VHI Health Plus Access (Plan B) Alternate cheaper options??

Red Setter 101

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Hi, My parents are due to renew their health insurance in January. They are on Health Plus Access (Plan B) and are reluctant to change but are struggling to pay the current price €4,091.16( 2045.58 each) My Dad is 71 Diabetic (Type 2), Mum is 68 ( had a TIA stroke last year but made 100% recovery) – both are fit & well..

They would like to cut the cost but I am struggling to know what are good plans to compare against.. Can anyone assist with some good options that would have similar features and better benefits with a much lower cost. I am open to look at All Insurers.

Thanks in Advance for your help

RS101
 
Red Setter 101,

Welcome to AAM.
The plan 'Health Plus Access' old Plan B, has no excess to pay on admission or for day case visits to private or hi-tech hospitals.
This plan also has full cover for orthopaedic surgery (hip or knee replacement surgery) in private or hi-tech hospitals.

a. Alternative VHI cheaper plans with no excess as follows;

1. VHI Company Plan Extra Level 1; price 1613pa; public, private and hi-tech hospitals covered as before, no excess, good day to day cover included,but VHI impose a 2 year waiting for extra day to day cover, for over 65s. They would stay on Plan B day to day cover while waiting.

Note; this plan has 80% cover for orthopaedic surgery in private or hi-tech hospitals. This could mean a shortfall of 2000+ depending on the hospital. However, this does not have to be a problem, if they choose either Blackrock Clinic or Mater Private for this type of surgery, there is no
shortfall attached. These 2 hi-tech hospitals do not pass on the shortfall to the patient.

2. VHI PMI 42 15 Plan; price 1643pa; this plan is similar to Company Plan Extra Level 1 but with extra day to day cover. Likewise, there is a
two year waiting time just for this upgraded day to day cover, for over 65s.
80% cover applies to orthopaedic surgery in private/hi-tech hospitals, but if surgery is done in Blackrock Clinic or Mater Private, there is no
shortfall to pay.

3. One Plan Extra; price 1543pa; public, private and hi-tech hospital cover as before. No excess. There is limited day to day cover on this plan.
There is 80% orthopaedic cover in private and hi-tech hospitals, so if either Blackrock Clinic or Mater Clinic is chosen for surgery, there is no
shortfall to pay.

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b. Alternative VHI plans including a hospital excess which is payable on admission or day case in a private/hi-tech hospital;

1. Health Plus Excess; price 1799pa; same hospital cover as before, this plan has a hospital excess 75 euro payable on admission/day case in
a private/hi-tech hospital. Limited day to day cover. Full cover included for orthopaedic surgery in private/hi-tech hospitals.

2. Health Access; price 1645pa; same hospital cover as before, this plan has a hospital excess 125 euro payable on admission/day case in a
private/hi-tech hospital. Limited day to day cover. Full cover included for orthopaedic surgery in private/hi-tech hospitals.

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c. Alternative Laya plan with full orthopaedic cover and a max hospital excess;

1. Laya Simplicity Plan; price 1087pa; public, private and hi-tech hospitals covered. Max hospital excess 100 x 2 per year, regardless of the
number of admissions to a private or hi-tech hospital. Day case excess 50 euro per visit. No excess applies to any public hospital.
Good day to day cover included on this plan, the first 100 not allowed. There is no waiting time applied to this extra upgraded day to day cover,
regardless of age. Full cover applies for orthopaedic surgery in private or hi-tech hospitals on this plan.
There is extra full cover for a private room in a private hospital on this plan.
This is the cheapest alternative plan to Health Plus Access, there is substantial savings to be made by switching.

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Hope this helps with decision making.

Snowyb
 
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Thanks Snowyb for the help - this is great info.... it is really a mind field.. I have been looking at the Simplicity as it looks good but the price reduction for some reason is scaring my parents to think they are losing huge amount of cover which doesn't seem to be the case..

For Inpatient a part from the Max hospital excess 100 x 2 per year (more than saved) The only potential areas of risk are with "Blackrock Clinic and Mater Private also have a €175 shortfall per night. No shortfall applies for specified orthopedic procedures. Given age profile ( 71 & 68) I would have some concern here that a fall leading to a broken bone of hip issue could cost dearly? Whats your thoughts here?

For out patient I see Individual excess at 300 vs 100.. I assume this means you pay the first 100 as opposed to the first 300 of your claim if you move?

