Fiona Reddan: Do children need private health insurance?

With health insurance renewals season coming up and the cost of cover inching up once more, you might be weighing your options. Do you simply stomach the increases, shop around more carefully, or cancel, or downgrade your cover?

According to the Health Insurance Authority (HIA), more than a million consumers are due to renew their health insurance in the coming months with about 50 per cent of policies up for renewal.

Dermot Goode, health insurance adviser with Total Health Cover, says the cost of insurance is "definitely on an upward spiral" and customers should expect increases of between 5 and 8 per cent in their renewals this year.

While the emphasis should be on shopping around to get the keenest prices, this can be confusing in a market overwhelmed with choice. According to the HIA, there are currently 314 products on the market.

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Faced with such a plethora of options, some parents may wonder whether an easy route to cutting their annual premium is to simply stop cover for their children. After all, as there are no private hospitals for children, some might argue, why bother getting them covered?

As with health insurance in general, insuring your children comes down to your personal choice – and how much pressure your bank balance can withstand. But here are some reasons why you might find it worthwhile.

Private care

According to John Haigney, health insurance adviser with Lyons Financial Services, the main reason for getting private health cover for your children is the access it gives to procedures in private hospitals.

While young children will typically be treated in public hospitals, Goode notes that when children are closer to the age of 10 or their early teens, “you’ll find consultants are happy to bring them into private hospitals for day-care procedures”. So ensuring you have cover for this may be a priority.

There may be no private children’s hospitals in Ireland but many of the adult hospitals now offer services to children and it is for this reason that many parents seek out cover for their offspring.

Beacon Hospital in Dublin, for example, launched a paediatric service in 2017 and offers day-care and overnight procedures, which include general surgery, urology, dentistry and ophthalmology. The Mater Private in Dublin also has a team of paediatric consultants, surgeons and anaesthetists.

According to Haigney, these hospitals can offer fast access to procedures, such as grommets and tonsillectomies or sports-related injuries; something that children may otherwise have to wait months for as public patients.

“It’s a huge advantage to have access to as it allows you to skip the waiting list in the public system,” he says.

Public care

Private health insurance will also offer cover in the event a child has to spend time in a public hospital, where you could be charged €80 a night up to a maximum charge of €800.

“There’s no [other] way around it unless you have a medical card,” says Goode.

And, like adults, it also allows children to skip waiting lists in public hospitals. “Health insurance for children is not about a private room really, it’s about access,” says Goode.

And, if you don’t get cover for your children now, they’ll be subject to the five-year waiting period to be treated for existing conditions should you put them on insurance at a later stage.

Day-to-day benefits

With free GP care up to the age of six (and plans to extend it to the age of 12), depending on your circumstances you might find that money back on everyday health visits won’t be a priority for your children.

The cheapest children's policies, for example, typically don't offer cover for day-to-day benefits, while you'll be looking at an excess of about €120 on policies costing in the €200-€250 range. But if you pay more, you will get better cover. Irish Life Health's Be Fit policy, for example, costing €308 per child, has an excess of just €1 and offers one free GP visit and 50 per cent back on subsequent ones.

According to Haigney, if you want to upgrade a policy at a later date to get access to these benefits for your children, you won’t be subject to any waiting periods. “You can upgrade as you need,” he says.

Shopping around

If you have decided that private cover for your children is worthwhile, you should be prepared to shop around to ensure you get the best deal.

According to Haigney, unless there is a pre-existing condition for children or you need specific cover for a reason, usually you'll be looking at a fairly basic policy that offers cover for private hospitals.

The cheapest policies for children start at about €130 a year, such as Vhi's PublicPlus Care (€134.11) or Assure Protect from Laya Healthcare (€151.28). However, neither covers private hospitals.

According to Goode, if you pay between €200 and €250, you’ll get cover for both public and private hospitals. Irish Life Health’s Benefit Plan is one such option as it gives you private treatment in public as well as private hospitals. It costs €206 for a child under 18 and covers day-care procedures in private hospitals, although there is a €150 excess on it.

And remember, just because you are on a certain policy doesn’t mean that your children must be on the same one.

“Every family should be looking at splitting their cover, everyone should be on a plan to suit their needs.”

Let’s say you pick a premium policy, such as Irish Life Health’s Health Plan 06, which costs €2,314 a year. If you were to automatically enrol your children on to that plan, it would cost €792 each for the first three children and €120 thereafter.

But the costs could more than halve if you put the children on to the insurer’s 4D Health 1 Plan, which costs €306 per child, or the aforementioned Benefit Plan, at €206.

You should also watch out for special offers; at Laya Healthcare, for example, from January 1st, while you have to pay for cover for your first child, the rest are free.

And you don't always have to insure your children with your insurer; both Irish Life Health and Vhi, for example, say that a policy for a child can be set up in a parent's or guardian's name when insuring a child under 18.

Child-Friendly Insurance Cover

Vaccinations

With vaccinations on our minds at present, it’s also worth noting that private health insurance can help defray the costs of additional vaccines you might wish your children to have.

The chickenpox vaccine costs about €160-€180, while you can also pay for a vaccine to protect against meningitis B. While this vaccine is now given as standard to newborn babies, it was introduced only in 2016, which means that many parents may wish to pay for older children who may not have received it.

It’s more expensive than the chickenpox job, at about €150-€160 a shot and two are needed, so that’s about €300-€320 in total. Prices vary from one GP practice to another so it might be worthwhile shopping around.

When it comes to getting some money back, Irish Life will pay between €30 and €50 towards the cost of both vaccines on some of its plans.

Vhi offers a €50 or €60 benefit for the vaccinations and this is included on a range of family plans and also in its new FirstCare Extra Day-to-Day plan, which costs from €198 per child.

Laya Healthcare offers cover of up to €50 towards the vaccinations (including HPV vaccine) on its new plan, Everyday Health. It says the benefit will also be added to two more plans from the 1st of January: Signify and Signify Plus.

Dental care

It’s one of the biggest expenses facing parents but unfortunately cover for orthodontics remains limited on most insurance policies. Laya Healthcare, for example, says it doesn’t offer any cover for braces, although it does offer a contribution towards routine and emergency dental.

The most comprehensive dental benefit it offers is a 50 per cent refund on the everyday medical expenses, up to €500 per year, and that benefit is available on more than 50 per cent of its plans.

Vhi has two dental plans but the benefit available towards orthodontic costs is a lifetime maximum of €500 per child on Dental Plan and €1,000 on Dental Plan Plus. And this benefit is subject to a 24-month waiting period.

As an extra, members can get €500 off the cost of orthodontic treatment via clearbraces.ie and there is no waiting period associated with this offer.

Irish Life Health says members can claim a €100 cash benefit for the costs of an orthodontist on some of its plans.

Speech therapy

With significant waiting lists for the public speech-therapy service, some parents may opt to go privately. With Laya Healthcare, while the level of cover varies, some plans offer cover of up to 75 per cent of costs for up to 12 visits a year.

At Vhi, the majority of its plans offer some benefit. This ranges from €20 for three visits to 75 per cent for unlimited visits subject to the annual excess and maximum of the plan. It also has a remote speech and language therapy service that is fully covered for all members.

Irish Life Health also provides cover and says the amount of the contribution depends on the level of cover specified on a member’s plan.