Private health insurance – stay or go?

Private coverage generally offers faster access to care

WITH the cost of health insurance expected to rise yet again following changes to hospital charges, the question on most people’s minds will be whether they should keep paying for private health insurance or leave the system altogether.

If the cost of private health insurance rises by half of what some experts predict, it will result in premiums approaching  levels that many families may have difficulty affording.

An inevitable reaction of some will be to drop cover completely. However, doing so will create a financial risk. For example, if one has a heart attack, a stroke, or is involved in a car accident and are taken to hospital, the cumulative overnight stay costs could result in a bill they would be unable to pay. Generally, this should cost less than €1,000, but for families that are already struggling financially, this could be cost that is too great for them.

There is also a question of the cost of surgeries where bills can run to vast amounts. So, before hitting the ‘cancel’ button on a private health insurance policy, here are some of the primary considerations.

Could certain hospitals ever make a difference to you?

Some private medical facilities will be out-of-bounds for non-private healthcare citizens. Many of the private health facilities have particular levels of medical expertise that may not be available through the public system. One needs to consider this when evaluating if they want to fork out €2,000 to €4,000 for private health insurance. Private health insurance gives access to more hospitals and to more treatments, which can significantly reduce waiting times for certain procedures.

Consultants — can’t you still see them?

The simple answer is yes. However, there is strong evidence that having private health insurance can speed up access to consultants if and when there is an emergency.

So, while not having private health insurance should not act as a barrier to actually seeing a consultant, it can delay access and when it comes to important issues or serious illness, speed can make all the difference.

How much could see a consultant cost?

Good question. This really depends on a few things, primarily ailment and the consultant one sees.

Even with some of the more expensive health insurance options, one may still be required to pay to see a consultant privately for the first time. And many policies carry excesses with charges for each visit.

What if I am diagnosed with a serious illness?

While it does not cost that much (and we’re talking relatively, here) to see a consultant privately on a once-off basis, ongoing visits will add up. A pacemaker can cost €30,000 or more, once all of the hospital, surgery, consultant and actual pacemaker fees are added in. Such prices are clearly beyond the majority of people without health insurance.

What if I develop a serious illness without private health insurance?

You would still be treated through the public system.

What if I am diagnosed with a serious but non-life threatening condition and I do not have private health insurance?

This is where things can get a little bit sticky. If you are diagnosed with a relatively minor condition — anything from a blocked artery to a non functioning hip  and go onto a public hospital waiting list, it could be a very long time before you get treatment or see a consultant. Under the private health insurance option there is generally faster access to hospitals and consultants and treatments.

Should I have health insurance at least for my children?

There is no private hospital for children in the state. Children can be seen by private consultants at a cost, the actual hospital care is done through the public health system. So, it is worth having some cover for them but is unnecessary to have them covered under the most expensive policies, because they will be treated in the public system.

Many schools also offer some level of insurance for students and while it may not cover all that private health insurance does, it can offer a low-cost level of protection for a range of ailments. Costs for this programme can be less than €20 per annum.

Finally, it is also important that families keep other critical insurance protections, especially life protection/serious illness. Also, with rising cost of cigarettes, there has never been a better time to quit, this will reduce life protection costs by 20%-30%, save users at least €3,000 per year, resulting in better health all around. Maybe those savings could be used for a far better lifestyle.

* Frank Conway is founder of the Irish Financial Review and CentSense, the youth financial literacy initiative.

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