Health Insurance Renewal

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Laois64

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I was on VHI Health Insurance Plan PMI 42 15 and decided to switch to Laya Complete Simplicity. VHI didn't increase my premium this year and there are only a few Euro difference in both plans. I have been toying with changing to Laya for a while to the best plan I could find nearest PMI 42 15 due to the fact that I am 64 and will be 65 in Aug and from my own research I think if I am not wrong that when one reaches 65 there may be an issue with waiting times or its more difficult to switch. I like the fact that there are no shortfalls with either cataracts or joint replacements with Laya and also as I would have access to a private bed in my preferred hospital the Beacon if unlucky enough to require either of the above. Dont get me wrong the private room is only a minor to me as I had major surgery recently in the Beacon and due to horrendous personal hygiene and needing help I felt awful for my nghbour and wished I had a private room in order to not annoy her. I understand there are excesses on the new plan and I will have to wait the two years to avail of no shortfalls on joint surgery if I ever need it. I do have an existing condition but I believe I will still be covered on my old plan as I was until my two years' waiting time expires. In other words I am thinking long term. I would very much appreciate your advice on if I am doing the right thing and if Complete Simplicity is a good plan as it appears to cover day to day also with an euro excess up to 7.5k or am I missing anything. I do realise my outpatients physio and chiropodists treatments are reduced in number of visits and amount one can claim. Thank you so much for your help in advance and for having such a fantastic service. Laois64.
 
Laois64,

To be honest, I would recommend Simplicity Plan @ price 1231pa instead of Complete Simplicity @ price 1617pa.
The hospital cover on both plans are identical, no difference whatsoever.
Regarding day to day cover, the only difference is the excess of 1 euro on Complete Simplicity compared to an excess of 100 on Simplicity.
You would be paying 386 extra to gain 100 euro extra day to day refund. It doesn't make financial sense.
By switching to Simplicity, you are saving 286 overall, even taking the 100 excess for day to day cover into account.

Private room is fully covered for all types of surgery in the Beacon hospital for illnesses that are not pre-existing at the moment.
In other words, the 2 year wait for a private room only applies to any illnesses you already have at present.
Your existing illness will continue to be covered as per the cover on your old VHI plan.
New illnesses arising in the future are fully covered, no waiting 2 years. Even hip and knee replacement surgery.

[broken link removed]

Don't worry if you've already changed to Complete Simplicity, you have 14 days after 1st January 2019 to change your mind again.

There is no difficulty switching at age 65 years.
What you are referring to is with VHI, they impose a six month wait for people over 65 who upgrade day to day expenses cover.
Laya have no waiting time, regardless of your age, for upgrading day to day expenses cover.


Regards, Snowyb
 
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Snowyb thank you so much for this information sometimes it is hard to see the wood from the trees while researching these plans. I see exactly what you mean by the excess. I do have existing medical issues and had nearly Euro1500 day to day bills in 2018 due to check ups etc. and Euro 1 is what I was focused on. From your response I think Laya is best health insurance overall and I already have my husband on Simplicity for last few years but he doesn't have medical issues like I have thankfully. I definitely do not want my in patient care compromised by switching and I can't see it happening if I do as I will still have same cover from PMI42 15 for next 2 years. Can you reassure me I am definitely o.k. switching to Simplicity like my husband also taking into consideration I have A Fib and get a number of spinal injections for back pain due to scoliosis which they will not even consider touching at my age. I also want to thank you so much for clarifying the 65 age issue, at last I now know what this is. You are really a wonderful source of knowledge on all of this and really appreciate your help and advice. I will be on to Laya this evening to switch to Simplicity as advised as soon as you respond to my worry outlined above and also is Simplicity a corporate plan? Thank you so much again Snowyb and a very Happy New Year.
 
Laois64,

If you get your spinal injections done as a day case procedure, you will have to pay 50 euro everytime.
If you are admitted to a private hospital for an overnight stay to get these injections, you will be charged 100 x 2 max for all inpatient
admissions for the full year( regardless of the amount of private hospitals admissions per year).

There's a saving of 480 euro approx per year by switching which will cover a fair amount of medical expenses.
Also, the overall refund of day to day expenses would not be as high as on VHI PMI 42 15.

The important information is that you will not lose any inpatient hospital cover by switching to Simplicity.

There are advantages to gain including full cover for a private single room in the Beacon hospital.
Full cover for hip or knee replacement surgery in any private hospital - note; the Beacon hospital would charge 3000
shortfall for this type of surgery on the VHI plan. Cataract surgery is fully covered in any private hospital on Simplicity plan.

Hope this reassures you about switching plans.

Snowyb
 
Again thank you very much Snowyb for your reassurance. I have fully decided to switch to Laya Simplicity and just wish I had done it long ago. Please keep up the good work, you have a wonderful forum.
 
Hello again Snowyb, I need your kind assistance yet again. You gave me great advice previously and I did change over to Simplicity with Laya. Now, however, our son is joining health insurance for the first time through his company. They will contribute portion towards whatever plan he chooses. He is 28 and as mentioned above I changed over to Laya from VHI due to no restrictions on orthopedic joint procedures and I think he should choose Laya. However, as a starter
plan with cover in private hospitals and Beacon together with reasonably good day to day expense cover (he doesn't have a medical card) what plan would you recommend. He is awaiting an appointment from Tallaght for the last year to have tonsils removed, would he have a waiting time also if joining now. Thanking you yet again.
 
Laois64,

Firstly, for new customers there is a 5 year waiting time to serve for any pre-existing illnesses/conditions before hospital cover is allowed.
So he will not be covered for a tonsillectomy for 5 years unfortunately. At the same time, after the first 6 months on the plan, all new illnesses/
conditions are covered in all hospitals - public, private and hi-tech hospitals.

In saying that, sometimes with corporate plans there may be special concessions attached, where waiting times may be waived for pre-existing
conditions/illnesses. It would be worth enquiring with hr department if such concessions apply.

As the company are paying a portion of the cost, it makes sense to choose Laya Simply Connect plan, price 1100pa.
Details as follows;
Simply Connect; price 1100pa; all public, private and 3 hi-tech hospitals covered, private/hi-tech excess capped at 150 x 2 max per year for all
admissions, day case excess 50 per procedure. There is no excess to pay in any public hospital. Good day to day cover on this plan, refund of
50% for gp visits, consultants, dental, physio etc - subject to a max excess of 500 per year.

[broken link removed]

Regards, Snowyb
 
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