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Pricewatch: Is the cost of your health insurance making you feel ill?

Many of us are paying over the odds for medical cover, but are reluctant to switch

If it’s January, then it must be time to talk about health insurance. All told, more than a million people will see their policies renewed in January and February with many of them at risk of paying over the odds for reduced levels of cover unless they act quickly.

It is important to stress at this early point that “quickly” is not the same as “rashly”. Far from it.

Unlike switching car or home insurance or moving from one electricity provider to another there is far more at stake when it comes to health insurance than the bottom line and making the right choices are more complicated than simply switching from company A to company B.

But – as we say every year – with just a small amount of research and a little bit of knowledge, many people will be able to save themselves hundreds of euro and many more might be able to improve their level of cover without seeing their costs increase.

Despite the savings on the table, hundreds of thousands of people will simply allow their policy to be renewed without asking too many questions of their provider. And once they miss their renewal window they will be locked into their policy for a full 12 months.

Dermot Goode of Total Health Cover has been guiding people through the maze of health insurance for many years and he describes switching as "emotive". He also points to what he describes as the "misguided loyalty" many people have for their existing providers.

Among the trends he identifies for the year ahead will be another round of price increases due to general medical inflation, with “increases of up to 5 per cent” in rates across all insurers likely.

Goode also notes that changes in the market mean many plans are disappearing and will be replaced by other “perhaps not such good value” plans.

All told, 25 VHI plans have been “retired, which means thousands of members will need to shop around for replacement cover”, he says.

But how can people know if they are paying over the odds? Goode has a simple checklist.

A good rule of thumb is that better value can be found for anyone who is on the same plan for three or more years or those who have all the family on the same plan

He suggests that adults who are paying more than €1,800 should not be doing so unless they have specific reasons for doing so. He also points out that many older members are on dated plans costing €2,500 per adult.

And he reminds people “in so far as is possible” to make sure they are on an up-to-date corporate plan. As we have said on this page many, many times before, under Irish law all health insurance plans have to be made available to all comers. That means we can access corporate plans as individuals and don’t have to go through our employers to do so.

And what are corporate plans again? Well, they are usually marketed at large corporate clients and as an enticement to those companies, such policies often offer the best value for money.

But it is worth noting that while insurers are legally obliged to make the plans available to everyone they are not legally obliged to tell us about them.

That is why the plans they sell to the general public tend to have friendly-sounding if entirely meaningless names like “We Care About You Plus” while the better-value corporate plans are often called things like “PMI 125 Xdr289”.

Goode has more tips. He says a good rule of thumb is that better value can be found for anyone who is on the same plan for three or more years or those who have all the family on the same plan.

"The people who absolutely need advice are those on the old, dated plans. I am thinking of those VHI policies that were once called Plan B and Plan B Options, and are now called Health Plus and Health Plus Access or the Laya Health Manager or Essential Plus plans or an Irish Life Level 2 plan."

He stresses that all of the above plans “are very good schemes” but they are “dated and overpriced”.

He notes that while the official stats suggest that the rate of switching is low – more than 60 per cent of the two million people have never switched, according to figures from the Health Insurance Authority – many people don't move from one company to another but do find better value with a different policy with their existing provider.

“I think the first thing a good health insurance advisor will do is try and find someone a better deal with their current provider for the very simple reason that it is less hassle for the consumer if we can do that,” says Goode.

I think there is something in the Irish psyche not to tell the insurers anything but, with a health insurance company, tell them everything

He gives the example of a VHI customer living in Swords who might have the Swiftcare Clinic on their doorstep. If they change provider then they will lose access to the clinic, so the financial savings would have to be very significant for that switch to make sense. "First and foremost we have to make sure the new provider gives you what you need," he says.

He stresses that even those who renewed in recent weeks still have the option of finding better value because there is a 14-day cooling-off period for new contracts, so anyone whose policy was renewed within the last fortnight could still shop around today.

Goode has advice on how people should approach their providers. “I think there is something in the Irish psyche not to tell the insurers anything but, with a health insurance company, tell them everything.

“Tell them the plan you have and every medical condition you have and every tablet you take and every doctor you see. They have to say whether it is covered or not. There is no discretion among them and they can’t use your medical history against you. It is either covered or not covered.”

He also reminds people that there are no waiting periods for people who already have health insurance.

“You get full credit for your previous membership, so if you have served all your waiting periods, they don’t have to be re-served if you change.

“All insurers must take you on irrespective of your age or medical history. If you are not paying any age loadings at present, then this won’t change if you switch to another insurer and, as with car /home insurance, you can switch back to your previous insurer again next year if you’re not happy with the new provider.”

Health cover: What’s the best deal for me?

Good value cover for around €1,000 per adult
VHI Enhanced Care 250: €1,024 per adult.
Irish Life Health (ILH) Benefit Access 300: €907 per adult.
Laya Signify: €989 per adult (includes 3 per cent credit charge).
Good semi-private corporate plans for around €1,400 per adult
These cover semi-private in private hospitals subject to a small excess per claim of up to €150 per claim. Limited cover for the high-tech hospitals is also included in these plans. They include 50 per cent refunds on eligible outpatient expenses with no excess to pay first.
VHI PMI 5310: €1,351 per adult.
Irish Life Health 4D Health 2: €1,394 per adult.
Laya Inspire Plus: €1,386 per adult (includes 3 per cent credit charge).
Good private room corporate plans at around €1,650 per adult
These are similar to the above plans except that they cover private accommodation in private hospitals, with limited cover in the high-tech hospitals. They include 50-75 per cent refunds on outpatient expenses with no excess to pay first.
VHI PMI 4810: €1,657 per adult.
Irish Life Health 4D Health 4: €1,680 per adult.
Laya Principle scheme: €1,656 per adult (includes 3 per cent credit charge)

Insurance costs: How can I reduce them?

Renewals
Shop around well in advance of your renewal. If you're not up to the task, have a trusted family member or friend help you as the savings could be €500-€1,000 depending on the plan held.
Advice
Don't rely on comparison websites as they are a useful guide only. If in doubt, seek independent advice and let someone else do the heavy lifting for you.
Switching
Don't be afraid to switch. It's just an insurance policy and if you ask the right questions and you're happy with the answers, switch and save. There is no reward for loyalty in health insurance.
Per person
Split your cover, ie consider the needs of each person on the policy and insure them on whatever plan matches those needs. You don't need to have everyone on the same plan or even insured with the same insurer.
Special offers
Check out those special offers such as free cover for children under 18 with one insurer.
Corporate schemes
Check out the corporate schemes as they include guaranteed refunds on eligible outpatient expenses which are not included on many dated schemes.
Phone
Still not sure you're on the right plan? Just phone your insurer and ask them if they have a lower-cost equivalent to your existing plan, ie similar benefits at a lower cost. You can put the same question to other insurers before you renew.
Excess
Don't be afraid to take on a small excess for private hospital claims – it's a great way to reduce your costs with minimum risk.
Cooling off
Don't forget about your 14-day cooling-off period after your renewal date during which you can amend or cancel your cover.
Topping up
If you're able to generate some savings, consider topping up your cover with a DeCare Dental plan or a cash plan from HSF health plan. For young people who can't afford full private health insurance cover, these schemes are definitely worth considering.

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