Girlfriend joining VHI??

Stewy18

hi folks,

I am a member of VHI for years now,
but my girlfriend is not,
wondering what's the best thing for my girlfriend as she does not have any heath insurance at the minute,
can I add her to my policy?, if so, is there a waiting period for her then?, also what about maturnity benefits , how long does she has to wait to get them?

thanks in advance...

The_Conductor

There is no problem whatsoever adding her to your policy.
There is no difference between her taking out a policy herself and going on your policy- tax is deducted at source etc.

She is treated as a new member- she will be subject to certain waiting periods i.e.

If she is involved in an accident there is no waiting period- she is covered immediately.

If she develops an illness after joining- she is not covered for the first 6 months.

If she has a pre-existing medical condition- she is not covered for the first 5 years.

If she becomes pregnant or wishes to claim pregnancy related benefits- she is not covered for the first year.

Benefits and indeed waiting periods vary depending on the plan she wishes to go on, her age, and other factors- you really are better off contacting the VHI directly and discussing it with them, than randomly asking people here for information that may be incorrect (unless of course they are VHI employees! )

SMcCarrick

dudara

Moved to Banking & Insurance & Pensions

dudara

Stewy18

thanks will do...

Darragh29

VHI are the least competitive provider of health insurance on the market. Advise her to shop around for a start and not be wasting her money propping up an inefficient organisation like the VHI. Check out Hibernian and Quinn, the savings are huge for the same or greater level of cover.

The_Conductor

Darragh29 wrote: »

VHI are the least competitive provider of health insurance on the market. Advise her to shop around for a start and not be wasting her money propping up an inefficient organisation like the VHI. Check out Hibernian and Quinn, the savings are huge for the same or greater level of cover.

It really depends.
The VHI tend to be more expensive- but this is because their members are almost twice as likely to have claims than are the members of Quinn or Avivas. This has happened because new firms were allowed to cherrypick younger more lucrative clients- while at the same time the VHI was forced to continue with Community rating schemes (and the current jackass tax on the under 50s is an effort to implement this by the back door). When BUPA were told they would have to partake in a national community rating programme with other providors- they got a 4 year moratorium, and then they pissed off selling the business to Quinn- who then tried to argue that as a new business they too should have another 4 year moratorium. Avivas on the other hand outsourced their backoffices and call centres to India to drive down their costs........

If you are young and only looking for basic health care insurance (up to the equivalent of VHI B without options) then Quinn are cheapest, followed by Avivas then the VHI. Equivanent of VHI B plus options- Quinn, the VHI then Avivas. VHI C minus options= Quinn, VHI, Avivas. VHI Plus Options (and all higher schemes = VHI, Quinn, Avivas........

The higher the level of coverage- the less competitive Quinn and Avivas are. The lower the level of coverage- the more competitive they are......

S.

antoinolachtnai

smccarrick wrote: »

It really depends.
The VHI tend to be more expensive- but this is because their members are almost twice as likely to have claims than are the members of Quinn or Avivas. This has happened because new firms were allowed to cherrypick younger more lucrative clients- while at the same time the VHI was forced to continue with Community rating schemes (and the current jackass tax on the under 50s is an effort to implement this by the back door).

You say that BUPA cherry-picked younger more lucrative clients. Is this really true?

You imply that VHI offered community rating, whilst BUPA did not. Again, is this actually true?

Did BUPA refuse anybody who the VHI would have taken on?

You do not mention the issue of capital adequacy. VHI does not have adequate capital to operate as a health insurer. The only reason it can continue to trade is because it is exempted from the usual requirements for a health insurer.

The_Conductor

antoinolachtnai wrote: »

You say that BUPA cherry-picked younger more lucrative clients. Is this really true?

You imply that VHI offered community rating, whilst BUPA did not. Again, is this actually true?

Did BUPA refuse anybody who the VHI would have taken on?

You do not mention the issue of capital adequacy. VHI does not have adequate capital to operate as a health insurer. The only reason it can continue to trade is because it is exempted from the usual requirements for a health insurer.

