Suggestions for Health Insurance

masterboy123

We are a couple and looking to get health insurance. We both are under 35 years.
Seen VHI, LAYA and Irish Life (aviva). Basic insurance costs about 85 euros per month for 2 persons.
Is there any in particular to look before purchasing the health insurance?
Also, do HSE employees get any discount or is there any way to claim tax back on premiums?

Thanks

coylemj

This website will help you compare schemes..... www.hia.ie

You pay the premium net of tax relief so there is no claiming anything back.

masterboy123

That's really helpful.

Thank you!!

masterboy123

Do health insurances rise if you make a claim, say visiting GP? For example what happens in a car insurance.

Pardon my ignorance.

Gael23

masterboy123 wrote: »

Do health insurances rise if you make a claim, say visiting GP? For example what happens in a car insurance.

Pardon my ignorance.

No they don’t.
But say if your diagnosed with a condition and you decide to upgrade your cover, that condition won’t be covered under the higher plan for a few years.

masterboy123

Ok, thank you Gael.

Just bought VHI insurance.

Gael23 wrote: »

No they don’t.
But say if your diagnosed with a condition and you decide to upgrade your cover, that condition won’t be covered under the higher plan for a few years.

Gael23

What plan did you go for?

Brian201888

Anything under €100 a month for both of you won't be worth the paper it's written on

masterboy123

We got One Plan starter. There was another cheaper one.

Is it any good?

Gael23 wrote: »

What plan did you go for?

Autochange

masterboy123 wrote: »

We are a couple and looking to get health insurance. We both are under 35 years.
Seen VHI, LAYA and Irish Life (aviva). Basic insurance costs about 85 euros per month for 2 persons.
Is there any in particular to look before purchasing the health insurance?
Also, do HSE employees get any discount or is there any way to claim tax back on premiums?

Thanks

Why would hse employees get discount?

Brian201888

masterboy123 wrote: »

We got One Plan starter. There was another cheaper one.

Is it any good?

It's a fairly pointless plan to have really, what do you forsee needing the health insurance for if anything?

enfant terrible

Is it true if you don't have health insurance you can just pay for what ever scan you need yourself, therefore skipping the public queue?

Then you are put on the waiting list for whatever operation you need.

Brian201888

Yes, you can ring any private hospital and pay for a scan yourself.

Eggs For Dinner

I wouldn't be without health insurance. My latest "jolly" last year came in at €78,000. If I had to wait on a public list, my consultant said there would have been no point, he wouldn't have been able to do anything when my turn came.

I pay €260 a month for myself and my wife.

Gael23

masterboy123 wrote: »

We got One Plan starter. There was another cheaper one.

Is it any good?

Being honest, no it’s not. No cover for private hospitals, or GP visits and you have to spend €250 before you get any kind of outpatient benefit.

Cheapest isn’t the best when it comes to insurance. Mine is €97 a month just for me because I want access to private hospital

enfant terrible

Eoghan_2 wrote: »

Yes, you can ring any private hospital and pay for a scan yourself.

Seems unfair, you pay say €300 for a scan then your on the list, skipping the queue.

Say you need a hip replacement is there a public and private waiting list once you've had your scan?

KERSPLAT!

I have the below.

http://www.irishlifehealth.ie/health-insurance-plans/health-plan-16-1/?showall=1

Thankfully I've only ever used it for GP visits. We have a scheme in work where they contribute so it's dead handy. As was said above, you need a decent plan otherwise you're talking crazy high excess and no access to the high-tech hospitals and it won't be worth having

Gael23

enfant terrible wrote: »

Seems unfair, you pay say €300 for a scan then your on the list, skipping the queue.

Say you need a hip replacement is there a public and private waiting list once you've had your scan?

