Nearly one million people renew their health insurance in the first three months of the year and up to 50% of us could be on better plans that either save us money, give us more benefits or both.
During this pandemic, your health insurance could be more important than ever.
Dermot Goode, the leading expert in healthcare benefits in Ireland talks to Irish Country Living about increasing rates, policy changes and trends in the industry.
“The first thing that everyone should know is that no matter what health insurance company you are with, you’re going to see price increases this year,” says Dermot. “This isn’t surprising news; consumers should expect their policy to go up by 5% to 6% each year.”
Why? “Medical inflation,” explains Dermot. “It’s a catch-all phrase that covers the development of new drugs, technology such as robotics, increases in consultant fees and private hospitals and more people claiming back their medical expenses. There is nothing you can do about these price increases. What you can, and should do, however, is to investigate the price increase on your individual policy. It’s not enough to read that the average rate of increase is 5%. Some policies may be that amount but some Laya plans, for example, went up by between 10% and 12% this year. You need to look at your plan and compare it to last year to see what the real impact is.”
Consumers also need to be aware of changes happening within the health insurances companies.
Laya Healthcare increased their rates on January 1 but they also made a big change to the way they cover certain orthopaedic and ophthalmic procedures. Dermot explains: “For years, Vhi and Irish Life have had restricted procedures which are shortfalls on some of their plans for the likes of knee replacements, hip replacements and shoulder replacements. Essentially, they do not cover the full cost in private hospitals.
“As a result, some consumers switched to Laya as they covered the full procedures. However, as of 1 January, there are about 10 plans that now have this 20% shortfall. If this is something that is really important to you because you have bad knees or a hip surgery coming up in a private hospital, you need to check if your policy is affected. There is no need to worry, there are other options available, but it just means you are going to have to shop around or you will end up with less benefits while simultaneously paying price increases.”
The big news for Vhi customers is that they have taken some of their older plans off the market. “The old Plan C-Health Plus Choice and old Forward Plan Level 1 are now discontinued. If you were on these plans, then Vhi will be reaching out to you offering a new plan called Advanced Plan Extra Day to Day. However, at €3,080 per adult, it is very expensive. We’ve already had Vhi members onto us about this and about 90% of those affected have not opted for the substitute plan that Vhi offered. Instead, there are much more competitive plans with similar benefits such as:
“I know this change can be annoying for members but try to look at it as an opportunity. The discontinued plans were old and didn’t offer good value for money. You may feel you are being forced to switch but you could save between €600 and €1,500 per adult while maintaining similar benefits,” says Dermot.
There are no major changes for Irish Life customers but like the others, they will have price increases so check your individual policy to ensure you aren’t paying over the odds.
During the first wave of the COVID-19 pandemic, the private hospitals entered an agreement with the HSE in which they were taken over. As members couldn’t use their health insurance in the same way, they were reimbursed money. In fact, VHI are now giving even more money back. Dermot says: “Essentially, when they reviewed their books, they ascertained that they didn’t give people enough back so they are reimbursing an extra €75 per adult and €25 per child to those who were members on 23 January. This money should be landing in people’s bank accounts around now.”
The situation where the HSE took over the private hospitals didn’t really work for any of the stakeholders – the consumer, the consultants, the health insurance companies. It was necessary at the time because we were in unchartered territory. Now however, the situation has changed and an arrangement has been reached in which the HSE can access 25% to 30% of the private hospital’s capacity, if necessary. Dermot says: “This seems to be a better solution. Private hospitals can continue to deliver care to their private patients.
“However, if urgent care needs to be given to a patient at a public hospital, that has to be postponed because of COVID-19, the HSE can move them into a private hospital. The patient will get the treatment they need without major disruption to service.”
COVID-19 has also resulted in a lot more consumers wanting private rooms on their policy, which isn’t surprising. Some more affordable policies that include private rooms are:
However, Dermot advises that if you are adding private room access to your policy, it does not guarantee you will get one. “It is all dependent on availability. Also, the ‘upgrade rule’ is an important consideration. The upgrade rule means that if you get a plan with better cover, the benefits do not apply to an existing condition for two years. For example, if you have diabetes and you are admitted to hospital because of your diabetes, you will not be entitled to a private room for this condition (for two years). If you break your leg, it is not related to your existing condition and you will be entitled to a private room then.”
If any of the above statements apply to you, then chances are you are overpaying on health insurance and you can get a better deal. That doesn’t mean you need to change provider but you may be able to get a policy that suits you better, potentially increasing your cover while reducing your premium.
Corporate plans offer very good value for money. They can be expensive however. Here are some of the more affordable corporate plans: