For the good of your health
We should never take our health for granted, but right now there's never been a better time to take out health insurance, writes Charlie Weston
Published 29/09/2016 | 02:30
HAVING quality health cover in place has never been as important, according to health insurance expert Dermot Goode.
He says there are nearly 500,000 people waiting for their first appointment with a specialist on the public system, and 78,000 are now waiting for surgery, including children.
Even when admitted to a public ward, you have to pay for the privilege unless you hold a medical card - this is up to €750 per person, per year, including children (or 10 nights at €75).
"So before you do anything, you're facing a potential charge for public treatment only of €750. One night in a private room in a public hospital could cost over €1,000 excluding consultants' fees, says Mr Goode, of TotalHealthCover.ie.
Given that there are over 360 plans in the market, many will wonder where to start.
"Well, if you're heading for 35 and you don't have any cover in place, you need to act soon to avoid the new age-related loadings," Mr Goode says.
If you join from 35 onwards, you will be charged a permanent loading of 2pc for each year over 34.
If you join before you turn 35, then you won't have to worry about this.
There are plans to suit all budgets and you can buy "entry-level" cover for as little as €500, Mr Goode said.
However, these are limited plans that cover public hospitals only, and are best to be avoided if you are seeking quality cover, he says.
However, if your objective is to beat the loadings, then these are perfect, Mr Goode says.
Ideally, you want a plan that will give you access to all public and private hospitals such as the Hermitage Clinic in Lucan, the Beacon Hospital in Sandyford or any of the four Bon Secour hospitals countrywide.
He says people need to remember that you will be hit for up to €750 in the public system anyway, and these quality plans are available from €800 to €950 as the table above shows.
But Mr Goode warned: "These are hospital plans only with an excess per private hospital claim and do not provide guaranteed cover for everyday out-patient costs.
"Never book any hospital treatment or MRI scans without contacting the insurer to check everything in advance."
Mr Goode says you might not always be happy with the answer, but if you follow this rule, you will avoid unnecessary shortfalls.
Expensive for families
For young families, the cost of health insurance is always a challenge. The question often asked is whether there is any benefit to insuring young children.
The answer is a definite yes, says Mr Goode, for the following reasons:
• Children will be charged the €75 public hospital charge just like adults. Consider a child who is hospitalised for 10 days following an emergency appendicectomy. This will result in a charge of €750.
• Children will be placed on waiting lists for routine surgery just like adults. Of the 78,000 patients waiting at present for surgery, nearly 5,000 are children (source: National Treatment Purchase Fund, July 2016).
• If you add your child to your policy at a later stage and they have an existing medical condition, all insurers will restrict them from cover for five years for this condition (pre-existing exclusion).
Given that children can be added to policies for between €200 and €250 per year, it is recommended that they be insured on the policy if at all possible.
Above right are sample family costs for two adults and two children under 18 based on current offers in the market:
For consumers who want comprehensive cover, especially for sports-related injuries, maternity and guaranteed refunds on their everyday medical expenses, such as GP, physiotherapy and many more, they need to consider a quality corporate plan, Mr Goode says.
This assumes that the member doesn't mind paying a small excess per admission to private hospitals.
These plans are designed specifically for companies that fund the cost of healthcare for their employees.
However, the legislation in Ireland makes it clear that every plan must be made available to all consumers if they request it by name.
The table, right, lists the best value corporate plans in the market right now for individuals and families (two adults and two children under 18).
How to do it
Taking out health insurance cover in Ireland is very straight-forward. There are no medicals or detailed questionnaires to complete.
However, you need to be careful of the waiting periods that apply to all new members on joining.
For example, conditions are covered for the first six months, except in the case of accidents which are covered immediately on joining.
You must be insured for 12 months before any maternity benefits apply and pre-existing conditions will not be covered for up to five years.
Your tax relief is granted at source so all premiums quoted will be net of tax relief. In other words, it doesn't get any cheaper.
For those lucky enough to have their cover paid via their employer, this tax relief at source mechanism does not apply.
Therefore, you must claim your tax relief (€200 max per adult, €100 max per child) directly from the Revenue Commissioners as part of your annual tax return.
If you are looking to top up your cover, you could check out the cash plans from HSF Health Plan or dental plans from DeCare Dental, the health insurance expert said.
Private medical cover is a valuable insurance product, but the devil is always in the detail, Mr Goode says.
Check everything in advance with the insurer, even for MRI scans to make sure you're fully covered. Claim all refunds on your policy especially for your everyday out-patient expenses.
Finally, prices increase each year, sometimes twice in the same year.
You must review your cover annually as you may be able to get the same cover elsewhere at a lower cost. Failure to do this each year simply means you will overpay for your cover, Mr Goode adds.