| 9.4°C Dublin

VHI now set to cut the types of illnesses it covers

HARD-PRESSED families with private health insurance could be hit with massive bills for treatments due to cutbacks on illnesses being covered.

VHI, which has 1.2m customers, already restricts some 22 illnesses that it will cover on most of its mid-market plans, while Aviva does not fully cover certain procedures on some of its plans.

Quinn is the only health insurer not to restrict certain procedures, Dermot Goode of Healthinsurancesavings.ie told the National Healthcare Conference in Dublin.

He warned that insurers were set to restrict more illnesses and procedures in a bid to keep their costs down.

With the VHI, people on mid-level plans who need a number of orthopaedic and ophthalmic treatments will have a shortfall of 20pc for the cost of the treatment if the procedures are carried out in private and semi-private hospitals.

This could mean someone who had a hip replacement could end up having to pay €4,000 themselves, according to Mr Goode.

Meanwhile, changes to a number of Aviva plans mean that policyholders will have to pay the first €2,000 themselves for some operations in private and semi-private hospitals.

This is because orthopaedic procedures, such as those carried out on hips, shoulders and knees, are no longer fully covered by Aviva in private and semi-private hospitals.

Mr Goode said that one way to avoid having to pay between €2,000 and €4,000 for some procedures in private hospitals was to pay up to €1,600 a year for higher end plans.

Currently, most families have dropped down to plans that cost each adult around €800 a year. Or the alternative is to have the operation done in a public hospital, Mr Goode said.

Earlier this week, VHI's Chief Executive Declan Moran was asked if there were moves to restrict the number of illnesses covered on medium range policies. He said: "Restricted illnesses are symptomatic of a marketplace where our competitors are cherry-picking the younger people who make fewer claims."

At the same conference, Aviva Ireland Chief Executive Sean Egan called for major reforms of health insurance to make cover more affordable for families.

He called for Health Minister James Reilly to allow private health insurers to negotiate directly with hospitals on bed charges.