IN A CAR accident, broken your arm or have a dodgy mole that needs removing, but not sure what it will cost you?
With the help of Dermot Goode General Manager of Cornmarket Healthcare Division, TheJournal.ie breaks down how you can access the system and tells you what it will cost you.
Do I have to pay?
There are two ways of accessing healthcare services in Ireland, either as a public or private patient.
Every Irish citizen or person who is ordinarily resident in the country has access to public hospital services, whether you have health insurance, a medical card or nothing at all.
However, the catch is that these services are not free and you may be subject to waiting times depending on your medical condition.
This can often be the case for certain orthopaedic procedures such as if you require surgery for a dodgy knee or hip.
I think I broke my ankle so I am going to go to the A&E – what will be the damage?
Unless you hold a medical card, you will be charged €100 for all treatment received in a public hospital accident and emergency room.
If you have already consulted your GP and you have a referral letter, then this charge will not apply.
Some health insurance policies give a contribution towards this A&E charge, but you will have to pay this up-front and claim your refund directly from your insurer at year end.
If this is not covered by your policy, then you may be able to claim standard tax relief on this expense as part of your annual tax return.
Uh oh, they think it might be serious so they are keeping me overnight, how much is this going to cost?
The bad news. You will have to pay €75 for each night in the public hospital. The good news is the amount is capped. You will only have to pay up to 10 nights in any 12 month period to the maximum of €750.
Health insurance companies urge consumers to take this into consideration when health insurance packages can start from €500 for an adult and less for a child.
Now the doctor says I’ll have to have surgery. Will I need to remortgage to pay for this!?
If you’re a public patient, you will be put on the appropriate list for that surgery and you will be contacted with a date for your treatment.
If going privately, you will be referred by your GP to a specialist who will arrange your treatment privately in line with the health insurance held. You will have to pay for all costs until such time as you’re admitted and your health insurance will take over at this stage.
I’ve been in a car accident and rushed to the emergency room. Is the hospital going to bill me?
This will be treated like any other emergency. All accident or emergency admissions will be brought to a public hospital A&E department. Unless you hold a medical card, you will be charged €100 which covers all tests carried out and treatment rendered.
I’ve found a strange looking mole on my body so I went to my GP and he is sending me to a dermatologist. Do I have to pay them?
Yes, you will have to pay your GP – about €50-€60 – and also the specialist he or she sends you too which could cost in the region of €150 – €250.
He thinks it should be removed, will you be billed for this?
Removal of a mole is a listed procedure, so you should contact your health insurer with the procedure code (the specialist will give this to you) and they will confirm your cover. Once it’s an approved procedure, then it will be covered by your insurance policy subject to the terms and conditions.
This will apply regardless of whether the minor surgery is performed in the specialist’s consultancy rooms or as a day-care patient in the private hospital.
Assuming you hold the correct cover and the consultant is registered with the insurer as ‘fully participating’, then you should be fully covered. Key rule is check all treatment in advance with the insurer.
If you don’t have insurance you will be given an appointment for the procedure under the public health system.
I presented to A&E and now they want to do more tests?
If you require additional tests such as x-rays, scans and blood tests and hospital treatment is deemed necessary, they will then admit you either to a public or private hospital as their private patient and either your health insurance will cover it or if you are going public you will have to pay the €75 per night, as specified previous.
I have been diagnosed with cancer (or another long term illness). What are my options?
If you are diagnosed with a serious illness the hospital will do everything it can to treat you as soon as possible. Whether you have health insurance or not, your case will be a priority.
If you want control over your treatment, health insurance will allow you to specify the hospital you want to attend, often the room you will be in and perhaps the consultant you would like to see and the treatment procedure you would like best.
If you are in the public system, a hospital and consultant will be assigned to you. Just like any other stay in hospital, you will pay the first €75 per night, capped at €750.
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