I needed an ultrasound about a year ago and I was told it would be 3 months public. Paid €120 and had it done in 10 days in a private hospital. As a public patient you need to have a certain level of disability before you will get a joint replacement. Pay €10k and you have it whenever you like.

screamer

For what it's worth ignore the day to day stuff and get a decent level of hospital cover because that is what private insurance is needed for. Operations that you'd wait years for on the public system that you can have in weeks on the private system. Yes it's not fair but that's the way it is. Look at Laya they are the cheapest and go for a policy with a hefty excess that way you get good cover at a good price and if you don't use it you don't have to even worry about the excess. If you do need to use it you'll gladly part with the few quid for the excess for the benefits.....

enfant terrible

Gael23 wrote: »

I needed an ultrasound about a year ago and I was told it would be 3 months public. Paid €120 and had it done in 10 days in a private hospital. As a public patient you need to have a certain level of disability before you will get a joint replacement. Pay €10k and you have it whenever you like.

Also heard on the radio under the treatment abroad scheme you can pay for the surgery up north yourself and the HSE will reimburse you.

So you can pay for you scan yourself to skip the queue and get on the list.

Then head up North and have your hip replaced and be fully reimbursed by the HSE.
https://www.thetimes.co.uk/article/hse-staff-tackle-1-200-rise-in-people-getting-treatment-abroad-920wsgbxs

While someone else pays thousands every year for health insurance.

That not unfair?

screamer

Brexit will put paid to that....

enfant terrible

screamer wrote: »

Brexit will put paid to that....

Yes but what if it doesn't.

If someone has 10k in the bank to pay for a hip replacement then can have their surgery without delay and then be reimbursed fully by the HSE.

While someone paying for private insurance every year has paid out thousands and will get nothing back even if they never needed treatment.

orthsquel

If you're employed by the HSE you may be eligible to enter one of their group schemes but you'd have to ask your HR department about that.

To be really honest, any Level 1 plan like One Plan Starter that just covers public hospitals only, is really intended for those just starting out and has very limited cover. You'll only have 66% cover for some scans in private hospitals......and be careful with maternity cover if that is important to you on those type of plans because they cover so little, you'd be better off going public for the pregnancy, although at the very least the consultant fees for maternity are at the standard rate of agreed charges, but cost for normal confinement is minimum benefit at 381 euro which means you could be paying more than that.
The outpatient excess is very high at 250 as already pointed out and you'd only be able to make 1 claim for outpatient consultant subject to that excess with any other benefits, so you won't get much back.

Other than getting insurance before LCR kicks in, it's not going to be much benefit, even for maternity as it's minimum benefit level. If you want to upgrade you'll serve waiting periods but only for pre existing conditions and maternity. If you are new to health insurance, you will serve any upgrade waiting period alongside any initial waiting period (5 years) for pre existing conditions.

The only plus with that plan is for day case procedures for public hospitals you'll have cover for that, subject to initial new condition waiting period (26 weeks) if you are new to health insurance.

What kind of hospital cover are you looking for? Are you looking for any private hospitals or just public hospitals? What benefits are important to you?

If you've purchased One Plan Starter with VHI already and set it up, don't worry you have the 14 day cooling off period from the inception date to change plans and providers.

masterboy123

Private Patient in a multi-occupancy (which may include semi-private) room in a public hospital and day case : Covered

Overseas benefit of 65,000.

It says maternity benefits are available only after 52 weeks of health insurance, as this is our first time getting health insurance. I am hoping to get better cover from next year, once we have this 52 weeks of condition over. We both are in our very early 30's.

CT full cover in public hospitals or private stand-alone centres/66% cover in private hospitals. What's private stand alone centres?

And I have checked even on high end insurances, only 35%-60% inpatient is covered. So i believe one will be paying out from personal pocket.

Can you suggest any better plan from VHI? So I can compare it. I have 2 weeks period to change it.

Eoghan_2 wrote: »

It's a fairly pointless plan to have really, what do you forsee needing the health insurance for if anything?

