1A in her 70's (with MCard): Plan B VHI HealthPlus Access. outside Dublin.

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wmd

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hi, I am trying to find alternatives for my mum in law (in her 70's) for Plan B VHI cover(HealthPlus Access).

She has had this cover for many years but Im trying to see if I can find something that will suffice her needs at a cheaper price.

Her main concern is to have cover for consultants if she would need it.

lso as she is based outside of Dublin, need cover for the regional hospital and possibly Galway clinics.

As she has a medical card, day to day cover for gp etc is not a necessity.

If anyone can offer some insight into the minefield of various policies I'd be very grateful - she would prefer to stay with VHI.

tks in advance
 
Hi wmd,

It doesn't matter that her renewal date is very near, she still has a further 14 days after March 1 to change her mind.

As your mother-in-law is over 65 yrs, there are a few things to take into consideration when choosing a health insurance plan.


Option 1
There aren't any identical cheaper plans with VHI, to match Plan B.
The nearest plan with similar hospital cover and good outpatient cover is called 'Company Plan Extra Level 3'. Price 1180pa
Note this plan may go up in price on 1 March 2013.

www.hia.ie/ci/comparison/step3?67&111/

This plan has an 80% restriction in a private or hi-tech hospital, for orthopaedic operations (hip or knee
replacement surgery + cataract eye surgery).
This 80% restriction could mean a shortfall of 2000+ depending on the type of surgery in a private hosp(Galway Clinic) or hi-tech hospital.
These operations could be required at some stage, for a person over 70.

However, this 80% restriction does not apply to any public hospital, so this shortfall could be avoided if this type of surgery was done in
the regional public hospital.

Alternatively, as a further option to avoid this shortfall, if she was prepared to have surgery in Dublin, both Mater Private and
Blackrock Clinic are fully covering all orthopaedic surgery. They are not charging any shortfall amounts.
I'm not sure if the Galway Clinic are collecting the 20% shortfall or not, it would be worth checking it out with them.
These are the implications of taking out a plan with an 80% restriction for a person over 65, who may need this type of surgery.

Otherwise, all other surgery would be covered the same as Plan B, in public,private or hi-tech hospitals.

Regarding, out-patient cover for consultant visits, there is good outpatient cover on Company Plan Extra Level 3, but unfortunately
VHI Healthcare impose a 2 year waiting time for people over 65 yrs, for upgrading outpatient benefits.
She would have to wait until March 2015/16 before being eligible to make a claim for these expenses.
VHI don't reward 20 or 30 yrs customer loyalty, whatsoever, the rules are applied regardless.



Option 2
Having outlined the obstacles and pitfalls above with VHI, there is a very positive alternative option if she was interested in switching
to Laya Healthcare.
I know she expressed a preference to stay with VHI and I know how reluctant people are to switch.

The positives of switching are;

1. It would be identical cover to Plan B - hospital cover.
2. There is no 80% restriction with any hospital for orthopaedic + cataract surgery. Galway Clinic fully covered any surgery.
3. There is excellent outpatient cover - 75% refund for consultant visits, 50% refund for physio, etc
4. Most importantly, there are no age related waiting times for outpatient cover with Laya - immediate cover applies.
5. Cheaper price.

The plan recommended with Laya Healthcare is called; 'Company Care Plus' Price 1059pa

www.hia.ie/ci/comparison/step3?67&198/

A 3% charge applies if paying in instalments. Total Price including 3% charge; 1090pa

NOTE: She could switch to Laya for 1 year and then in March 2014 change back to VHI Company Plan Extra Level 3. By doing this,
she would not have to serve a 2 year waiting time for outpatients cover with VHI at that stage. Well worth considering, if being with VHI is
important to her.

A lot of food for thought to consider - if none of the above suits, she can always stay on Plan B.


Snowyb
 
snowyb - many thanks. thats great info. I see that some of the price hikes start on 1st march, can she cancel her existing policy tomorrow and take out new one straight away to avail of the lower prices? - think I saw that somewhere?


Also, we were just looking at price and Company Plan is a good bit cheaper, apart from the excess that applies per claim and restriction as regards 'special procedures' (any idea what these refer to?) is there anything else I should be looking out for?

Also, in relation to outpatient consultant visits - as far as I can see Plan B offers €39 per visit with a €300 x/s. This would be higher on the Company Plans with a lower x/s? Is this what you mean in relation to 2 year waiting period for upgrading? Apologies I'm getting confused.

thanks in advance
 
wmd - Just to clarify a few things, is she picking VHI Company Plan Extra Level 3?

If she is, you would need to ask VHI a few questions before making a final decision.

You need to find out if it is increasing in price on 1 March 2013 and what the new price will be.

As far as I know, VHI don't allow you to change renewal date, even for a day or two. It would be worth a try
to ask if she could, to avoid the price increase - though I wouldn't hold my breath.
It was a similar case with Laya Healthcare that you are thinking of, Laya do allow customers to change a day or two early
to avoid a price increase.


'Special Procedures' means orthopaedic operations like hip or knee replacement surgery and cataract eye surgery.

