Medical card holders and private medical insurance

[flakie]

I have recently become aware that people with chronic illness are at a severe disadvantage when it comes to private medical insurance --

if they move up in income to the point where they can no longer avail of the medical card, they are then requiring private medical insurance, which as standard has a few years qualifying time before they compensate for a "pre-existing" condition.

Shouldn't the medical card be considered a form of medical insurance for these purposes? For instance, if you move from VHI to BUPA traditionally, they will waive the qualifying period because you've been previously insured.

This is a horrible state to be caught in -- are there any parties out there who will be fighting this particular obstacle in the way of people with chronic or long-term illness?

[Paraic]

I have recently become aware that people with chronic illness are at a severe disadvantage when it comes to private medical insurance --

if they move up in income to the point where they can no longer avail of the medical card, they are then requiring private medical insurance, which as standard has a few years qualifying time before they compensate for a "pre-existing" condition.

It's probably tangential to the point you're making, but there is a separate Long Term Illness Scheme for people with certain qualifying chronic illnesses. I believe this would cover some people in the circumstances you're describing, but only for medicines and appliances, not for doctors' visits.

See

http://www.dohc.ie/public/informatio...ss_scheme.html

Paraic

[Ronanr]

It strikes me that the whole system of the medical card, assistance for people with long term conditions, etc is not very well streamlined.

People whose rising income happily puts them outside the medical card income limit have the problem Flakie describes, people with long term illnesses have difficulty dealing with the bureacracy, and this new "GP only" medical card means that people on fairly low incomes will then have to pay for the mecicines they are prescribed when they visit the docter.

I know of somebody who is on a low wage. He has a medical condition that requires him to take a particular medication. His condition is very manageable if he takes his medication, but the monthly cost of it was about 130 Euro per month.

He has the Drugs Payment Scheme card which entitles you to a refund of purchases of medicines over a certain level per month.(I think it was 78 Euro per month up to yesterday, 85 Euro per month from now on)

He was not eligible for a medical card previously. His situation is that he has to visit his GP about four times a year to get checked up and to get his prescription renewed.

So previously his expenses were 30 Euro (I know thats cheap for a GP visit) four times a year for the docter (total 120 Euro per annum) and 78 Euro per month for medicine (936 Euro per year).

Now he will be eligible for one of these new "yellow -pack" medical cards. This means that he will be no longer have to pay for his doctors visits.(saving him 120 Euro a year).

However, the change in the Drugs Payment Scheme limits mean that he will have to pay an extra 84 Euro per annum (total 1020)for his medication.

He feels rather bitter about it - What the right hand gives the left hand...and all that

[Edited on 1/1/2005 by Ronanr]

[Edited on 1/1/2005 by Ronanr]

[Ronanr]

I know perhaps he should be grateful for what he does get, but it strikes me that his situation is probably common with people who have long term medical conditions or who have a child that has one.

This new medical card put such people (usually people who are employed in a low-wage job - the unemployed already have the full medical card) in a particularly difficult position - the less expensive part of their medical expenses will be covered by the medical card, the more financially onerous bit will not.

Then it suddenly struck me (as yer one from Nighthawks used to say), perhaps it would be better if the government reversed the entitlement of the new type of medical card.Instead of people getting their GP visits paid for with the card, they should have to pay for the GP visits, but the prescriptions should be free.

This would not be a huge burden to the people who get the new cards and who are basically healthy - they will probably only visit the doctor once or twice a year anyway, and although they will have to pay for that the type of people who are eligible for the new cards are not totally destitute remember.

However, those who HAVE a long term condition or are in bad health regularly will probably benefit more, as their pharmaceutical expenses are probably more than their medical ones (on average).

What do people think?



[Edited on 1/1/2005 by Ronanr]

[Ronanr]

I am having quite an interesting conversation with myself here!


A revealing book review in the 'New Republic' online reminded me that things could be worse.

It was a review of "Uninsured in America: Life and Death in the Land of Opportunity" (By Susan Starr Sered and Rushika Fernandopulle)


It deals with the difficult lives faced by those in America who cannot afford health insurance and do not have the money to pay for medical or dental care when they need it.

They interviewed more than 120 uninsured Americans in Texas, Mississippi, Idaho, Illinois, and Massachusetts as well as physicians, administrators, and health-policy officials. The result is a collection of heartrending stories of the "caste of the ill, the infirm, and the marginally employed"

A quote from the review:

"As one uninsured woman who works part-time in a call center tells them: "I've gotten toothaches so bad, so that I just literally pull my own teeth. They'll break off after a while, and then you just grab ahold of them, and they work their way out ... The hole closes itself up anyway." As the insured reader guiltily and involuntarily runs his tongue over his teeth upon reading these lines, the authors' caste argument essentially proves itself.

And there's plenty more where that came from, as the authors present through their subjects a laundry list of ominous examples of untreated suffering, ranging from gallbladder disease to diabetes to asthma, addressed alternately by hopeful neglect and homemade cocktails of alcohol and over-the-counter pain medication--or in the harrowing case of an Idaho man with recurring bone spurs in his feet, a power sander."