Health Insurance Why would I need health insurance?

I can certainly see the value of accessing private healthcare in certain circumstances (early consultations, scans, elective surgery) but I am undecided as to whether private health insurance is the best way to provide for such (uncertain) costs.

To give an example, if you knew that a 30 year old male would, on average, spend (say) €10,000 on such services during the balance of his lifetime, would it make financial sense to pay health insurance premiums of (say) €2,000 per annum? What if the premiums for the same cover rose to €10,000 per annum? Presumably there is a point at which the insurance simply becomes a bad deal (even if you can afford the premiums) but I have no sense as to where you would draw the line.
 
Sarenco said:
Presumably there is a point at which the insurance simply becomes a bad deal (even if you can afford the premiums) but I have no sense as to where you would draw the line.
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It is a tough call. I would not be critical of someone whose strategy to cover their medical risk is via this approach. It is not an approach I would be comfortable adopting or advocating.

I think the middle ground option would be to take a basic health insurance policy with high excess that will help with hospital situations, and to use the premium saving to build up a reserve fund to cover medical or other emergenices, including excesses on any medical treatments accessed.
That's the advice I would give to someone thinking of dropping medical insurance entirely.

Some people are more comfortable carrying higher and lower risk, and obviously whether you consider yourself in perfect health or have conditions is a big input into what you consider your level of risk to be.

If you rely only on an emergency fund with no insurance... Something to consider. The cost of medical treatment is rising faster than inflation, so your fund which may cover current expenses could fall short when needed.
 
confuseddotc said:
So, a few simple questions... (I think)

If I go to A&E with an emergency, they ask me for medical card or insurance. If I have neither, do they refuse to treat me?
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Nobody is refused at an A&E.

The AE fee is 100.

It's NIL if you have a letter from a GP referring you there.

It's also NIL if you have a med card.
 
From an article on The Journal about waiting times in the public system.
http://www.thejournal.ie/hse-waiting-times-1847351-Dec2014/

"27,000 people are currently on a list for a [MRI] scan, and there are major backlogs at St. Vincent’s University Hospital and the Mater in Dublin, with patients waiting more than a year for the test. The situation has reached critical levels at the Mid-Western Regional Hospital in Limerick where there are 2,000 waiting more than 2 years."
 
With the important changes in healthcare legislation only a few weeks away this whole question of whether health insurance is REALLY necessary is becoming more relevant.
Our family has never had health insurance and to this day our GP regularly assures us it isn't really necessary.
His thinking - and I tend to agree with him - is that in the event of an emergency or serious medical condition any patient would be treated anyway regardless of whether they had insurance or not.
For non-serious illnesses or complaints all private health insurance does is speed up waiting times for consultant appointments and MRI scans etc which you could easily pay for privately from the many thousands of euros you have saved over the years by not having health insurance.
A couple of years ago I needed a colonoscopy,MRI scan and in an unrelated procedure had to see a cardiologist - I paid for all these privately and they came the equivalent of one year's premium.
Like everything,I suppose,it's a gamble but almost everyone I know who has had health insurance for donkey's years has never had to use it.
And when they have there are so many exemptions and additional fees they've had to pay it has felt like a rip-off.
In many ways I feel it's the same argument with travel insurance although because it is so cheap in comparison it would appear foolish not to have it just in case.
I can't helping thinking there's going to be a big push in the next few weeks to get people to sign up to the really basic health insurance being offered but the reality is for €400 or so a year are you really going to get that much more than a glorified public health policy - and once you're in the net premiums will start hiking up fairly rapidly.
 
Yes but the trouble is you can pay for the scans, consultants etc but had you needed for example a bypass after your visit to the cardiologist then unless you had been saving serious money these past years it would be unaffordable, it's not the cost of the scans or tests that is the issue, it's any hospitalisation and/or operations needed subsequently. My father had a hip op lately, bill was over 40k, luckily he had insurance or how long would he have been waiting on the public list.
 
Monbretia said:
Yes but the trouble is you can pay for the scans, consultants etc but had you needed for example a bypass after your visit to the cardiologist then unless you had been saving serious money these past years it would be unaffordable, it's not the cost of the scans or tests that is the issue, it's any hospitalisation and/or operations needed subsequently. My father had a hip op lately, bill was over 40k, luckily he had insurance or how long would he have been waiting on the public list.
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Surely if not having the bypass would have been life-threatening it would be carried out anyway under the public health system ?
And statistically how many people require such large operations compared to the huge number of people paying health insurance.There are no people I know of in my generation who have ever required a major operation.
It's like paying extra health insurance to go into a room you share with one complete stranger rather than a ward full of complete strangers - you're still not getting privacy.
 
