Can your wallet afford a private emergency?

WITH PUBLIC emergency facilities closing down around the State, and waiting times continuing to increase in the ones that remain open, opting for a private alternative seems like an increasingly attractive option.

However, while waiting times may be much quicker, depending on your complaint – and the size of your wallet – you may find your best option is to stick with the service offered by your nearest public hospital. So what do you need to know to help you decide?

DO I NEED A REFERRAL?

Just like in your local public hospital, you won’t need a referral letter from your GP to attend, but can show up on a walk-in basis. Alternatively, you can be referred by your GP or be sent in a private ambulance.

Also, to cut down on waiting times many private emergency departments will allow you to phone in advance to arrange an appointment – provided, of course, your ailment isn’t urgent.

Most private facilities tend to be consultant-led, which means you will either see a consultant or have your case reviewed by a consultant. And best of all, they commit to a waiting time of one hour – indeed Blackrock Clinic boasts of an average waiting time of just 12 minutes.

There are a number of options. In Dublin you can consider an emergency department attached to a private hospital, such as The Beacon Hospital and the Blackrock Clinic in south Dublin, or the Hermitage in Lucan.

In the west, the Galway Clinic also has an emergency department.

Another option, depending on your problem, is to consider an urgent care centre such as those run by the VHI.

Its Swiftcare centres, in Dundrum and Swords in Dublin, and in Cork, treat a variety of minor illnesses and injuries, while the Mater Rapid Injury Clinic, in Dublin’s Smithfield, offers a similar service and is aligned with the Mater hospital.

HOW MUCH WILL IT COST ME?

Given that a trip to your local emergency department will set you back €100, you may find that opting for a private alternative won’t cost much more. At Blackrock Clinic, for example, the fee is €120, while Beacon Hospital charges €120.

However, if your GP refers you to the emergency department and you choose a public hospital, you won’t have to pay anything – but this discount doesn’t generally apply in private emergency departments. So, you will have to pay the consultation fee on top of the €50-€70 bill from your GP.

At the urgent care centres, you can expect more.

For example, the Mater Rapid Injury Clinic has no charge for patients with either medical cards or GP referral letters, while the VHI’s Swiftcare clinics charge a reduced fee of €65 for those with GP letters.

On top of the consultation fee comes charges for a host of other services. At the Beacon, for example, a blood test will cost €30-€60 and an X-ray from €120.

At the Blackrock Clinic, an X-ray is €95, laboratory tests go from €50 to a maximum of €250, while at the VHI’s Swiftcare clinics, an X-ray is €90, blood tests start at €30 and stitches are €60-€90.

And you may find there is even a charge for the smaller things. At the Beacon you will have to pay €20 for crutches, while a charge of €35 for changing a dressing applies at Blackrock.

However, private hospitals have made some concessions to the recession, and there is now a cap on costs in certain hospitals.

For example, at the Blackrock Clinic there is a cap of €500, which means that no matter what series of tests are ordered, the total won’t exceed this figure. At the Galway Clinic the cap is €495.

But be warned: if you are referred on to a specialist consultant, you will have to pay a charge of €150 – and this isn’t covered by the €500 cap.

And, if you have to come back for a review visit, be prepared to pay again. At the Beacon it will cost you €70, while Blackrock will charge you €100.

CAN I CLAIM ANYTHING BACK?

Depending on your plan, you might be able to get something back on the initial consultation fee. For example, if you are with the VHI and you see a GP or consultant at one of these facilities, you will be able to get €60 or €25 back, respectively, if you are on Family Plan Plus Level 1.

At its Swiftcare clinics, depending on your plan, you might get an immediate €75 reduction on the €125 fee – but this isn’t allowable on all VHI plans, so check first. And, you can also claim back on radiology and pathology expenses – for example, on the aforementioned family plan you could get 50 per cent back on tests costing up to €300.

With Quinn, the cost of the consultation and related tests is charged as an out-patient expense, so, depending on your plan, you could get 50 per cent back, up to €50.

Aviva does not offer money back on emergency facilities at private hospitals, but if you have a day-to-day plan you can get a contribution towards the cost of Swiftcare centres.

However, be warned that an excess on such expenses may apply, which means the contribution from your insurer only kicks in once you have paid a certain amount first – so check this from the outset. For example, with Aviva you can claim for radiology and pathology expenses, but these are subject to €150 individual or €250 family excess on the majority of plans.

Finally, remember that any expenses you have incurred and have not been reimbursed are eligible for a tax rebate of 20 per cent. You can apply for this by filing your Med 1 form with the Revenue Commissioners.

WHEN IS IT BEST TO GO TO PUBLIC EMERGENCY DEPARTMENTS?

Private hospitals do not offer as wide a range of care as public hospitals so, depending on your complaint, it may be best to prepare yourself for a long wait and attend your local public hospital instead.

After all, you don’t want to attend one hospital only to be transferred to another.

Generally, private hospitals offer specialist care in cardiology, so will be able to treat patients complaining of heart issues, as well as other ailments such as respiratory conditions or gastrointestinal conditions.

Urgent care clinics, such as those offered by the Mater and VHI, are best used for minor traumas, wounds or limb injuries.

Swiftcare clinics don’t cover serious medical emergencies such as chest pain, breathing difficulties, loss of consciousness or severe burns.

Similarly, private emergency clinics usually don’t treat patients with acute psychiatric conditions or pregnant women.

WILL PRIVATE EMERGENCY DEPARTMENTS TREAT CHILDREN?

Unfortunately, given the urgency with which most parents would like to see their offspring treated, most private emergency departments will not treat young children.

While the Galway Clinic will see children older than four, at Blackrock the limit is 14 , while at the Beacon and the Mater’s injury clinic, children under 16 will not be seen. At VHI’s Swiftcare clinics, children over the age of 12 months will be seen.

WHAT HAPPENS IF I’M ADMITTED TO HOSPITAL?

Unless you have private health insurance that covers treatment in the hospital attached to your private emergency department of choice, the wiser option might be to attend a public hospital alternative.

If you do, however, depending on your plan, you could be covered for everything apart from the initial consultation fee.

Under the VHI’s Family Plan Plus Level 1, for example, you will be entitled to a semi-private room in a private hospital, other than the Mater Private and Blackrock Clinic.

With Aviva, if you have a Level 2 type plan you will get a semi-private room in a private hospital, while Quinn offers similar cover under its Essential Health plan.