VHI Query re Excess

Hi there, currently on Plan B and very confused about the claim system/excess. So the excess for GP visits and Consultant Visits they say is E100.00. I have had 2 consultants visits recently for E160 & E120 respectively. I was calculating that this would be as follows:

E280 paid to Consultant.

E100 is the excess - E180 is remainder so 50% of that payable is E90.

However, VHI say E280 paid to consultant - 50% of that is E140 -( E100 is excess so actual benefit to be applied is E40) and take 50% of that so i get E20.00.

How can they apply 50% twice?


Soory

I don't think you are on Plan B with the benefits you've mentioned. May be a policy similar but not Plan B (now known as Healthplus Access)

How the outpatient works is:

•You have an excess (you've mentioned €100)
•You have a specific ELIGIBLE amount or % for different types of receipts (you've mentioned 50% for cons)

You add the ELIGIBLE amounts together and the excess is deducted from that total.

This calculation would be correct:

€160/2 = €80
€120/2 = €60
Total = €140
Less excess €100
Amount due to you €40

kitty81,

The refund on Plan B per consultant visit is 60 euro so in your case this is 60 x 2 visits = 120.
120 - 100 excess = 20 euro.

A 50% refund for consultant visits only applies if the consultant visit takes place in a VHI Swiftcare Clinic.

[broken link removed]

Hope this helps to explain this more clearly.

Snowyb

Hi snowyb

While I agree with you about the figures for Plan B, alot of plans have moved to a % of cover for cons, GPS etc now. That is why I mentioned to sooty that I don't believe they are on Plan B (as they mentioned the %)

I am certain that it has nothing to do with going to a consultant through Swiftcare Clinics