Health Insurance Waiting periods and change in cover

[Brendan Burgess]

From the HIA website

If I have a basic plan with Laya and upgrade to a bells and whistles plan, I have to wait for 2 years for the extra cover for existing illnesses.

But what if I switch from Laya to Aviva? How can they say whether I have extra cover or not? For example, I have a €500 excess on my current Laya policy. If I get similar cover without the excess from Aviva, do I have to wait 5 years?

Policies are difficult to compare, so I can't see how they can answer this question.

 

[Mexicola]

If you move from a plan with a high excess to one with none, Aviva will apply the waiting period. They classify a lower excess as a higher benefit.

 

[Brendan Burgess]

Thanks Mexicola

Does that mean that they will apply an excess or that they won't cover some claims?

Brendan

 

[BazzaDP]

Would you have been covered on your old policy? And are you also covered on your new policy? If so you get the minimum cover out if those two policies while you serve your waiting period.

So if your Laya policy covered a procedure with a €500 excess and Aviva covers same procedure then you'll only get the Laya coverage for that procedure for two years (5 years for older customers).

If your Aviva policy doesn't cover the procedure, but Laya did, then you're not covered so get nothing.

If Aviva policy covers something but Laya didn't, then that's an increase in benefits and so you will not be covered for 2/5 years depending on age.

When you join up with Aviva you'll be ask who your previous insurer was and what level of cover you had. If you make a claim this will be verified with Laya and the claim paid appropriately.

You cannot get around this by switching insurers - that would defeat the whole point of the open market and all legislation to allow you to choose equally between insurers without penalty. Remember waiting periods are for insurers benefits.

Saying that, those are the max waiting periods and there's nothing to stop any insurer waiving them completely if they want.

 

[Mexicola]

Brendan, once you serve the original new customer to health insurance waiting periods you only ever have waiting periods again if you upgrade cover. (Providing there has not been a break in cover).

In your scenario, when moving plans with similar cover (say semi private in a private hospital) but with a reduced excess the insurers can classify the reduced excess as a higher benefit so they can apply a waiting period before the reduced excess kicks in. In this case you will be covered but with the higher (€500) excess still applying.

Hope this makes sense

 

[serotoninsid]

Don't mean to take this off topic but this is another aspect that could be simplified if the number of plans was limited to a handful.