On Friday 30 April 2015, phone lines in health insurance companies across the country were jammed, as thousands made the desperate call to secure health insurance before close-of-business.
If they had left it one more day, those over the age of 35 would be faced with loadings on their premiums, due to the introduction of the lifetime community rating (LCR). The level of loading depends on age but the older you are, the more you pay.
Were you one of the 100,000 people who made that urgent call? If so, your premium is due for renewal this weekend, but what kind of policy did you take out?
Dermot Goode of Total Health Cover says a quarter of people made their decision in haste and probably don’t know what policy they have or what it covers.
“Of the 100,000 people who purchased health cover ahead of the LCR deadline, we know approximately 50,000 opted for good-quality plans,” Dermot explains. “Many were older people who said: ‘Look, we did well for ourselves, not having health insurance for so long. Now we’re buying in, we might as well get a good package.’
“The remaining 50,000 opted for low-level plans. While half of them did so because of financial limitations and wanted to go for that level of cover, the other half selected their plans in haste. These were the people who left it to the last minute, who couldn’t get through because the phone lines were jammed. They went online, got the cheapest plan but probably never did a review or even got advice. There’s a good chance they have no idea what they bought.”
Time to act
If that sounds like you, now is the time to act. “These plans really only cover the bare minimum. They have been stripped bare and just about meet the regulatory requirements. So many have no private hospital care, for example, minimum maternity benefit, no private MRI cover and forget about money back on routine visits,” says Dermot.
“If you bought this type of cover, and you know all this, that’s fine. You know where you stand. The problem is there are people who don’t know these details and then if something goes wrong, they’re caught out.
“For example, I was recently contacted by a guy whose wife is expecting in August, and he just realised they don’t have proper maternity cover on their plan. They can’t do anything about it because even if they get a better policy today, they won’t be covered for this baby, due to the upgrade rules.
“So if you did buy a basic health insurance package last year, I’m not saying spend more money, but I am advising you to review your policy and make sure you’re getting the type of cover you want and expect,” Dermot explains.
Given that even entry-level family plans are going to cost you more than €1,000, you need to question whether you are getting value for your money.
For example, 60% to 70% of all procedures are now performed on a day-case basis. However, many entry-level policies do not cover these procedures in private hospitals.
Dermot elaborates: “If, for example, you have to have an exploratory procedure, your consultant might say he or she can do it next Monday in a hospital such as the Bon Secours in Cork or Barringtons in Limerick. If your plan doesn’t cover you there, you could, of course, see if your consultant will do it in a public hospital where you are covered.
Going private
“However, a lot of consultants are now only seeing public patients in public hospitals. So if you do end up going to the Bon Secours, for example, you will have to pay €1,000 for the procedure, on top of the €1,050 you’ve already paid on your family policy.”
So if you are thinking of upgrading, what kind of money are you talking about? “For reasonable quality health cover, you need to spend approximately €850 per adult – these plans will give you access to all public and private hospitals and some even cover major heart surgeries in the high-tech hospitals, such as Blackrock Clinic and the Mater Private. This means that you should be covered regardless of which hospital facility you’re referred to for treatment. People who want cover for routine medical expenses – such as GP, physiotherapy, dentists fees, etc – should expect to pay approximately €1,200 per adult.”
What is the lifetime community rating?
If you are purchasing a private health insurance policy for the first time at the age of 35 or older you will pay a 2% loading on top of your premium for every year you are aged over 34. For example, if you take out a private health insurance policy for the first time at age 40 you will pay 12% more.
Insurance FAQs
Q: I renewed my policy earlier this week, but now I think I need better cover. Is it too late?
After you renew you policy, you have a 14-day cooling-off period where you can switch plans. Also Laya Healthcare, GloHealth and Aviva Health will allow you to change plans mid-year. VHI only lets you change within your two-week cooling off period.
Q: What’s the upgrade rule?
If you are upgrading your policy, you may be faced with some waiting periods before you can avail of the benefits of your new policy. If you have an existing condition, for example, you may have to wait two years until you can reap the benefits of your new policy. If you take out the policy and develop a condition afterwards with no symptoms or treatments in advance, then the cover should kick in straight away.
Patrick Kelly is a 34-year-old farmer with no medical issues. Before he turns 35, he has decided he really should get his health insurance sorted.
