With Swiftcare now restricted, where can you bring your injuries?

It was convenient while it lasted, but families across the State will only have limited access to VHI Swiftcare clinics from September. Operating in Dundrum and Swords in Dublin, and Mahon, Cork, and previously open to all, the VHI has decided to restrict use of the clinics to its own members having taken full ownership of the clinics earlier this year.

A service first launched in 2005, it quickly grew in popularity, allowing people to access minor trauma and injury services. Last year some 84,000 people were treated at the insurer’s clinics, up 3 per cent on 2015, with turnover of almost €14 million in 2015, and pre-tax profit of almost €3 million.

Now, however, the service is only available to VHI customers. Good news for them as it means a significantly reduced number of people will be eligible to attend.

The insurer has also enhanced the benefits its members can enjoy when attending Swiftcare. From September 1st, all VHI customers of in-patient hospital plans will get some discount on the €125 fee charged at Swiftcare, and as it’s applied there and then, members won’t have to claim it back.

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The insurer has also introduced a cap on the amount that a member might end up paying for various tests etc. For example, someone on a cheaper plan, such as One Plan Starter, may end up paying €50 for their Swiftcare consultation, while all further expenses will be capped at €150. On a pricier HealthPlus Choice plan however, the consultation will be just €25, with a cap of €100.

But where should everyone else go if they don’t have an illness or injury that requires visiting their local A&E unit?

What are the other private A&E options?

Private A&Es have been growing in number in recent times. In Dublin, patients can attend the Mater Private, Blackrock Clinic, Beacon or Hermitage in Lucan, while outside the capital the Galway Clinic also operates such a service.

Last year the Mater Private opened a second A&E service in its Cork hospital, although it operates shorter opening hours than many others, while the Bon Secours has a medical assessment unit.

Another option is the minor injury clinics such as the St. John's Injury Unit in Limerick or the Mercy Injury Unit in Cork.

The Smithfield Rapid Injury Clinic in Dublin, for example, which is operated by the Mater Hospital, charges the same fees as emergency departments at the public hospitals but promises you "fast assessment and treatment". It only treats minor injuries, such as sprains and broken bones, but may be a good option for those who would have sought out the Swiftcare clinics for such injuries previously. However, it operates shorter opening hours than Swiftcare, and is closed at weekends.

More clinics on the way

And other clinics may be on the way. During the summer Affidea, which operates 12 clinics in Ireland, said it would invest €25 million over the next couple of years as it looks to compete with the VHI and broaden the range of services in its clinics. It's possible that it may also do this in conjunction with a health insurer, such as Irish Life or Laya, and offer a similar service to the VHI. Indeed, according to a spokeswoman for Laya, the health insurer says it is "confident that our members will be able to access a new and improved network of rapid-access injury and minor illnesses clinics in early 2018".

A major plus of the Swiftcare model is that it treats babies as young as 12 months – although, depending on the illness or injury, many anxious parents still find themselves dispatched to the nearest public children’s hospital on arrival.

Nonetheless finding a private A&E offering a similar age cohort will be challenging.

Most private hospitals will only treat teenagers. Blackrock Clinic, for example, will only treat children over the age of 16, while at the Mater Private the age limit is also 16, as it is at Smithfield and the Hermitage. Children between the ages of five and 16 can be treated for minor injuries only at the Galway clinic.

How restrictive are the opening hours?

When it comes to opening hours, it’s hard to beat Swiftcare, which is open from 8am-10pm 365 days of the year. Most private A&Es operate closer to normal working hours, and so may not be as convenient.

The Galway Clinic, for example, opens from 10am-6pm Monday-Friday, and closes a little earlier at 5pm. on weekends and bank holidays. The Mater’s rapid injury clinic is only open from 8am-6pm weekdays.

How much do they cost?

If you opt for a private A&E it’s most likely going to cost you.

"People need to be careful," warns Dermot Goode of Total Health Cover. "If you have a fracture, you go to Beaumont, pay €100 – and you could be there for 12 hours – but it covers everything."

At a private A&E, on the other hand, you’ll be charged for everything.

Typically, you’ll pay €140-€150 to access a private A&E, or less if it’s Smithfield Rapid Injury or Swiftcare. But that is only the first charge you’ll encounter.

This charge only covers the registration fee; thereafter you'll have to pay for every test that is required. And these can add up. An X-ray, for example, costs €120 at Beacon Hospital in Dublin, while a CT scan is €250 at the Mater Private.

However, the good news is that these expenses are typically capped. Blackrock Clinic ,for example, operates a cap, whereby those attending won’t have to pay more than €500 for their visit. However, this cap does exclude certain procedures, such as referral to a specialist consultant, cardiac MRI and cardiac CT.

What can I claim back with an insurance policy?

Given the costs, if you have private health insurance, you may be keen to learn what you will be entitled to get back. Goode suggests you ring your insurer now and have a plan in place should you need to rush to an A&E.

“Be very careful before you walk through, Make sure you have cover in place to cover those expenses,” he advises.

You may be entitled to a reimbursement of some of the private A&E charge depending on the terms of your insurance policy. With Laya Healthcare, for example, most members will be entitled to claim back between 50-75 per cent of this registration fee, although an excess might first apply, depending on the plan.

Similarly, the cost of additional tests and X-rays etc can be submitted as an outpatient expense with the insurer, while MRIs/CAT scans etc may be covered in full depending on the terms of your policy.

“You’re never fully covered in a private A&E no matter what plan you have,” warns Goode, but notes that you should get “roughly 50 per cent back” via your outpatient expenses. Certain expenses such as “fracture boots, sutures, dressings” will not be covered.

As such, he recommends that when attending a private A&E, you get an itemised receipt to ensure you can claim back as much as you can.

Remember, however, if you have an excess on outpatient expenses on your plan and you haven’t met it, you may not be able to claim anything back. Again, this should form part of your initial consideration as to whether or not a private A&E is for you.

Another important consideration to make is what happens if you need to be admitted? If you don’t have cover for a private or so-called “high tech” hospital, you might find yourself back out on the street needing to be readmitted to a public hospital via its A&E.

According to Laya Healthcare, more than 90 per cent of its schemes provide some level of cover for private hospitals, although this will obviously differ depending on the cost of your plan. Essential Connect Family, for example, offers a once-off family excess of €300 for inpatient cover in a private hospital.

The other option if you don’t have insurance or adequate cover is to pay for it yourself.

At the Beacon Hospital, for example, you can now request the price of an operation or procedure on a self-pay basis. General day-case surgeries cost from €995, while it has package prices for a procedure such as a hip replacement (€14,000).

Remember, you can also claim tax relief on all medical expenses which are not reimbursed by an insurer via your Med 1 form at a rate of 20 per cent.