Eggs For Dinner

enfant terrible wrote: »

Seems unfair, you pay say €300 for a scan then your on the list, skipping the queue.

You don't skip any list. A scan is just that. If it shows up that you need treatment or an operation, you go on the public waiting list or get it done privately

Gael23

masterboy123 wrote: »

Private Patient in a multi-occupancy (which may include semi-private) room in a public hospital and day case : Covered

Overseas benefit of 65,000.

It says maternity benefits are available only after 52 weeks of health insurance, as this is our first time getting health insurance. I am hoping to get better cover from next year, once we have this 52 weeks of condition over. We both are in our very early 30's.

CT full cover in public hospitals or private stand-alone centres/66% cover in private hospitals. What's private stand alone centres?

And I have checked even on high end insurances, only 35%-60% inpatient is covered. So i believe one will be paying out from personal pocket.

Can you suggest any better plan from VHI? So I can compare it. I have 2 weeks period to change it.

There is no cover if you were to need an operation or test and wanted it done in a private hospital. There’s nothing back if you go to your GP or get referred by your GP to a specialist. For me I pay €150 for an overnight admission and €50 for a day procedure but mine is double the price of the one you picked.

orthsquel

masterboy123 wrote: »

Private Patient in a multi-occupancy (which may include semi-private) room in a public hospital and day case : Covered

Overseas benefit of 65,000.

It says maternity benefits are available only after 52 weeks of health insurance, as this is our first time getting health insurance. I am hoping to get better cover from next year, once we have this 52 weeks of condition over. We both are in our very early 30's.

CT full cover in public hospitals or private stand-alone centres/66% cover in private hospitals. What's private stand alone centres?

And I have checked even on high end insurances, only 35%-60% inpatient is covered. So i believe one will be paying out from personal pocket.

Can you suggest any better plan from VHI? So I can compare it. I have 2 weeks period to change it.

Just to clarify on waiting periods as a new member: you'll serve 5 year waiting period for pre-existing conditions, 52 weeks for maternity and 26 weeks for new conditions. They're the main ones. Scans related to pre existing conditions are subject to same 5 year waiting period.

Then there's upgrade waiting periods: 2 years for pre existing conditions and 52 weeks for maternity.

If you were thinking of serving the 52 week maternity and then upgrading, you'll still serve the upgrade maternity waiting period, then the maternity benefits of the lower plan will apply, as you won't get the higher benefits straight away. If you're choosing a plan now with minimum benefits for maternity that cover will apply when you upgrade, which means you'd be better off going public in the public health system for the delivery.

With the plan with VHI you'll have full cover for semi private room and day case procedures in a public hospital. A private room is at semi private rate so you'll pay a shortfall to the hospital yourself. The chance of getting a private room is very limited in a public hospital as generally used for those who are infectious themselves, or at risk of infection to others.

As for Private Stand Alone centres.... public scan centres would be related to public hospitals, private hospitals are related to the Bons, Hermitage, Galway Clinic, Beacon, Private Stand Alone centres may refer to Affidea / My Medical / Alliance Medical scan centres... I'm not too sure on that tbh you may have to contact VHI to verify. But you can review their hospital directory https://www.vhi.ie/downloads/MRI_External_Directory_with_Plans.pdf and do take note of where in your area is excluded for scans as One Plan Starter is referred to in the Notes within each Directory segment.

It depends on what cover you're looking for and what your budget is, and what you want covered in a plan. A plan like this may well suit you in terms of budget and even for getting in the door of health insurance before you are 35. If maternity isn't a concern, and you just want some sort of access to public hospitals for day case procedures after you've served the waiting periods, it may work.