I'm not implying it.
I'm stating they entered the market with the knowledge of the existence of 'Community Rating', but decided they were going to fight it- and indeed brought it all the way to Europe. The government in its infinite wisdom decided that as a new business they would have a 'holiday' from partaking in Community Rating. As soon as the holiday elapsed, and they would have had to start to make equilibrium payments to the VHI, they sold up their business, and then Quinn, the purchaser, made an application as a 'new health insurer' for another 'holiday'. Its all on public record.

BUPA did not refuse to take on anyone the VHI were currently covering- they did however offer an entirely different set of conditions in Ireland than they do elsewhere- imposing far stricter conditions with much longer lock out periods than would be considered normal. For anyone going to them, under the age of 35, without a diagnosed serious medical condition- it was brilliant- they could undercut the VHI by over 40%. The VHIs subscribers meanwhile who were under 35 were supporting their older peers- as their only option other than to do so, was to desert the company and join BUPA for cheaper insurance (and consequently higher insurance for the older generations. Well over 220,000 did.

The success of BUPA and subsequently Quinn, was entirely a product of the Community Rating Scheme- and the existence of equalisation payment holidays for new businesses. The VHI even prepared several policy documents for the Minister for Health- clearly arguing the case against equilibrium- so they too could tier their products at different age groups- or price insurance on the basis of risk assessment. The government told them to stuff it. This is the genesis of the new health 'tax' that everyone under the age of 55 is paying. If Quinn were to actively target the older generations- they could take a lions share of these takings- but its simply not worth their while- meantime the VHI is under government instructions to carry on as usual.........

Its a total market distortion- and the imposition of risk equalisation by the back door, when elements of it failed to stand up to legal scrutiny.

Yes- I neglected to cover the capitalisation of the VHI (and the current problems that Quinn have in this respect- which are currently with the regulator). It is a clear anamoly that the Irish government is both the largest providor of public and private health care in the Irish market- and something that needs to be addressed as soon as possible, as per the 2006 Commission ruling. As a state body the VHI was exempt from the capitalisation requirements of a private business- quite simply because it was/is operating under government guarantee (and was wholly an instrument of government policy- a la the risk equilisation mess). The did not have the risk associated with operating in the market- that risk was (and continues to be) borne by the government. As you are aware- they have until 2014 to bring their reserves up to the required level- we can only assume the intention is that they will then be sold off.......

S.

antoinolachtnai

I think BUPA would have said that their problem was not with the principle of community rating per se, but with the way the government was applying it.

BUPA charged people of all ages the same amount for regulated cover, no?

Healthcare insurance is quite a bit more complex than just community rating. VHI had many other advantages in the marketplace that BUPA et al did not have (as a state incumbent in any industry will have).

One aspect of it is the situation where the company does not need to be capitalised. The other is the power the company has with suppliers of healthcare services.

Of course none of this helps the OP.

broker2008

- Surprised to see that Hibernian Aviva rebranding hasn't reached everyone !;)

http://www.avivastadium.ie/

- Quinn charge the same premium for all ages - community rating ensures this.

"The higher the level of coverage- the less competitive Quinn and Avivas are. The lower the level of coverage- the more competitive they are......"

- not quite sure about this ?

NuMarvel

smccarrick wrote: »

I'm not implying it.

I'm stating they entered the market with the knowledge of the existence of 'Community Rating', but decided they were going to fight it- and indeed brought it all the way to Europe. The government in its infinite wisdom decided that as a new business they would have a 'holiday' from partaking in Community Rating. As soon as the holiday elapsed, and they would have had to start to make equilibrium payments to the VHI, they sold up their business, and then Quinn, the purchaser, made an application as a 'new health insurer' for another 'holiday'. Its all on public record.

BUPA did not refuse to take on anyone the VHI were currently covering- they did however offer an entirely different set of conditions in Ireland than they do elsewhere- imposing far stricter conditions with much longer lock out periods than would be considered normal.

For anyone going to them, under the age of 35, without a diagnosed serious medical condition- it was brilliant- they could undercut the VHI by over 40%. The VHIs subscribers meanwhile who were under 35 were supporting their older peers- as their only option other than to do so, was to desert the company and join BUPA for cheaper insurance (and consequently higher insurance for the older generations. Well over 220,000 did.
S.

