Health Insurance No waiting period for immediate upgrade - corporate plan

[Thomas1]

Hi Folks

My wife has a corporate plan through her employer and a feature (as explained by the agent) is that you can upgrade to any plan mid-year and only pay the higher cost for the period where you need the higher cover, say 3 months for a specific procedure / hospital. The upgrade waiting period was waived. Sounds brilliant, pay for cheaper insurance until something happens.

I asked the agent could anyone get this plan - he said yes but the no wait pro-rata upgrade feature is only available to employees.

So my question is - is this technically in line with “all plans for everyone rule”?

Thanks
T

 

[Sue Ellen]

Hi Thomas,

What company is this referring to? Presumably VHI because you speak of Corporate plans? Sounds too good to be true. I would certainly be getting that in writing.

The upgrade waiting period was waived.

When you say 'was' did they apply this rule to a claim made by your wife which has been met by the insurer?

So my question is - is this technically in line with “all plans for everyone rule”?

he said yes but the no wait pro-rata upgrade feature is only available to employees.

Don't understand your question because you also mention only available to employees.

 

[Clamball]

I know my daughter’s employer offered paid VHI 12 months ago. Spouse and children also included. Anyone who signed up was waived waiting periods. So I am guessing it is a sign on benefit for companies, rather than a feature of the specific plan.

 

[Thomas1]

Hi Sue

Yes it’s VHI. The health insurance offering is a new benefit from the (large) company for employees. The agent explicity stated that the plan could be upgraded in future for a short period to cover a procedure or hospital not covered under the regular plan and no waiting period would apply.

The reason why my wife rang was because the standard company plan has 60% ophthalmic cover and she was concerned. The agent said that if she needed something done, she can upgrade the plan for a few months pro-rata the cost of the better plan and obtain those benefits. No waiting period would apply before the better cover was activated.

My wife had the phone on speaker so I asked if I, as a member of the public, could get that plan and benefit. The agent said I could have the plan but I couldn’t upgrade for a specific procedure / hospital without the normal waiting periods applying - the waiver relates to company employees only.

To me it sounded like paying for 3rd party car insurance and upgrading to comprehensive after a crash and being covered but the agent was adamant.

I am au fait enough with health insurance as I review my own plan annually and also for others so this is either an excellent benefit or the agent has gotten mixed up (in a severe way).

T

 

[Sue Ellen]

I am au fait enough with health insurance as I review my own plan annually and also for others so this is either an excellent benefit or the agent has gotten mixed up (in a severe way).

Seems bonkers. Myself and hubby were only discussing it here and related it back to your motor insurance comment.

Sounds like a lot of work for their claims staff

 

[irbx]

Hi Sue

Yes it’s VHI. The health insurance offering is a new benefit from the (large) company for employees. The agent explicity stated that the plan could be upgraded in future for a short period to cover a procedure or hospital not covered under the regular plan and no waiting period would apply.

The reason why my wife rang was because the standard company plan has 60% ophthalmic cover and she was concerned. The agent said that if she needed something done, she can upgrade the plan for a few months pro-rata the cost of the better plan and obtain those benefits. No waiting period would apply before the better cover was activated.

My wife had the phone on speaker so I asked if I, as a member of the public, could get that plan and benefit. The agent said I could have the plan but I couldn’t upgrade for a specific procedure / hospital without the normal waiting periods applying - the waiver relates to company employees only.

To me it sounded like paying for 3rd party car insurance and upgrading to comprehensive after a crash and being covered but the agent was adamant.

I am au fait enough with health insurance as I review my own plan annually and also for others so this is either an excellent benefit or the agent has gotten mixed up (in a severe way).

T

Same with my wife who works Multi National. Their with Laya and pay for the inspire plus for employees and their family.

Same all waiting periods were been waved as employee benefit. I was concerned about 20% excess for joints and eyes. But was advertised to ring with procurement code first and for that company they can temporarily upgrade cover so 20% excess would not be charged.
It is not benefit of the plan, it's benefit to the company since their buying many together. That Laya is waving waiting periods.

