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The Essential Gold scheme offers a wide range of benefits including comprehensive public and private hospital cover, consultant fees, out-patient benefits, overseas cover, maternity cover, convalescence and EU cover.
Please note that if you are taking out health insurance for the first time, while you have immediate cover if you have an accident, waiting periods will need to be served before you can avail of full cover.
If you are transferring from another health insurer and have already served these waiting periods you will not have to serve them again.
Also introducing Consultant Connections, a new support service for QUINN-healthcare members and their doctors. Click here for more.
Hospital cover
Members of the Essential Gold scheme are covered for a private room and day case procedures in all participating public and private hospitals, including the Mater Private hospital, The Blackrock Clinic and The Beacon Hospital.
To find the hospitals covered by the Essential Gold scheme and details of these excesses please click here to view the hospital list.
Cardiac cover
In addition to your hospital cover mentioned above, you also have full hospital cover for certain types of major heart surgeries in the Mater Private Hospital, the Beacon Hospital, the Blackrock Clinic and the Galway Clinic.
CancerCare Support
All cancer patients who travel for out-patient cancer treatment (i.e. chemotherapy & radiotherapy) are entitled to an accommodation grant. Members can claim up to €100 per night when travelling a minimum of 40 miles to the treatment centre.
Consultant cover
Fees charged by a consultant relating to your hospital stay will be covered in full provided the consultant is fully participating with QUINN-healthcare. Ninety nine percent of consultants participate with QUINN-healthcare.
Out-patient benefits
Out-patient costs refer to medical expenses that you pay yourself on a day-to-day basis, such as GP fees, visits to consultants or fees for physiotherapy.
You can see the different expenses we cover and the amounts you can claim for each expense below.
An excess applies to any out-patient claim on the Essential Gold scheme, this means that the first €220 for an individual policy or the first €380 for a family policy must be covered by the member themselves. Any expenses in excess of this can be submitted for refund.
Each receipt you have from throughout the year is worth a certain amount towards your excess and these amounts are listed below.
However, we pay for the following treatments in full and you do not have to pay any excess.
They are:
- MRI scans carried out at certain QUINN-healthcare approved centres; Charlemont Clinic (Dublin), Charter Medical (Dublin), Advanced Radiology (Rockfield, Dundrum), Auteven Hospital (Kilkenny), MRI Centre (Bon Secours, Galway), MRI Ireland (Sligo General Hospital), MRI Centre Cork (Mercy University Hospital), Barrington's MRI Centre Limerick
- Mammograms for breast cancer screening at the following QUINN-healthcare approved centres, Beaumont Private Clinic, South Terrace Medi-Centre, Cork, Blackrock Clinic, Bon Secours, Galway, Mid-Western Regional Hospital, Limerick;
- DEXA Scans for osteoporosis screening at the following QUINN-healthcare approved centres, Galway Clinic, Charter Medical, Dublin 7, Barrington’s Hospital, Limerick, Bon Secours, Cork, Bon Secours, Dublin, Dr. Darragh Foley Nolan, Waterford;
- PET scans carried out on an out-patient basis in the Beacon Hospital and The Mater Private Hospital;
- CT scans carried out on an out-patient basis at Beaumont Private Clinic, Barringtons Hospital and The Charter Medical Diagnostic centre;
- Colon cancer screening in five centres; The Mater Private, Advanced Radiology (Rockfield, Dundrum), Barrington's in Limerick, The Mercy University Hospital in Cork and the Galway Clinic;
- Breast prosthesis (following in-patient treatment);
- One hairpiece each year (following in-patient cancer treatment);
- Home-nursing for children under 18 years (following a hospital stay of five consecutive days) - €100 per day for the first 28 days;
- manual lymph drainage for cancer patients. This advanced therapy improves the quality of life for many cancer sufferers. Members are entitled to claim up to €500 for this treatment.
This is the list of out-patient benefits which are subject to the out-patient excess and the amount you can claim for each
- Consultant radiologist fees: full refund.
- Pathologist fees: up to €20 for each referral.
- Radiology and pathology charges: full refund provided tests took place at a QUINN-healthcare participating hospital or approved diagnostic centre.
- Hospital casualty charges: up to €20 per episode.
- Physiotherapy: up to €20 per consultation and a max of 25 visits each year.
- General practitioner: up to €20 per consultation.
- Approved complementary therapies - acupuncture, homeopathy, chiropractic and osteopathy: up to €20 per consultation and a max of 12 visits per practitioner.
- Reflexology - up to €20 per visit for up to eight visits each year.
- Certain medical and surgical appliances: up to the amount shown on the QUINN-healthcare approved list (please ask for details).
- Consultant fees (excluding maternity): up to €51 per consultation.
- Consultant fee (for maternity): up to €400 per pregnancy.
- Home nursing following in-patient treatment for a person aged 18 years or over.
(on consultant referral): up to €40 each day for up to 40 days each year. - Women's cancer screening (at approved centres): up to €30 each year.
- Blood tests for the purpose of prostate cancer screening: up to €20 each year (at approved centres).
- Dental visit: up to €25 each year.
- Emergency dental treatment for and immediately following an accidental external impact: up to €510 for restorative treatment.
- Optical (FAOI) - eye test and/or glasses or contact lenses: up to a combined maximum of €20 per year.
- Orthoptic cover - up to €20 per visit for up to eight visits each year.
- Executive health check (at approved centres) - €100 per year.
- Speech and language therapy (on GP or consultant referral), chiropody and occupational therapy: up to €20 per visit for up to 12 visits combined each year.
- Dieticians fees: up to €25 per visit for five visits per year.
- Physical therapy: up to €20 per visit for up to eight visits each year.
- Sports Health Screening: up to €150 once every two years.
To view the list of participating therapists click here
Overseas cover
Members of the Essential Gold scheme are entitled to emergency overseas cover. If you have an accident and need inpatient treatment while abroad you will be covered for emergency local treatment up the value of €55,000 per episode. Repatriation to Ireland or the nearest medically appropriate country is also covered if treatment is not available in the country that you are travelling in.
QUINN-healthcare members receive an emergency overseas 24-hour assistance number. This number must be contacted prior to any emergency treatment.
This overseas cover provides a certain level of cover for emergency treatment that may be required while overseas temporarily and therefore is not a substitute for travel insurance.
Also, as an Irish resident you are entitled to get healthcare through the public system in countries of the European Union (EU), European Economic Area (EEA) or Switzerland if you become ill or injured while on a temporary stay there.
Until now, you needed an E form (such as the E111 or the E128) to get such treatment. Now, these paper forms are being replaced by the European Health Insurance Card. One card is needed for each individual or member of the family.
Maternity cover
We will pay a generous benefit for each delivery in private or semi-private participating hospital accommodation.
Essential Gold scheme members are covered for up to three nights accommodation up to a maximum of €3,350.
We will also pay consultants fees for a normal delivery up to €869.81 (including epidural).
Consultants must be participating in our full cover scheme. Please ask us for details or click here to check if your consultant takes part in our full cover scheme.
If you decide to have your baby at home we will then pay a grant of up to €3,350
Convalescence
If your consultant tells you, you need a stay in a state-registered nursing home after a stay in hospital, we will pay €75 per day towards the costs for 14 days.
EU Cover
If you require treatment that is certified by our medical adviser as unavailable in Ireland, we will provide cover if we arrange treatment in one of our participating hospitals in the EU.
