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Tuesday 25 July 2017

The 60-second guide to... private health insurance jargon

An excess is the first part of a claim you must pay for yourself
An excess is the first part of a claim you must pay for yourself

Excess: The first part of a claim you must pay for yourself. For example, if the excess on your policy is €250 - and you're claiming for €500 worth of medical bills - you'll typically only get €250 back from your insurer.

Inpatient cover: This is where your insurer covers all or part of the bills that arise from an overnight (or longer) stay in hospital.

Outpatient cover: This is cover for medical treatment that does not require an overnight stay in hospital.

Daycase surgery: Surgery which can be completed during the day - without the need for a patient to stay overnight in a hospital or clinic.

Day-to-day expenses: Medical expenses such as GP, dentist or physiotherapist visits. Some private health insurance plans cover a percentage of the cost of such expenses. Watch out for excesses here though. Some plans cover a certain amount of day-to-day expenses but the excess on the plan is so high that the value of refunds secured (if any) is small.

Co-payment: This occurs when you must cover a good chunk of the cost of certain procedures, such as orthopaedic procedures, because your insurer won't foot the entire cost of the surgery or procedure. The shortfall not covered by your insurer (and which you must pay for) is often as much as €2,000 per claim.

Waiting period: The length of time you must have health insurance before you can make a claim. These waiting periods can be longer than normal if you have a pre-existing medical condition.

Pre-existing medical condition: An illness, ailment or condition, which existed before you took out health insurance for the first time - or before you took out a policy following a break in cover of 13 weeks or more.

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