Tuesday 15 October 2019

Your Questions: Will my health insurer cover me for treatment outside the country?


Stock image
Stock image
Charlie Weston

Charlie Weston

Question: I have had medical insurance now for many years but I may have to travel outside of Ireland for essential medical treatment. The surgery is available in Ireland, but the leading expert in this field is based in Germany. Will I be covered by my plan?

Answer: Most health insurance policies indicate that they will cover treatment abroad once it is medically necessary.

However, all such claims are subject to pre-authorisation and full cover is never guaranteed, according to Dermot Goode of TotalHealthCover.ie.

You will need to contact your insurer immediately and you will be sent the pre-authorisation documentation.

This will need to be completed by your consultant indicating what treatment is necessary, why the surgery should be carried out abroad, what the prognosis will be in terms of further treatment, and the estimated cost etc.

The health insurer will then assess the case on its merits and decide what benefit will apply, if at all. If the claim is to be admitted, the insurer will normally pay up to the level that it would pay if the procedure was carried out in Ireland. But you will be liable for your own travel and accommodation costs as well, Mr Goode says.

Answer: Last year my wife and I entered a restructuring agreement with our mortgage lender on our home as we were struggling to meet our payments. We were offered a term extension for five years in order to reduce our monthly outgoings. My wife recently looked up our mortgage protection policy and realised that it only covers us for 30 years, not the 35 years of our new term. Can we change our policy at this stage to make sure we are not under-insured?

Answer: The first thing you should do is have a broker assess your current financial circumstances. Depending on the type of policy you have, your existing policy may suffice. If not, then switching to another policy may be an option, assuming that you have no major health issues, says Mike Knightson, director of KM Financial Brokers.

Both Royal London and New Ireland have mortgage protection convertible term policies and if you have one of these then it is straightforward to amend the policy, he says.

If you have an Irish Life policy and it has been in place for less than five years you may be able to increase the term by up to five years. If you do not have a conversion option, then Mr Knightson recommends considering a replacement policy. A broker should be able to offer you an affordable option, the caveat being that a new policy would be dependent on medical underwriting. If your health has deteriorated, then this may not be an option.

Question: I'm now 49 years of age and I am finally in a position to put decent money into a pension scheme. From the age of 25, I was a stay-at-home mother with three children and then opened my own business five years ago. Between raising my kids and starting my business I couldn't afford to save for my retirement, until now. Through hard work, my sole-trader business is going really well, so I assumed I would be allowed to make up for my lack of savings in previous years, but Revenue told me that I can't.

Answer: We currently have a lifetime limit on the size of pension fund that you can accumulate over your lifetime. This is designed to limit the State support that workers receive in accumulating a pension.

But we also have an annual pension limit rule which allows workers to claim tax relief up to a fixed limit each year.

It is this pension rule that can be detrimental to certain working groups, the self-employed and women. Unfortunately, you fall into two of them, according to Jerry Moriarty, CEO, of the Irish Association of Pension Funds (IAPF).

Women who take time out from paid employment to raise children automatically forgo their annual tax relief allowance for pension contributions during the period of years that they are not in paid employment.

Returning to work after an extended absence, means women cannot make up for their lost contributions and they effectively miss out on the tax relief afforded to their male colleagues in their absence.

While the amounts you can receive tax relief on increase as you get older, it isn't always enough for those workers who either begin saving late or have had to take a break in pension saving at some point, Mr Moriarty says.

Consider setting up a company pension plan and the company can pay in, which would help you have an adequate pension in retirement.

Do get independent financial advice.

Most health insurance policies indicate that the insurer will cover treatment abroad once it is proven to be medically necessary

Women who take time out from paid employment to raise children automatically forgo their annual tax relief allowance for pension contributions

Irish Independent

Also in Business