Health insurance customers to benefit after takeover of private hospitals

The country’s three largest health insurers have announced a series of refunds and rebates for customers following the Government’s effective takeover of 19 private hospitals.

The move will mean private hospitals will deal exclusively with public patients during the current Covid-19 crisis.

VHI is to waive premium costs by an average of 50 per cent for subscribers for an initial three-month period on foot of the Government’s move to effectively take over private hospitals.

Laya Healthcare is to provide a cashback payment to its 600,000 subscribers.

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This will involve a payment of €195 for every adult member and €60 for every child member. It said for a family of two adults and two children this would involve a total of €510. Different arrangements may apply in cases where subscription costs are paid by employers.

Irish Life Health said its customers with advanced plans would receive between 36 per cent and 60 per cent of their monthly premium back. It said those on plans with largely public hospital cover would receive rebates of between 17 per cent and 21 per cent “ depending on their specific policy and including the Government levy which is still payable for the period”.

The company said the reduction will be applied retrospectively to premiums paid by customers for April, May and June.

VHI said on Thursday that the Government’s initiative would limit access to the country’s private hospital network for its subscribers.

Laya Healthcare said it proposed benefit to members would “be split into three equal instalments and paid over three months - April to June 2020 -which is the estimated period of time that our hospitals will be re-organised in response to Covid-19.

“We will pay the first instalment by the 30th of April 2020. Members must have a current active policy on the 1st of each month - April, May, June - to qualify for the monthly instalment.”

VHI said the Government’s takeover of private hospitals “in effect changes the nature of the services that can be provided to customers right now and as a result claims are likely to fall.

“ In recognition of this all VHI private health insurance customers will see premium waived by an average of 50 per cent over the next three months according to their plans.”

"The waiver period will be for an initial three months (mid-May 2020 to mid-August 2020) and if there is an extension or curtailment to the partnership agreement between the Private Hospitals Association and the HSE, this waiver will be adjusted accordingly."

The State-owned health insurer also said that as many dental practices were now closed for non-emergency business due to Covid-19, it would also be waiving 30 per cent of the premium for customers with Vhi dental insurance for the same three month period.

The company said it would also continue to pay claims for any treatments that fell outside the agreement between the Government and private hospitals. It said this included the provision of cover for private care in public hospitals, psychiatric inpatient and day care treatment, maternity care and treatment for addiction.

VHI and Laya will also cover the public hospital statutory charges - €80 a day up to a maximum of 10 days - levied in respect of patients treated in the private hospitals covered by the deal with the Government.

VHI also said it was introducing a series of measures for customers who found themselves in difficult financial circumstances as a direct result of the pandemic. It said it had developed “a range of appropriate supports to offer customers based on their specific individual circumstances”.

VHI acting chief executive Declan Moran said: "Vhi has an important role to play in these uncertain times and our promise to our customers is that we will be there for them during these difficult days. We are fully supportive of the government's efforts to have a single united response to fight this crisis and Vhi is committed to playing its part."

VHI also said it was is extending day-to-day benefits to include telephone or online consultations with GP’s, clinical psychologists, physiotherapists, dieticians, and practice nurses as well as physical therapists, occupational therapists and speech and language therapists.

VHI said its clinical services SwiftCare, Paediatric Clinic and Hospital@Home were open and continued to provide services to customers daily.

“They have moved to an appointment only basis enhancing patient and staff safety. Support benefit and services including Online GP, Nurseline 24/7 and Midwife Support Services remain in operation.”

Laya Healthcare said: “If a member’s employer pays for their health insurance, we will distribute a payment directly to the employee and a separate payment will be made to the employer. Companies have different arrangements with their employees - some pay for cover in full, others make a part-contribution, so exact details will be communicated to these members and their employers directly to reflect their individual circumstances.”

Laya also said it would provide a range of other services to members, including:

• Unrestricted access for all members for three months to video consultations with GPs and  physios
• Unrestricted access to one-to-one video consultations with Health and Wellbeing experts covering parenting, financial and nutrition advice
• Unrestricted access to Healthcoach video consultations for members aged over 18  providing  health and fitness plans
• the full cost for members to access urgent care consultations and treatment for minor injuries in Laya Health and Wellbeing Clinics.