Saturday 17 August 2019

Getting the best health cover without paying a huge premium

As price hikes kick in for health insurance, it's a good time to shed expensive plans, writes Louise McBride

'In the midst of these price increases, it is hugely important to seek out good-value private health insurance - and to shed overpriced plans. Failure to do so could see you struggle to afford health insurance going forward'
'In the midst of these price increases, it is hugely important to seek out good-value private health insurance - and to shed overpriced plans. Failure to do so could see you struggle to afford health insurance going forward'

Many people will pay hundreds of euro more for their private health insurance this year - following a series of summer price hikes. The cost of a private health insurance plan with VHI will increase by as much as €320 a year once the insurer's price rises kick in at the start of August. VHI is increasing the price of about half of its plans.

Laya Healthcare increased the price of 82 of its plans at the start of July, while Irish Life Health (ILH) hiked its prices in June. There could be further price increases to come.

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"Medical inflation is running at anything from 5pc to 8pc to cover new technologies, new drugs, wage inflation and so on," said Dermot Goode, health insurance expert with totalhealthcover.ie. "Consumers should budget for at least a 5pc increase on their [private health insurance] costs - and those on the most dated plans should expect potentially higher increases. All health insurers are reporting an increase in claims - especially from the private hospital sector. Although the hope is that there will be no further price increases until early 2020, further hikes for later in 2019 cannot be ruled out - depending on future [health insurance] claims experience."

In the midst of these price increases, it is hugely important to seek out good-value private health insurance - and to shed overpriced plans. Failure to do so could see you struggle to afford health insurance going forward.

The Sunday Independent lined up Goode to track down some of the best-value private health insurance plans on the market.

Young, single: €1,100

Let us say you are a 30-year-old single person who has no dependants, in good health.

The least you can expect to pay for a good private health insurance plan which covers hospital care and a certain amount of daily medical expenses (such as GP visits) is about €1,100, according to Goode. Some of the best plans you can get for that price are VHI's Company Plan Plus Level 1.3 (which currently costs €1,128 a year) and Laya's Simply Connect plan (€1,133 a year), according to Goode.

Both plans offer cover for day-to-day medical expenses - and one of the advantages of these plans is that there is an excess (the first part of a claim you must pay yourself) of only €1 on outpatient (treatment which does not require an overnight hospital stay) expenses. This makes it easier to get money back on daily medical expenses, such as GP visits.

"Most young people only need cover for outpatient expenses," said Goode. So having a plan which offers good cover for outpatient expenses can be invaluable for a young person, as the only health insurance claims they may make could be for GP and physiotherapist visits - as opposed to treatment in a hospital.

Should hospital care be required, both Company Plan Plus Level 1.3 and Simply Connect cover a private room in a public hospital, and a semi-private room in a private hospital. Limited cover for certain major procedures in the high-tech hospitals is also available.

The 4D Health 1 plan (which costs €1,089 a year) from ILH is another one recommended by Goode for this individual. Although this plan offers similar cover for hospital treatment as the Laya and VHI plans, as 4D Health 1 has an excess of €125 on outpatient expenses, its cover for day-to-day medical expenses is not as good.

Avoid the older private health insurance plans, as these are likely to be much more expensive than newer ones. "A 30-year-old single person could easily spend €1,500, €1,700 or €1,800 a year on an older plan," said Goode.

For example, VHI's Health Plus Access (previously the old VHI Plan B) costs €1,933 a year.

Bear in mind that the prices of the VHI plans quoted here may change once the insurer's price rises kick in on August 1. So if you are planning to move to or buy a VHI plan, do so before August 1 if you can - though this is unlikely to be possible if your renewal date falls after that date.

Young family: €3,000

Let us say you are a family of four - with two adults in their early 40s and two children under the age of 10. The least you can expect to pay for a good private health insurance plan is around €3,000. Goode suggested VHI's PMI 0710 (which currently costs the family €2,976 a year), Laya's Simply Connect Plus (€3,146 a year) and ILH's 4D Health 2 (€3,150 a year). "These represent some of the best-value semi-private corporate plans in the market," said Goode.

The plans include cover for a semi-private room in a private hospital - though co-payments are required for certain orthopaedic and ophthalmic procedures with PMI 0710, and for certain orthopaedic procedures with 4D Health 2. There is no shortfall on specified orthopaedic procedures under Simply Connect Plus.

These three plans also have a reasonable excess on most private hospital stays, and offer cover for certain cardiac procedures at Mater Private and Blackrock Clinic, as well as cover for day-to-day medical expenses.

Cover for daily medical costs is always valuable when young children are involved - but it is increasingly useful for adults today too.

"Private hospitals know insurers are scrutinising every [health insurance] claim coming in," said Goode.

"So you can expect to get a lot of medical tests and checks before being admitted to a private hospital - so that there's no question that you need to be admitted to the hospital. So having day-to-day cover [for such tests] is important."

It may be worth splitting your cover - that is, insuring the adults under one plan and the children under another. In doing so, you may be able to get cheaper cover for your children.

Retired couple: €3,000

The least that a couple in their mid-60s can expect to pay for a good health insurance plan is about €3,000. Goode recommends VHI's Company Plan Extra Level 1 (which currently costs €1,548 per adult a year, or €3,096 per couple), Laya's Prime scheme (€1,425 per adult, or €2,850 per couple) and ILH's 4D Health 4 (€1,524.50 per adult, or €3,049 per couple).

These plans include cover for a stay in a private hospital - though there is a shortfall on cover for orthopaedic procedures with all of them, so this couple would need to foot some of the bill for orthopaedic surgery if they required it.

The co-payment (the portion of a bill which you pay yourself) for orthopaedic procedures could be as much as €2,000 with 4D Health 4 - and possibly more with the other plans (depending on the cost of the procedure).

However, some of the private hospitals are waiving the shortfalls for such procedures - rather than risking losing the customer, according to Goode. This is worth bearing in mind if you are reluctant to buy a plan which might trigger a co-payment. Despite this, never assume that a private hospital will waive a co-payment - always check in advance. These plans also cover a number of cardiac procedures at Mater Private, Blackrock Clinic and Beacon Hospital; such cover could be invaluable in your retirement years. The plans have good cover for GP visits and other day-to-day expenses too.

"These are excellent corporate plans but they may not suit everyone, and so you should seek expert advice before switching to these schemes to ensure they match your specific requirements," said Goode.

So if you have any medical conditions or issues, or are in need of medical or surgical appliances, check that your insurance will cover you for these before switching from another plan - or before buying your first plan (if this is your first purchase of private health insurance).

Be aware that changing plan while receiving medical care or treatment could be unwise. "It can be a risk to chop and change cover in the middle of treatment," said Goode.

Older people often have most to gain by changing health insurance plans as they tend to be on old ones -which are usually the most expensive type. For example, VHI's Health Plus Premium (previously the old Plan D) will cost €3,495 a year per person from August 1.

Remember, an old plan could be twice as expensive as a new plan, despite the cover on the new plan being similar to, or even better than, the cover on the old one. As always, buyer beware.

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