Switching health insurance during pregnancy

Re: Welcome to the parents club

Thanks a lot. As it happens we're switching from BUPA back (after several years absence) to VHI because that's what's offered by my job. I'd prefer to stay with BUPA based on past experience but they're paying so I don't want to look a (BIK taxable) gift horse in the mouth. The VHI rep. that I spoke to said that (a) there was no problem in switching, (b) that if non-public treatment/care had already been initiated (I don't think that this is the case and believe that treatment/care to date has been under the public health system) then BUPA would meet the initial costs with VHI taking over once we switched (c) that the maternity cover waiting period didn't apply since we had already "served" it with BUPA and (d) that enhanced cover under the VHI Family Plus plan versus the existing BUPA Essential Plus plan would kick in immediately. I have requested a copy of the detailed terms & conditions to check all of this since they don't seem to be available from the VHI website but if most or all of this is true then it seems fine, even if (d) is a little surprising to us! In relation to charges the VHI rep., in common with others here, mentioned that the likely semi-private/private cost over and above that covered by insurance was likely to be for the consultant and to come it around the Eur 1-2K mark with tax relief available on most of it. If anybody has any relevant information on this topic please feel free to post it. Thanks.
 
Re: Welcome to the parents club

Many congratulations to yourself & herself, Clubman. The estimate for the consultant fee seems low. If I recall correctly, it was over €3k for our private consultant's fee last year. BUPA refund a small piece of this on their outpatients scheme and HSA covered another chunk of it too.
 
I would expect your private consultant fee, in a public hospital, to be 2K (they will also bill your health insurer about €250). Until capaill's post I have never heard of any private patient ending up in a public ward and I remain a sceptical, also €1200 look too cheap; perhaps capaill your experience was related to semi-private care?. RainyDay's 3K looks expensive, unless that was in a private hospital/clinic. It is quite possible for a private patient to end up on a semi-private ward although this might prove a better experience for a first-time mother as there is more comings and goings from the nurses etc.
 
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Clubman,
My wife is currently 'in the family way' as well. Shes is going to consultant privately, but as it does his deliveries in Public hospital she will be entitled to the full cost of hospital stay covered, and in theory should get a private room in puiblic hospital. As they have one private room she'll need to be lucky to get this so you usually end up sharing. its the Erinville in Cork.

On her first visit to the Consultant she was told his fees were 2k and that the VHI would cover 255 of this. Thats the plan B amount. However, as I am on Plan B Options this would actually be 385.
However, this is where it gets complicated for me as well. In work, we are being switched over to Family Plan plus effective May 1st. On this plan the VHI pay 650 towards pre/post natal consultant visits. My wife is due in August. Now she hasn't paid anything yet but it was strongly hinted to her that she should pay the full 2k on her next visit, which is first week of May.

Now first off I don't know if the consultant bills the VHI direct and that we pay the balance, or that we pay the full 2k and look to claim money back. From being on the phone to the VHI I think we are entitled to the 650 amount as opposed to the 385 as there is no waiting period for this.

However, the girl also said that there was an increase from 1600 to 2000 towards the cost of hospital cost if you were in a private hospital having the
baby but she indicated to me that my wife would not be eligible for the higher 2000 allowance as this DID have a waiting period.

I hope that helps somewhat, and if anyone knows if you pay the consultant direct before claiming the money back or if you only pay you the lower amount and he claims the other part direct I'd appreciate that!!!
 
Well, we switched from BUPA (me on Essential New and herself on Essential Plus) to the work VHI scheme (Family Plan Plus). Any expenses incurred to date (€200 for a non routine scan and triple test) are not covered by either so any reclaimable expenses will only be incurred later on and the claim will be submitted to VHI. As far as I know there is no major difference between the cover available under the two plans.

On a related point - we were never asked or billed by the hospital for the [broken link removed] that we expected to be levied. Is this unusual?
 
