The costs of living with a Chronic Disease

The costs of living with a chronic disease

Living with a chronic disease can be expensive. Regardless of whether you attend a rheumatologist privately or opt to access your care through public healthcare system, there are certain out of pocket costs that are unavoidable.

Unless you are entitled to a medical card,  these will include the costs of medications, the cost of attending your GP and the incalculable costs of time taken off work through illness or to attend a doctor.

I have used a disease like rheumatoid arthritis as an example but similar figures will apply to conditions like psoriatic arthritis, ankylosing spondylitis or lupus. A typical Irish patient with rheumatoid arthritis would have a drugs bill of between €500-€600 per year (up to a maximum of €1600 for patients on biological treatments) and have to pay anywhere between 6-12 GP visits (for blood tests and visits) (€300-€500 pa).  A total therefore, for an average patient with rheumatoid arthritis of about €1000 annually in fixed costs relating to GP visit and medications.

The cost of private rheumatology

Where one decides to attend a rheumatologist privately some additional costs will accrue. The first is consultation fees. A typical patient with rheumatoid arthritis  might attend 4 or 5 times in the first year of their illness and if they do well on treatment (which most do), visits will be much less frequent (perhaps once or twice a year). This means direct private rheumatology costs of €500-600 in the first year and then €110-€220 in the second year. 

How will health insurance help?

Most insurers will allow you to claim back some of your GP fees and outpatient consultant fees at the end of the year (depending on your level of cover and usually subject to an annual excess).  You will be expected to pay as you go and submit your receipts at the end of the year. 

Remember to collect your receipts, store them somewhere you can easily find them. If you have mislaid your receipt, please ask and we’ll be happy to send you another one. 

Outpatient Investigations

Subject to a shortfall (usually a few hundred Euro) you can usually claim back the costs of X-rays and blood tests done in private hospitals. This will be particularly relevant where you have an expensive test that is not directly paid to the hospital by your insurer (e.g. a CT scan or Bone scan). 

Remember that where these tests are performed through your GP you will not be liable to these charges in the first place. Don’t be afraid to ask your doctor how best to save money on your tests.

MRI scans

Most insurers will provide direct payment for MRI scans (i.e. they pay the MRI centre directly) provided the scan is done in an approved centre (your doctor will usually know) for an approved indication (they will cover certain conditions and not others – again your doctor will usually know what these are). 

Day care procedures

This is where having health insurance really helps. If you are attending a rheumatologist you may require certain procedures to be performed as part of your care.  These include joint injections and infusions.

Your health insurance will usually pick up the costs of all of these charges directly. Some of the less expensive policies will demand that you pay a shortfall / copay for each procedure performed. Depending on the policy this may cost €100-200 per procedure. Where you are on treatment with a drug that needs to be given 12 times in any year this will add up very quickly.

If you attend a rheumatologist on a regular basis, it is therefore important to have a policy that does not demand that you pay a shortfall for procedures or day case procedures.

Hospital Admissions 

If you have to be admitted to a private hospital, it is essential that you have adequate health insurance. Health insurers will usually cover the cost of your hospital stay and all relevant investigations, treatment and medical costs. These bills can run into thousands of euro’s so make sure you’re covered! 

If you have any questions about medical costs please ask a member of our office staff. THey are there to help you.

Insurance company websites

Health Insurance Authority  The Health Insurance Authority is a statutory regulator of the private health insurance market in Ireland. The Authority also provides information to consumers regarding their rights and health insurance plans and benefits.

Aviva Health

ESB Medical Provident Fund

Garda Medical Aid

Hospital Saturday Fund

Prison Officers Medical Aid