BUPA didn't fight community rating. They fought Risk Equalisation. Community Rating was never the issue. The transfer of tens of millions of euro every year to the dominant player was the issue.

And the terms and conditions applied by BUPA in Ireland were similar to those laid out by VHI. Were these conditions different to other countires? Yes. But the health insurance regulatory environment and market structure is also different so it follows that the conditions would be different. For example Minimum Benefits set out the minimum terms and benefits that every insurer must adhere to. The lock out period to which you refer (which I'm presuming is the pre-existing waiting period) is the same with all insurers - 5 years for unders 55s, and so on.

You should also remember that anyone of any age going from VHI to BUPA would also receive the same price saving and benefits as someone under 35 without a diagnosed medical condition. And the waiting periods they have served with VHI came with them.

And for the record, I'm a former BUPA employee. But I'm hoping any counter arguements will be more than "Of course you'd say that!"

The_Conductor

NuMarvel wrote: »

BUPA didn't fight community rating. They fought Risk Equalisation. Community Rating was never the issue. The transfer of tens of millions of euro every year to the dominant player was the issue.

Aka- they were happy to poach the younger members who were less likely to claim from the VHI- leaving the VHI with a far older age profile and via the community rating mechanism, a necessity to charge all members the same rate?

Eventually no-one in their right mind, unless they suffered from serious medical conditions or were aged or infirm- would stay with the VHI (or any other company which found itself in a similar situation).

BUPA, Quinn and Avivas have the right to refuse to cover anyone for any reason whatsoever (and indeed rightly so). However in a market where flawed government regulation (i.e. the community rating scheme) exists- the only mechanism to stop a run on one company (irrespective of whether its the former monopoly or not)- is via the introduction of some sort of a risk equalisation scheme.

The 2006 court case focused on the risk equalisation aspect of the scheme- however both are interlinked- its not possible to argue they are not. Link here The judgement acknowledged this- however the challenge was successful- as the Minister had exceeded the powers granted to her under the 1994 legislation (which did not specifically mention RES).

Community rating was and is an issue- in so far as it is government policy- and the manner in which it works is a severe distortion of the market place. The RES was an attempt to maintain this imperfect distorted market, with all players, including the incumbent, on a level pegging. This was acknowledged in the submissions to the EU Commission by the Department of Health in 2006 (partly as a result of which the government are under EU instruction to divest themselves of the VHI within 10 years- which is why the VHI are capitalising themselves as a wholly commercial entity- rather than as a state body).

The sole argument for the RES is that the new comers to the market can cherry pick younger customers who have a much more favourable risk profile than do the customers of the market incumbent. Unfortunately it is a valid argument. What the government needs to figure- is community rating worth saving at any cost- and why should the under 55s be discriminated against in order to support the older generations- particularly as the wealth transfer from the younger to the older generation over the past decade is unprecedented. It looks probable that a large portion of the younger population who may at one time have aspired to have private health insurance will simply say the price is too high- why should I subsidise my parents and my grandparents?

Community rating has the best of intentions- but you have to accept that in order to positively discriminate against one group (the over 55s) that there is a reciprochal negative discrimination against another (the under 55s). The younger you are- the higher that discrimination. Unfortunately the over 55s are more than 6 times more likely to vote than the under 55s- and votes are what counts.......

Its disingenuous to try to claim that risk equalisation and community rating are two seperate issues- they are horribly interlinked- one would not exist without the other. The current tax based mess is simply a way of hiding everything behind a curtain. I'd love to know what would happen were a few disgruntled customers to challenge the scheme on the grounds of age related discrimination (it does actually meet the criteria of the Act......) Its a story that is far from over.......

The_Conductor

Ps- I'd never use the 'Of course you'd say that' response- I enjoy intelligent debate...... I'm not always right, far from it- but I love to see both sides of an argument out in the open.

antoinolachtnai

smccarrick wrote: »

BUPA, Quinn and Avivas have the right to refuse to cover anyone for any reason whatsoever (and indeed rightly so).

