Health Insurance All Insurance policies Orthopedic cover - 80% for specified procedures

Curlyfella

Registered User
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Hi

I'm just reviewing different policies on the HIA website and I've noticed that at best, the orthopaedic cover is at maximum -
"80% for "specified orthopaedic and ophthalmic procedures"
on nearly all polices.

The article below from 2018 - states that
  • Laya Healthcare offers the best orthopaedic cover - having no shortfalls for replacements on the majority of its plans.
  • VHI has a number of procedures which are only 80pc covered in private hospitals. These procedures include orthopaedic and ophthalmic procedures but unfortunately, this list is not available to the general public. -
  • Irish Life Health has a list of 10 restricted orthopaedic procedures which carry a co-payment of €2,000
https://www.independent.ie/business...rocedures-result-in-co-payments-37607687.html

Irish life do have a list of the procedures which require co-payment for cardiac procedures while the rest do not.
This needs to more transparent.
  • Irish Life Health cardiac procedures requiring co-payment below
https://www.irishlifehealth.ie/Iris...ardiac-Procedures-Subject-to-Co-Payment_W.pdf

A recent article below

https://www.businessworld.ie/financial-news/Consumers-warned-to-beware-of-benefit-changes-to-Health-Insurance-Plans--574182.html

CONSUMERS WARNED TO BEWARE OF BENEFIT CHANGES TO HEALTH INSURANCE PLANS

  • Laya have recently introduced co-payments or shortfalls on 3 of their popular plans for certain major orthopaedic and ophthalmic procedures when carried out in private hospitals
  • Laya Healthcare is the latest to announce such a change to their popular 360 Care ‘private room’ corporate plans (360 Care & 360 Care Select). Up until 30th June, these plans covered the full cost of major orthopaedic and ophthalmic procedures in private hospitals but from 1st July onwards, they are introducing a 20% shortfall for these procedures which is a significant change to the cover and which TotalHealthCover.ie say could leave members with a shortfall of up to €3,000 for the likes of a hip or knee replacement.
  • Speaking today, Health Insurance Consultant with TotalHealthCover.ie, Dermot Goode said, "When many members receive their renewal notices, they don’t always review the documents sufficiently to appreciate any reduction in cover. This is a particularly important issue for older members, who may have opted for these plans specifically to have this ‘full cover’ in place. It’s important to note that VHI and Irish Life Health have similar shortfalls already on many of their corporate plans. Members of these Laya plans should seek independent advice before renewing for another year as there are a number of alternative schemes where members can retain this cover."
 
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