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Question of Finance: How comprehensive is my health insurance?

Q: My neighbour fell ill a couple of months back and had to spend some time in hospital.

While she was still convalescing at home, she received a phone call from her insurance company saying that, although she had health insurance, the full amount of her bill was not covered.

This resulted in a significant cost to her. I am now concerned about my own policy and I was wondering if there are certain things I should look out for?

A: You have seen first-hand how costly medical expenses can be and the anxiety that they can cause someone.

While it's good that you have a policy, I would advise you to check right away whether or not you are covered for the following -- and if not to amend your policy accordingly.

Depending on your locality, try to ensure you have cover for direct settlement magnetic resonance imaging (MRI) and CT (computerised axial tomography, CAT scan) scan centres.

This means you won't have to wait to get access and you don't need to pay if they are classified as 'direct settlement' centres.

Also, make sure your local hospitals are not excluded and don't have excesses applied to accommodation. Most people are not aware that cover for private accommodation in public hospitals, in most cases, does not guarantee fast access to treatment.

Have a plan with some access to private hospitals. You should also find out if you have cover for major cardiac procedures in the Blackrock Clinic, Mater Private and Beacon Hospitals.

Chemotherapy, radiotherapy and colonoscopies account for 60-70pc of all health insurance claims, so it's important you check that you have full cover for these day-case treatments in private hospitals.

  • Stuart Endall, health insurance manager at www.getcover.ie

Irish Independent