Will insurance cover MUHC megahospital’s private rooms?

The McGill University Health Centre calls it the “ideal room” for recovering hospital patients: one person only, private bathroom, a nice sitting area and natural light.

But the MUHC’s announcement that each and every room in the new megahospital will be single-patient only has prompted fears that it will exclude patients whose insurance doesn’t cover private rooms.

Yves Millette of the Canadian Health and Life Insurance Association says those fears are unfounded.

Millette, Senior Vice President of Quebec Affairs for the umbrella organization which represents nearly 100 private insurance companies, explained that although it’s true that the public system usually only covers shared rooms, it will pay for a private room if a patient’s condition demands it, or if there is no shared option available – as is the case with the new MUHC.

“If you need a private room due to your condition, like if you have an infectious disease, it was always paid for,” Millette told OpenFile. “If you requested your own room for privacy reasons, they might not cover it.”

In other words, public health plans will pay for a private room – unless you have to ask for one.

Hospitalization is covered under the Canada Health Act, so the public system has no choice but to pay up when single-patient rooms are the only option.

Millette pointed out that most people who have supplemental health insurance purchased through a private company – including many employment-based group plans – have paid private rooms included in the plan. So they neither gain nor lose from the new hospital model, except that now one of the perks of their private insurance will be offered to everyone.

And maybe that’s the way it should be. The results of a McGill University study published earlier this year suggest that private rooms reduce the rate of hospital-acquired infections by 50 percent and shorten hospital stays by 10 percent.

There are also the obvious comfort and privacy considerations. Gone are the awkward hospital-room encounters with the guy in the next bed in the backless gown, a long-time staple of comedy movies.

Instead, the website for the new hospital features pictures of a single bed with a cheery green comforter, a pretty tree outside the window, and a family enjoying a private moment.

MUHC communications officer Cinzia Colella said single-patient rooms respect patients’ privacy and make it easier for family and friends to help care for their loved one. Colella said single-patient rooms are also easier on staff.

“They are more flexible and allow for better equipment integration," Colella said. "This means that care can be brought to the patient's bedside without them having to be moved. As well, it gives medical staff the chance to work in more functional spaces.”

So the good news about the MUHC’s hospital rooms is that you’re covered – well, when it comes to health insurance, anyways.

There’s still no news on the future of those backless hospital gowns.