Thanks

RS101
 
Red Setter 101,

Hi-tech hospital cover on mid-level plans is a grey area and hard to define at times.
The list of plans recommended above, do not have unlimited access/admissions to hi-tech hospitals including Health Plus Access.
Unlimited access would be covered on top level plans.

However, hi-tech hospital cover on mid-level plans has changed and improved since 2008.
As a result of the recession in 2008, the 2 hi-tech hospitals Blackrock Clinic and Mater Private brought out a waiver system whereby they
waive any shortfalls on a wide range of procedures and surgeries. They do not pass on these charges to the patient so in effect there is full
cover in these hospitals for a wide range of surgery.
At that time in 2008, many people switched from top level plans to lower price plans, to save money. This would have had a direct impact on
the hi-tech hospitals, so as not to lose business - the waiver system was established.

Blackrock Clinic's waiver system is more extensive than Mater Private, the majority of surgery/procedures are fully covered in Blackrock Clinic.
There is some information about this on the following links, they are helpful with queries re cover/waivers/surgery for different plans being considered;
http://www.blackrock-clinic.ie/about-blackrock-clinic/freephone-enquiry-line/

https://www.materprivate.ie/dublin/patients-visitors/billing-insurance/

I think a situation re a fall of an older person would probably be an A + E situation to assess the damage and decide if surgery or alternative action is required.

I can fully appreciate their concerns about switching providers after a lifetime with the same company.
There are also good alternative options with VHI worth considering, those with the extra day to day cover are very good value, after the 2 year
waiting is served. Hospital cover would be identical to Plan B, just the 80% orthopaedic cover which is no problem if Blackrock Clinic or Mater Private is chosen for hip or knee replacment surgery.

A final suggestion worth considering is maybe using a broker that specialises in health insurance for professional advice.
I have no personal experience of brokers but when you're spending 4000 on something per year, a hundred or two is tiny in comparison.

Regards, Snowyb
 
Thanks Snowyb..

Based on above I went and talked to Laya on their behalf.. The response I received was that Simplicity is the best Corporate Plan they have currently and that it meets everything Plan B does (with some excess) and adds a bit more- Laya did say that there is a 2 year waiting period for any pre-existing conditions but that those conditions were covered up to Plan B level so no real reduction in cover.... When my parents listened in on the call they decided to take the risk and move so you have 2 very happy customers today- They have saved enough pay their crazy car insurance!!..

They also called VHI, who had no response or push to keep them - I guess having taken their money for 37 years they were happy to see the risk off the books!..

AAM is a great site & you are great at what you do.. thanks again.

Happy RS101!.. :)

PS Note the amount saved for my parents is €1,916 which has to be an omen given the year that's in it...!!
 
That makes 3 happy customers - I also switched to Simplicity recently as it wasn't launched last year at my renewal.
The 2 year waiting would be for the extra cover - 'private room in a private hospital' only in respect of any pre-existing conditions.
Cover for the private room in a private hospital would apply straight away in respect of any new illnesses or conditions.
An equivalent plan with VHI including private room in a private hospital cover would be Health Plus Choice(Plan C), price 2984pa.:)

Snowyb
 
That makes 3 happy customers......

Hi Snowyb,

Firstly, I would just like to thank you for some excellent information. Maybe, I too will join Simplicity and that will make 4 happy customers!
I've two questions......

1. I'm currently with LAYA - Flex Explore 175 - renewal 1st January. Do you have any idea why when I put this policy type into the HIA system, the Simplicity product does not come up as a comparator? - (i.e. am I allowed switch between the two?).

2. If I stick with my existing plan - can I purchase it "on-line" and get the 10% discount rather than simply renew the policy at the full whack?

Thanks again
 
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Dan Murray,

1. The reason Simplicity plan does not come up as a comparator is because Simplicity has extra cover including a private room in a private hospital.
So it would not be an equivalent plan cover wise. There is absolutely no reason whatsoever why you can't switch to Simplicity. Its a corporate
plan available to everyone. If you have any pre-existing conditions, there would be a 2 year wait to use the extra cover - private room in a private
hospital, just in respect of any pre-existing conditions. The extra cover is allowable straight away for any new illnesses. There is no waiting time
for the extra day to day cover, regardless of age.

2. If you stick with Laya Flex Explore 175, the online system wouldn't allow you to buy online at the moment, too early. The 10% discount,
strictly speaking, is aimed at new customers so it rejects renewals but from previous posts in relation to this, it just involves cancelling your
existing policy at renewal date and setting up a brand new policy. Just watch that the 10% discount is still available online on 1 January 2017,
its a crazy time of year, when most renewals take place, but nothing is guaranteed around that time.

