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How to access rehab with health insurance

health insurance

For those experiencing existing mental health conditions in Ireland, there are private medical insurers who can help you cover treatment.

As addiction experts, we know that receiving the appropriate care and support when you have a mental health disorder is pivotal to attaining long-lasting recovery.

Below, we will go through the various health insurance options to help you understand your options when it comes to seeking private residential care for substance abuse.

Please note that there is no guarantee that you can be covered for all addiction problems as policies are always assessed on a case-by-case basis.

There are also so many different policies and schemes that you would have to check with your provider to see if they cover residential care for addiction.

Main Irish Health Insurers and their cover

VHI Healthcare

Dublin, Vhi House, Lower Abbey Street, Dublin 1 D01 DX77
Tel: 056 444 4444

VHI Healthcare offers private health insurance and cover that will give you access to face-to-face online consultations with doctors in Ireland and 24/7 mental health support to help you manage your mental health better.

Their mental health cover is detailed as follows:

  • In-patient mental health treatment for up to 100 days
  • Mental health therapy sessions – €75 per visit (12 visits)
  • 91 days in-patient treatment for alcoholism, drug or other substance abuse in any five years
  • You can access confidential counselling and information services to assist in coping with personal, work, financial or legal issues

See more.

St. Pauls Gardaí Medical Aid Society

St. Paul’s Garda Medical Aid Society, Plaza 255, Blanchardstown Corporate Park 2, Ballycoolin Rd., Dublin 15
Telephone: 01 8991604

Treatments for alcohol, drugs or gambling abuse is covered for 28 days including detoxification. Here, the patient will be obliged to undertake the full course of treatment; if treatment is not completed or abandoned then the patient will be responsible for the fees.

After the course of treatment begins, patients will be unable to redeem any further residential stays at the expense of their insurance for a period of five years, which starts from the date of discharge.

Any form of aftercare or consultation following this inpatient treatment will not be covered.

Click here for more details and hospitals/rehabs accepted.

ESB Staff Medical Provident Fund (ESB MPF)

MPF: 061 430561 or Ext 55361

email MPF email: mpf@esb.ie

Medical Provident Fund is a non-profit medical insurance scheme, who have been providing reliable insurance for more than 60 years.

They make special arrangements for psychiatric and substance abuse treatment.

Psychiatric Care

  • They allow for and cover in-patient hospitalisations in any given 12-month period, starting from the date of admission.
  • Any additional periods of hospitalisation within the same period are subject to a maximum of 100 days are cover 70% of the hospital charges.

Substance Abuse

  • Full cover applies for the first period of hospitalisation and has a maximum 28 day stay, which includes detox. The overall cover is subject to a period of 90 days in any given 5-year period.
  • Any further admissions within the 5 years will be covered by 70% of the MPF Premium Plus Scheme and 70% by the Premium Schemes.
  • Once your limit has been reached, no payment for in-patient treatment will be considered until 5 years following that date.
  • Again, please do note that if you abandon your prescribed course of treatment before it’s over then you will be responsible for any of the costs incurred up until that date.

See MPF Guide PDF.

GeoBlue

­­­Geo Blue covers mental, emotional, alcoholism and drug abuse.

Offering bespoke inpatient and outpatient cover for mental health, the same services are also offered for any form of substance abuse too.

Details are as follows:

  • Inpatient mental health: 100% up to 60 days
  • Outpatient mental health: 75% up to 40 visits / 60% thereafter
  • Inpatient substance abuse: 100% up to 60 days and detox
  • Outpatient substance abuse: 75% up to 40 visits / 60% thereafter

LAYA Healthcare

Eastgate Road, Eastgate Business Park, Little Island, Co Cork, T45 E181, Ireland https://www.layahealthcare.ie/

LAYA is not a health insurance that we currently accept however this may change. As with all insurance policies your level of cover will depend on your chosen scheme. That said LAYA is a very well known insurer in Ireland and does offer a comprehensive package to cover alcohol and drug addiction.

“We know that getting treatment for any condition can be daunting and costly and it is no different for mental health issues. Rest assured, we’re right beside you to provide practical, financial and emotional support, as well as access to the best healthcare facilities in the country.”

Some of the mental wellbeing benefits LAYA offers include

PDF full details.

Aviva Insurance Ireland

https://www.aviva.ie/

“Addictions and substance misuse We do not cover treatment for addictions (such as alcohol addiction or drug addiction) or substance misuse (such as alcohol misuse or solvent misuse), or treatment of any illness or injury needed directly or indirectly as a result of any such misuse or addiction.”

Irish Life Health/ GloHealth

https://www.irishlifehealth.ie/

Irish Life Health (which own Glohealth) is not a health insurance that we currently accept. However they do offer insurance cover for rehab.

Psychiatric Treatment

Related to substance abuse (both drug and alcohol)
91 days per 5 years (up to the level of Hospital Cover provided under your plan) More.

Please note:

  • Smarmore Castle does not endorse any particular insurance provider, including the ones mentioned on this list.
  • Smarmore Castle is unable to provide specific advice on individual insurers, including those mentioned on this page. We do not have any knowledge of their past performance or what charges you can incur.
  • This list is not exhaustive. This means that many other insurance providers can provide specialist cover for many different conditions. You will need to judge the provider based on finding the most appropriate care for your situation.
  • Smarmore Castle works with the following insurers mentioned on this list, which means members of these funds, which include family members are able to access our addiction rehabilitation services.

Smarmore Admissions

All admissions are subject to a full assessment, as well as the terms and conditions of the relevant funding provider.

Smarmore Castle makes no guarantee that the above information is correct or that any terms and conditions of any policies mention are still applicable.

Downloads
Smarmore Castle Brochure.pdf