Entry-level plans
An entry-level plan will cost him approximately €420 per year individually or €1,050 for his family (two adults, two children) but what do these type of plans cover?
The following relates to a plan that gives full-cover for day-case and multi-occupancy rooms in public hospitals only.
Some plans may cover a private room but it is extremely difficult to get a private room in public hospitals.
Some plans don’t even cover all public hospitals, so Patrick needs to be careful that the plan selected covers all public hospitals in his locality. This plan will fully cover the €75 per night (€750 max per year) public hospital charge and will also cover the new private charge of €813 per night, which may also apply in public hospitals, even though he might still end up in a public bed.
There will be minimum cover for other benefits, such as convalescence, psychiatric (public facilities only), maternity (€400 towards the hospital cost), out-patient (all expenses subject to limits and excesses), MRI scans (approved public hospitals only), emergency medical treatment while abroad (not available on all plans) and substance abuse (covered in public facilities only).Due to the introduction of these new “multi-occupancy” rooms in public hospitals, even those going privately using this type of cover are never guaranteed a private or semi-private room.There is little or no cover for private hospitals on these plans.Mid-level plans
If Patrick decides to opt for a mid-level plan covering public and private hospitals, he will be looking at costs in the region of €800 to €890 per year. However, his cover will now have the following:
Cover for most public and private hospitals. Some plans will cover all standard private hospitals (small excesses may apply per private hospital admission). Cover for all day-case procedures in private hospitals which could cost up to €1,000, depending on the procedure involved. MRI scans in approved private hospitals or scan centres will be included in these plans.Maternity cover is also included, up to three days full cover (up to €3,000 for hospital costs and approximately €850 towards the consultant’s fees).Private psychiatric treatment and also treatment for substance abuse in specialist private facilities.Some of these plans will cover certain cardiac procedures in the high-tech hospitals.The main reason for opting for one of these plans is to do with risk management. If you have cover for all public and private hospitals, then you should have access to most consultants, irrespective of who your GP refers you to.
By taking out this type of cover now, you avoid the risk of being caught by the upgrade rule if you try to increase your cover after a medical problem has been diagnosed.
Online
For more information and advice on your renewal, log on to www.totalhealthcover.ie
On Friday 30 April 2015, phone lines in health insurance companies across the country were jammed, as thousands made the desperate call to secure health insurance before close-of-business.
If they had left it one more day, those over the age of 35 would be faced with loadings on their premiums, due to the introduction of the lifetime community rating (LCR). The level of loading depends on age but the older you are, the more you pay.
Were you one of the 100,000 people who made that urgent call? If so, your premium is due for renewal this weekend, but what kind of policy did you take out?
Dermot Goode of Total Health Cover says a quarter of people made their decision in haste and probably don’t know what policy they have or what it covers.
“Of the 100,000 people who purchased health cover ahead of the LCR deadline, we know approximately 50,000 opted for good-quality plans,” Dermot explains. “Many were older people who said: ‘Look, we did well for ourselves, not having health insurance for so long. Now we’re buying in, we might as well get a good package.’
“The remaining 50,000 opted for low-level plans. While half of them did so because of financial limitations and wanted to go for that level of cover, the other half selected their plans in haste. These were the people who left it to the last minute, who couldn’t get through because the phone lines were jammed. They went online, got the cheapest plan but probably never did a review or even got advice. There’s a good chance they have no idea what they bought.”
Time to act
If that sounds like you, now is the time to act. “These plans really only cover the bare minimum. They have been stripped bare and just about meet the regulatory requirements. So many have no private hospital care, for example, minimum maternity benefit, no private MRI cover and forget about money back on routine visits,” says Dermot.
“If you bought this type of cover, and you know all this, that’s fine. You know where you stand. The problem is there are people who don’t know these details and then if something goes wrong, they’re caught out.
“For example, I was recently contacted by a guy whose wife is expecting in August, and he just realised they don’t have proper maternity cover on their plan. They can’t do anything about it because even if they get a better policy today, they won’t be covered for this baby, due to the upgrade rules.
“So if you did buy a basic health insurance package last year, I’m not saying spend more money, but I am advising you to review your policy and make sure you’re getting the type of cover you want and expect,” Dermot explains.
Given that even entry-level family plans are going to cost you more than €1,000, you need to question whether you are getting value for your money.