Regards, Snowyb
 
Snowby,

Thanks again - you sure knows your onions about this stuff....

I must admit that I find it all a pain in the back-side - all these companies, going to all this effort (and expense), to design an unnecessarily confusing system - with the regulator letting them run wild. Terrible stuff.

So, if I have this right.....

1. I have a policy with LAYA where the premium is higher than an alternative policy with LAYA. It's just that the alternative policy provides substantially better benefits than my existing policy and if I switch to the better lower premium policy, I have to wait 2 years to benefit from the enhanced terms of this lower premium policy in respect of in-patient care for pre-existing conditions.

2. The in-patient benefits of the lower premium policy are so substantially better than my existing policy that the Regulator does not include the lower premium policy as a legitimate comparator to my existing policy!! For the love of God!

3. I am entitled to cancel my existing policy and start up a "new policy" the same day - thereby securing a 10% reduction in premium from LAYA - who still presumably pretend to offer community rating. Do other health insurers do this charade also? Presumably, there is nothing preventing me from this cancel & re-purchase (rather than a renewal) approach?
 
Yes, you are spot on everytime. The other providers don't do discounts so the same price applies to new or renewing customers.
Laya offer these % discounts to attract new customers online but they only end up annoying existing customers.

Snowyb
 
They could have stayed with VHI and gone on PMI 41 15 and still saved 1582 euro without having to take the reduction in cover for Blackrock Clinic and the Mater Private on the Simplicity plan
 
Hi Snowyb,

That time of year again to renew the parents insurance and as expected Simplicity has increased by €103PP for the renewal so its time to ask whats new and comparable to Simplicity and is there any savings to be had..?

In terms of the changing from VHI Plan B to Laya Simplicity last year I want to share an update as its a big step for older people.. - Thankfully everything went well but we did test the plan very quickly as my mother had another stroke just weeks into the plan and we managed to get a follow up operation on her Carotid Artery done in the Mater Private at no cost except €100. That said only for the Mater Private finance team assisting me, Laya were doing everything they could to wriggle out of it.. The catch was in " We cover everything Plan B covers" seeing that this was a past illness.. Unfortunately plan B didn't specify clearly what the agreement was with the Mater private.. Something for others to note - Talk to the accounts/finance teams in the hospitals up front, I found them excellent in the Mater and really followed up wit Laya and even got me confirmation in writing Pre-Op that there would be no charge.. When you talk to customer service team in Laya i found i just kept getting people reading from the script and no one was able to get into the detail and they kept refering to whats in VHI Plan B but only what you read and this was not the agreement with Mater/VHI... The finance teams had all the agreements and were able to talk to Laya and sort it out so credit to them in this case..

Hope this helps someone else..

Thanks,

RS101..
 
Red Setter 101,

Simplicity is still probably best value overall at the moment, based on the 100 x 2 max inpatient excess.
It increased in price last April, so they have avoided this price increase until now.

Alternative plans at a similar level of cover would have an excess payable for each private/hi-tech admission.
1. VHI PMI 44 16; price 1102pa; all public, private and 3 hi-tech hospitals, excess 150 per inpatient admission or day case visit.
Private room in a private hospital fully covered on this plan.

2. VHI PMI 43 16; price 1171pa; all public, private and 3 hi-tech hospitals, excess 150 per inpatient admission + 50 per day case visit.
Private hospital covered upto a semi-private shared room. Supplement to pay for a private room. Good day to day cover with a 1 euro excess.
Note; Simplicity day to day cover would apply for the first six months as VHI have a 26 week wait for day to day cover for over 65 years.

Also; both of these plans have 80% orthopaedic cover in private and hi-tech hospitals, Simplicity has full cover for this type of surgery.
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Glad everything worked out re your mothers surgery.
The paperwork from Laya that follows surgery should set out clearly all the relevant costs involved and explains clearly what plan they are
applying regarding cover - ie whether a previous plan still applies for 2 years as its a pre-existing condition etc.
If there is still an amount outstanding at the end of the statement, this is the grey area waiver system I was referring to in previous posts.
Any amount still outstanding, after Laya settles the bill, is normally payable to the hospital, not the health insurance company.
Both Mater Private and Blackrock Clinic are very often not passing this type of shortfall on to the patient.
I have personal experience of this type of situation.

Regards, Snowyb
 
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