Brendan,
Healthplus Premium does not have any excesses to pay in any hi-tech hospital.
You pay top dollar in premium costs every year for full cover whether you actually use it or not.
The hi-tech hospitals Blackrock Clinic and Mater Private are the two hospitals in question here. Beacon is fully covered on cheapest plans.
According to the Health Insurance Authority comparison shown in your post, cardiac and knee and hip replacement surgery is fully covered
(no 600 excess, no 200 shortfall per night) on your plan Control 600 Connect. It shows that other surgery/treatment is covered with a cost of
600 excess + 200 shortfall per night. Also, day case procedures are covered with an excess charge of 175 per procedure, ie a once off payment
on the morning of the procedure.
Regarding the 'other surgery/treatment', the reality in practise is a different story altogether.
Since 2008, the year of the financial crash, these 2 hi-tech hospitals came up with a waiver idea so as not to lose customers due to people
switching to lower priced plans. Their hospital business was immediately at risk.
Blackrock Clinic decided to waive all shortfalls on the majority of plans with hi-tech hospital cover.
Recently, they updated their website to include a facility for checking the cover on any plan in Blackrock Clinic.
The following link shows hospital cover for 'Control 600 Connect' in Blackrock Clinic.
http://cover.blackrock-clinic.ie/Home/Step4?FullyCovered=False&PlanId=1031&CompanyId=4
Non-cardiac procedure fully covered with just the 600 excess once-off payment. 200 per night shortfall waived by Blackrock Clinic.
Inpatient stay (per diem). fully covered with just the 600 excess once-off payment. 200 per night shortfall waived by Blackrock Clinic.
Note; orthopaedic cover(hip or knee replacement surgery) is fully covered with 600 excess. According to Laya website, no excess applies
to ortho surgery in Blackrock Clinic. see following link
https://www.layahealthcare.ie/media/layahealthcare/LAYA-OrthoCoPay-A4-004-0817-v1.pdf
So, in reality there is full cover across the board in Blackrock Clinic on Control 600 Connect with just the 600 excess to pay, a once off payment
on admission or 175 for a day case procedure. This hospital does not have shared wards anymore, all rooms are single occupancy with ensuite
bathroom.
The same story applies to Mater Private but they don't highlight this as clearly as Blackrock Clinic.
Again, cardiac and orthopaedic surgery is fully covered on your plan 'Control 600 Connect' - no shortfall of 200 per night, no 600 excess.
For other types of surgery, the information on Mater Private website is lacking in detail regarding their waiver list.
Its through personal experience that you find out what the real story is.
I have personal experience of my own parent last year who had 3 different episodes in Mater Private.
The first episode was a three week stay in hospital with treatment for the first 2 weeks followed by surgery and recovery in week 3.
Admission was through their private A+E, which cost 600 - breakdown 180 for consultant and 420 classed as hospital excess etc.
This 3 week stay was paid by Laya according to their agreement with the hospital. There was a 4200 shortfall that was not collected by the
hospital. The same applied with the other 2 stays - shortfalls of 1000 were not collected by the hospital. The admissions were for different medical issues. The plan involved was Laya Simply Connect. It was also in a single private room.
So, it makes sense to have a plan, including hi-tech hospital cover costing no more than 1500 max, depending on what excess amount you're
happy to pay. Examples; Simply Connect costs just 1100. Simplicity covers a private room in a private hospital and costs 1231. There's a max excess on these 2 plans per year(150 x 2 Simply Connect) and (100 x 2 Simplicity).
The Control 600 Connect plan might be off-putting with a 600 excess.
A few examples of VHI plans;
VHI PMI 07 10 @ price 1188pa; which has a capped excess of 150 x 1 per year for all private or hi-tech admissions, 50 excess per day case procedure. Good day to day cover, 1 euro excess, 50% refund for consultant visits, gp etc.
PMI 44 16; price 1154pa; private room in a private hospital covered, excess 150 per admission and day case procedure.
PMI 38 14; price 1661pa; No excess to pay, excellent day to day cover on this plan.
Its hard to justify paying over 3000 when you can pay two thirds less without losing cover.
I hope I haven't gone overboard with information but its the details that matter.
The information he was given about not being covered only for specific procedures is not true.
Regards, Snowyb