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Health Insurance

An increase in premiums for the majority of VHI customers has put health insurance back on the radar - but how can you check what you are covered for and what are your rights and costs if you wish to switch insurers!

Tina Leonard, Consumer Champion

First off the VHI price hike - why so and can we expect other insurers to follow suit?

Last Thursday the VHI announced their price increases for 2011, effective from 1st February, and they were astonishingly high. VHI blame a 10% rise in claims and a 21% increase in the cost of private beds in public hospitals. They also say the level of tax credits available to them to provide support for their older insured customers is ineffective. This is crucial as VHI have by far the oldest customer profile, which means that over 50% of their expenditure is on the healthcare needs of their older customers. In contrast the majority of Aviva and Quinn's customer base has a younger profile and therefore, are less likely to draw down insurance. This means those companies have lower costs.

Traditionally the VHI announce annual price changes in January. Aviva tend to do so in April, so we'll have to wait until then to see whether they will increase premiums and to what extent. Quinn usually announce premium changes in November and last November they announced increases of an average of 7.9%.

How much more will people have to pay?

For VHI customers on family plans such as the Parents and Kids Plans and the One Plans, LifeStage Choices and Plan A, premiums will increase by 15%. The majority of their customers (60%) are affected by this change.

Example: average annual increase €331 or €27.60 per month.
Almost one third of VHI customers are on Plan B and Plan B Options and this is where the biggest increases are: Plan B/Plan B excess 35% and Plan B Options 45%.

Example: Plan B increases by €317 to €1,224 and Plan B Options by €441 to €1,430.

Other increases: Plan C - 25%; Plan D - 21%; Plan E 21%.
What are the implications and potential costs when changing policy?

Under Irish law we all have the right to switch without penalty. Plus we cannot be refused cover and premiums cannot be weighted against your age or a pre-existing health condition.
Lets go through some scenarios:

If you switch health insurers to a policy with a similar level of cover, while being treated for an illness.

Your cover will not be affected and there will be no waiting period.

If you are upgrading your cover

A waiting period may apply before any new additional benefits kick in (max 2 years under 65, max 5 years over 65, 52 weeks for maternity).

If you downgrade the level of your cover

If you want to upgrade again in the future a waiting period may apply.

If you quit and have a gap of 13 weeks or more before signing up for a policy again

You will be regarded as a brand new customer and waiting periods will apply.

The maximum waiting periods for 'new' customers are 26 weeks if you are under the age of 55 years, 52 weeks if you are aged 55 and under age 65 and 104 weeks if you are aged 65 or over. However, you will be covered in the event of an accident or injury that occurs while you wait for full cover.

Note the waiting periods are much longer if you have a pre-existing illness (5 yrs under 55; 7 years 55 - 59 years; 10 years 60+ years).

Three Things you can do NOW to save money:

If you are VHI customer and your policy is not up for renewal until later in the year, call them and renew now to lock in current premium prices for the next 12 months.
2. Ask to switch to the equivalent company plan.
3. Compare policies and switch providers.

What is the benefit of moving to a company plan?
All policy providers sell company plans but they are only marketed to businesses and are not generally advertised. They provide the same or similar level of cover and are cheaper. However, by law they must be available to all, so ask to switch to the equivalent company plan to save.

Examples of Company Plan Prices:

VHI Plan B Option €986 (€1,430 from 1st February) - VHI Company Plan Plus Level 1 €805

Save €181 or €625 from 1st Feb

Quinn Essential Plus €995.15 - Quinn Company Care with Excess €705

Save €290.15

Aviva Everyday Plan level 2 €1,017.50 - Aviva Business Plan Extra €799.10

Save €218.40

If you have health insurance and want to switch cover - checklist of what you need to check before you make the move
There will be different premium prices and savings to be made but make sure you are happy that the level of cover you are choosing is adequate for your circumstances.

Level of hospital cover i.e. semi-private or private room. Benefits available i.e. is a physiotherapy benefit important to you or maternity care? Do you want high outpatient cover? Do you want cover for your kids?

Risk i.e. what excess is charged for the benefits you are most interested in and are you willing to cover that yourself? Policies with higher excess may have lower premiums.

Price i.e. compare the price of the premiums along with the cover provided.

The best place to check and compare all policies is at (Health Insurance Authority), where you can compare products across providers or within a provider, including cover provided and cost.

Health Insurance Checklist:

o Level of hospital cover
o Benefits available
o Risk
o Price
o Compare policies at

Examples of equivalent policy prices:

. Quinn Essential Health: €728.64 (plus €184.47 per child/student)
. Aviva Hospital Plan Level 2: €825 (plus €190 per child/€320.60 per student)
. VHI Plan B Excess: €824 (plus €297.95 per child/ student) €1,112 from 1st February

Starter Policies:

. Quinn Essential Starter: €416.99 (free children/students)
. Aviva Access Level 1: €506 (plus €236.60 per child / €253 for students)

. VHI Plan A: €607.76 (plus (€184.04 per child / €205.45 per student) or €698.92 from 1st February.
How to check for what you are covered for:
You have to read through your policy or if in doubt contact your provider and ask them. To work out how much you're covered for, take an example and subtract the excess to work out if you will have to make part payment yourself.

If you lose cover from work - what are your options?
If you lose your job and they were paying for your private health insurance, you can choose to keep on the policy and pay it yourself, or do your research and switch if you find a policy that suits you better.

An alternative is a health cash plan provided by the HSF (Hospital Saturday Fund), who have actually seen their customer base grow by 25% despite the numbers leaving private health cover. See

HSF Health Plan sells health cash plans. The difference between this and private healh insurance is that the cash plan covers day-to-day outpatient expenses, while prviate medical insurance focuses more on in-patient / hospital operation expenses. Day to day cover has become increasingly important given the PRSI and medical card cover has become limited in many instances i.e. dental care.

Many are combining a lesser private health plan with a HSF plan, or switching to HSF only. Be aware that if you switch to HSF Health Plan only you will NOT be covered for private hospital beds/treatment.

A health cash plan is a type of medical insurance, but is not termed 'private' as such in the same way as VHI, for example. It is simply a claim for a cash benefit (which may be a flat rate grant or may be related to the cost of the service provided) after a consultation or treatment has taken place and the bill has been settled. The range of benefits includes many 'everyday' health costs such as a visit to the GP, dentist or optician, physiotherapy, chiropody and even the purchase of a hearing aid.

HSF Health Plan is the trading company of the charity, the Hospital Saturday Fund. Its history stems back to 1873, when the charity was founded in the UK by a one-time Senator in the Irish Parliament, Reginald Brabazon, the Earl of Meath. HSF Health Plan started operation in Ireland in 1949 and as there are no shareholders, the profits go back into the company plus are distributed to charities. As a result they do not engage in big budget advertising.

Plans cost from €2 a week to €17 a week (per family) and children are free. You pay for your doctor or consultant visit, pharmaceuticals, or eye test, send in your receipt within six months and you will be reimbursed by either 50% or 100% depending on what plan you are on. There is no excess on any plan.

Other claims have flat fees, so for example, you get a 'birth grant' of up to €171 and for (public) hospital stays you get back €75 to €120 per night up to 40 nights. Typical cash back for a GP visit is €37. A 24hr GP advice line is also provided.

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