A project for the expansion of out-patient services, including a free annual check-up, was announced yesterday by the health insurer BUPA Ireland. The initiative, on a pilot basis, is the first of its kind on the Irish health insurance market.
BUPA is linked with the Irish Medical Organisation in the scheme which is aimed, according to BUPA's director of provider affairs, Ms Maureen Lynott, at "encouraging the prevention, detection and treatment of illness at an early stage on an out-patient basis".
As well as the annual check-up, including male and female cancer screening, other procedures carried out by a GP will also be covered. The initiative includes treatment by a consultant of asthma, women's breast disease, prostate cancer and Alzheimer's Disease, with a "small co-payment" from the subscriber. The co-payment arrangement will also be available for visits to a GP. Families will have their annual excess, the amount they have to spend until they can claim, lowered from £350 to £60.
The BUPA customers in the scheme live in Waterford city and Malahide. They will be registered at no extra charge on their existing premium. Agreement has been reached between the IMO and BUPA on prices for these services; however, neither side would reveal yesterday the prices agreed.
Dr Liam Lynch, vice-president of the IMO, said his organisation was centred on supporting an expanded access to primary care and certain specialist consultant treatment.
"The scheme provides a greater financial incentive for patients to receive their treatment at the lowest level of complexity," he said. "It provides doctors with a real opportunity to expand the range of service available to their patients and to encourage healthy living and early treatment when illness occurs. All information regarding patients will remain confidential to their own doctors."
Ms Lynott said the initiative was aimed at finding out the impact of expanding insurance cover and out-patient services on the overall use of those services, on the general cost of health services and the overall use of those services.
She explained that existing health insurance tended to focus more on inpatient care and acute episodes which required hospitalisation. The current structure of health insurance had not kept pace with the developments in out-patient care. Out-patient claims, she said, were subject to high annual excesses when a member made a claim, while in-patient care was fully covered.