St Patrick’s Mental Health Services (SPMHS) aims to provide as much information to you to make it as clear and easy as possible to avail of our mental health services.
We are an independent, not-for profit organisation, and we do not receive government funding. We receive fees for our services from our service users and/or their health insurance company.
We are covered by all health insurance companies in Ireland (VHI, Laya or Irish Life Health). Where it is appropriate, we advocate on behalf of our service users for mental healthcare benefits provided by insurance companies and other related issues in the sector.
Getting information about insurance
We understand that the health insurance market is complex. There is a wide range of policies and plans available, which each one covering different services and having its own terms and conditions.
If you are considering a health insurance plan, you might find it helpful to visit the Health Insurance Authority (HIA) website for information and guidance.
If you are looking at buying an insurance policy, switching providers or changing your cover, we have gathered a list of useful questions to ask about how the insurer covers mental healthcare. You can find the list further below on this page.
Choosing a plan
It is useful to know that mental healthcare is specifically provided for in the laws which underpin voluntary health insurance. This set of laws is known as Minimum Benefit Legislation.
Minimum Benefit Legislation states that every health policy must provide a minimum level of cover for hospital services. For general mental healthcare or general psychiatric cover, the minimum benefit amounts to 100 days of care in any given calendar year.
Some insurers provide extra cover of up to 180 days but this depends on the insurance plan you choose. Insurance cover is also provided for alcohol and substance abuse treatment and this is restricted to 91 days in any five-year period. It is worth noting that not all policies hold cover for every hospital and you should check that St Patrick’s Mental Health Services is covered with your insurer when taking out a policy for the first time or switching insurance companies or plans.
It is also important to know that a health insurer cannot refuse to sell you insurance, even if you have an existing medical condition. However, there may be a waiting period from when you begin the plan to when you can claim your benefits under it.
Before settling on a plan, be sure to ask for full details of the benefits.
Understanding your plan
Ahead of confirming your policy, you might find it helpful to ask the questions below of your insurer to be confident that they will provide the cover you would like or need.
- What are the benefits for mental healthcare provided by this policy?
- Are these benefits the minimum you are obliged to provide, or do you provide extra mental healthcare benefits?
- How do I distinguish between different mental healthcare providers? Is there a quality standard?
- Do you cover or provide benefits for day care and/or care in the community (for example, in the Dean Clinics)? If so, what are these benefits? Will I be required to pay a shortfall for day care or treatment in the Dean Clinics and, if so, how much?
- Do you provide cover for adolescents in the Willow Grove Adolescent Unit in St Patrick’s Mental Health Services?
- Can I decide, using guidance from my care team on my mental healthcare needs, how I use benefits under this plan? For example, can I use these benefits for inpatient and/or day care?
- Are any terms of the policy dependent on age for people named on it?
- What are the limits, if any, to my cover in any given calendar year?
- Is there a waiting or exclusion period before I can claim mental healthcare benefits if I join or switch my policy?
If you have additional questions that you would like to ask before contacting your insurer, please call the Finance Department hunt-line on 01 249 3533 and one of our team members will be happy to assist you.
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