Wahaay said:
Surely if not having the bypass would have been life-threatening it would be carried out anyway under the public health system ?
And statistically how many people require such large operations compared to the huge number of people paying health insurance.There are few people I know of in my generation who have ever required a major operation.
It's like paying extra health insurance to go into a room you share with one complete stranger rather than a ward full of complete strangers - you're still not getting privacy.
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I have health insurance, and view it as "earthquake insurance".

The salient (and sad) point is that in circumstances where someone needs something like a colonoscopy and actually has bowel cancer, there's a good chance that they will die on a waiting list if they have no health insurance.

Heart attacks, leg breaks, etc - Every gets decent treatment. But niggles or niggles that are actually more than that - Having health insurance can save you.
 
Yes it would be carried out under the public system but how urgent it was would determine how quickly it would be carried out, one of my uncles waited so long for bypass surgery on the public system that by the time his turn came around his condition had deteriorated and he was unsuitable for it. Statistics are all well and fine but if I'm the unlucky one who needs the care I want the cover, I couldn't care less about private rooms or semi private or half the country in the same room as me but I want access to the care quickly.

It's all about how comfortable you are with risk, all insurance is based on that, life insurance/house insurance/car insurance (although it's illegal not to have that) but they are all taken out with the hope of never needing them and people who feel lucky can take a chance on not bothering with them. Personally I'm a bit of a pessimist so I have them all :)
 
The Sunday Business Post has an interesting article today (15 March 2015) that basically concludes that many low-cost health insurance policies are essentially worthless.

The article confirms that there are no separate lists in public hospitals for private policy holders, who will have to wait for an appointment and surgery like a public patient. in fact, the article goes further and states that private policyholders may actually find themselves at a disadvantage as public waiting list initiatives favour those without insurance.

Does anybody else think this is very troubling in the context of the current high-profile initiative to "encourage" (blackmail?) younger people to take out health insurance to subsidise their elders (aka lifetime community rating)?

Is this yet another example of an Irish regulator (in this case the Health Insurance Authority) being asleep at the wheel?
 
My wife and I stopped health insurance a couple of years ago as we were leaving the country. We returned last year and decided against renewing it. Thankfully we never needed to use the health insurance for the decade we were on it. We both feel that the current effort to force people into signing up by May 1st is a little underhanded. I rang and enquired about the basic package from Laya and the Sunday Business Post is spot on - there is no benefit re. waiting times in public hospitals. As a result, we 're going to give it a skip.
 
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Ireland can be strange place at times, but surely it can't be the case that the Minister and Regulator have embarked on a policy drive to incentivise a cohort of people that are least able to afford it to take out policies with private insurers that are essentially worthless, simply to subsidise older policyholders?

That can't be right - can it?:( I have always struggled to understand the economics of our healthcare system so I assume I'm missing something...
 
Sarenco said:
Ireland can be strange place at times, but surely it can't be the case that the Minister and Regulator have embarked on a policy drive to incentivise a cohort of people that are least able to afford it to take out policies with private insurers that are essentially worthless, simply to subsidise older policyholders?

That can't be right - can it?:( I have always struggled to understand the economics of our healthcare system so I assume I'm missing something...
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It's just another example of the 'old sow that eats her farrow'. Official Ireland has targeted the young disproportionately during the recession. The same has happened in the UK under the Tories. It's particularly galling to witness the 'young and dynamic' face of FG - which promised Universal Healthcare - acting in tandem with the health insurance industry to pressurise the negative equity demographic into paying for worthless policies to make the older and the least affected demographic's policies more affordable. Is it any wonder that young and educated people are leaving in their droves?
 
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If you pay Insurance, you will get to see the specialist, if you have a Medical Card you will get to see one of their understudies or Trainee.
 
roker said:
If you pay Insurance, you will get to see the specialist, if you have a Medical Card you will get to see one of their understudies or Trainee.
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I was admitted into the A&E of the Mercy Hospital in 2002 after being referred there by an out of hours GP service. I received the full battery of tests - colonoscopy etc. within a few days - and was under the care of the Consultant (not registrar) throughout. The only problem was that I had to wait on a trolley for a few days prior to receiving a hospital bed. I didn't have any health insurance at that stage. What inspired me to take out a policy was the trolley delay as opposed to the excellent care I received from the consultant.
 
