High Excess Plan Options

The health insurance market has taken a real beating since the start of the year on the back of numerous price increases across the market. Thankfully, the insurers recognise that action is required if they have any chance of keeping cash-strapped consumers on their books. They have all launched various options which, if you are prepared to accept a certain level of risk, could prove very attractive in terms of keeping health cover in place.

What do we mean by risk? Put it simply, if you are prepared to reduce the number of hospitals you’re covered for or maybe take on excesses and/or co-payments for private hospital treatments only, then you might be able to reduce your costs considerably. For many people now, health insurance is about queue-jumping or having cover for those big events where you could end up in hospital for a lengthy stay and run up a bill of thousands of euro.

Below is a summary of some of the offers catching our eye at present. Remember, the higher the excess you accept, the bigger the savings!

1. VHI Healthcare One Plan 500 – adult €689.75 child €231.50 student €317.00 Family 2 adults & 2 childen = €1,842.50
   • It covers a semi-private room in a public hospital and private hospitals
   • For all private hospital admissions, there is a €500 excess for the first 2 in-patient stays.
   • It has restricted cover (60%) for certain orthopaedic and ophthalmic procedures in private hospitals (22 procedures – check the list with VHI)
   • There is cover for day cases in private hospitals with a €150 excess but does not cover any of the hi-tech hospitals for day case procedures (Blackrock, Beacon, Mater Private).
   • Cardiac cover is provided in the Beacon Hospital only for listed major cardiac procedures - subject to €500 excess
   • There is very limited out-patient and maternity benefits on this plan.
2. Laya Healthcare Advantage 500 Explore - adult €658.36 child €218 student €218 Family of 2 adults & 2 children €1,753 (plus 3% if paying by direct debit)
   • Covers all public hospitals (private room) and most private hospitals (semi-private). This plan has a €500 excess per claim in a private hospital (including per day case procedure)
   • It has restricted cover for certain orthopaedic procedures in the Galway Clinic only (check these with Laya in advance of any treatment).
   • There is full cardiac cover in the Blackrock Clinic and Mater Private (no excess). This is covered in the Beacon also but with a €500 excess
   • There is very limited out-patient and maternity benefits on this plan.
   • Further discounts apply from time to time if the product is bought online.
3. Aviva Health First Focus Plan - adult €849.00 child €241.00 student €424.00 Family of 2 adults & 2 children €2,180
   • This plan covers a network of public and private hospitals (private room)
   • There is a €150 excess per episode of care for treatment in a private hospital. This also covers the Beacon Hospital as a private hospital
   • A €2,000 co-payment applies on certain listed orthopaedic and cardiac procedures if carried out in a private hospital
   • Blackrock Clinic and Mater Private not covered.
   • Very limited out-patient and maternity cover.
   • Up to €120 back on 1 visit to A&E (not subject to any excess) and access to ‘Back-Up’ scheme is included (8 physiotherapy treatments for €50 for eligible members).
4. Glo Health Net Most 500 - adult €660.00 child €236.00 student €330.00 Family of 2 adults & 2 children €1,792
   • This plan covers a network of public and private hospitals.
   • There is a €500 excess for overnight stays in private hospitals but only a €50 excess for day case procedures in private and hi-tech hospitals (no cover for Blackrock Clinic).
   • A €2,000 co-payment applies on listed orthopaedic procedures in private hospitals.
   • No Cardiac cover in hi-tech hospitals unless the cardiac module is added – extra €240 per adult. This is a unique add-on option
   • Private room upgrade can be added for public and private hospitals for an extra €215 per adult.
   • There is restricted access to orthopaedic hospitals and psychiatric/addiction centres – key message with all these plans is check that the hospital listing meets your needs
   • Free cover for all kids under 3 years old
   • Choice of 3 free personalised packages, e.g. free travel insurance or sports pack.

As with all insurance plans, the devil is in the detail. Whilst the pricing is very attractive, always make sure that the benefits meet your requirements. Be aware of the upgrade rule; if you reduce your plan and increase it again at a future renewal date, your cover will be restricted to the lower plan for any existing medical conditions for a period of 2-5 years depending on your age. No matter which plan you hold or which insurer you’re with, check all treatment in advance to avoid unnecessary shortfalls.

If you’re contacting the insurer directly, make sure that they explain everything to you over the phone. Otherwise, if you’re uncertain as to which plan suits you best, get good advice!!

Dermot Goode

All prices quoted are net of tax relief at source and are correct as of 12/5/14 as per www.hia.ie (Health Insurance Authority). However, prices and benefits are subject to change and consumers should confirm all details directly with the insurer in question.