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HEALTH insurers are set to further cut back on the illnesses they will cover on medical policies.
VHI already restricts some 22 illnesses it will cover on most of its mid-market plans, while Aviva does not fully cover certain procedures on some of its plans.
Quinn is the only health insurer not to restrict certain procedures, Dermot Goode of Healthinsurancesavings.ie told yesterday's National Healthcare Conference in Dublin.
He said insurers were set to restrict more illness and procedures as a way to keep their costs down.
This would mean that consumers would lose out.
Already the three insurers were tweaking the benefits almost weekly on the plans they offer, he said.
With the VHI, people on mid-level plans who need a number of orthopaedic and ophthalmic treatments will have a shortfall of 20pc for the cost of the treatment if the procedures are carried out in private and semi-private hospitals.
This could mean someone who had a hip replacement could end up having to pay €4,000 themselves, Mr Goode said on the margins of the conference.
Changes to a number of Aviva plans mean that policy holders will have to pay the first €2,000 themselves for some operations in private and semi-private hospitals.
This is because orthopaedic procedures, such as those carried out on hips, shoulders and knees, are no longer fully covered by Aviva in private and semi-private hospitals.
Insurers were imposing restrictions as a way to avoid even higher price hikes than those that have already been imposed by the three players.
Symptomatic
One way to avoid having to pay between €2,000 and €4,000 for some procedures in private hospitals was to pay up to €1,600 a year for a higher-end plan, Mr Goode said. Currently, most families have dropped down to plans that cost each adult around €800 a year.
The alternative was to have the operation done in a public hospital, Mr Goode said.
Asked if there were moves to restrict the number of illnesses covered on medium-range policies, VHI chief executive Declan Moran said on Tuesday that the company was always reviewing its plans.
"Restricted illnesses are symptomatic of a marketplace where our competitors are cherry-picking the younger people who make fewer claims," he said.
At the same conference, Aviva Ireland chief executive Sean Egan called for major reforms of health insurance to make cover more affordable for families.
Mr Egan called for Health Minister James Reilly to allow private health insurers to negotiate directly with hospitals on bed charges.
He said the current approach, where the minister sets bed charges, was a contributory factor to rising premiums.
Direct negotiations between insurers and hospitals would lead to cost savings, which in turn could be passed on to customers, he said.
Mr Egan also said the proposal was in line with the minister's own universal health insurance policy. And he called for the regulation of the VHI by the Central Bank to be prioritised.
"The failure to regulate the VHI perpetuates a situation where the VHI is treated in a different and more favourable manner from its competitors," Mr Egan claimed.
Irish Independent