The restriction of 80% for these operations means that VHI will only pay 80% of the cost of surgery if it is done in a private or hi tech
hospital. The patient would have to pay the other 20% of the cost - which could amount to 2000euro or more depending on the cost of
surgery.
There are ways to avoid these costs, by having orthopaedic surgery in a public hospital or travelling to Dublin to Mater Private or
Blackrock Clinic.
I tried to explain this as best I could in the previous post.



Regarding outpatient expenses with Company Plan Extra Level 3, (1 euro x/s with 100 per consultant visit etc). This part of the plan
is seen as an upgrade in cover by VHI, compared to her existing plan b, with 300 x/s and 39 per visit.
So as a result, VHI will not allow her to claim outpatient expenses until she waits for 2 years.
While serving this 2 year waiting time, VHI will allow her to claim outpatient expenses on her old Plan B while waiting.(300x/s 39 per visit)

Plan B outpatient cover is not great, as your expenses have to exceed 300 before you qualify for a refund.

The only way to avoid this 2 year waiting time, is to switch to Laya Healthcare for one year, where you can claim outpatient exps 75% refund per
consultant visit straight away, as Laya don't apply any waiting times for outpatient cover.

Hope this explains things a bit better.

Snowyb
 
Last edited:
Snowyb thank you. I was just about to post a similar question about alternatives to my plan because I was fnding it difficult to wade through the waffle and what different terms mean.
You have helped me understand the issues I was concerned about.

One question, as long as I am downgrading to an option that gives me the same hospital/outpatient cover, (I don't need day to day anymore), am I right in thinking that I do NOT have a waiting period?
The whole waiting period thing is confusing for me.
 
Hi Subtitle,

What you're thinking is correct, once your hospital/outpatient cover is either identical or lower on the new plan - there is no waiting period to serve.

However, in order to give a better opinion, I would need to know the name of your existing plan and the new plan you are considering.


There is full info on the hia website re waiting times for both inpatient and outpatient cover, according to a persons age.
I appreciate it can be more confusing than helpful at times.

www.hia.ie/consumer-information/waiting-periods/switching-upgrade-waiting-periods/

Snowyb
 
Last edited:
Thank you Snowyb,
I'm on Family Plan plus 2 (1340.50 euro pa) and I am looking at One Plan 250 (758.50 pa).
My concern is to have hospital cover and cover for cat/mri/pet scans. I am anxious to keep my cover for cancer related treatments.
I am not concerned about gp visits.
Thanks again.
 
Hi Subtitle,

Having looked at your existing plan compared to One Plan 250, there would be no waiting times as you are downgrading
both hospital and outpatient cover.

However, I discovered another plan with VHI, called 'PMI 12 11' which you may be interested in considering:


It offers exactly the same hospital cover as your existing plan, Family Plan Plus Level 2, So you would not lose any cover
whatsoever. Hospital excess 125 same as before.
The cover for radiology,mri scans,pet,ct scans, x-rays etc are also identical, so no change there.

There would NO waiting times as it is changing to a plan with similar cover.


The out-patient cover has an excess of 150 but it still includes cover for the full list, ie consultant,gp,dental,physio etc.
I know outpatient cover wasn't a priority, with a bigger excess it would mean you would need to have a min of say 3 consultant
visits or over 6 physio visits to qualify for a refund.


Price per adult is; 865pa


Compared to One Plan 250 (price 789pa), PMI 12 11 would be a much better option, for an extra 76euro overall or 1.50 per week.

Regarding your situation with ongoing health issues, I think One Plan 250 compromises a lot on hospital cover.
Plan PMI 12 11 would put you in a more comfortable position all round, with all hospital options still intact if the need arises.

I waited until today to reply, to make sure there was no increase in price (50 plans with VHI increased today 1/3/2013).

This is well worth considering - you can see the 3 plan comparison here:

www.hia.ie/ci/comparison/step3?253&82&256/

I don't know your renewal date, so I don't know how much timeframe your dealing with.


Snowyb
 
Thank you very much Snowyb. I just had a look and that plan suits me much better. You're very kind to take the time to help me, I appreciate it very much.
 
snowyb said:
Hi wmd,




Option 2
Having outlined the obstacles and pitfalls above with VHI, there is a very positive alternative option if she was interested in switching
to Laya Healthcare.
I know she expressed a preference to stay with VHI and I know how reluctant people are to switch.

The positives of switching are;

1. It would be identical cover to Plan B - hospital cover.
2. There is no 80% restriction with any hospital for orthopaedic + cataract surgery. Galway Clinic fully covered any surgery.
3. There is excellent outpatient cover - 75% refund for consultant visits, 50% refund for physio, etc
4. Most importantly, there are no age related waiting times for outpatient cover with Laya - immediate cover applies.
5. Cheaper price.

The plan recommended with Laya Healthcare is called; 'Company Care Plus' Price 1059pa
Snowyb
Click to expand...

SnowyB - I switched my MIL to this plan for 2014. The price difference between both plans was €800 ! So a big saving. Thank you !
 
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