Health Insurance VHI Plan B vs Laya Simplicity

Jewells

Registered User
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5
Hi!
My parents VHI Health Plus Access ( Plan B ) is due for renewal on 1st July. They are in their 60s and in pretty good health (Dad has history of cancer but is in remission 6 years and is very well).

Their main concerns are cancer, cardiac, orthopaedic and ophthalmic care.

The Beacon would be their preferred hospital.

I think Layas Simplicity is a better and much cheaper plan (not withstanding the 2 no. €100 excess per year and some overnight excesses).
I compared the 2 on HIA and have a good understanding of the cover but would appreciate fresh eyes

1. They are afraid to change because of Dad's history and that there would be waiting periods, penalties and less cover. This isn't true unless there's an increase in cover but since Simplicity has the same or better cover so there would be no loss of cover. Am I right?

2. Is there anything in Health Plus Access not covered by Simplicity. I don't think so.

3. Is the cardiac cover (ie Tevi) the same? I think it is.

4. Day to day cover is better on Simplicity.

5. Is there anything I'm missing?

Thanks,
J
 
Jewells,

Just to clarify, Cardiac Tavi procedure is not fully covered on Simplicity plan.
There is a shortfall of 175 per night in the 2 hi-tech hospitals + 100 excess.
Beacon hospital is covered with just 100 excess for this procedure.
If this particular procedure is important, there are 2 alternative VHI cheaper plans that fully cover this surgery.
These 2 plans are similar to Health Plus Access, the only difference is that they both include a private/hi-tech excess 75 or 125 if admitted
to a private or hi-tech hospital.

Details as follows;
1. HealthPlus Excess; price 1841pa; same hospital cover as before, excess 75 per admission or day case.
2. Health Access; price 1685pa; same hospital cover as before, excess 125 per admission or day case.
[broken link removed]


As Beacon hospital would be their preferred hospital, Simplicity would fully cover this hospital, with low excesses.
Regarding hi-tech hospitals Mater Private and Blackrock Clinic, this is a grey area relating to special procedures cover.
VHI don't give specific details on the Table of Benefits and are vague regarding this information by phone.
For clarity on the finer details of this cover, I would be inclined to verify the information with a health insurance broker.

The health insurance brokers seem to have access to this very detailed information, which should also be made available to customers.
This would provide extra re-assurance and peace of mind especially with regard to your parents concerns.
It involves a fee, which is well worth spending, considering the overall cost of health insurance, in their case 4000+ every year.
This kind of once-off advice, will carry you forward in the years ahead.

I am not a broker, and I've no connections with professional brokers.
The well known ones are Dermot Goode or Patrick Brennan.
Details as follows;

https://www.totalhealthcover.ie/

http://irishhealthinsurance.ie/index.php

Hope this helps with their decisions.

Regards, Snowyb
 
Last edited:
Just to clarify, Cardiac Tavi procedure is not covered on Simplicity plan.

The HIA website has a section in their comparison tool called "The Blackrock Clinic, the Mater Private and the Beacon Hospital, certain Cardiac Procedures" which had "Covered" for Laya Healthcare Simplicity and "90%" for VHI HealthPlus Access (Plan B). How is it possible to know that the Laya plan doesn't cover Cardiac Tavi but the VHI one does based on that? Or am I looking in the wrong place?
 
BazzaDP,

Just to update, my mistake, the TAVI cardiac procedure is covered on Simplicity plan - it is not fully covered, there is a shortfall of 175 per night
and 100 excess in Blackrock Clinic and Mater Private. This procedure is fully covered in Beacon hospital with just 100 excess.

As the list of procedures and codes are not accessible to customers, its difficult to know what is covered on any plan.
They will confirm on a code by code basis if you are having surgery done to confirm if a procedure is covered, but as a customer trying to
choose a plan, there is no customer access to a comprehensive list of codes in order to make an informed decision.

I am also on Simplicity plan, so I am still on a learning curve in this matter.
I confirmed the above information with Laya healthcare.

I have amended the above post to reflect this updated position.

Regards, Snowyb
 
Cheers. But still confused as HIA say Cardiac Procedures on those hospitals are fully covered, but I do see certain special procedures are subject to the excess so does Tavi come under that?

Even with those excesses Laya Simplicity seems like the better plan as it's €500 - €900 cheaper than other plans mentioned and excess is capped at first two claims (though shortfall is not). Especially if VHI only cover 90% - I imagine that 10% could add up if you do need these specialist procedures!!

Going through renewal for HealthPlus Access (Plan B) for my in-laws and was recommending Simplicity for all these reasons so you got me a little worried there but still think it's the best option for them at the mo...
 
The Tavi cardiac procedure costs 40,000 approx so a 10% shortfall could be 4,000 on Plan B.
Its a shorter stay in hospital as its keyhole surgery so 175 per night looks like a better option.
Also, this is where the other grey area with the hi-tech hospitals comes into play, both Blackrock Clinic and Mater Private
have a waiver list whereby they don't collect the shortfall on a range of surgerys and procedures.
Blackrock Clinic have an extensive list whereas Mater Private's list is more restricted.

I know someone who had by-pass surgery in Blackrock Clinic on an Irish Life plan with a 2000 co-payment for cardiac surgery included.
This 2000 was waived, just the small excess was paid.

VHI created a seperate category called 'Level 2 cardiac procedures' which includes Tavi surgery and the cheapest plan with this cover is
Health Access price 1685pa. So any lower priced VHI plans don't have TAVI cover at all. It must be classed as a special procedure with
Simplicity plan with a 175 shortfall per night, which I think is fair enough, once the bulk of the cost is covered.

So, it makes Simplicity seem even more attractive at 1190pa, including the extra day to day cover + extra cover for a
private room in a private hospital, full cover for orthopaedic joint replacement surgery. It ticks all the boxes.
The overall savings mount up over the years, of which some can be kept aside for the rainy day fund.

Regards, Snowyb
 
Hi,
I am on the Laya Simplicity plan too. I went to Blackrock Clinic to see a consultant recently. I had MRI done in Whitfield Waterford (fully covered... no payment) but alas the images were missing from the disc they gave me, so I had two Xrays in Blackrock on the day at a cost of €100 each. These are covered under an outpatient claim. My visit cost me €400 (200 Xray and 200 consultants fees). This then equates to the excess on the Simplicity policy. All in all I think Simplicity is good value and the savings on the policy outweighs VHI's similar plan.
 
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