Surviving price hikes
Many top-plan consumers will be considering reducing their cover after Budget changes. Charlie Weston outlines the alternatives
SOME health insurance plans are set to be affected more than others by the changes in the Budget. Those on the top plans, such as VHI Health Plus Premium (Plan D) or Health Plus Platinum (Plan E), will see their premiums rise by €493 and €784 per adult respectively. Those insured on equivalent plans with the other insurers will experience similar increases, according to Dermot Goode of Healthinsurancesavings.ie
So, what are their options?
Well, for those on the top plans that cover private accommodation in the hi-tech hospitals, such as Blackrock Clinic, Mater Private and Beacon Hospital, they could drop one level to semi-private cover (no more than five beds in the ward).
They would retain their cover for the same hospitals but would no longer be covered for the private room, which is never guaranteed in any event.
According to Mr Goode:
* Those on VHI Plan E (Health Plus Platinum) could reduce to Plan D (Health Plus Premium), which would reduce their premium from €4,720 to €3,263 per adult.
* Those on Laya Health Manager Gold could reduce to Health Manager Silver, reducing their premium from €5,728 to €3,601 per adult.
* Those on Aviva We Plan Level 5 could reduce to We Plan Level 4, reducing their premium from €4,466 to €3,245 per adult.
* GloHealth has Ultimate Plan, which actually covers a private room in the hi-tech hospitals and this can be purchased for €3,275 per adult.
Many consumers insured on the above plans will be considering reducing their cover significantly as these plans are no longer within their price range.
There is a considerable difference in benefits associated with such a move. For example:
VHI members could reduce to Health Plus Extra (B Options), which will cost €2,096 per adult, which is a saving of €1,168 compared with Health Plus Premium (Plan D).
However, they will no longer be fully covered for all treatments in the hi-tech hospitals.
This plan covers up to a semi-private room in all private hospitals and provides full cover in the hi-tech hospitals for listed cardiac procedures and day-case procedures only.
For those reducing their cover, they also need to be aware of the upgrade rule; that is, you can increase your cover again at each renewal, but any existing medical conditions will only be covered on the lower plan for the next two years if you're under 65 and five years if over.
Laya members could reduce to Total Health Select, which will cost €1,553 per adult compared with €3,601 on Health Manager Silver.
This plan covers you for a private room in all private hospitals, excluding the three hi-tech facilities (Blackrock Clinic, Mater Private and Beacon Hospital). You would have full cover here for listed cardiac procedures and day-case procedures only, according to Mr Goode.
An additional positive of this plan is that it includes day-to-day cover, which gives you refunds on a whole range of routine medical expenses with no excess to pay first.
Aviva members could reduce to Level 2 Complete Health, which will cost €2,138 per adult and generate a saving of €1,107 compared to the We Level 4 Plan.
This plan covers up to a semi-private room in all private hospitals, including the Beacon Hospital in Dublin.
However, for the remaining hi-tech facilities, full cover is restricted to day-case procedures and listed major cardiac procedures only.
For those interested in switching to the new provider, GloHealth, its Ultra Plan is available for €2,113 per adult.
Similar to the Laya alternative plan, this scheme covers you up to a private room in all private hospitals excluding the hi-tech facilities.
In these hospitals, full cover will be restricted to day-case procedures and listed major cardiac procedures only.
Mr Goode warned consumers that some of the lower-cost options include shortfalls in private hospitals on a whole range of orthopaedic procedures, such as hip replacement etc.
But he said the above alternative plans have no such shortfalls.
These plans are excellent alternatives for those on the higher-priced plans, Mr Goode said.
MID-RANGE PRICE PLAN OPTIONS
There is a significant number of health insurance customers already insured on these mid-range plans which they can no longer afford.
So what are their options and what are the potential pitfalls?
It is worth noting that the plans listed below, with the exception of the Laya plan, include "restricted procedures".
This refers to a short list of mainly orthopaedic procedures where the member will have a co-payment if they elect to have the procedure carried out in a private hospital.
Glo and Aviva have approximately nine to 10 procedures on their list with a co-payment of €2,000, whereas VHI has 22 procedures on its list and the shortfall is up to 20pc of the hospital charge.
Also, the Aviva alternative includes an overnight excess in private hospitals of €125 per admission; that is, the first €125 of the total bill for private hospital admissions must be paid by the member.
With VHI, for those currently insured on either Health Plus Extra (B Options), costing €2,096 per adult, or Health Plus Access (Plan B), costing €1,705, they should consider Company Plan Extra, which costs €1,415 per adult.
With Laya, for those insured on either Essential Plus, costing €1,985, or Essential Plus with excess, costing €1,631 per adult, they should consider HealthWise Plus (no excess), which costs €1,054.
With Aviva, for those insured on either Level 2 Complete Health, costing €2,138 per adult, or Level 2 Hospital, costing €1,633 per adult, they should consider Nurses & Teachers Choice (discounted version), which costs €1,090 per adult.
For those insured on the Glo Ultra plan, costing €2,113 per adult, they should consider Best Plan, which costs €1,118 per adult.
For those members who have adult dependents on their policies – dependents aged 21 or over – they should consider splitting their cover.
This means putting their dependents on lower cost plans more suited to their stage in life; that is, these dependents will be more likely to incur routine medical expenses rather than prolonged stays in hospital.
All health insurers have a range of corporate plans that provide excellent overall cover, including guaranteed refunds on routine medical costs, such as GP, routine dental, physiotherapy and consultants' fees.
Mr Goode said all these plans include small excesses on each admission to private hospitals. With the exception of the Laya plan, all include restricted procedures as outlined above.
* All prices quoted are net of tax relief at source and are correct as of October 16 as per www.hia.ie (Health Insurance Authority). However, prices and benefits are subject to change and consumers should confirm all details directly with the insurer in question.