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Patients get unexpected hospital bills as health cover fails to meet cost

THOUSANDS of people who end up in hospital are being billed for costly medical procedures despite having health insurance, it has emerged.

Consumers were warned yesterday to check with their health insurance provider before entering a hospital or face owing thousands of euro.

This is because more health plans have now restricted the illnesses they will cover, charge excesses, and only cover some private hospitals, Dermot Goode of healthinsurancesavings.ie said.

An excess is the amount an insured person has to pay themselves when they make a claim.

So many people are being hit with shortfalls on their health insurance cover that private hospitals have now started to screen people before they will admit them to ensure the hospital is not left with a bill it cannot recover from the insurer, Mr Goode said.

"Thousands of people are getting caught. They don't check beforehand and blindly fire ahead into a private hospital and assume they will be covered," he said.

And people are being given the wrong information by poorly informed insurance staff even if they do check whether they are fully covered, the health insurance expert said.

In the past people who had health cover were covered for all procedures. But now health insurers are cutting back on what they will cover in an effort to restrict premium rises. There are more than 200 different insurance plans, with a bewildering level of cover for each.

Mr Goode said that many mid-level plans -- like VHI's One Plus, Glo's Better plan and Aviva's Level 2 -- had a list of illnesses that are only partially covered if carried out in private hospitals.


These tend to include hip and eye operations, with shortfalls of €2,000 typical.

And people who have a corporate plan -- which are provided by their employer or bought by a family because it is cheaper with better benefits -- are starting to find that they end up having a shortfall.

In contrast, procedures in public hospitals tend to be fully covered for those with health cover, Mr Goode said.

Yesterday, VHI said its members should check with it before agreeing to have any procedure done in a private hospital.

"The true gauge of the value of a plan is whether or not it provides the cover that a customer needs. Lower priced plans cost less because they offer a more limited type of healthcare cover," the VHI said.

The news about the restrictions comes as Aviva became the latest to announce a hike in its premiums. They will go up by between 4pc and 7pc on October 15, in a move that will cost families an extra €100 a year.

Across the market, premiums have risen by around 50pc in the past 18 months. It now costs a family around €2,000 for health cover.

Irish Independent