Are you certain about this? Third question on this page seems to contradict this. http://www.consumerconnect.ie/eng/Hot_Topics/Switch_+_Save/Health_Insurance/

Its disingenuous to try to claim that risk equalisation and community rating are two seperate issues- they are horribly interlinked- one would not exist without the other.

They are interlinked, in that risk equalization is a means of implementing community rating. There are other ways in which it could be implemented.

Community rating could exist without risk equalization.

The_Conductor

antoinolachtnai wrote: »

Are you certain about this? Third question on this page seems to contradict this. http://www.consumerconnect.ie/eng/Hot_Topics/Switch_+_Save/Health_Insurance/

I've a friend who works in Quinn- she says they have a 2 specific lists of reasons for refusing cover to applicants one of which is almost 14 pages long. I do not have a copy of these lists, nor have I asked to see it. She claims that one list is for people applying to join from other insurers, and the other for customers who have not previously had health insurance.

antoinolachtnai wrote: »

They are interlinked, in that risk equalization is a means of implementing community rating. There are other ways in which it could be implemented.

Community rating could exist without risk equalization.

Community rating could exist without risk equalisation- only if you accept that you would end up with a VHI full of older sicker customers and Quinn/Avivas full of younger healthier customers. Its unfortunately a fact. As newcomers to the market place- BUPA (Quinn) and Avivas have a natural propensity to attract younger customers who often may not have had insurance cover previously. These low risk customers allow them to have lower premia- which in turn attract the lower risk members of the VHI to join them (the closed windows for older customers, or customers with pre-existing medical conditions make the VHIs older customers far less likely to move). So- you get new companies with younger, healthier members, and an old company- with a much higher proportion of older, less healthy members. Its what has happened.

antoinolachtnai

Well, then someone should complain, because that's not how it is supposed to be. Of course, it depends on what exactly is on the list.

It's possible to argue about the extent of the distortion you rightly describe.

However, VHI has distorted the market for health services in other ways and this works to VHI's advantage. VHI is the price-setter for retail health services, and it has allowed these prices to grow to quite a high level. It is difficult for other insurers to negotiate lower rates.

You cannot look at the issue of community rating alone.

There is also a reality that is not taken into account that the private health services are subsidised to a greater or lesser extent by the public ones.

The_Conductor

antoinolachtnai wrote: »

Well, then someone should complain, because that's not how it is supposed to be. Of course, it depends on what exactly is on the list.

I agree with you- people should complain- they have not yet done so however. I think they would have far better grounds to complain over the tax on the under 55s however.

antoinolachtnai wrote: »

It's possible to argue about the extent of the distortion you rightly describe.

Its very possible to argue over it- quantifying it is entirely a different matter.

antoinolachtnai wrote: »

However, VHI has distorted the market for health services in other ways and this works to VHI's advantage. VHI is the price-setter for retail health services, and it has allowed these prices to grow to quite a high level. It is difficult for other insurers to negotiate lower rates.

Its accepted that medical inflation is significantly higher than general inflation- and that Irish costs are actually less than 70% of international norms (OECD calculations). Recent negotiations have seen all 3 insurers negotiate significant discounts- which is why 2 of the private hospitals are now reported to be in deficit positions for the first time, and a lot of the co-location projects look like being nuked by the private companies.

antoinolachtnai wrote: »

You cannot look at the issue of community rating alone.

Agree 100%
There is massive reform necessary- of which community rating is just one plank.

antoinolachtnai wrote: »

There is also a reality that is not taken into account that the private health services are subsidised to a greater or lesser extent by the public ones.

However- on inverse side of the coin is everyone is entitled to public health care- so in the absence of private health insurance, public health costs and the demands for public health, are significantly higher.

NuMarvel

smccarrick wrote: »

I've a friend who works in Quinn- she says they have a 2 specific lists of reasons for refusing cover to applicants one of which is almost 14 pages long. I do not have a copy of these lists, nor have I asked to see it. She claims that one list is for people applying to join from other insurers, and the other for customers who have not previously had health insurance.

