Friday 30 September 2016

The scary health bills facing Irish women

Life-saving cancer treatment could cost an Irish woman more than €80,000

Published 17/07/2016 | 02:30

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Irish women are facing bills running into the hundreds of thousands for life-saving medical treatment. Even stints in hospital for the less serious health problems typically encountered by women could easily cost tens of thousands in this country. Furthermore, while private health insurance can be a big help if you want to be treated privately and quickly, even this is no guarantee that you won't be hit with a scary hospital bill. So what are the typical health problems that land Irish women in hospital - and what bills could they face should they have to pay their own way?

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Breast and skin cancer: €80,000 plus

Breast and skin cancer are among the most common cancers suffered by Irish women. The cost of cancer treatment can run into the hundreds of thousands if you are being treated as a private patient. For example, the bill for Ipilimumab - a new cancer drug which has been described as life-saving - could easily run over €80,000. "A single dose of the drug Ipilimumab (Yervoy) is about €20,000 and a patient would need at least four doses in a course of treatment," says Simon Nugent, CEO of the Private Hospitals Association.

Although most insurers cover Ipilimumab, your insurer may only cover it in certain circumstances. For example, VHI provides cover for Ipilimumab "for the treatment of advanced (unresectable or metastatic) melanoma in adults - subject to prior approval". Laya covers the drug on a case-by-case basis. Aviva, which has previously refused to cover Ipilimumab, now does so "provided the drug is being used within the terms of its license".

Having a baby: Up to €11,000

You could face a bill of €11,000 or more to have a baby - if you don't have private health insurance and want to attend hospital as a private patient. This is largely due to the consultant fees and accommodation costs you will be hit with.

Expect to pay consultant fees of €2,000 to €6,000 as a private patient - and of €1,000 to €2,000 as a semi-private patient, advises Barbara Sheahan, head of health and dental at the Kindlon Insurance Group.

On top of this, you must pay for hospital accommodation. An overnight stay alone in a private room costs €1,000; a night in a semi-private room costs €813. As a woman will typically stay in hospital for between two and three nights after a standard delivery, the least that a private patient can expect to pay for accommodation after having a baby is between €2,000 and €3,000. The least a semi-private patient will pay is between €1,626 and €2,439.

Your accommodation bill will be even more expensive if you have a Caesarean section - as women often stay in hospital for five nights after this procedure. A private patient could therefore easily face a €5,000 bill for accommodation after having a C-section. So between consultant fees and accommodation, a C-section could cost a patient up to €11,000.

There are also additional charges for the delivery itself. A normal delivery for a private patient in a Dublin hospital usually costs around €300. These fees are typically covered by your private health insurance - but you will have to foot the bill yourself should you not have health cover and decide to be treated privately or semi-privately.

Even if you have private health cover, you could still have to pay a few grand on top of your insurance for your maternity care. Semi-private patients attending Dublin's Rotunda Hospital for example must pay either €1,100 or €1,800, depending on whether their care is consultant-led or not.

Before going into hospital to have your baby, ask your private health insurer if you are fully covered for a semi-private or private room - and to what extent consultant fees are covered. If you have only recently signed up to private health insurance, you may not yet have served the 52-week waiting period for maternity care and so you won't be covered.

You can avoid all of these costs by having your baby as a public patient. "If you choose to go publicly, maternity care is fully funded by the State," says Sheahan. "This includes GP appointments, pre-natal appointments and ultrasounds. You will be in a public ward in a public hospital when having your baby. You cannot opt for a private room at the time of birth if you are a public patient all along."

However, public patients usually have to wait longer than semi-private or private patients for hospital appointments - and their appointment times may be restricted to certain days and times. (Private patients usually have a choice of days and times). Public patients are also less likely than private patients to be seen by the same doctor at each antenatal visit and for their delivery.

Incontinence: €4,500

Many women suffer from urinary incontinence problems after childbirth. There are a number of treatments for such problems, including a surgical implant known as urethral sling. This procedure is covered by private health insurers, according to Sheahan - though of course, this will depend on your plan.

There is also a new laser treatment for urinary incontinence. "This is not yet covered by any of the health insurance providers - nor will it likely be for a number of years," says Sheahan. This laser treatment typically costs €1,900 a go, according to Sheahan. Three treatments are usually recommended - and offered for €4,500.

IVF: €40,000

Many couples go down the in vitro fertilisation (IVF) route when they're struggling to conceive. You could face a bill of €40,000 or more should you try to have a baby through IVF and even after paying this, there is no guarantee that you will have a baby.

"The average cost of a round of IVF is €5,000 to €10,000," says Sheahan. "The average number of treatments per couple is four so a couple could face bills up to €40,000."

Your private health insurance (should you have it) will offer little if any cover for IVF.

"The cover offered for IVF under private health insurance is very limited and it is only available from some insurers under certain plans," says Sheahan. "The best plan on the market for IVF treatment is Glo Health's Best Ultimate Cash II. The most you can claim back on this plan for IVF treatment is €2,000 - and this can be claimed twice per lifetime."

Bad knee: €19,000

Women often suffer with weak knees - particularly in old age. It could cost €19,000 to get a knee replaced.

Problems with the lower back and hips are also common. A discectomy is a type of surgery that you may undergo if you have back problems. It involves the removal of the whole or a part of an inter-vertebral disc. "It can cost anything from €5,000 to €15,000 for a discectomy - sometimes more," says Dermot Goode, health insurance expert with totalhealthcover.ie. It could cost between €12,000 and €15,000 to get a hip replaced.

Most insurers have co-payments on orthopaedic procedures, which means they won't foot the entire cost of such surgery - leaving you to cough up a few thousand euro. Many VHI plans for example have a co-payment of 20pc on certain orthopaedic and ophthalmic procedures when they are carried out in a private hospital. This means you must foot a fifth of the cost of such surgery yourself.

Many Glo Health and Aviva plans have a co-payment of €2,000 for certain orthopaedic procedures in private hospitals - which means you must pay up to €2,000 towards the cost of such surgery. Laya is the only health insurer in Ireland which has no co-payments.

Boob job: €5,000 plus

The cost of breast enlargement surgery could run to several thousand euro or more - and the least you can expect to pay is around €5,000. As private health insurance typically won't cover such surgery, you will need to foot the bill for yourself. Breast reduction surgery is treated differently however. "Breast reductions are covered by each of the four private health insurers," says Sheahan. "This is subject to pre-approval and a substantial amount of clinical indicators must be met - for example, a Body Mass Index of under 25 is usually a condition."

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