Does our health insurance company cover the surgical removal of the child’s wisdom teeth?

Q My son has major problems with impacted wisdom teeth and needs to have them surgically removed. We have no additional dental insurance, but private health insurance. Does our health insurance company cover the costs for the surgical removal of wisdom teeth? Gerry, Co. Tipperary

A The cost your health insurance will cover will depend heavily on the type of policy you have, as coverage can vary widely. Wisdom tooth extraction is either performed by a dentist or surgically removed in a hospital – it is up to the dentist to decide which option is best. Some general dentists treat impacted wisdom teeth, but most do not.

If you decide to have a procedure, I would always recommend getting pre-approval from your health insurance company. There are three pieces of information you need to ask your provider. These are: the name of the specialist performing the procedure, the procedure code (a code typically used to identify surgical or medical procedures), and the name of the hospital you are attending.

There are several procedure codes for the removal of wisdom teeth depending on the position and impact.

Most Tier 2 plans – which cover semi-private rooms in private hospitals – cover all private hospitals, but in recent years certain plans have excluded some private hospitals, so it’s important to be insured for the hospital before visiting.

Coverage for HRT or visits to a menopause clinic

Q Does one of the private health insurance companies provide coverage for hormone replacement therapy – or visits to a menopause clinic, such as B. The Menopause Hub? I am now in my forties and would like to take out a health insurance company that offers good insurance cover around the menopause – if necessary. Would you recommend any plans? Niamh, Co Cork

A There are no health insurance companies that are specifically geared towards menopause. The Menopause Hub is run by a multidisciplinary team of counselors, psychologists, physical therapists and nutritionists. Many business plans share the cost of these visits if listed with your provider as a participating consultant.

In the past 12 months, providers have included menopause coverage in their plans. Irish Life Health, for example, has launched a new suite of ‘Health Guide’ plans. There are four options in this suite, and these plans include menopause benefits – each catering to different budgets in price and benefits.

Laya Healthcare added menopause insurance to some of its high-end plans in January and will be adding it to several of its policies starting July 1.

Convalescent Care Coverage

Q My mother recently had a bad fall and has spent the last few weeks in the hospital. The hospital has said she may need to spend a few months in convalescent care before she can return home. My mother has a VHI Health Plus Access Plan. Does this plan cover convalescence care – if so, how much convalescence care is covered? The hospital has also said my mother will need housekeeping when she returns home – assuming she is able to return home. Does the VHI Health Plus Access plan provide coverage for domestic help or household support? Colin, City of Dublin

A Recovery is a minimum benefit, so all three Irish health insurers are required to include a certain level of this coverage in each policy. Unfortunately, the coverage offered is often limited and will not be extended beyond 14 days. Health Plus Access is offering accommodation in a semi-private or private room for €51 per night for the first 14 nights. Even VHI’s top plan “Premium Care”, which is €4,000 per person per year, only covers €70 per night for the first 14 nights. There are a variety of approved recovery centers which can be found on the VHI website.

VHI has a fantastic Hospital@home service covered by HealthPlus Access. If you are referred by a GP or counselor with one of the eligible conditions, the team will visit your mother and assess your mother’s needs. All necessary medication and equipment will be provided and she would be seen by a member of the team at least once a day and at most 3 times a day.

Maternity leave according to the new plan

Q I returned to Ireland from a stay abroad seven months ago and took out health insurance as soon as I returned. I found out last month that I am pregnant. I had planned to wait until I was on the policy for the required 52 weeks before getting pregnant as I wanted private treatment. What is the difference between public and private care and can I pay for private care without completing the maternity leave waiting period? Gillian, County Galway

A There is a waiting period of 52 weeks for maternity benefit. The good news is that because you had 52 consecutive weeks of coverage at the time of the birth, you are covered for the maternity benefits listed in your plan. You do not have to have the policy for 52 weeks before you become pregnant.

There are three maternity care options in Ireland – public, semi-private and private.

Your care will be fully funded by the State if you opt for public treatment – ​​as long as you are an Ordinary Irish Resident. You are on a public ward and do not pay for doctor visits, ultrasound scans, obstetrician appointments or delivery costs. Public care usually results in a midwife-led birth, but if there are complications, access to an obstetrician is available. Wait times for public supplies in Ireland are longer than private ones – and you get fewer scans. Depending on the type of health plan you have, you may receive a contribution towards some prenatal and postnatal services.

Semi-private care means you’ll see your advisor or a member of their team on every visit, and it often means less waiting time than in public care. If your plan includes this type of care, your provider will cover the cost of the semi-private room at €813 per night. There are no plans that fully cover the costs of semi-private maternity counselors and these can range from €900 to €3,000. You pay these fees, but all other costs are covered by your health insurance company. Some plans contribute to these consultant fees and other prenatal and postnatal benefits.

Private Care allows you to see the same private counselor throughout your pregnancy and often performs more frequent scans and visits. You choose the obstetrician and he is usually present at the birth. Tariffs cover the cost of a private room (€1,000 per night) and some tariffs may contribute to consultant fees, which typically range from €2,000 to €5,000 for private care. As a rule, private doctors do not accept patients without health insurance. Does our health insurance company cover the surgical removal of the child’s wisdom teeth?

Fry Electronics Team

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