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Sunday 25 September 2016

We are planning to get IVF - who offers the best private health cover for this treatment?

Your questions: Barbara Sheahan, head of health and dental with the Kindlon Insurance Group

Barbara Sheahan

Published 12/06/2016 | 02:30

We are planning to get IVF - who offers the best private health cover for this treatment? (Stock picture)
We are planning to get IVF - who offers the best private health cover for this treatment? (Stock picture)

My partner and I are having trouble conceiving, so we have decided to go down the IVF route.

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Which private health insurer and private health insurance plan is the best one to be on when it comes to cover for IVF?

Also, do private health insurers typically restrict the cover they provide for IVF to one round of treatment?

Tom, Baltimore, Co Cork

Unfortunately the cover offered for In Vitro Fertilisation (IVF) under private health insurance is very limited and it is only available from some insurers under certain plans.

Glo Health offers a 10pc discount for certain types of infertility treatment in the Beacon Hospital in Dublin - and this discount can be used on an annual basis. This benefit is included in Glo's maternity personalised package - which can be added to most Glo Health plans at no additional cost.

From June 30, Glo Health will have some of the best cover available on the market for IVF, Intracytoplasmic Sperm Injection (ICSI) and Intrauterine insemination (IUI) - which are all types of fertility treatment. On that date, its 'Best Plan Ultimate Cash II' will cover 50pc of the cost of these treatments (up to a limit of €2,000).

Unlike any of the other providers; this benefit can be used twice per lifetime in any treatment centre. There is a waiting period of 52 weeks before this benefit can be used. This plan also offers €300 for maternity consultant fees which, in conjunction with the maternity personalised package, brings the total amount members are eligible to claim to €600. The price of this plan is being reduced from €1,719 to €1,593.76 at the end of this month.

Most VHI plans do not cover IVF. However, its PMI 0411 covers €2,000 of the cost of IVF, ICSI or IUI. This is a once-off benefit so you can only use it once in your lifetime as a member. This was the best infertility benefit available on the Irish market prior to the introduction of Glo's offer above. The treatment must be carried out in one of the five VHI approved clinics - that is, Clane Fertility Clinic, Cork Fertility Clinic, Rotunda IVF, Merrion Fertility Clinic and Galway Fertility Clinic.

You must also be on the plan a year before you start any fertility treatment to be covered for the benefit. This plan is on the expensive side, coming in at €3,666. In saying that, this is the only plan on the market that will potentially fully cover the costs of private maternity care.

Laya healthcare offers cover of up to €1,000 per lifetime towards IVF, IUI or ICSI. This benefit is available on a number of its plans when carried out in one of the seven Laya approved centres - that is, Cork Fertility Centre, Galway Fertility Clinic, Clane Assisted Conception Unit, Sims IVF clinic, Merrion Clinic, Rotunda IVF and Morehampton Clinic.

Aviva doesn't offer specific cover for infertility treatment. However, some of its plans offer excellent outpatient benefits - which can assist with the additional costs (such as consultant and GP fees) while undergoing fertility treatment.

My husband and I are in our late 20s. We don't have private health insurance yet but we're planning to start a family. Our finances are a bit tight so I'm not sure if we can really afford private health insurance.

Is there any difference in the care I will get if I go public, semi-private or private to have a baby?

Sorcha, Ballyferriter, Co Kerry

The most important thing you should be aware of is that all four health insurance providers impose a 52-week waiting period for maternity benefits when you are taking out health insurance for the first time. This means that you must have your health insurance for at least a year at the time you are giving birth - in order to be covered.

You don't however, have to have insurance for a year before you conceive. Still, it would be important to act fast if you are hoping to be covered for maternity benefits.

All private health insurance plans have to include some level of maternity benefits, regardless of age or gender, due to the minimum benefit legislation. The are three options available when it comes to maternity care - the public health system, semi-private care and private care. All options offer good maternity care so it really comes down to your own personal choice.

If you choose to go publicly, it is fully funded by the State. This includes GP appointments, pre-natal appointments and ultrasounds. You will be in a public ward in a public hospital and you cannot opt for a private room at the time of birth if you have been a public patient all along. So even if you have private health insurance cover but choose to be treated publicly, you are not then entitled to a private room in a public hospital after you have given birth. So really it does not make a difference whether you have private health insurance or not should you choose to be a public patient.

However, failure to familiarise yourself with all aspects of the cover could lead you to miss out on some valuable benefits such as post-natal home help and breastfeeding consultancy.

Semi-private treatment is only available in Dublin hospitals. Under this type of care, you would attend a consultant's team in a private clinic in a public hospital. As part of this, you may have some of your appointments with your GP (an arrangement known as combined care). You may have a semi-private room but this is subject to availability.

Most plans on the market cover the cost of the room (which is €813 per night) and the delivery. You would pay the consultant directly for your pre- and post-natal appointments. You may be able to get some of the money paid for appointments back, depending on your plan.

If you choose to go privately in a public hospital, you will choose your own consultant and pay them directly. Your appointments would all be with this consultant. You may avail of a private room in a public hospital but again this is subject to availability.

Most plans will cover the cost of the room which is €1,000 per night and the delivery.

I am in my early 40s and pregnant with my first child. Due to my mature age, my doctor has advised I get first-trimester screening - as this can help detect Down syndrome. It costs about €250. Are the costs of tests such as this covered by private health insurance?

Clare, Monkstown, Co Dublin

Only two of the four providers contribute towards first-trimester screening.

VHI offers up to €200 on 17 of its health insurance plans. Glo Health offers a maternity personalised package which can be added to most plans for free. Under that package, there is a €30 contribution towards an early pregnancy scan in Dublin, Cork, Galway or Limerick.

From the end of this month, Glo Health is also adding a benefit of €200 towards foetal screening to its 'Best Ultimate Cash II' plan.

Email your questions to lmcbride@independent.ie or write to 'Your Questions, The Sunday Independent Business Section, 27-32 Talbot Street, Dublin 1'.

While we will endeavour to place your questions with the most appropriate expert to answer your query, this column is a reader service and is not intended to replace professional advice.

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