Laya Renewal - Alternative to Simplicity or stay with it?

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allencat3

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Hi, we’re a retired couple (76 & 65). Both of us are fine touch wood though we see GPs / consultants occasionally in relation to hypertension, chronic glaucoma and minor health issues (my husband) and heart/eye issues - not serious (myself). Have MCards (reviewed annually). Today my husband’s Laya Simplicity Plan is up for renewal - €1,232pa, and mine (next Jan) is same plan. Would we continue with that plan or is there an alternative plan? Many thanks for the assistance.
Allencat
 
allencat3,

The only reason for staying with Simplicity plan, is if full cover for a private room in a private hospital is important to you.
A private room means single occupancy with ensuite private bathroom facilties.
Note; a single private is never guaranteed and is very often not available.

A semi private room means sharing a room with 2, 4 or 6 beds and sharing bathroom facilties.

If a private room is not that important to you, I would recommend considering Laya Simply Connect plan.

1. Laya Simply Connect Plan; price 1100pa; all public, private and 3 hi-tech hospitals covered, private/hi-tech hospital excess 150 x 2 max per
year for all admissions, day case excess 50 per procedure. Note; there is no excess in any public hospital.
There is good day to day cover on this plan, with a 1 euro excess which means that a refund applies straight away for private consultant visits,
etc. The max refund per person is 500 per year.

[broken link removed]

So, if a private room doesn't matter to you, there is savings of 260 in total for switching to Simply Connect. Also if you have private consultant
visits or other medical expenses, your refunds will be better than Simplicity because of the lower excess.

NOTE; Your husband has 14 days after renewal date to switch plans if he wants.
There will be a list of price changes and plans on the HIA website this week which will show any special offers for late December and January.
This will confirm your options if any, apart from Simply Connect. It will be worth checking these out before deciding.

Regards, Snowyb
 
Snowby,
Certainly we’re not too fussy about type of hospital room - and having taken note of suggestions, your assistance is very much appreciated.
Allencat
 
allencat3,

There are no changes re price on Simply Connect @ 1100 for December or January.
There are also no better plans on offer for your renewal dates.

Snowyb
 
Hi Snowyb,

Could I add to this discussion and query one point with you re. the above comparison – if my outpatient costs for any given year exceeded the €500 max limit cover under the Simply Connect plan, would I be better to stay on the Simplicity plan ?

Thanks,

JP
 
J.P.,

Just to clarify the way it works when claiming a refund for health expenses with Simply Connect. The figure of 500 means 50% of 1000 expenses.
So if your expenses don't exceed 1000 or 1200, it is more beneficial to move to Simply Connect.
The main reason for choosing Simplicity is if you want private room cover in a private hospital.

If you have a few hundred euro medical expenses a year, Simply Connect pays out more than Simplicity because of the 100 excess which is
deducted from the total of allowable expenses. Simply Connect only has a 1 euro excess deducted from total allowable expenses.

On a seperate note, I've just discovered that the Health Insurance Authority have just updated their comparison website, so all previous links
are not showing. It looks very cumbersome and confusing to say the least.
They're supposed to simplify the comparison process, I think they've just added more layers of confusion into the mix!

Snowyb
 
Hi Snowyb,

Thanks for that. With regard to the €500 “outpatient” refund cap per member under the Simply Connect plan, a simple day procedure in a hospital could come to a total cost somewhere in the region of €1,000 – in this instance does the cost of such a day procedure come under the definition of “outpatient” under the Simply Connect plan ?

Thanks again.

JP
 
J.P.

I think you are confusing a 'day case procedure' with 'day to day outpatient medical expenses' which are two totally different things.
Both would come under the umbrella heading of 'outpatient' which simply means you are not staying overnight in hospital.

Day Case Procedure; This means having a minor procedure done in the hospital but not staying overnight. This covers a wide range of areas
for example - eye cataract surgery, hernia surgery, varicose veins etc. These type of day case surgeries/procedures are fully covered on both
Simplicity and Simply Connect plans. You just pay 50 euro when you are giving your details on the morning of the surgery. This 50 euro is called
a day case excess and it is only paid in a private or hi-tech hospital. There is no 50 euro to pay in any public hospital. There is no limit on the
amount of day surgeries you can have in a year, you just pay 50 euro each time.

Day to Day Outpatient Medical Expenses;
Day to day expenses means the cost of visiting your own gp/family doctor, dentist visits, physiotherapy, chiropodist and so on. If you have visits
to a consultant before being referred on for surgery or treatment either for a hospital stay or as a day case in the hospital, these consultant visits
are 50% refunded under both plans. All of these medical expenses can be sent in to claim a 50% refund at the end of the year by post or during
the year on the mobile phone app.
On Simply Connect plan the total refund is; 50% of 1000 = 500 per year per person less 1 euro excess.
On Simplicity plan the total refund is 7650 less 100 excess per person per year.

