Health Insurance Policy required with Laya that has 100% orthopaedic and ophthalmic at cheapest rate

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Up Rovers

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Hi All,

Some elderly friends are insured with Laya and were satisfied with the Prosper Advanced policy until the ortho/ophth cover reduced to 40% shortfall I think earlier this year. Can anyone tell me if there is a policy with 100% cover for both the ortho/ophth that does not cost a fortune these days? Any recommendations?
 
I have indeed thanks, just looking at it at moment, but do find it a little complicated and just getting my head around it now. Health insurance is a minefield probably on purpose :(
 
I've found that tool poor tbh (no offence to the creator!) It flagged plans as having better cover that didn't, they actually had worse cover so was wasted time looking at them - health insurance is a minefield so designing an app must be tricky so it's not meant as a criticism more a user warning.
 
messyleo said:
I've found that tool poor tbh (no offence to the creator!) It flagged plans as having better cover that didn't, they actually had worse cover so was wasted time looking at them - health insurance is a minefield so designing an app must be tricky so it's not meant as a criticism more a user warning.
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I don't know if it changed since launch but I thought I remembered it being useful but when I checked it just now to compare my current plan (Level Health Plan B 300 Day To Day) against the market it also suggested plans as being cheaper with better cover which were not. :confused:
 
You could pay into this for years then find an excess is applied some year and you are back to square one. They do this all the time. Ask a physio and optician for a review to see if you are likely to need this in the near future.
 
JoeRoberts said:
You could pay into this for years then find an excess is applied some year and you are back to square one.
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It's generally referred to as "renewing" your policy.

But you can't renew something that's changed.

I think they ought to be compelled to drop a policy rather than change it and instead invite the customer to choose another from their vast selection.
 
I need to be looking at renewing soon and same issue, two family members that have already done the research have switched from Laya to the Level Health plan B which doesn't have full cover but has a 2k co-payment with these procedures, at least it's a fixed amount! I definitely won't stay with a plan that has a percentage shortfall for a procedure, ideally I want fixed.

Now it doesn't have all the benefits that the one I am on had but I'd prefer give them up than risk that percentage shortfall.

Probably my view coloured by the fact that my Dad had a hip replacement which turned into 2 on same hip back I would say 15 yrs approx ago and the bill from hospital was 40k, he was insured luckily. Now 40% of that would be a fair whack! Granted he was unlucky but not everything goes to plan, part of the point of insurance really.
 
I'm with Prosper Advanced also and I've just finished hunting for a new plan for the same reason. I looked mainly at Laya - anyway this is the complete list of their current ortho plans:

https://www.layahealthcare.ie/media/site/pdfs/list-of-cover-for-specific-Orthopaedic-Procedures.pdf

To help narrow that down, I used my recent claims history as a guide, plus any likely upcoming appointments or procedures. As well as full orthopaedic cover I know I need good daycase and semi-private/private overnight rates, also a minimum €2000 out patient limit including 50% radiology cover, plus some dental and optical.

A quick Google took me to the plan details on Laya's website, which quickly narrowed the list down to ten. I put these into the HIA comparison tool, 5 at a time which brought the number down to two - ConnectCare 150 and Simplicity. The €100 Everyday expenses with Simplicity is annoying but it's €250 cheaper than ConnectCare, so I'll go with Simplicity.

It's not an easy process finding a suitable policy for your individual health needs. And most of my contenders cost at least €3k pa. But there are cheaper policies if some of your requirements are less. Last year I was personally refunded almost the same amount as the annual fee I'd paid, so looked at it that way it's not necessarily worth saving a few euro. Horses for courses.
 
mct1 said:
Last year I was personally refunded almost the same amount as the annual fee I'd paid
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One thing about this is that it doesn't include what you did pay that was not covered. My policy has a lot of excess plus the first 300 'admin fee' of any hospital is not covered, but your policy hopefully does not have too much of those. I had one or two things done last year and I still paid out over 1k on medical costs.
 
Dont forget you can wait a bit and get it done on the public system or even the cross border treatment purchase scheme if urgent enough.
 
elcato said:
One thing about this is that it doesn't include what you did pay that was not covered.
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Fair point, and that's a good reason to look at the policy excesses on hospital overnights and day cases and take those into account. Obviously, on top of that there's also the remaining percentage cost of your everyday expenses after refunds are made.

Ultimately, I believe that tailoring your insurance to your specific medical needs is the most effective way to keep your healthcare costs down. Definitely not a one size fits all. And most of what you don't get back you can claim against tax.
 
mct1 said:
Ultimately, I believe that tailoring your insurance to your specific medical needs is the most effective way to keep your healthcare costs down. Definitely not a one size fits all.
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The problem is that it's very difficult to do this and I know of lots of situations (including my own) over the years where people are facing diagnostics or procedures and are still far from clear as to what is covered and what isn't even after speaking to their insurers.
 
ClubMan said:
I don't know if it changed since launch but I thought I remembered it being useful but when I checked it just now to compare my current plan (Level Health Plan B 300 Day To Day) against the market it also suggested plans as being cheaper with better cover which were n
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thanks for the feedback. just seeing this now.... was busy with the +120 plan changes that have happening in the last week. The scoring method the system uses has been improved recently also. it should be more balanced between the score given to "day 2 day" benefits and general hospital cover. That said one plan vs another can be quite subjective. Your "Plan B 300 Day to Day" comes out as the best at that price point currently.
 
Looks like the Laya Inspire Plus policy that I changed to this year has also hiked up the contributions of orthopaedic and opthalmic procedures from 20% to 40%.
 
Nutso said:
Looks like the Laya Inspire Plus policy that I changed to this year has also hiked up the contributions of orthopaedic and opthalmic procedures from 20% to 40%.
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I could be totally wrong but it seems to me, that the calculations would be tough to figure out if the more expensive policies with the higher cover, and less contribution from insured, are overall cheaper or dearer in the long run . If you take into account the high excesses, the poor day-to-day cover, possibly lower in-stay cover and then maybe the 60%, 40% or 20% contribution needed it becomes mind boggling :(
 
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