VHI Company plan - Excess for day to day expenses

[Afterflood]

Hello all,

I have cover with VHI.

I have outpatient cover for optician (eye test/glasses/lenses) of 75%, max EUR100 every 2 years.

There is also an annual excess of EUR150 on outpatient expenses.

Does this mean that if I get a pair of glasses for 300 that I will get EUR100 from VHI?

If anyone could advise I would appreciate.

Thank you.

 

[huskerdu]

Hi Pat,

I do not think that you will, if that is your only out-patient claim for the year.

The 100 which you can get for the glasses is less than the excess of 150, so you will get nothing.

Here is a more complicated example

Optician claim 100
Consultant (3 visits maximum cover per visit = 60) Total = €180.

In this case, the claim is (100+180)=280 - (excess of 150), so you would get €130.

 

[aamusername]

I've removed this post as it contained incorrect information and I don't want to confuse anyone.

 

[huskerdu]

Hi Pat,
I would have thought that, assuming you have no other outpatient expenses this year for simplicity, the excess of 150 would simply be subtracted from the 300.

That is completely incorrect, That is not how the excess works.

The definitition of excess in the VHI T&Cs is
"
An amount that we will deduct from your claim, as set out in your Table of Benefits"

They subtract the excess from the claim, not from the total cost to you.

 

[burmo]

Are you sure you have an excess of 150 euro? I used to have Company Plan and I had 1 euro excess...

 

[aamusername]

Thanks huskerdu. I must have always been thinking about it backwards. It looks like the OP wouldn't get anything then assuming that the glasses were their only expense that year :-(. Sorry about that, because my excess is one euro I probably haven't paid as much attention as I should have to how VHI treat the excess.

Burmo, I checked the excess for the specific plan the OP has on the HIA website, and the excess is indeed 150.

 

[huskerdu]

Thanks huskerdu. I must have always been thinking about it backwards. It looks like the OP wouldn't get anything then assuming that the glasses were their only expense that year :-(. Sorry about that, because my excess is one euro I probably haven't paid as much attention as I should have to how VHI treat the excess.

Burmo, I checked the excess for the specific plan the OP has on the HIA website, and the excess is indeed 150.

Its not very obvious, and they dont make this very clear, so your assumption was a easy one to make ( I made that assumption until I looked it in detail).

Its an issue that I think people should be more aware of when moving plans.