Switching health insurance during pregnancy

Say one switches from one health insurer to another and, at the same time, from a "lower" level of cover to a "higher" level of cover during a pregnancy when maternity care has already started - what's the story...

• Presumably the maternity waiting period is waived if continuous cover of more than 52 weeks (or whatever it is) has been "served"?
• Will the first insurer pay out benefits for care up to the point of the switch and the second insurer will pay out benefits thereafter?
• Will the enhanced benefits of the "higher" plan be available immediately on switching and, if now, how do they decide what benefits will be available since it's nearly impossible to compare like with like across different health insurers?
• Are you faced with the excess under the first insurer's policy at the start of treatment and the excess under the second insurer's policy or do insurers facilitate only facing the excess once for a course of care/treatment when switching during this time?

(Hopefully you can get the gist of what I'm asking above!)

I've tried to read the health insurance policy booklets (VHI don't seem to have theirs on their website any more unless I missed them) and am not clear on the answers to these questions.

Thanks.

I'm afraid I can't really help with the health insurance question, your best bet may be to try to talk to some one on the phone?? I know some insurance companies waive the waiting period if you are changing from another insurance provider, are you changing under these conditions?

If you want to change from one level to another in a hospital in Dublin (ie, from public to semi to private or whatever), many hospitals wont let you change, particularly if you want to go to private the consultants book up very early...

Thanks for the feedback.

I know some insurance companies waive the waiting period if you are changing from another insurance provider, are you changing under these conditions?

Yes - as far as I know they are obliged to waive the waiting periods once one has previously served them with another insurer. The point is more to do with switching (a) mid treatment and (b) from a lower to a higher plan and what the implications are for (1) excesses (2) higher levels of cover and (3) which insurer covers what for the treatment/care. The issue of changing the level of cover while in hospital etc. is not relevant to my query.

Interesting question:

As a result of a promotion at work, I was ugraded from VHI plan B to plan C just before my second pregnancy. When I telephoned VHI, I was informed I would receive VHI plan B maternity benefits during the delivery as there was a 'kicking-in' period of two years before the Plan C maternity benefits would commence. However, as plan B covered the care I received completely anyway, I have no proof that I did not receive plan C benefits.

The interesting question is, had I transferred to another insurance company, would I have received the upgraded benefits straightaway?

Let us know how you get on.

Re: re:Switching health insurance during pregnancy

Thanks ngirl - will post back if/when I get more info.

Re: re:Switching health insurance during pregnancy

Hey Clubman, going to answer them all, hopefully, this is my understanding!

Presumably the maternity waiting period is waived if continuous cover of more than 52 weeks (or whatever it is) has been "served"?
Yes

Will the first insurer pay out benefits for care up to the point of the switch and the second insurer will pay out benefits thereafter?
Possibly, the second insurer could pay the whole amount and submit a claim to the first insurer for the amount prior to the switch though

Will the enhanced benefits of the "higher" plan be available immediately on switching and, if now, how do they decide what benefits will be available since it's nearly impossible to compare like with like across different health insurers?
No, a pre-existing condition (I know pregnancy is not an illness) has a "bedding-in" period, and maternity cover is treated in the same manner. While it's a piece of string question to compare like with like across insurers, most would operate a policy that could be broadly compared with another - So say you are on Plan B with the VHI, then you would benefit from Essential Plus on BUPA for the purposes of the pregnancy.

Are you faced with the excess under the first insurer's policy at the start of treatment and the excess under the second insurer's policy or do insurers facilitate only facing the excess once for a course of care/treatment when switching during this time? I can't say - it's unclear, I would recommend speaking directly to the companies concerned, and definitely get a response IN WRITING!!

Re: re:Switching health insurance during pregnancy

Thanks mo3art - your answers concur with the initial feedback from the health insurer apart from the last two points which they haven't yet addressed.

Re: re:Switching health insurance during pregnancy

Interesting topic this.
I'm switching from VHI to VIVAS at the end of this month and there's been various to-ing and fro-ing about who pays for what.
As baby will be born after I make the switch , VHI wouldn't pay for expenses incurred to date which is a pretty sum when you go private even though I was with them when I incurred the expenses.
But now it appears that VIVAS will pay for all maternity related expenses I have incurred even though I was on the VHI plan when they were incurred....but I have insisted that I get that in writing!
There won't be a waiting period when I move and I will face the excess of only VIVAS

Re: re:Switching health insurance during pregnancy

That's very interesting brack. When I get some feedback myself I'll post back here.

Re: re:Switching health insurance during pregnancy

VHI wouldn't pay for expenses incurred to date which is a pretty sum when you go private even though I was with them when I incurred the expenses.
But now it appears that VIVAS will pay for all maternity related expenses I have incurred even though I was on the VHI plan when they were incurred....but I have insisted that I get that in writing

Click to expand...

Note that neither VHI nor BUPA pay the bulk of the consultant's fee if you go private or semi-private for maternity.

Re: re:Switching health insurance during pregnancy

Any rough idea of what they might come to?

Re: re:Switching health insurance during pregnancy

Clubman

Second son born in november. Wife was private patient in the Coombe.

Note going private does not gaurantee a private room. Wife ended up on public ward due to there not being any available space in the private ward at the time.

Cost of consultant ex VHI was €1200. But don't forget you can claim back some of that against your tax bill at the end of the year.

C

Re: re:Switching health insurance during pregnancy

Note going private does not gaurantee a private room.

Yes - I realise that this is the case with any stay in hospital under health insurance that covers semi-private or private accommodation and that such accommodation is only provided if available.

Cost of consultant ex VHI was €1200. But don't forget you can claim back some of that against your tax bill at the end of the year.

Thanks for that info. I was just wondering what the ball-park figure might be.

No one here has asked yet but doesthis question meanthat congratulations are in order? A potential Bohemians player in the making?

Yes as it happens. Thanks. Not sure about the Bohs player bit although we'll do my best to raise a fourth generation of Bohs supporter since we all need a cross to bear in life.

Well congratulations Clubman!

Re: Congrats to you both.

Clubman,

Sincere congratulations to you both. Happy days ahead.

Sueellen.

Re: Congrats to you both.

Thanks a lot everybody.

Welcome to the parents club

Congratulations!

Re: Welcome to the parents club

I'll add my congrats too!

FWIW, I don't know what hospital you are going to, or where you live, but when I was pg on #1, I rang around the main Dublin hospitals and found them very helfull and clear about fees and what was covered by the various health plans. If you are going private (I think) the fees vary from one consultant to another, so you may need to have an idea of who you are going to. But the accounts department in the hospital were very helpful.