Tuesday 19 June 2018

What cover is best for fertility treatment?


Email your questions to lmcbride@independent.ie or write to ‘Your Questions, Sunday Independent Business, 27-32 Talbot Street, Dublin 1’. Picture posed by models
Email your questions to lmcbride@independent.ie or write to ‘Your Questions, Sunday Independent Business, 27-32 Talbot Street, Dublin 1’. Picture posed by models

Barbara Sheahan

Q: My partner and I are looking to start a family in the next two to three years. We were hoping to go for an initial consultation and fertility testing in the next few months and then getting the ball rolling with intrauterine insemination (IUI) at some stage over the next year. I'm wondering what the best plans are for fertility treatment and IUI? I'm currently with VHI and it has advised me that there's a 52-week waiting period for such cover. Is this normal? I'm open to switching insurance providers if needs be. Gemma, Smithfield, Dublin 7

Your private health insurance policy will unfortunately only cover a fraction of the cost of fertility treatment - regardless of which provider or plan you select. However, over the last year, there has been many fertility benefits added to a number of private health insurance plans -which is good news.

VHI introduced a fertility benefit on a selection of its plans. This benefit includes a €100 discount on the cost of the initial consultation, €450 towards the cost of one cycle with IUI treatment, and €1,000 towards the cost of two cycles of in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI).

VHI introduced this benefit on a number of its suite of 'One Plan', 'Company Plan' and 'PMI' plans. There are some excellent plans in each of these suites depending on what your budget is. 'Company Plan Plus Level 1.3' and 'Company Plan Extra Level 1' are excellent policies from VHI which are very competitively priced.

Laya Healthcare offers cover of up to €1,000 per lifetime towards IVF, IUI or ICSI. This benefit is available on several of its plans when carried out in one of Laya's approved centres. Laya's 'Simply Connect' and 'Complete Simplicity' are both good plans which include this fertility benefit.

Irish Life Health has released a suite of plans called the '4D Health' range. There are five policies in this range to which you can add a personalised package called 'Fertility Extra'. The amount you can claim depends on the policy you select. The IVF, IUI and ICSI benefit ranges from 50pc cover - up to a maximum of between €500 and €1,000 (depending on your plan). There is also a contribution towards fertility screening tests, counselling, and nutritionist and acupuncture visits. 'Best Ultimate 2' is another excellent plan from Irish Life Health which offers 50pc cover for IVF, IUI and ICSI - up to a maximum of €2,000. Unlike any other policy, this can be used twice per lifetime.

As for the 52-week waiting period you mentioned, this applies to all providers if you are taking health insurance out for the first time - or if you are upgrading your maternity cover.

So you won't get a shorter waiting period by switching.

Dangers of cheap insurance

Q: I was discussing health insurance with some of my colleagues and I seem to be paying a lot more than people my age. I am 45. What would be the average premium people are paying at my age? I hear some people are paying as little as €600 for a policy. I am worried that I will not have enough cover if I opt for a policy at such a price though. Martha, Cork City

Unfortunately this is something which is popping up more often in the last couple of years. People are buying policies costing €600 per year and thinking they have excellent health insurance cover.

In reality though, policies costing around €600 a year will give you very little cover in the event of you needing treatment.

While affordability is important for most people, bear in mind that these plans are entry-level plans which will have huge excesses - or very limited hospital cover. (Excesses are the first part of a claim which you must pay yourself. Some excesses are so high that it may not be worth making a claim).

If you were to go public for hospital care, you would be charged €80 per night - up to €800 in any one year.

Most people take out health insurance because they feel they can't rely on the public health system.

If you want a reasonable level of cover, you could get you a good private plan for €900 - which is only an extra €100 more than you would pay if you faced the maximum €800 charge to stay in a public hospital for ten or more days in a year.

If you want a very good plan with cover for all public and private hospitals, cardiac cover in the high-tech hospitals, and cover for day-to-day expenses, you need to be spending at least €1,200 on cover.

There is no fixed premium that people of certain age groups should be paying - it really depends on the level of cover you require, your budget and your medical circumstances.

Health insurance premiums are expensive and the sheer volume of plans available can be overwhelming.

Before committing to another year's premium, ask your adviser or insurer if there are any plans similar to your existing plan.

If they suggest an alternative plan, always ask them to outline how it differs to your existing plan - rather than to simply point out the similarities as this will make it easier for you to identify any benefits you may be losing by moving to a different plan.

Cover for consultant visits

Q: My health insurance renewal date is coming up. I am currently on a plan which doesn't give me any refund on day-to-day benefits like consultant and GP visits. This is my main expenditure as I have an ongoing medical condition and must visit a consultant four times a year - which costs me €200 per visit. I also see a doctor about five times a year. I don't have a medical card so I would like a policy where I can claim back a portion of the cost of these visits. Can you recommend a plan that would allow me to do so? I am 43 years old and do not want to spend more than €2,000 per year on insurance. Nora, Ranelagh, Dublin 6

There are several corporate plans available which tend to be the most competitively priced plans on the market and often offer the best day-to-day cover.

Despite the name of these plans, they are open to everyone - so they are certainly worth considering.

If you are happy to have an excess (where you pay the first part of an insurance claim yourself) on your plan, a good option would be Laya Healthcare's 'Complete Simplicity' plan - this plan allows you to claim back 50pc of the cost of consultant and GP visits.

Other plans worth considering are VHI's 'PMI 25 11' plan - which offers €100 back per consultant visit and €40 back per GP visit (up to a limit of 12 visits of each a year), or Irish Life Health's 'Be Fit 3' - which offers a full refund on your first two consultant, GP and A&E visits and 50pc back on all subsequent visits.

If you would like a policy without an excess, I would recommend Laya Healthcare's '360 Care' - which covers 75pc of the cost of GP and consultant visits (though the refund for consultant psychiatrist visits is higher), VHI's 'Company Plan Extra Level 2' - which offers €100 back per consultant visit and €40 back per GP visit ( up to a limit of 12 visits of each a year), or Irish Life Health's 'Best Ultimate 2' plan - which covers 75pc of the cost of consultant and GP visits.

The key thing to remember is that if you are switching provider to an equivalent plan, you are covered immediately.

Existing conditions are irrelevant and you cannot be penalised when switching just because you may be more sick than another person.

However, you should always tell your adviser or insurer about any illnesses so they can ensure that you are getting the best policy to suit your needs.

Barbara Sheahan is health insurance expert with www.healthinsurancehelp.ie

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