If you have less than 1000 euro of day to day expenses, it is more beneficial to be on Simply Connect plan as it pays out more than Simplicity
plan. This is only because Simply Connect has a 1 euro excess, whereas Simplicity has a 100 euro excess which means the first 100 is not allowed.

I hope it is a little easier to understand.

[broken link removed]

The Health Insurance Authority have reverted back to the original comparison website, hopefully it is back to stay.

Regards, Snowyb
 
Hi Snowyb,

Thank you for such a detailed and meaningful response - much appreciated.

Regards,

JP
 
@snowyb,

May I just ask if you switch from Simplicity to Simply Connect, is it considered downgrading, given that you are forfeiting the private room in a private hospital cover? Is there then a waiting period if we wanted to switch back the following year?

Many thanks for your help and advice as always.
 
Armada,

If you wanted to switch back again to Simplicity the following year, the waiting time of 2 years will only apply to any pre-existing illnesses/conditions.
This waiting time is also only for a private room in a private hospital, semi-private room will be fully covered for all pre-existing illnesses, no waiting
applies.
Note; a private room is often not available in a private hospital and is never guaranteed.


Snowyb
 
Thank you Snowyb for your prompt and helpful reply. Simplicity is a good policy but I fully agree that in reality if we attend our local (public) hospital the reality is that we will be on a trolley or if very lucky in a six-bedded ward as our nearest private hospitals do not offer emergency care.

Reading between the lines, I'm guessing Simply Connect is possibly the better option going forward.
 
The public hospitals use the private rooms for patients with highly contagious infections or patients in their final days/terminal illness so they
can have a level of privacy with their family. So its the exception to the rule if you would get a private room in a public hospital.
Both Simplicity and Simply Connect plans fully cover a private/single occupancy room in a public hospital if you ever get one.

Regarding private hospitals, the private room cover would really come into play if you were going in, on a pre-arranged basis to have
surgery of whatever type. Its never guaranteed, even if its by appointment but Simplicity plan fully covers a private/single occupancy room
in a private hospital if a room is available.
With Simply Connect, there would be a nightly shortfall of 165 per night for a private room in a private hospital.

I go through the same decision making every renewal date, between Simplicity and Simply Connect.
Last 2 years I chose Simplicity, but on my last renewal date I switched to Simply Connect, compromising on the private room.
Simply Connect is cheaper by 130 euro in price and it also pays out more in day to day refunds if you have a couple of hundred expenses.

It all depends how much you value the private room cover in a private hospital.

Regards, Snowyb
 
I am on Laya Simplicity with a renewal date for myself and husband being 1st February 2019. Wondering is this the best value for money for us. We are in our early 60's Meath based so most private hospitals would be Dublin if required. Hubby has blood pressure issues for years and had a heartattack with stents fitted in 2011. He is now suffering with Knee issues. Had cartilage scraped 2 years ago but not successful.
I have cholestrol issues and also knee issues which will probably require surgery at some stage.

I am happy enough with the Simplicity Plan . Some years I reach my excess for outpatients and others I dont.

What I am wondering is Am I overthinking the 150 euro a night in patient payment in The Mater Private etc as would worry if admitted there couldn't possibly afford this after a few days.

Thoughts Snowyb please.

Happy to go with anything else suggested as always take and appreciate your advice.
 
Meath Lady,

Like the previous poster, the only reason for picking Simplicity plan is if a private room in a private hospital really matters to you.
If it is not the most important feature, I would consider switching to Simply Connect plan @ price 1100pa.
Its a personal choice and both plans tick all the boxes.

I think you are overthinking the 175 per night inpatient payment in the Mater Private. Regarding both your medical issues relating to
heart(cardiac) and knees(orthopaedic), they are both fully covered on both plans with no excess or shortfall in the Mater Private.
So there's no need to worry.
Mater Private fully cover a wide range of surgeries and treatments, as part of their waiver list. My own parent had a few episodes in the
Mater Private last year for different issues. One nearly a month, with no charge applied. Other stays were 10 days, a week with no extra
charge. All covered by Simply Connect plan so I wouldn't be concerned.

All the best,
Snowyb
 
Oh thats great Snowyb. I will look at both again so. Not really bothered about private room just concerned that might not afford the 175 per night if it ended up a long stay so good to know thats not applicable to cardiac or orthopaedic.
Hubby ended up in A and E yesterday with cardiac issues and went to public hosp where he waited for almost 10 hours. Prob make more sense to go to Hermitage or Mater Private.
 
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