Tuesday 6 December 2016

Charlie Weston: Those who took out health cover for the first time last year have big decisions to make

Some policies only give access to public hospitals

Published 28/04/2016 | 02:30

There is no need to have the entire family on the same plan - consider splitting your cover to reduce your costs. Picture posed
There is no need to have the entire family on the same plan - consider splitting your cover to reduce your costs. Picture posed

People who took out health insurance for the first time last year have some big decisions to make in the coming weeks.

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Around 100,000 people took out cover for the first time last year, with most of those doing so to avoid loadings.

The loadings come courtesy of lifetime community rating (LCR). This is a new system that penalises those over a certain age who take out health insurance for the first time.

The introduction of lifetime community rating last May meant that anyone aged 34 or over who takes out health insurance for the first time now has to pay a permanent age loading that will be dependent on their age. The older you are, the more you pay.

Health insurers had responded to the introduction of LCR by bringing out a new range of low-cost policies to attract those taking out cover for the first time.

Many of these policies were priced between €400 and €500.

Half of newcomers took out basic cover. But many of these entry-level policies are next to useless.

Having bought one, you may find that you still have to queue for medical treatment, according to independent broker Dermot Goode.

Mr Goode, of TotalHealthCover.ie, said large numbers of new entrants who bought these low-priced plans will find they have access to public hospitals only.

He said it was becoming increasingly difficult for consumers to access private treatment in public hospitals, due to long waiting lists that are forcing hospitals to cancel elective surgeries.

The bottom line is that the value of health insurance plans that only give access to public hospitals must be questioned.

Another problem with entry-level plans is that they often do not cover MRI scans (magnetic resonance imaging), which are pretty standard these days.

Routine medical expenses, such as going to a GP or physiotherapy or attending a medical consultant, are not reimbursed in cheaper plans.

Mr Goode said that even those who do get in privately to a public hospital are likely to be put into a public ward.

Their insurer will be hit for a daily charge of €813 per night, whereas everyone else in the same ward will only be charged €75 per night.

"In other words, we have now reached a stage where you must have cover for private hospitals such as Hermitage, Beacon and the Bon Secours hospitals as well if you want to be guaranteed your accommodation preference," Mr Goode said.

The reality is that for an additional €350 to €450 per adult, people can potentially double their cover to include both public and private hospitals.

If they do that they will have real health insurance cover in place.

Remember, that a day-care procedure in a private hospital can cost up to €1,000 including consultants' fees.

People who took out entry-level plans should also be aware of the upgrade rules when an existing condition is diagnosed.

You may have to wait up to two years for any higher benefits on an upgraded plan depending on your insurer, your age and whether or not you have a pre-existing condition.

This rule prevents members upgrading their plan to access a higher benefit and, once the treatment is over and the claim has been paid, downgrading to a cheaper plan.

Another thing to remember is that there is no need to have the entire family on the same plan.

Too many families keep everyone on the same plan and pay too much. Consider splitting your cover to reduce your costs.

Irish Independent

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