Scheme offers access to essential care at a reasonable cost

BUPA's initial product range is based on two principles: all customers should have full and timely access to essential medical…

BUPA's initial product range is based on two principles: all customers should have full and timely access to essential medical care at reasonable cost, and customers should be able to pay more to buy extra convenience and comfort.

For this reason the company has introduced two ranges of products. These are the Essential Scheme and the Cash Plans. A customer can opt for the essential scheme on its own, or he/she can add on one of the cash plans to give a higher level of hospital accommodation.

Because the cost of the cash plans increases with the age of the insured, older age groups would fare worse with BUPA than with VHI.

Under its most basic plan BUPA members will be able to have heart surgery in the high-technology Mater Private and Blackrock Clinic in Dublin.

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BUPA's Essential Scheme is the basic healthcare insurance plan. Under it, a BUPA customer could have semi-private accommodation in 63 hospitals throughout the Republic and private accommodation in 30 hospitals. An individual would pay an annual premium of £172.27 for this scheme while someone joining as part of a group scheme would pay £155.04. Premiums for Essential Scheme cover are tax-deductible at the Standard Rate.

This scheme would not entitle insured people to semi-private or private accommodation in hospitals such as St Vincent's Private Hospital or Mount Carmel Hospital in Dublin or the Bon Secours Hospitals in Dublin, Cork, Tralee and Galway. To upgrade to this level of accommodation the customer would have to add to the basic level of cover by taking out one of the cash plans.

But there are a number of distinguishing features in the Essential Scheme:

. All members with this basic cover will be able to have heart surgery in the Mater Private or Blackrock Clinic at no extra cost. Currently VHI members on Plan A have only 35 per cent of their costs covered, rising to 90 per cent of costs for Plan B and C members and full cover for Plan D and E members.

. BUPA members will have full cover for doctor fees for outpatient cancer radiotherapy treatment. Female members will get discounts for cancer screening.

. There will be no balance billing for accommodation, day surgery or out-patient surgery. Balance billing arises where the insurance cover does not pay the full cost of treatment and accommodation and the patient has to pay a top-up charge.

. BUPA is introducing cover of up to £15 per consultation for approved alternative practitioner therapies.

. Annual outpatient "excess levels" will be lower for BUPA members than for VHI members.

BUPA's Cash Plans are different from anything available from VHI. Premiums paid under these plans do not currently qualify for tax relief. By paying an additional premium, customers can upgrade their hospital accommodation to the hospital of their choice.

But there is an additional benefit - if the customer has bought, for example, Cash Plan 2 which is worth £60 per night in accommodation terms and then decides to remain in the accommodation available under the Essential Scheme, BUPA will pay the customer £60 per night. This allows the customer a choice between a cash payment or upgrading their hospital accommodation.

The cost of the cash plans increases with the age of the insured and the level of benefit chosen. Cash Plan 1, which offers a benefit of £30 per night, costs £22.27 per annum for a person aged under 18 years and rises to £122.26 for people 55 years and older. The top Gold Plan costs £177.73 for a person aged under 18 years rising to £705.60 for a person aged 55 years or older.