For example, 60% to 70% of all procedures are now performed on a day-case basis. However, many entry-level policies do not cover these procedures in private hospitals.
Dermot elaborates: “If, for example, you have to have an exploratory procedure, your consultant might say he or she can do it next Monday in a hospital such as the Bon Secours in Cork or Barringtons in Limerick. If your plan doesn’t cover you there, you could, of course, see if your consultant will do it in a public hospital where you are covered.
Going private
“However, a lot of consultants are now only seeing public patients in public hospitals. So if you do end up going to the Bon Secours, for example, you will have to pay €1,000 for the procedure, on top of the €1,050 you’ve already paid on your family policy.”
So if you are thinking of upgrading, what kind of money are you talking about? “For reasonable quality health cover, you need to spend approximately €850 per adult – these plans will give you access to all public and private hospitals and some even cover major heart surgeries in the high-tech hospitals, such as Blackrock Clinic and the Mater Private. This means that you should be covered regardless of which hospital facility you’re referred to for treatment. People who want cover for routine medical expenses – such as GP, physiotherapy, dentists fees, etc – should expect to pay approximately €1,200 per adult.”
What is the lifetime community rating?
If you are purchasing a private health insurance policy for the first time at the age of 35 or older you will pay a 2% loading on top of your premium for every year you are aged over 34. For example, if you take out a private health insurance policy for the first time at age 40 you will pay 12% more.
Insurance FAQs
Q: I renewed my policy earlier this week, but now I think I need better cover. Is it too late?
After you renew you policy, you have a 14-day cooling-off period where you can switch plans. Also Laya Healthcare, GloHealth and Aviva Health will allow you to change plans mid-year. VHI only lets you change within your two-week cooling off period.
Q: What’s the upgrade rule?
If you are upgrading your policy, you may be faced with some waiting periods before you can avail of the benefits of your new policy. If you have an existing condition, for example, you may have to wait two years until you can reap the benefits of your new policy. If you take out the policy and develop a condition afterwards with no symptoms or treatments in advance, then the cover should kick in straight away.
Patrick Kelly is a 34-year-old farmer with no medical issues. Before he turns 35, he has decided he really should get his health insurance sorted.
Entry-level plans
An entry-level plan will cost him approximately €420 per year individually or €1,050 for his family (two adults, two children) but what do these type of plans cover?
The following relates to a plan that gives full-cover for day-case and multi-occupancy rooms in public hospitals only.
Some plans may cover a private room but it is extremely difficult to get a private room in public hospitals.
Some plans don’t even cover all public hospitals, so Patrick needs to be careful that the plan selected covers all public hospitals in his locality. This plan will fully cover the €75 per night (€750 max per year) public hospital charge and will also cover the new private charge of €813 per night, which may also apply in public hospitals, even though he might still end up in a public bed.
There will be minimum cover for other benefits, such as convalescence, psychiatric (public facilities only), maternity (€400 towards the hospital cost), out-patient (all expenses subject to limits and excesses), MRI scans (approved public hospitals only), emergency medical treatment while abroad (not available on all plans) and substance abuse (covered in public facilities only).Due to the introduction of these new “multi-occupancy” rooms in public hospitals, even those going privately using this type of cover are never guaranteed a private or semi-private room.There is little or no cover for private hospitals on these plans.Mid-level plans
If Patrick decides to opt for a mid-level plan covering public and private hospitals, he will be looking at costs in the region of €800 to €890 per year. However, his cover will now have the following:
Cover for most public and private hospitals. Some plans will cover all standard private hospitals (small excesses may apply per private hospital admission). Cover for all day-case procedures in private hospitals which could cost up to €1,000, depending on the procedure involved. MRI scans in approved private hospitals or scan centres will be included in these plans.Maternity cover is also included, up to three days full cover (up to €3,000 for hospital costs and approximately €850 towards the consultant’s fees).Private psychiatric treatment and also treatment for substance abuse in specialist private facilities.Some of these plans will cover certain cardiac procedures in the high-tech hospitals.The main reason for opting for one of these plans is to do with risk management. If you have cover for all public and private hospitals, then you should have access to most consultants, irrespective of who your GP refers you to.
By taking out this type of cover now, you avoid the risk of being caught by the upgrade rule if you try to increase your cover after a medical problem has been diagnosed.
Online
For more information and advice on your renewal, log on to www.totalhealthcover.ie
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