I find it very hard to believe that a list like this exists. Does your friend work for Quinn Healthcare or another part of Quinn insurance? If it is healthcare, is she certain that it's a list of reasons for not letting people join? Could it be a list of conditions/illnesses that aren't covered or reasons why someone isn't covered from day one (e.g. waiting periods)? If you could ask her to just give you one of the points on the lists it might clarify what the list is about.

Open enrolment regulations are very clear. Insurers cannot refuse to enrol anyone who asks be they a switcher or new to health insurance, perfectly fit or on their last legs. To do otherwise is illegal. Lifetime cover regulations mean that once someone joins, renewals can't be refused, with limited circumstances (e.g. non-payment of subscriptions). So if someone has had €150,000 in claims paid out in the previous year, health insurers HAVE to offer to renew their cover on the same basis as everyone else on that product.

smccarrick wrote: »

Community rating could exist without risk equalisation- only if you accept that you would end up with a VHI full of older sicker customers and Quinn/Avivas full of younger healthier customers. Its unfortunately a fact. As newcomers to the market place- BUPA (Quinn) and Avivas have a natural propensity to attract younger customers who often may not have had insurance cover previously. These low risk customers allow them to have lower premia- which in turn attract the lower risk members of the VHI to join them (the closed windows for older customers, or customers with pre-existing medical conditions make the VHIs older customers far less likely to move). So- you get new companies with younger, healthier members, and an old company- with a much higher proportion of older, less healthy members. Its what has happened.

What closed windows do you refer to here?

antoinolachtnai

However- on inverse side of the coin is everyone is entitled to public health care- so in the absence of private health insurance, public health costs and the demands for public health, are significantly higher.

If they are entitled anyway, then why are the consultants being paid extra money to provide cover to people they are already being paid to care for?

The system would never work only that we have public-private consultants. The private system could never support the cost of training a consultant. Also, the public hospitals provide a backup network for the private sector operations. When my tonsilectomy went a bit awry (not due to any negligence, just one of thos things and it wasn't a big deal in the end), I wasn't sent back to the private hospital where the job was done to get it sorted out - I was sent as an emergency case to the large public teaching hospital.

As a result, the public sector must end up with a disproportionate amount of difficult cases.

The_Conductor

antoinolachtnai wrote: »

If they are entitled anyway, then why are the consultants being paid extra money to provide cover to people they are already being paid to care for?

The system would never work only that we have public-private consultants. The private system could never support the cost of training a consultant. Also, the public hospitals provide a backup network for the private sector operations. When my tonsilectomy went a bit awry (not due to any negligence, just one of thos things and it wasn't a big deal in the end), I wasn't sent back to the private hospital where the job was done to get it sorted out - I was sent as an emergency case to the large public teaching hospital.

As a result, the public sector must end up with a disproportionate amount of difficult cases.

Thats partially what I was getting at- its not that patients are proportioned one way or the other- the two are interlinked (as your treatment was). If you are looking for a private hospital with a full array of services- you are looking for a hospital aping the American model- where you do not get treatment, unless you have private health care.

Even in the provision of private health care- the Irish model has been more married to the Scandinavian model- than the US model. How else would there be positive discrimination in favour of the oevr 55s *in the provision of private health care*.........

We can debate the relative merits of the private versus the public health care system until the cows come home (there is a very pertinent thread in the Work and Jobs forum where public sector doctors detail their experiences of working in the public sector and their interactions with their colleagues- notably, nurses).

Both private sector and public sector bring different attributes to the table- and indeed have a lot to teach each other- notably in work practices.

Re- the cost of training consultants- according to the HSE- the reason that junior doctors are paid their current salaries, and work their levels of overtime- is because they are receiving ongoing work skills training- towards their aforementioned aspired towards, consultant position. So- its actually the junior doctors themselves, who are paying for their training- with 80-90 hour weeks, and after the current communications from the HSE, the bulk of this will be unpaid. I disagree with this on principle. The idea of being treated by a doctor at the end of a 24 hour shift, or having been on call for the last 5 days- scares me- and scares many of the doctors.

