Small health savings are not to be sneezed at
Before getting locked into a health insurance policy, shop around for the best option for you and your family to make the switch pain-free, writes Charlie Weston
FAMILIES can save up to €1,400 a year by getting better value health insurance.
Price hikes that were announced last December along with a number of rises in the middle and end of 2014 will now be applied to those renewing on the same policies, according to Dermot Goode of TotalHealthCover.ie.
This is despite price cuts and premium rate freezes being announced recently by VHI and Laya for the year ahead. Mr Goode said people often inadvertently accept an increase that can be up to 50pc, as they are too busy to seek out better value.
The spate of hikes in premiums last year means families could end up paying an extra €1,400 by renewing the same policy.
This situation is exacerbated by the fact that all four insurers - VHI Healthcare, Laya Healthcare, GloHealth and Aviva Health - now have 12-month contracts in place. It used to be the case that families could break out of their contract inside a year without penalties.
Is switching your health insurance cover straight-forward?
Mr Goode says it is. Once you understand the different aspect of the products you are considering and you are clear on what you're losing/gaining, then you should approach this as you would your car or home insurance.
That means shopping around each year for the best deals and if you are happy with the terms and conditions of the new policy, switch.
However, you can only change your cover at your renewal date.
You will get your renewal notice approximately four weeks prior to this date, but you have a further 14 days after this (cooling-off period) during which you can decide to either renew, amend or cancel your cover.
If I switch, can I change my mind a month later and revert back to my previous insurer?
No. After your cooling-off period has expired, you will be deemed to have renewed your policy and technically you are locked into an annual contract for the next 12 months, Mr Goode said.
If you do try to exit your policy, most insurers will impose financial penalties to recover the health insurance levies that they have paid on your behalf. Some charge an additional administration fee as well.
Will I be on cover immediately if I switch plans?
If you have already served your full waiting periods with your previous insurer, then the answer is YES.
The legislation is very clear in this regard so, if you are 52-years-old and you have had private health insurance in place for more than five years with no break in cover, then you will be on cover immediately once you are switching to an equivalent plan.
If I change provider and I improve my hospital cover, will I be covered immediately?
Not necessarily. All insurers operate an upgrade rule to prevent someone upgrading their cover knowing they are going to be hospitalised for treatment of an existing medical condition, Mr Goode says.
In this scenario, your cover will be restricted to your current benefits for the next two-to-five years, depending on your age.
Except for VHI, the other insurers will allow you claim on the new plan for any new conditions that present immediately after the change of cover.
With VHI, you may be restricted to your previous plan benefits even for new conditions until a short waiting period has been served.
Do I have to disclose existing conditions or pending treatment when I switch?
Not at all, Mr Goode says. Our community-rating system means that everyone must be charged the same premium irrespective of their age, gender or medical history.
The health insurers will only ask for your existing health insurance details and how long have you been insured on this policy.
They cannot ask you about your medical history or whether you are due to have surgery as it has no bearing on the premium.
However, a good adviser may touch on this to make sure that any plan recommended meets your requirements.
Mr Goode says you should consider a scenario where you change provider on March 1 and you are scheduled to have a hip replacement in a private hospital on March 10.
Assuming the hospital in question was fully covered on your previous plan, and that you have served all your waiting periods, your new insurer must pay the bill based on your policy terms and conditions.
Do I have to reserve all my waiting periods again if I change provider?
No, your new insurer will only ask for details of your previous insurer, level of cover and how long you were insured.
This will be recorded on your new policy and if a claim is submitted, your new insurer will contact your previous health insurer to verify that these details are correct.
All health insurance policies are annual contracts, according to the expert from TotalHealthCover.ie.
Once the 14-day cooling-off period has expired, you are tied into an annual contract but you are free to shop around at each renewal and make whatever changes you require at this time.
If you decide to change back to your previous insurer at the next renewal, it must accept your application.
If I switch provider, will this affect any claims not yet submitted?
No, not at all. Once the expenses are eligible and were incurred before the policy expired, then they will be settled by all insurers as per the terms and conditions of the policy.
What questions should I be asking the insurer before switching?
* What's the closest equivalent plan to what I have already across all your plans.
* Whatever they recommend, ask them to explain exactly what you're losing or gaining.
* Get them to clarify exactly how their upgrade rule applies and whether there would be any upgrade in cover if you switched to their equivalent plan.
* Confirm that they cover the same public and private hospitals and what their coverage is for the high-tech hospitals like Blackrock Clinic, Mater Private and Beacon Hospital.
* Confirm if there are any excesses on the policy for private hospital treatment.
* Confirm if there are any co-payments for orthopaedic, cardiac or other procedures.
* Check out their scan coverage for MRIs based on your geographic location.
* Confirm what is available on the other product under the headings of maternity, psychiatric, convalescence, day-to-day and emergency cover whilst abroad.
* If you are due to have any medical procedures in the near future, check the procedure code and consultant cover with the new insurer prior to switching.
* Golden rule is you always check your cover in advance with your insurer irrespective of which plan you're on or how minor the procedure might be.
How to switch health insurers
Don't leave it to someone else
* Start the process as soon as the renewal notice lands.
* Remember you normally have four weeks prior to the renewal date and a further 14 days after.
Do your own research before contacting the health insurers
* Check out the best deals on www.totalhealthcover.ie.
* Compare these plans on www.hia.ie to get the full product details.
* Once you've an idea as to the best deals on the market, now you're ready to speak to the insurers.
Contact your existing insurer
* Ask for the closest equivalent plan to what you have already including all their corporate, nurse, teacher or other plans.
* When you get a recommendation, check again that this is their best offering as all these calls are recorded for your protection.
* Get an explanation of all the product differentials especially what you might be losing and also ask them to explain how their upgrade rule works.
* Check to see if there are any "special offers" for children or student cover.
* If you're happy with the alternative plan proposed, the insurer will sort everything over the phone for you in five minutes.
* Always ask the insurer to confirm everything in writing.
Shop around with the other health insurers
* Once you have the best deal from your existing insurer, you can now check if there's anything better on the market.
* Contact the other insurers and repeat the process outlined above.
* Alternatively, you can use www.hia.ie to see what equivalent plans are available and you can then contact the insurer in question.
Get independent advice
* If you find the above process too time-consuming or complex, get independent advice from a broker who is qualified to advise on health insurance and who deals with all providers.
Potential saving: up to €1,400 for a family
Total time: 50 minutes