Questions and Answers

What is my policy number?
Your ESB staff number is the policy number for you and for all those on your policy.

What Private hospitals am I covered for?
The accommodation type and hospitals you can access depends on the each individual member's policy.

What are the difference between the three schemes available to members?
See here for comparison of cover on the three schemes.

How can I make a claim for Chartered Physiotherapy costs that I incurred?
Complete all sections of the Benefit Claim form on both sides and forward to the office along with the original receipts. Only Official receipts are acceptable with itemised detail on the cost. Benefits are paid in line with the Policy that the claimant holds.

How can I make a claim for outpatient consultant fees that I incurred?
Complete all sections of the Benefit Claim form on both sides and forward to the office along with the original receipts. Only Official receipts are acceptable with itemised detail on the cost. Benefits are paid in line with the Policy that the claimant holds.

How can I make a claim for outpatient blood tests (pathology) costs that I incurred?
Complete all sections of the Benefit Claim form on both sides and forward to the office along with the original receipts. Only Official receipts are acceptable with itemised detail on the cost. Benefits are paid in line with the Policy that the claimant holds.

How can I make a claim for outpatient radiology costs ( xrays, ultrasounds, mammograms, dexa costs) that I incurred?
Complete all sections of the Benefit Claim form on both sides and forward to the office along with the original receipts. Only Official receipts are acceptable with itemised detail on the cost. Benefits are paid in line with the Policy that the claimant holds.

How can I make a claim for Minor surgical procedures carried out by a GP?
If the GP has a direct billing system with MPF (check with Doctor) - you just have to complete and sign a MPF claim form, that the surgery will provide.

If the GP does not have a direct billing arrangement with MPF, you pay on the day and get a itemised receipt with the procedure code. Complete all sections of the Benefit Claim form on both sides and forward to the office. Benefits will be paid at participating rate.

How can I claim for MRI and CT costs?
If the hospital /Clinic is an approved centre, you just have to complete and sign the MPF claim form, that the hospital/clinic will provide.
If the hospital /clinic is a non approved centre. You must pay on the day and submit itemised official receipt, accompanied by completed Benefit Claim form and send it to the MPF office. Benefits are paid in line with the Policy that the claimant holds.

If I have private health insurance, must I sign to be a private patient on admission via A/E to a Public hospital?
MPF members, like all other citizens, pay the required health contributions in their PRSI to gain entitlement to treatment as a public patient in HSE hospitals, if that is their choice. This issue of waiving your right to be treated as a public patient only applies to non-elective admissions such as via Accident & Emergency (A&E).

Public Hospitals can only issue charges to MPF when a member waives their entitlement to be treated as a Public patient by signing a Private Insurance Patient form. This form should not be signed unless it is your choice to do so.

The following is the admission procedure that you should encounter at a HSE Hospital when being admitted via A&E:

  1. Patient must be asked on admission if they wish to waive their right to be treated as a public patient.
  2. If you choose to waive your right to public treatment, it is in order to sign a Private Insurance Patient Form and consent to waive your right to be treated as a public patient. The Hospital are then entitled to charge full private rates for this full hospitalisation at up to €813 per night along with associated professional fees (even if you are hospitalised in a public ward).
  3. If you choose to avail of your entitlement to be treated as a public patient, only sign the Public Hospital Claim Form. In this instance, the hospital is entitled to charge €80 per night, for a maximum of 10 nights and this charge is fully covered by your MPF policy.

There is evidence that some hospitals are insisting that patients admitted through A&E departments must use their private health insurance. This is not correct. If you are content to be treated as a public patient, you can insist on your right to be so treated and cannot be forced to do otherwise. Likewise, you are fully entitled to use your private health insurance and waive your right to be treated as a public patient. However, please note that in the event of being admitted to a public ward, this has no benefit to you as a patient in terms of treatment for this particular hospitalisation.

Members admitted via A&E have advised that they are also receiving Private Insurance Patient forms to sign after their discharge from hospital. In this scenario the hospitals have not adopted the correct procedures and are attempting to reclassify the hospitalisation as private in order to charge private rates. They cannot do so unless a patient waives their right to public treatment by signing the Private Insurance Patient Form. We urge members not to sign forms in this situation.

The additional costs incurred by the Fund for paying private rates for public beds does have an impact on the subscription rate that you as a member will ultimately pay for your private health insurance policy so your vigilance in this area will benefit you and all fellow members.

How will my refund be paid to me?
There are two methods of payment. Electronic Funds Transfer, directly to your bank account and cheque payment. EFT payments of approved claims, are made on a fortnightly basis. Cheque payments of approved claims, are made every two months. If you are on the cheque option, you can change to EFT by completing a Change of Bank Details Form

What do I need to claim tax relief for costs not covered by MPF?
Retain all remittances issued by MPF with each payment. Remittance are issued by email or by hard copy. These remittances are accepted by the Revenue Commissioners as proof of benefits paid by MPF.

How can I claim for an admission to a Public Hospital?
The majority of public hospital in the Irish Republic have the MPF hospital claim form. You will be asked to sign and complete appropriate sections on admission . You will also be asked to complete a request for private care form by the hospital, in which you can opt for private care. The hospital will deal directly with MPF for payment of the hospital charges and professional fees that may arise during your admission. Benefits are paid in line with the Policy that the claimant holds.

How can I claim for an admission in a Private Hospital?
All Private hospitals in the Irish Republic have the MPF hospital claim form. You will be asked to sign and complete appropriate sections on admission . The hospital will deal directly with MPF for payment of the hospital charges and professional fees that may arise during your admission. Benefits are paid in line with the Policy that the claimant holds.

How can I claim for optical and dental costs?
While MPF does not make a contribution towards these costs, you may have a claim from the Medical Benefits Area in ESB.
Please contact this section at Tel: 01-7026699 option 3.

Does MPF cover dental treatment?
Cover for dental treatment is confined to a small number of surgical dental procedures e.g. surgical removal of wisdom / impacted teeth. All such treatments must be pre-certified by our Dental Advisor. Dental x-rays and pre/post consultations are not covered. Cover does not apply to fillings, extractions, cleaning, root canal treatment, crowns, dentures or any other routine dental treatment.

How can I claim hearing aid costs?
MPF makes a contribution of €400 per hearing Aid for Premium Plus members only. This benefit is payable once every four years. Complete all sections of the Benefit Claim Form on both sides and forward to the office along with the original receipts. You may also have a claim from the Medical Benefits Area in ESB.
Please contact this section at Tel: 01-7026699 option 3.

Some members may also be able to make a claim on Medical Benefits section of ESB. Please contact this section at Tel: 01-7026699 option 3

Am I covered overseas for medical expense incurred?
MPF benefits are designed to cover treatment within the State.
Members are advised to take out adequate travel insurance before going abroad.
If you are travelling within the EU, you should get a European Health Insurance Card (EHIC) from your local Health Board. This will entitle you to treatment in public hospitals, whilst in Europe. Download EHIC Application form here.