Re: Welcome to the parents club

We haven't received a bill from the Rotunda yet but a notification from VHI came today itemising the charges arising and what was remitted by VHI directly to the hospital and the shortfall was €500. I don't have the detailed breakdown to hand so I can't say specifically what this related to. To date we have not paid anything to the hospital other than €200 for the scan and triple test mentioned above which were not covered under the public health service or by our insurer.
 
Oh - as it turns out the shortfall of €500 is irrelevant - the charge in question for obstetrician was about €913 and VHI paid €413 but because the Rotunda deals directly with VHI on these charges the lower benefit paid out is taken as full payment for the services rendered. This means that there are no outstanding in-patient charges that we have to cover. We will presumably be billed separately for ante-natal semi private care by the Rotunda which, I believe, is not covered but qualifies for tax relief.
 
So - the latest installment. In spite of what I posted above it turns out that the Rotunda (for the second time in three years) sent us effectively final notice demand for the outstanding €500 and berating us for not having paid this on admission (as I mentioned before) in spite of the fact that (a) nobody ever asked us for this at any stage over the pregnancy (b) we were never invoiced by the hospital (as opposed to being notified by VHI) for any charges relating to the pregnancy (c) when we left the hospital after the delivery stay I specifically asked if we owed anything and was told that we didn't and that the VHI form would cover everything and (d) the charges listed on the invoice do not match those displayed on their website. We had nothing but praise for the actual care that we received in the hospital over the pregnancy but based on this second dodgy invoicing experience with them their patients' accounts department don't seem to know what they're doing. We are perfectly willing to discharge our liabilities with them but only on the basis of being invoiced properly for the relevant charges and not being blamed for their incompetence in not collecting this charge earlier. We have made a formal complaint (as we did the last time only to be told that the invoicing mistake - a letter threatening legal action even though we had not been invoiced that time either and all the charges had been paid by BUPA anyway - was an aberration made under mitigating circumstances) to the hospital again.
 
Someone I know opted for public care ... for the first 7 months or so ... and then upgraded and become a private patient closer to term.
The only advise I can give is try to use a maternity hospital rather than a private hospital for the best standard of care. It makes sense that the more births a hospital has, the better equipped they will be to opt for eventualities. I speak from experience having had one child in Mt. Carmel, my second was born in the Coombe. Also if you opt for a private hospital you will be eligible to pay all fees for ultrasounds, blood test etc.
 
Hi,

Congratulations! I'm not answering your questions above but for any first timers the following points are of interest:

It may be a long way off yet but don't forget to call your health insurer when babs arrives as even though they claim babs is covered until next renewal date, they will not accept any claims for babs unless he/she is named on the policy at the time of the expense. (Typically you would incur a 75 euro charge for a private paediatric check-up after six weeks).

Also please note that even if you are going privately it is still well worth considering going down the combined care route with your local doctor. This is especially useful AFTER babs is born because babs and mother have six weeks of free care with the local doctor and that can be especially useful if you live a long way off from the maternity hospital (which also covers babs and mother for six weeks).

L.
 
For some reason we have still not heard back from them since the Complaints Manager acknowleged our complaint (actually complaints - since we had another about being surreptituously and presumptuously being registered as "Roman Catholic" on admission without being asked) in December but the ball is in their court and they need to issue a proper invoice (not a hand scrawled bit of paper) before we pay the €500 that we presume that we owe them. If they don't get back to us then we will not be volunteering to pay this charge.

As I mentioned to somebody recently, in spite of all the problems that we hear about with the health service, I/we have had no problems with the medical care side of things in the past decade or so but the administrative/billing side of things seems to be a bit chaotic...
 

A friend of mine was attending the Rotunda as a semi private patient on her second pregnancy and had paid her €500 deposit. Unfortunatly she suffered a miscarriage.

As she was waiting to see the doctor a week later (for whatever procedure is necessary in these circumstances), someone from accounts came to her and asked if she wanted a refund of the €500 or should they hold onto it for her next baby ...talk about insensitive ..so nothing would surprise me about their admin system.
 
Wow - that's pretty insensitive alright. I'll keep you posted on our issue..
 
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