Re: your tonsilectomy- private hospitals do not in the main have emergency facilities (the new St. Vincents Private, will be a welcome exception to this). My wife experienced the opposite to you- her GP told her to present in A&E because she was seriously ill and unable to swallow. They told her it was psychosomathic and sent her home. I organised an emergency private appointment with a gastroenterologist- who diagnosed her within a week, and commenced treatment- privately. Her surgery ultimately was done in a public hospital- but after she was transferred from ICU to a corridor and left there during a football match- unable to move and on dialysis, I personally organised a bed for her in the private hospital again.

Horses for courses, everyone's experiences are different........

antoinolachtnai

Junior doctors get pretty good salaries, no?

Part of the reason why there is a shortage of consultants is that the consultants don't fully dedicate themselves to their public work. If they did, the queues would presumably be shorter in the public system

The problem is that the private system isn't actually adding any capacity to the system. It is just 'borrowing' resources from the public system and selling them at a profit to the VHI.

I don't think it's right that the government pays for 80 percent of the system, then some people get to pay a top-up and get priority access to the parts of the system which are under most demand, the consultants.

The_Conductor

antoinolachtnai wrote: »

Junior doctors get pretty good salaries, no?

They start @32k

antoinolachtnai wrote: »

Part of the reason why there is a shortage of consultants is that the consultants don't fully dedicate themselves to their public work. If they did, the queues would presumably be shorter in the public system

They are exhausted from 15 years of 60-90 hour weeks- with the prospect of being a consultant held up as a trophy- or the nightmare of being a GP heldup as what might happen if they don't make the grade. Personally I wouldn't mind being a GP- but I'd rather be a vet- a few years of working in a callcentre killed any empathy I might have had for the public at large.

antoinolachtnai wrote: »

The problem is that the private system isn't actually adding any capacity to the system. It is just 'borrowing' resources from the public system and selling them at a profit to the VHI.

I agree with you.
Anyone who tries to tackle this mess gets badly burnt- the politicians refer to the Department of Health as Nicaragua..... The problems is rigid work practices, and inflexible unions- in particular the INO. Its amazing how many operations get done in public hospitals on the treatment purchase scheme, after official theatre hours, because the staff don't have their hands tied.......

antoinolachtnai wrote: »

I don't think it's right that the government pays for 80 percent of the system, then some people get to pay a top-up and get priority access to the parts of the system which are under most demand, the consultants.

I don't think its right either- but an even bigger injustice is the fact that the government are the biggest providor of both public and private health care in the state. That quote from Animal Farm rings true- 'All animals are equal, but some animals are more equal than others'......

Both public and private sectors are severely dysfunctional. Government meddling and union intransigence has all but brought both to a grinding halt. If you suggest reforming the public health system- you have the INO out on strike demanding a 35 hour week. Fecking nurses don't appear to care about patients anymore- its all now that we've got our nursing degrees, we can all aspire to be managers...... It used to be that nursing and medicine were considered to be vocations- not any more........

antoinolachtnai

It was very weird that they set up a system whereby people could have 'public' or 'private' healthcare, and have it all paid for by the state. At least now there is some tiny degree of competition in the private end of things.

Can you explain the thing about the NTPF to me again? Is it the same staff working in the public hospital theatre after hours?

What does a 'starter' junior doctor actually end up going home with? With overtime and all the rest?

Toots

Just thought I'd throw my 2c in here, if your GF is young, then shop around and see what the best cover is. Personally, I was on VHI since I was born (obviously on my parent's policy until I was 20) and then on my own. I took out my policy as Plan C + Options which was the same as what I had been on with my parents. I switched to Aviva iPlan level 3, which is actually better cover, but was about €350 cheaper for the year than my VHI was (and I was on the BOI group scheme with VHI which meant I was getting it at a discount anyway). Another reason I switched is because they contribute to the cost of the Cervical Cancer vaccine and things like Laser Eye surgery, also the maternity benefits were slightly better. I've had to claim with both VHI and Aviva, and as regards the claims process, they're pretty much identical, both very easy to deal with and very efficient in processing the claims quickly. Have a look around at their websites, compare the cover and the prices and go with whatever one provides the best cover for less.