. Got a referral from GP for removal of eyelid cyst mid-December, advised to send it off to Eye & Ear, Mater Private and Medicare in Fairview (Private), only just got a response from the Eye & Ear. Wonder why I bother paying for medical insurance at all..
 
Clamball said:
Go to your gp and ask for a referral to one of them, he will give you a letter. Then phone and get an appointment, you can even book an appointment on-line.
Click to expand...

Most doctors send the referrals directly on-line these days, the consultant then triages the referral and if they are going to see you themselves they will write to you with an appointment. This is the way it has worked for me a few times recently. Have seen quite a number on websites recently who are not taking on new patients because they are too busy or are only taking on specific illnesses. One secretary told me that after my referral was vetted the consultant may well refer it to another one who specialies in that illness/field.
 
It must depend on the Specsavers. I know from experience the one in Stillorgan like to refer you to the Blackrock clinic.
 
I got Affidea to refer me to the Consultant who saw me last time, who is listed as working for Mater Private, but it seems to have had no effect.

It must be that they are getting the private payment but using the public services, i.e. some kind of accepted 'scam'.
 
I wouldn’t think so @Gnobak, I think you have been just unlucky. The main way to access private health care is through your GP as you will normally need a referral.

I had a small growth on my eyelid which I went to my GP about in July, and she sent a referral to the private consultant. I got a phone call offering me an appointment in early August. The consultant wanted to remove it and offered me a minor surgery date in Oct, but with work I needed to defer to November and it was done in a morning. So it all worked very smoothly for me.
 
There is confusion over what the term public and private means in Ireland. It doesn't just refer to the hospital, it refers to your legal status.

In a public hospital you have the right to be a public patient. The means the cost is free except the A&E fee. However you can waive that right and become a "private patient" in that very same hospital. All that changes now is you get an itemised bill for every treatment that you are now liable to pay. Your insurance then covers this bill.

In a private hospital you are automatically a private patient. You can cover the bill via self pay or via insurance.

The public hospital appears to be billing you as a private patient via your insurance. Of course they want you to stay, you're paying them money.

If you want private care in a private hospital you have to choose it yourself. Get your own referral for a consultant, either generic or named. Then pick the hospital you want to go to and submit the referral to them to get an appointment.
 
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