After many days of searching and doing comparisons on hia.ie (and i mean DAYS) I decided to go with a plan with high excess (€600) for us.
It means I can get 2 adults and 2 kids insured for just over €2k and with some small day-to-day expenses returned with €1 excess. I picked Laya Control 600 Total.
We can still get the day cases (like endoscope) covered privately in our local hospital with no excess. if we are unlucky enough to need to pay the 600 excess so be it, its a gamble i am prepared to take.
It means we keep our access to private hospitals.
if you downgrade your policy, then get a condition that needs hospitalisation or you know you'll need an operation going forward, there could be a waiting period again to upgrade.
If you keep the access levels high, then you can opt to get a dearer policy next year with lower excess.