Health Insurance Looking for alternatives to VHI (PMI 41 15) but fearful of moving

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faketales

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I am not sure why I am on this plan but it sees to have served me okay. In the last year my wife joined me on the plan as is my son born during the year.

However its now €342 per month (for the 3 of us) and I want to see if there is better value with a similar plan or if I have something in there I don't need. I think I paid about €100/month for myself a few years ago.

Ages: 38/39
Son: <1 year
Based in Cork Area

I seem to average 2/3 GP visits a year and currently get 50% back and 50% on consultant visits.

I see a cardiologist yearly in the Mater Private, I am monitored but noting imminent. Maybe in 20 years. Obviously things can change. Should I be looking for HiTech Cardiology?

I honestly don't even know where the surgery options would be?

I am also not even sure what room type I have or would want. I think my priority would be on getting the surgery quickly and not being financially ruined rather than sharing a room.

I also have a an unrelated procedure twice a year in the Bons Cork, its in a "sideroom". Not sure if its classed as day patient or outpatient. At the moment I just pay €50 a visit where a VHI are billed for €200. I have the procedure code but don't see how I can search plans for cover.

I don't want to lose that (unless its worth it obviously), its also possible the frequency may increase. Do I need to keep a low excess?

I wear glasses and get a new pair every few years.

My wife doesn't have any ongoing issues, a few GP visits a year.

Any advice welcome.
 
Hi faketales,

Perhaps a chat with totalhealthcover.ie would be in order because of how much you are paying for the 3 of you. There is probably a waiting list which I understand can be weeks so if your renewal is imminent it may be too late for that option. The fee appears to be €150 for a family.

That policy sure is expensive for what cover you are getting especially when your wife is covered on it also, both @ €1,818.86 :( Not sure what cover your son needs or what price you should be paying for him.

Because of the level of cover required for your cardiac and other issue you will need to discuss these with VHI or possibly the other two insurers to ensure that you get the best cover at the most competitive price. Discuss with all of them pre-existing conditions and the Upgrade Rule.

Before calling them make out a list of your queries with regard to cardiac cover, exactly what cover you have for hospital stay and day-to-day expenses. Write it all down as it can be hard to digest and remember afterwards quite a lot of info all at the one time.

I have done a comparison on the HIA website here with a popular VHI plan just to give you some advice.

A discussion with your cardiac specialist would appear to be in order to familiarise yourself with any procedures that may be needed in the future. Perhaps they could guide you with regard to health insurance also.


Day-to-day expenses

faketales said:
I seem to average 2/3 GP visits a year and currently get 50% back and 50% on consultant visits.
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On a lot of the plans at that price the cover is more often 75% cover for both.

The annual excess on your plan @ €100 as compared to the quite often €1 is very high.

Your overall limit (Outpatient Policy Limit) on the day-to-day ´@ €1,750 is low too considering what you are paying.

Your Table of Benefits with VHI for that plan is here for the 4115 policy.

Obviously the above is just my own opinion and observations and I don't have any medical qualification :)

I've just had a very quick look and noted the above as I have to head out now. I will have a read again later when I get a chance :)

Hope this helps.

Sue Ellen.
 
Hi Sue Ellen,

Thank you for your reply. A consultation with totalhealthcover.ie seems ideal for me and a fair price given potential savings and being informed. It could assist me for a few years. I got in contact and no surprise they are booked up for a month. Will definitely work with them or someone like them next year. I am not sure how ordinary citizens are meant to make fully informed decisions given the complexities.

I spoke with VHI this morning and they recommended two alternative plans.

PMI 4810 which on balance seemed better service for a similar price, 75% back on day to day and some other improvements but of course a slight increase in others like day patient excess.

They also recommended PMI 1811, which would be a saving of €900 for the family. It seems similar to my current plan with 50% back but I would lose cover for the Galway Clinic and Hermitage in Dublin. I am not sure I need them anyway.

To add to the confusion they mentioned the Bons in Cork seems to be moving to mostly private rooms. So while I am satisfied with semi private if all is available is a private I could be stuck with the difference in a bill from the Bons. PMI 4810 had the upgrade capped at €50 a day.

On the balance I am considering moving to PMI 1811, I will also compare to the plan you recommended, given the short time I am keeping my search to VHI for this year.

Anything I am missing or VHI didn't mention re PMI 1811?

Thank you again!
 
Hi faketales,

It is a minefield and as you say very hard for the ordinary joe bloggs/joanne bloggs :) to keep on top of things. I'm many years investigating my cover because we got caught out some years ago with the Upgrade Rule for cover for my husband. It makes one more aware of the importance of this insurance. Another company that I have seen mentioned in the past is https://www.irishhealthinsurance.ie/ but I know absolutely nothing about them or what they charge. I suppose they could be worth a call. Thousands of people fall due for renewal this Sunday 21st for I suppose they will all be busy.

I personally don't put a lot of emphasis on the excesses on the hospital stay because they will jump around from €50/€75/€100 possibly per stay in hospital or just the first stay in the insurance year but that can be pin money compared to not having the correct in hospital stay. Perhaps my view is wrong on that but looking at the bigger picture it is small money.

One rep in VHI did mention about the Bons in Cork to me the other day and it did sound as if you could get caught for a lot if you had a long stay. It would appear that since Covid some of the hospitals are trying to change to private rooms.

