Written Answers. - Private Medical Insurance.

John Dennehy

Question:

238 Mr. Dennehy asked the Minister for Health and Children if he will request that the Voluntary Health Insurance company would cover routine CAT scans for persons who are admitted as outpatients rather than requiring them to be admitted; and if he will make a statement on the matter. [2856/03]

The position is that the Voluntary Health Insurance Acts give explicit powers to the VHI board in relation to determining the nature of the cover to be provided under its health insurance products for the treatment and care of members. Similarly, the regulatory framework covering health insurance business generally provides for insurers to determine the nature of, and manner in which, benefits for the treatment of members under their plans are provided. This is subject to providing a specified minimum level of benefit, mainly relating to in-patient services. As Minister for Health and Children I do not have a statutory or administrative role in such determinations by insurers in relation to their plans, provided cover complies with the provisions of the Health Insurance Acts and related regulations.

Following inquiries, VHI Healthcare has confirmed that CAT scans, as other x-rays, are predominantly an out-patient investigation and coverage varies according to the plan of the mem ber. VHI Healthcare provide cover for in-patient CAT scans. However, it has pointed out that it does not provide such cover when there is no clinical necessity for admission to hospital.
Question No. 239 answered with Question No. 235.