VHI have a facility on their website to help you choose a plan, otherwise you can use the HIA comparison tool to just compare the One Plan Starter for similar and slightly better plans on the market; just select "I do not know what plans to compare" and select the semi private public hospital, it will give a lot of alternatives of similar cover from all providers. The next ones with slightly higher premium and maybe cover are from Irish Life Health (Kick Off) and Laya (Assure Vitality) and may be worth reviewing. You can also just choose "I do know what plan to compare" and select the VHI plan and it will give options of a similar cover, which is much of the same sort of plan.

edit: generally speaking, mid range high end policies would have shortfalls for high tech private hospitals like the Mater Private (Dublin) and Blackrock Clinic in Dublin, some with 50% cover or 80% cover. With VHI those would be listed as Private 4 hospitals and generally not fully covered. Only the Level 5 enhanced plans would have full cover, within limits. But most insurers would provide full cover for semi private room in a private hospital, either without an excess or with an excess. Some providers may have a percentage cover e.g. 65% or 25% cover for private or high tech hospitals depending on the plan, where you have a shortfall you pay yourself.

edit to add, just noticed on vhi (and it's in bargain alerts) VHI extended their Online Advantage until 1st Oct. https://www.vhi.ie/onlineadvantage
It may be worth asking in VHI about alternative plans to give a step up from what you have and clarify cover. VHI don't allow you to change your plan mid-year, so worth getting the right plan for your needs from the start.

masterboy123

Hi Orthsquel,

First of all I very much appreciate your detailed response. I have definitely acquired most useful info around Health Insurance.

I have downloaded VHI app and it shows all important key points, including consultant visit 60 euros.

Few things remain unclear. Do we still pay 100 euros charge for attending A&E in a public hospital? And regarding maternity cover, what level of health insurance is considered as good enough? I have also heard it's better to go Public for maternity as you can be seen by on call consultants also rather than waiting for your own consultant?

I have applied for 100 euros discount after signing up for online documentation. Vhi will release this discount in October.

orthsquel

No worries, health insurance is a minefield to get around, but the HIA is particularly useful. It can take lots of research to find what you want and what's right for you.... to try and find that balance between your budget and what you want and need from health insurance.

One Plan Starter doesn't have any benefit for A&E charges, so yes you would have to bear the cost of that yourself, and you can't claim it back through your plan. If it were there it would be under outpatient benefits. You do have VHI Swiftcare as a minor injury clinic; if you went to private A&E (e.g. Hermitage, Galway Clinic, Bons, Beacon to name a few that have one) you'd pay the cost yourself. You could maybe claim it back as a medical expense through Revenue with a Med 1 form. Consultant fees you may be able to claim back to the limit of your plan; your inpatient benefits won't kick in until you are admitted to hospital. One thing to remember is that when you are admitted to a public hospital, if you go as a public patient or private patient (with your health insurance) the treatment is still the same.

Maternity.... what's "good enough" cover is relative to what you want and need covered. As maternity is a minimum benefit there's always some level of cover. Basics would be normal delivery, and caesarean cover, in-patient consultant fees, pre/post natal expenses. You can get a lot of extras in various benefits and some may come as standard on advanced plans.....and VHI have a section in their member area about the various extra benefits like Mother & Baby Bundles, Fertility and Infertility benefits. https://www.vhi.ie/maternity-benefits

Public Vs Private for maternity can come down to preference. Some people may want to see their own private consultant the full length of the birth and others not. Either way can be seen as a benefit, I suppose depending on whether the pregnancy is straightforward or if there's complications. Maternity cover tbh is generally a bit vague in the details on the plans if you've no experience of delivering a baby and what would be covered, across all providers. You might be best to give VHI a ring, or use their webchat to clarify a few things.

uck51js9zml2yt

Wife needed a procedure done in the rotunda.to see a consultant public was a 12 months wait minimum.
She saw him private in a week and was done a week later.
I had heart surgery. Saw the cardiologist public in 8 weeks (6private) and was done privately. 40k bill covered for an 800 euro policy.

My last policy I went through cornmarket. They had a group discount for some of the policies we got.family of 4

Autochange

Is vhi PMI 36 13 a good policy for an individual?