Hi di74,
Firstly just to explain a few things regarding VHI plans and people over 65.
If they are switching to any VHI plan with good outpatient cover ( ie. with a 1euro excess), VHI will impose a 2 year
waiting time before they can make a claim for consultant visits etc. While waiting 2 years, they would still have outpatient cover on their
current plan B Options - which has a high excess 250 per person.
Regarding their main concerns about the 80% restrictions with private and hi tech hospitals for orthopaedic and cataract surgery,
there are ways around it to avoid any potential costs.
1. The 80% restriction does not apply to any main public hospital, so surgery as above is fully covered in Cappagh Hospital and a range
of other public hospitals.
2. The two hi-tech hospitals Blackrock Clinic and Mater Private are fully covering this type of surgery since 2008. This means that even
though VHI only pays them for 80% of the cost of surgery, both hospitals are NOT charging the patient for the 20% shortfall. This is a
very good option to go for if the need arises. I have personal experience of this with a relative in 2012 and its true, no extra costs involved.
Just the usual private consultant visit and x-ray costs.
3. Any other private hospitals would charge the patient for the 20% shortfall, which could be 2000 to 4000 depending on the type of
surgery and the hospital involved. It was mentioned on AAM before that Mount Carmel were not charging the shortfall at one stage, but you
would have to check it out fully and any other private hospitals to clarify their upto date position on that.
The only alternative plans with VHI with no 80% restriction are as follows;
Health Plus Access ( plan B ); Price per adult; 1524pa
Health Plus Excess (plan B excess); Price per adult; 1376pa
www.hia.ie/ci/comparison/step3?68&67&69/
There is full cover in private hospitals for all surgery except the Hermitage Clinic Dublin and Galway Clinic - 90% cover for orthopaedic
and cataract surgery applies. Note; these 2 hospitals could charge 10% shortfall to the patient, just something to watch out for.
There is also full cover in the hi-tech hospitals for orthopaedic and cataract - 10% shortfall won't be charged.
The 2 plans you are researching at present are fine in content but you can do slightly better on price with VHI;
Here are a few alternatives to consider;
1. Plan PMI 14 11; price per adult; 1050pa - 75 euro hospital excess - good hospital cover and good outpatient cover.
3. Company Plan Extra Level 3; price per adult; 1280pa - no hospital excess - good hospital cover + higher outpatient cover.
www.hia.ie/ci/comparison/step3?68&257&111/
NOTE; These 2 plans both have the 80% restriction for orthopaedic and cataract surgery but any extra costs can be avoided if they
choose hi-tech or public hospitals as already explained above.
Also, there will be a 2 year waiting time applied to the outpatient part of these 2 plans because of their age.
They would be covered while waiting, under outpatient cover B options as explained above also.
I know they are reluctant or against switching providers, but as a final option, I would highly recommend having a look at plan
Company Care Plus with Laya Healthcare just to see what it offers.
Company Care Plus; price per adult; 1201pa(1237pa) price in brackets includes a 3% charge if paying by instalments.
www.hia.ie/ci/comparison/step3?68&198/
1. It is identical to Plan B Options regarding hospital cover with extras.
2. No 80% restriction for orthopaedic or cataract surgery in any hospital.
3. Excellent outpatient cover 75% refund for consultant visits and 50% refund for physio, chiropodist etc.
4. No waiting time imposed for outpatient cover, immediate cover applies regardless of your age.
5. Extra option of a private room in a private hospital for a shortfall of 50euro per night - same with vhi is 300-400 per night.
Even if they choose Company Care Plus for this year and then go back to VHI next year, they will avoid the 2 year waiting time
for outpatients next year with Vhi.
There's a lot of food for thought to digest and info to take into account.
You would think that paying 1837 each per year for health insurance, it would at least include decent outpatient cover, not so with VHI.
To describe it as a rip off is an under-statement.
There's plenty of savings to be made and lots of time to make a decision.
Regards, Snowyb