RE: Health Insurance

MonkeyTail

Hi,

Just wondering if anyone can help…

I been looking into getting health insurance but am so so confused by all the different plans, I been told that the plan B option with VHI is quite good and have been looking around for something similar. Quinn offer a Essential Plus (excess) that seem to be quite similar, they also offer Essential Plus (NO excess), Essential Gold, Essential ect…

Which one is best? Help Please!!

NuMarvel

If you haven't done so already, have a look at the Health Insurance Authority's guide to choosing health insurance (on their website here).

Basically, have a think about what kind of cover you want before looking at the plans. There are nearly 200 plans on the market now so it's no wonder you're already pulling your hair out. The HIA guides go through it in more detail, but in summary this is what you need to think about:

What kind of hospitals do you want cover in?
In Ireland there are public hospitals (state owned or funded. Primarily public patients but access to private facilities), private hospitals (privately owned) and hi-tech hospitals (large private hospitals with very specialised equipment).

In terms of costs, products that give full cover in public hospitals are cheaper than those that give full cover in private hospitals. And products that give full cover in h-tech hospitals are the most expensive.

Most people in Ireland, myself included, are on a product that gives them cover in public and private hospitals and partial cover in hi-tech hospitals. My reasoning for this is to give myself as wide a choice as hospital options, without breaking the bank. Some products include an excess for treatment in private or hi-tech hospitals, so make sure you’re aware of this.

Even if you use a hospital not fully covered by your plan (e.g. your plan covers public hospitals and you use a hi tech hospital), most plans, but not all, will partially cover the hospital costs with you paying the balance.

What kind of accommodation do you want in hospital?
When in hospital you have two accommodation choices: a private room (room to yourself) or a semi private room (shared room with up to 5 other people).

If you have a preference for a private room in your chosen hospital type, pick a product that covers that. Bear in mind though that neither insurers nor hospitals can guarantee the availability of a private room.

Something else to bear in mind is that some private hospitals, especially the newer ones, only have private rooms – e.g. Whitfield Clinic in Waterford. If there’s a particular private hospital you want cover for, it wouldn’t be any harm to check what kind of rooms they have first.

What illnesses are covered?
For each insurer, any illness covered by their top level of cover will be covered by their most basic plan: the important thing is where you’re treated (i.e. hospital and accommodation) and not what you’re treated for.

I mention this so you don’t think that you need to buy the most expensive plan to have all illnesses covered. In fact, some of the benefits of the most expensive plans (cover in h-tech hospitals for major heart surgery and out-patient radiotherapy) are available on the most popular plans.

That said, if there's a specific illness you're concerned about (e.g. family history, etc), see if you get any additional benefits for that.

Out-patient cover
Most traditional health insurance plans have very limited (i.e. as good as none) out-patient cover for GPs, physio, consultants, etc. However, alot of the newer products do, but still not full cover (usually around 50 to 60% cover).

In any case, PAYE workers get tax relief at the standard rate (currently 20%) for some of these costs.

Other benefits
There are a plethora of other benefits available. For example, maternity cover, emergency cover while abroad, cover to travel abroad for treatment, screening, lifestyle benefits, nurselines, GP lines, cover in nursing homes after a hospital stay... and alot more. Have a think about what you think you'd like included on your cover and shop around accordingly.

The most important stuff
At this stage, starting out, probably the key thing to get right at the start is the kind of hospital cover you want as that's where the biggest expense is and it’s what the waiting periods primarily apply to. With regards to the other stuff (out-patient, lifestyle, nurselines, etc) don't get too bogged down in it right now.

Joining
A few points about joining - There's no medical to complete, it's a simple application (name, address, date of birth, etc). When you start health insurance for the first time, there are waiting period to serve, i.e. lengths of time to wait from the date of joining before certain types of cover kick in. This are age related and for under 55s they are:

Initial waiting period of 26 weeks - Nothing is covered for the first 26 weeks except for hospital treatment due to an accident or injury.

Maternity waiting period of 52 weeks - see above

Pre existing waiting period of 5 years. This means any hospital treatment related to a condition present prior to your joining date isn't covered for the first 5 years of membership. You don't have to declare any illnesses; it's ultimately based on what a consultant says on a claim form. This is why I think you're ALWAYS best to ring your insurer before any treatment.

The waiting periods above usually don't apply to out-patient cover, so if you're getting physio for a bad back from years past, you can probably still claim for costs incurred after you join (as well check the exact terms before signing the dotted line).

I think that covers most of the basics. The HIA website also has a comparison tool so use that as well, but like I said above, you're probably better having a rough idea of what you want before looking at the plans.

broker2008

NuMarvel wrote: »

What kind of accommodation do you want in hospital?
When in hospital you have two accommodation choices: a private room (room to yourself) or a semi private room (shared room with up to 5 other people).

Great post but I thought a semi private room had 5 beds and public ward 6 beds ?

NuMarvel

broker2008 wrote: »

Great post but I thought a semi private room had 5 beds and public ward 6 beds ?

You might be right about the semi private room, but of the three public wards I've been in, two had more than 6 beds. More like 10/12 beds. The third had 6 beds, but it was in the new CUH maternity hospital so maybe new builds will have lower bed numbers for infection-control purposes. Or maybe maternity hospitals might have lower bed numbers per ward to allow room for the newborns? (Please note the question mark, any and all baby related stuff is alien to me!)

broker2008

Sorry should have said that semi private room have maximum of 5 beds and public ward at least 6.