Consumers will wonder if there’s a point to cover if they face charges

THE threat by a leading private hospital to force patients to pay up in situations where their insurer disputes the bill will make many wonder what is the point having health insurance.

The Blackrock Clinic says it may pass costs on to patients because health insurers are increasingly refusing to cover treatments. It has been alleged that insurers are challenging policies, pre-existing illnesses and lengths of stay in order to reduce claims costs.

This has raised the in frightening prospect of those with insurance footing the bill for a hospital visit.

Some of those bills could run to thousands of euro, a scenario that will scare the two million people with cover.

Health insurers argue that it is best practice for them to ensure they are not being invoiced for procedures they do not consider to be necessary, or for overlong stays in hospitals by their members. That also applies where the health cover someone has specifically rules out covering a pre-existing condition.

This ensures claims costs, and premiums, are kept down for everyone.

Part of the problem is that many health plans do not fully cover having procedures done in the likes of a high-tech facility like Blackrock. Sometimes there is a shortfall.

Patients considering using private hospitals are advised to ring up in advance of having a procedure done.

If the planned procedure is cleared by the insurer in advance then the cost is a matter between the insurer and the clinic.

Disputes between private hospitals and insurers can arise over lengths of stay, but if doctors deem a certain stay necessary, then that is hard luck for insurers.

Moves by private hospitals to try to land bills that have always been covered on those with insurance are unacceptable and will deter people from paying for health insurance.