 

[Thomas1]

Same with my wife who works Multi National. Their with Laya and pay for the inspire plus for employees and their family.

Same all waiting periods were been waved as employee benefit. I was concerned about 20% excess for joints and eyes. But was advertised to ring with procurement code first and for that company they can temporarily upgrade cover so 20% excess would not be charged.
It is not benefit of the plan, it's benefit to the company since their buying many together. That Laya is waving waiting periods.

Same as my wife’s company so (Irish domestic). It’s some perk in fairness.

 

[Placeinthesun]

I’ve been told something similar to above. Referred to consultant who will perform any procedure needed in one of the high tech hospitals. Id have a large excess to pay per night (according to my policy) so I was going to ask my GP to refer me to another consultant.

First though rang my insurance provider and the agent said that if I need the procedure, they will temporarily move me to higher plan and then revert me after. I only pay the difference for relevant number of days. No wait times. (The higher plan would be double the price of my current plan.)

It sounds too good to be true so I’ve been thinking the agent must be wrong. But found this thread today which has me thinking maybe not. It is a corporate plan for the company I work with and agent said it was a feature of that. Though nothing written in the plan that mentions that.

I’m still not sure whether to proceed or not as it was just a phone call and have nothing in writing and worried about a large bill if the agent has got it wrong.

 

[Clamball]

The calls are recorded so if there is a dispute just say when you phoned at date/time you were told x and they will listen back to confirm.
I has an issue with Laya when my child turned 18 and I had phoned about cover cost for her as two letters from Laya had quoted different figures (I missed that the cover period mentioned on the second letter that arrived which was for the previous year and so her cover was cheaper then). I explained to the agent I had gotten two letters with two different prices for my child and was the second letter with the cheaper quote correct. My understanding of the call was he said yes. Several months later I discovered my error when Laya was looking for the balance to be paid. I was sure my recollection was right so dug out the previous 2 letters and on the one with the cheapest figure was my note that I had phoned on a certain date and this letter was correct. So I phoned Laya and explained the two letters, the phone call, and I could now see my mistake that the latter letter referred to the previous year but I was sure the agent had confirmed the price on the call as being correct for the future year. So the listened back to the recording and called me back. Apparently at the end of that call I had said something to the effect that “So just to be clear, you are confirming that the price quoted €xxx is the correct figure for next year?” and the agent had said yes. I am guessing he got a reprimand for that but Laya honoured what he had agreed to. Having the date of the call on the letter was very helpful for them to track down the recording.

 

[Sue Ellen]

I’m still not sure whether to proceed or not as it was just a phone call and have nothing in writing and worried about a large bill if the agent has got it wrong.

Send an e-mail and ask them to confirm or clarify on your query. Mention that you discussed it over the phone but would like confirmation in writing.

With VHI the optical cover is generally every 24 months so I write to them and ask them to clarify when I qualify next. I worked off a date confirmed by e-mail one year and they in turn dismissed my claim as they said I went too early i.e. did not meet the 24 months criteria. e-mail proof duly forwarded on and hey presto they admitted their error and paid up. Ever since for situations like this I try to get everything in writing if possible.

Referred to consultant who will perform any procedure needed in one of the high tech hospitals. Id have a large excess to pay per night (according to my policy) so I was going to ask my GP to refer me to another consultant.

Are you hoping that you could avoid the high tech (presumably Mater or Blackrock) and maybe qualify without high excess for Beacon? Don't forget that you will then start over with waiting time to get appointment with new consultant and pay the 1st timer fee @ generally €250 instead of maybe €150/€180. I made an appointment for one recently and have to wait six months to be seen and have no idea how long for procedure to come around. After going through all of that you may well find that they talk about the same hospitals too.

I spoke to VHI when renewing recently about this option on some policies. It does seem far fetched but they did say that a small number of large companies have negotiated this arrangement. It is a very good perk so well worth investigating further.

Best of luck with your procedure and endeavours to get it sorted.

 

[Placeinthesun]

Thanks for the advice Clamball and Sue - much appreciated.