epicaricacy said:
I was admitted into the A&E of the Mercy Hospital in 2002 after being referred there by an out of hours GP service. I received the full battery of tests - colonoscopy etc. within a few days - and was under the care of the Consultant (not registrar) throughout. The only problem was that I had to wait on a trolley for a few days prior to receiving a hospital bed. I didn't have any health insurance at that stage. What inspired me to take out a policy was the trolley delay as opposed to the excellent care I received from the consultant.
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That's an interesting point. Would you have been guaranteed (or pretty much guaranteed) a bed if you had a private policy that covered public hospitals only? Seems like a significant premium to pay for a piece of furniture but I am struggling to see what other possible benefits could arise under these policies - they certainly don't seem to provide faster access to a diagnosis or treatment (which I suspect is why the vast majority of people take out health insurance in the first place).
 
The Right Hook had a good piece this evening with a Consultant from the Mater on the subject of Health Insurance (he used to be on the board of VHI). Reckons there are 320 different plans and the amount of people that he sees who later find out that their policy doesn't cover them entirely is high.
Also that a lot of the yellow pack plans now being offered ahead of the deadline are not worth it- they'll have so much they won't cover you for.

He also went discussed waiting lists and how jumping higher up as a result of having health insurance is no longer possible, and hasn't really been happening in the past 2 to 3 years.
 
I've had health insurance for 20 years. First with VHI, then latterly with Aviva on the advice of a financial consultant. I don't know how bureaucratic Aviva is compared with other companies, but all my experience of having been ill has been with them. Baroque, Byzantine, and Kafkaesque is how I would describe them. When very ill, I wasn't up to gathering the paperwork for them at all. There is no allowance made that people claiming are necessarily sick. And being a single person I don't have anyone who could do this for me.

The next claim I made was for an amount in the region of €2200, various consultant visits (out-patients) and a couple of procedures. The reimbursement? €115. The difficulty was that I had seen a number of different consultants, rather than the same one and so there was a new excess each time. The fact that is was for the same problem made no difference.

Roll on to the present:
GP wants to refer me for a colonoscopy, so asks me to phone Aviva to find out what I'm covered for.

Aviva can't tell me because they need the name of the consultant, and the procedure code.

Back to the GP, she still can't write the letter as she doesn't know if the consultant is covered, and she also doesn't have a list of procedure codes for each health insurance company; but she can give me a list of consultants she would refer to.

Back to Aviva. They still can't give me the procedure code for a colonoscopy as they "aren't medically trained"!!! They can however tell me if the consultants are registered with them. All are. Some are "fully participating", some are "public only", some are "public, private and high technology hospital". I'm still not sure what "public only" means, I still don't know if I'm covered for a colonoscopy because I don't have the code.

I have to ring the consultants for the code. But it's now almost 7pm, and this has taken up a large part of my day, and away from the stuff I do daily in order to scrape together the €251 per month that I pay Aviva, so that they can do their damnedest to ensure I do not /cannot claim anything back.


So: why do I have health insurance?

I don't know.

If I had saved the 251 for the last 5 years (a total of €15,000), I'd have cheerfully paid up/gone public and still be quids in. Instead, I've torn out my hair, wasted my time and energy, made numerous phone calls to unfortunates in call centres, and been put under a lot of stress.
 
Trying to decide whether to take out private health insurance.I am 57 and my wife is 56. We dropped private health insurance over 21 years ago.I had to attend hospital once for blood transfusion via public system all free. If we both join before next week cheapest policy is working out at near €1000.We cannot claim in the first year as we would have 52 week waiting period.If we upgrade to a better policy later we would also have a further waiting period.We are both fit and healthy.I have ran 28 marathons, train daily and my wife walks every day. I know it still does not guarantee good health.We both do not care whether it is a public ward we end up in.Am I correct in saying that under the public system that the max that one is expected to pay in any 12 month period for a hospital stay is €750.Are operations extra on to this? I paid salary protection policy for 23 years .When I tried to get the insurance company to tell me how much money I had wasted they would not give me the figure.I guessed myself €14,000. So As we have saved on private health insurance over the last 21 years should we continue ? It seems that under the above quotes we got from some companies you are paying €1000 in the first year for nothing as you cannot make claim.If you decide to upgrade and get a decent policy you will have a further waiting period.Is this Fine Gael's notion of Universal Health coverage get everybody take out private health insurance and then exclude certain age groups for lenghts of time. Why do not private health insurance companies give one the option of undergoing rigorous medicals , join up then.What is the purpose of a 52 week waiting period. I go to great length to take care of my own health , diet, exercise and lifestyle .It seems Insurance companies are not interested in taking this into account.End of rant!
 
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