David_Dublin,
As your mother is considering re-joining health insurance having lapsed for a long number of years, she will be treated as a new first-time
customer and certain things have to be taken into account when making this decision.
First of all, there is a 6 month waiting time before hospital cover applies, this applies to all new customers.
Note; accidents and injuries are covered in this first 6 months, but any other hospital treatment or surgery will not be covered until after this
waiting time is served.
Secondly, if your mother has any pre-existing illnesses or conditions, there is a 5 year waiting time to be served before these illnesses are
covered for hospital treatment. If she has no pre-existing illnesses, any new illnesses arising will be covered after the initial 6 month waiting time
is served.
Lifetime Community Rating
Thirdly, if you take out health insurance over the age of 34 years, there is a 2% loading added on to the premium for every year that you exceed
34 years. However, you are given a credit for every year that you previously held health insurance.
In your mothers case, she is 40yrs over the 34 age limit so technically a 40 x 2% = 80% loading would apply but loadings are capped at 70%
for anybody over 69 yrs.
As you already mentioned she had health insurance for a number of years in the past, she will be entitled to a 2% credit for every year she had cover. However, it is upto the customer to show proof of previous cover details, if previous cover was before 2009, as the health insurance providers would not keep details before 2009. This could be tricky going back a long number of years for the customer.
https://www.hia.ie/consumer-information/lifetime-community-rating-explained
The plans recommended by VHI would not be suitable for your mother, as One Plan Starter covers public hospitals only which means she would
go onto the same long hospital waiting lists for surgery as those with no insurance, which is pointless. Also, the Health Access plan is too
expensive, there are cheaper plans available with Laya that would tick all the boxes at a cheaper price.
Details of Laya plans as follows;
1. Essential Health 300; price 873pa + loading; all public, private and Beacon hospital covered, an excess of 300 applies per admission to a private hospital or 125 excess applies per day case visit. No excess is payable in public hospitals. Full cover applies for joint replacement surgery in private hospitals on this plan - no excess or shortfall applies for this surgery.
Note; a price increase applies from 1 July 2017 - 916pa + loading; lifetime community rating loading will be added onto basic price as applicable.
2. Simplicity Plan; price 1190pa + loading; (no price increase applies to this plan) all public, private and 3 hi-tech hospitals covered, excess 100 x 2
max per year for private/hi-tech admissions, day case excess 50 per visit, good day to day cover applies - first 100 not allowed.
Again, full cover for joint replacement surgery in private and hi-tech hospitals on this plan, no excess or shortfall applies for this surgery.
Note; the applicable % loading will be added onto the basic premium every year.
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The above 2 plans are well worth considering, they both cover all public + private hospitals. The main difference relates to the excess payable
if admitted to a private hospital for surgery or day case. Simplicity also covers Mater Private and Blackrock Clinic plus day to day expenses cover.
Although there will be an extra loading charge added onto the overall price, it is still worth having health insurance based on the cost of
different types of surgery and the length of waiting lists.
There's plenty of food for thought to take in.
Hope this enlightens your decision making.
Snowyb