Sunday 30 April 2017

Your Questions: Can we get insurance for herbal medicine?

Does private health insurance typically cover herbal medicine? (Stock picture)
Does private health insurance typically cover herbal medicine? (Stock picture)

Barbara Sheahan Head of health insurance with healthinsurancehelp.ie

Our baby daughter suffers from eczema. Doctors have advised us to use steroid creams to treat the condition. My husband and I are very wary of using the creams on our daughter's skin when she is so young. We have recently started to use herbal medicine to treat her eczema.

If our daughter's eczema turns into a lifelong condition, we want to make sure we are on a private health insurance plan that offers good cover for herbal medicine. Does private health insurance typically cover herbal medicine?

Aine, Ashbourne, Co Meath

Irish Life Health is the only private health insurer which offers money back on herbal medicines. It provides cover for 'alternative medicines' on several of its day-to-day plans. Health Plan 13 is a competitively-priced plan for children, costing €373.90 per annum. With Health Plan 13, you can claim back €35 of the cost of a visit to a medical herbalist - up to a maximum of seven visits a year.

Another good option is 'Be Fit 3'. This plan costs €471.40 a year for a child under the age of 18. With this plan, you can claim back €40 of the cost of a visit to an alternative medicines practitioner (such as a medical herbalist) - up to a maximum of seven visits a year.

Ways to pay hip consultant

I have a hip problem and have been seeing a consultant for treatment. I am called back to see him every two months to see if my hip problems are any better - sometimes I am called to my consultant's private rooms and other times, I am called to the public clinic. For some time, I had never been asked for a fee but recently, my consultant has asked me to pay €100 to see him in his private rooms. I am a pensioner on social welfare so I don't have much money. I have private health insurance - but it doesn't cover consultant fees. Are there any private health insurance plans which fully cover consultant fees?

Tom, Blanchardstown, Dublin 15

While there is no plan on the market that fully covers all consultant fees, there are many plans which cover a certain amount of consultant fees. You don't necessarily have to move providers either.

VHI's PMI 25 11 plan costs €1,586.06 and it offers €100 back per consultant visit - up to a maximum of 12 visits per annum. The inpatient cover (cover for overnight stays in hospitals) is very strong on this plan also. However, this plan has restricted cover for a list of 22 orthopaedic and ophthalmic procedures in private hospitals. A hip replacement is on this list of 22 procedures so if you are in need of a hip replacement and intend on going privately, this plan only offers 80pc cover, leaving you to foot 20pc of the bill.

Irish Life Health's Be Fit 3 plan costs €1,495.70. It gives a full refund on the first two consultant visits over the year - and a 50pc refund on all subsequent visits. Be Fit 3 also has restricted cover on certain orthopaedic procedures when carried out in a private hospital. There is a €2,000 co-payment applied on these procedures - which means you must pay €2,000 towards the bill.

Laya Healthcare's Complete Simplicity plan costs €1,433.72 and offers 50pc back on consultant fees. While there is no shortfall on orthopaedic cover on this plan, there is a shortfall on the cover for overnight hospital stays if getting certain 'special procedures' in the Blackrock Clinic and The Mater Private.

Claiming tax relief on course

My private health insurance covers some of the cost of an antenatal course which I attended before I had my baby. I sent the receipt for that antenatal course into my insurer when making a claim for maternity benefit. I asked my insurer to send the receipt back to me once it had processed my maternity claim as I had been planning to claim tax relief on the portion of the bill which was not covered by my insurer. However, my insurer didn't send the receipt back and when I followed this up, my insurer told me that it discarded the receipt. Can I still claim tax relief on the portion of the antenatal bill not covered by my insurance?

Eimear, Bray, Co Wicklow

The Revenue Commissioners never asks for receipts when submitting a Med 1 form. However, you are told to hold on to receipts for up to six years after you make the claim in case they come looking for them.

In this case, if Revenue requested a receipt, you should contact your provider and request a 'Statement of Claims' - which would be sufficient for the Revenue.

Baby blues over hospital bill

I was admitted to hospital for observation the night before my baby was born. My waters broke early the next morning and our baby was delivered before lunchtime. I was in hospital for four nights in total. My insurer is only covering the three nights and I'm facing a big bill for the fourth night as a result. Do insurers typically only cover three nights' accommodation in hospital when you go in to have a baby?

Naomi, Naas, Co Kildare

This is an unusual case and I would need more information on your level of cover to understand why the claim is not being fully paid. Maternity cover is a minimum benefit and therefore should be covered on every policy regardless of the age or gender of the policy holder.

There are three maternity options in hospitals - public, semi-private and private. If you choose to go publicly, it is fully funded by the State. This includes GP appointments, pre-natal appointments and ultrasounds. You will be in a public ward in a public hospital and you cannot opt for a private room at the time of birth if you are a public patient all along. So even if you have private health insurance but choose to be treated publicly, you are not then entitled to a private room in a public hospital after you have given birth. So really it does not make a difference whether you have private health insurance or not should you choose to be a public patient.

Semi-private treatment is only available in Dublin hospitals. You would attend a consultant's team in a private clinic in a public hospital. You may have some of your appointments with your GP - an arrangement known as combined care. You may have a semi-private room but this is subject to availability. Most plans on the market cover the cost of the room (which is €813 per night) and the delivery. You would pay the consultant directly for your pre-and post-natal appointments. You may be able to redeem some money back on certain plans - this amount varies, depending on the plan.

If you choose to go privately in a public hospital, you will choose your own consultant and pay them directly.

Your appointments would all be with this consultant. You may avail of a private room in a public hospital but again this is subject to availability. Most plans cover the cost of the room (€1,000 per night) and the delivery.

If deemed medically necessary by a consultant for the hospital stay to be longer than the typical three-night stay, then the insurer should always cover this cost. Some reasons this wouldn't be paid is if you haven't served your maternity waiting period (which is 52 weeks) - or if you were placed in a private room and your policy only covers semi-private accommodation.

Barbara Sheahan is head of health insurance with healthinsurancehelp.ie

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Email your questions to lmcbride@independent.ie or write to 'Your Questions, Sunday Independent Business, 27-32 Talbot Street, Dublin 1'.

While we will endeavour to place your questions with the most appropriate expert for your query, this column is not intended to replace professional advice.

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