Monday 23 October 2017

Smart Consumer: How a tiny splinter taught me a really big financial lesson

Charlie Weston with his
wife Emer, daughters Gillian and Helen and
Monty the dog. Photo by Martin Maher
Charlie Weston with his wife Emer, daughters Gillian and Helen and Monty the dog. Photo by Martin Maher

Charlie Weston on his pricey stay at a private hospital

They say it is the small things that trip you up. Well, a little wooden splinter certainly grounded me -- forcing me to spend nine nights in hospital as well as knocking me back financially.

Sitting down for lunch one Friday I felt something jab my leg. The wooden seating seemed to have a splinter sticking out of it and it entered my leg.

The splinter would not budge. Over the weekend it failed to come to the surface, and by Sunday my leg began to swell up.

It was time to get medical attention. I decided on the expensive option of visiting a VHI SwiftCare clinic in Swords.

The doctor tried and failed to dislodge the splinter, and told me to come back the next day. "That will be €125," I was told.

By the time I went back the next day, my leg was starting to balloon."Get to a hospital now. You need antibiotics," I was told in the SwiftCare clinic.

I now had a choice: go to busy Beaumont Hospital, where I might be waiting eight hours in accident and emergency, or to an A&E in a private hospital.

I decided to ring my health insurer to see if I had the option on my health insurance of going to a private hospital.

I have a corporate plan -- available to everyone but marketed only to companies -- these plans are often cheaper than individual plans and frequently have better benefits.

The plan is Simply Health Excess with Laya (the company that used to be called Quinn Healthcare).

Once I finally got through to Laya Healthcare, I was told that there would be a €200 excess but that everything else should be covered.

So I went to the Beacon Hospital in Sandyford in Dublin.

Such is the confusion about health plans that the first thing they do in a private hospital these days is get the accounts staff to screen you to see what exactly you are covered for on your health plan.

"Yes, there is a €200 excess on your plan." I knew that.

"And an additional cost of €87.50 a night," the accounts staff in the Beacon Hospital told me. "And could we have two nights' fees upfront, please."

I was taken aback. But I decided that as I had yet to see any medical staff I would have a row with Laya later.

I stayed in the Beacon for nine nights, was pumped with antibiotics, and had three operations under general anaesthetic.

I had developed an infection in the leg from the splinter, a condition called cellulitis.

My little stay in hospital also involved an MRI scan, x-ray and an ultra-sound scan.

I shudder to think what all of this cost, but at least my insurance was covering most of it.

What is not covered is the €116 cost of filling a prescription when I finally got out of hospital, loss of earnings, and taxi trips -- no pressure was to be put on the leg for a while.

Soon after I got home, a bill for €612.50 arrived from the Beacon for the seven nights (at €87.50 a night) I had yet to pay for.

So the hospital was charging me €787.50 in total for my nine nights, a cost I had not been told about when I rang my insurer before going there.

I decided to confront Laya with my complaint. I kindly asked to speak to a supervisor.

"I made a decision in good faith to go to the Beacon private hospital based on duff information I got from your company," I explained in a calm voice.

The supervisor was helpful and mannerly. She looked at the file, consulted the recording of my call and said: "Yes, you did exactly what we always advise people to do. You checked with us first before going to hospital."

Laya agreed it got it wrong and said it would pay the €612.50 bill from the Beacon.

Yes, I write about health insurance in the Irish Independent, so Laya may have been careful to keep me onside.

But even if that was not the case, I feel I had a strong argument not to have to pay the €87.50 a night charge.

The whole experience was a valuable lesson. I have learned that even if you have health insurance, do not go near a private hospital unless you are sure your plan covers all costs associated with your procedure.

Charlie Weston is the personal finance editor

Irish Independent

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