I had PMI4810 last year and was a little nervous about the €50 extra per night especially if there was a long stay. On the other hand in some of the hospitals you would be very lucky to get a private room because they are scarce and I always feel they are kept for the very sick patients. When I rang VHI they recommended PMI2410 instead as it appears to curtail the extra €50 per night so on that basis I moved to it. If you are going to spend the extra money it would probably be a better bet but you would need to look through the Table of Benefits and compare them to be sure.

The HIA comparison between PMI1811, PMI4810 and PMI2410 is here.

The Table of Benefits are here: PMI1811 PMI4810 and PMI2410

The PMI1811 does seem like a fair policy maybe geared towards people living outside Dublin and realistically how likely are you to come to Dublin unless you were extremely sick. It does mention on occasions restrictions for cover for Hermitage, Galway Clinic and think it mentioned cover for Beacon at one stage.

If you think that you personally need the better instay cover because of your cardiac etc you could go to the PMI2410 and as wife and son appear to be quite healthy you could go for the PMI1811 for them (if you're brave enough :) :) )
 
Thank you. I'll have to pull those up on the computer screen later to fully compare.

I agree with you on the big vs small stuff. If I'm going in for surgery €50 vs €75 won't make a bit of difference.

My current plan includes the hi tech (two Dublin hospitals) fully for cardiac but only to 35/45% for other stuff. They are things I could get done in Cork any way so I wouldn't be going to Dublin for them to a hospital with only 35% cover. May as well make it 0%.

Although I find the €50 per day procedure to be kinda high vs €75 per stay (not night).

I have a couple of day procedures a year which I am in and out from in our under an hour. I don't feel like a patient at all but each one is a unique procedure. It's basically a blood test.

Even things like the difference between 50% and 75% for gp and consultants could be worth less than €100 a year to me.

I feel the cap of €50 a day isn't too bad. Although I don't know what that compares to? How much is a bonus private room vs single? We are all trying to make choices with only a piece of the picture.

A 10 night stay would be pretty serious but €500 wouldn't ruin me financially. A few months might I suppose!
 
faketales said:
I feel the cap of €50 a day isn't too bad. Although I don't know what that compares to? How much is a bonus private room vs single? We are all trying to make choices with only a piece of the picture.
Click to expand...

I haven't come across this situation where its more or less a top-up paid by yourself but as you say it could mount up on a long stay and that's why I think my new one PMI2410 is better and may suit you too. AFAIK there are also a few other small better features on it. You could check it out with VHI. Don't forget you have a 14 day cooling off period after renewal to change your cover.

Haven't a clue about the private room -v- single. I landed up in a private room because there was nowhere else free. After a couple of days moved to semi because of someone going for surgery with private cover. The hospital only charged the semi rate. The semi can be ok depending on who or how many you share with. In some of the hospitals these days semi can be a few. If you are quite sick you may not be in form for sharing. I always feel that the routine in hospitals is to suit the running of the hospital and not suiting the patients which is understandable I suppose. It can be very hard sometimes to get proper sleep.
 
Sue Ellen said:
I haven't come across this situation where its more or less a top-up paid by yourself but as you say it could mount up on a long stay and that's why I think my new one PMI2410 is better and may suit you too. AFAIK there are also a few other small better features on it. You could check it out with VHI. Don't forget you have a 14 day cooling off period after renewal to change your cover.

Haven't a clue about the private room -v- single. I landed up in a private room because there was nowhere else free. After a couple of days moved to semi because of someone going for surgery with private cover. The hospital only charged the semi rate. The semi can be ok depending on who or how many you share with. In some of the hospitals these days semi can be a few. If you are quite sick you may not be in form for sharing. I always feel that the routine in hospitals is to suit the running of the hospital and not suiting the patients which is understandable I suppose. It can be very hard sometimes to get proper sleep.
Click to expand...


I have no preference for private, I may actually prefer semi private in some cases. At best it's down my priorities.

I think the situation you described is what I have heard happen. It's basically like a free upgrade in a hotel if they don't have your room level. VHI just don't guarantee that the hospital won't look for additional.

I'm well into my cooling off period unfortunately. It end Wednesday. I should have been at this over Christmas.

Basy day with baby. Will do a few hours reviewing tomorrow.
 
Hi,
We are a couple in our 70’s. We are in 4D Health 4 with Irishlifeplus. This premium has shot up in the last 12 months.
This gives good cover. We now have a GP visit card so lose the benefits of 75% of GP’s fees. We could increase the Excess figure to 150. Should we seek a plan that does not have a 20% on certain orthopaedic procedure? Do all 4D Health 2/3/4/5 have this 20% included.
Would Layla Simply Connect Plus be a better choice for us?
Thanks in advance for your assistance.
 
Hi Park00,

Welcome to AAM.

It would be best if you were to start a new thread on this subject rather than linking into an old one.

In the meantime perhaps (if your renewal is not imminent) it would be best if you were to get a review from someone like totalhealthcover.ie in light of your requirements.

I cannot comment on Irish Life and have very little knowledgeable about Laya policies. The only thing I do notice from comments on AAM that Simply Connect Plus does appear to be the go to policy for anyone looking for total cover for ortho and ophthalmic.

Previous threads on the VHI PMI 4115 are here.
 
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