# 2A+17yo+11YO, VHI B OPT: renewing soon. €4.3k something must give.



## phoenix (4 Mar 2013)

Hi

We are a family of 4.  Two adults, a 17 year old and an 11 year old.

We are all currently covered by VHI, PLAN B, OPTIONS.

I now see that the children are over insured.  I'm a health worrier and want to maintain a decent level of cover.  I am not particularly worried about day to day medical expenses at the moment, but do want to be able to be able to see a consultant without delay if I or my family need to.  I also wouldn't be adverse to being sick in some level of comfort (although I would obviously prefer not to be sick at all) so semi private would be good to have.

I opted for b options as there is cardiac history in both sides of the family and I thought this would be best cover.

Next year our premium would be 4300 euro , so something has to give.

I rang vhi and they recommended we move to plan b and the children to parents and kids which would give us a premium of around 3300.

I, like others find the hia comparison site difficult to navigate (it gave me 126 options) and would be grateful for any help from others out there.

Thank you.

Phoenix

Ps...also like others I have been with vhi for over 30 years and am reluctant to leave but that reluctance is based on fear not fact.


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## oldnick (4 Mar 2013)

These are just opinions not gospel....

Seeing a consultant "without delay" does not depend on whether you have private insurance.
 Seeing a consultant more quickly (which doesn't mean without delay - my daughter needs to see a neurologist and it takes weeks even privately) depends on whether you are willing to pay i.e. requesting a private consultation.

VHI does not pay the full costs of private consultations on your plan.  There's an "excess". You'd have to see a consultant privately many times in a year before it's worth paying for private health insurance.

Many consultants will deny this (but my brother-in-law consultant swears it's true).....
Once you visit a consultant privately regardless whether you are on any private insurance or not -he/she may be able to facilitate a more speedy appointment for a procedure/operation -whether private or public - more quickly than seeing a consultant during the public(free) visiting hours.
In other words the disgusting private fees of Irish consultants helps gain quick access to treatment.

As regards some degree of comfort in hospitals -yes it may be worth private insurance and thus Plan B -nothing added- may be the best on offer from VHI at present.

Mind you, if you've had an accident or serious illness  A and E will give immediate treatment regardless of any plan.

 I think Irish private insurance is one big fiddle.


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## snowyb (4 Mar 2013)

Hi phoenix,

What is your actual renewal date?

Snowyb


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## phoenix (5 Mar 2013)

Hi snowyb

22 march 13 is our renewal date.

Old nick thanks for your observations/opinion.  You may very well be right, I have never considered not having health insurance of some sort but that is just me.  It provides me with a level of comfort rightly or wrongly.

As long as I can afford to pay it, I think I will continue to do so.  But as premiums are escalating, that may change too.

You have put a seed in my mind to investigate further.

P


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## oldnick (6 Mar 2013)

A further note following your comments.

My wife insists on it. I point out we've spent over 60.000 euros in the last 30 years on VHI.
If we'd invested it in a safe interest bearing account we'd have 100.000 euros.

-and we still pay a portion of the rip-off consultant fees and other small procedures (some scans).

My wife responds with what VHi have paid for my heart stent procedue some years ago.
I point out that it's free with the national health.

She shows me how much has been spent on my daughter -mainly on useless operations that didn't diagnose her conditions. (eventually we went to UK where she was treated but VHI didnt recognise the procedure and refused to pay).

I point out that VHI has spent far less than we have paid.

I can't win. She, like your good self , wants peace of mind/level of comfort.
The irony is that she hasnt had one cent spent on her in the last thirty years.

Like you, I'm facing a another annual bill of nearly 5.000 euros and will fight to go on the basic plan you've been advised to take. Still over 3k !

I suppose that now I'm 66 and she's , well, younger we probably do need that level of comfort/peace of mind. Therefore I'm weakening in my battle to against paying for something that every citizen should have for nothing.

Not sure why i wrote all this. Maybe it's that damn VHI bill in front of me !


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## snowyb (6 Mar 2013)

Hi phoenix,

With a renewal date of 22nd March 2013, you are off to a good start  -  you will avoid the next round of price increases on plans with
all 4 health insurance providers from 28/3/2013 to 1/4/2013.

The only company that offers identical hospital cover to Plan B Options is Laya Healthcare; all the other companies have a restriction for 
orthopaedic surgery.   Details are explained with each individual company.  It doesn't need to be a problem, just something to be aware of and 
having the know-how to avoid any potential costs.



LAYA HEALTHCARE; Adult Options; Alternative plans to Plan B Options with no hospital excess.

1.  Healthwise Plus No Excess;      Price per adult;  885pa (911)  -  good hospital cover,no hospital excess,limited outpatient
2.  Total Health No Excess;           Price per adult;  1018pa(1048) -  good hospital cover,no hospital excess,lower shortfalls hi-tech,
3.  Company Care Plus;                 Price per adult;  1059pa(1090) -  good hospital cover,no hospital excess,excellent outpatient cover,
                                                                                                         lower shortfalls for hi-tech and private cover. 

Alternative with hospital excess;
4.  Total Health Choice;                 Price per adult;  874pa(900)   -  good hospital cover,100 hosp excess,good outpatient cover.

www.hia.ie/ci/comparison/step3?68&277&320&198&323/


LAYA HEALTHCARE; Kids Options

1.   Essential First ;                   Price per child;     195pa (200) - Public hospital cover only, limited outpatient cover.
2.   Healthwise Plus No Excess Price per child;     248pa (255) - Public,private and hi-tech cover, no hosp excess,limited outpatient cover.
3.  Simply Health Starter;         Price per child;     253pa (260) - Public hospital cover only and good outpatient cover.
4.  Total Health Choice;           Price per child;     273pa (281) - Public,private and hi-tech hospital cover and good outpatient cover,100 hosp excess.

www.hia.ie/ci/comparison/step3?68&285&278&323&277/

Above prices in brackets for adults and kids options include the 3% charge if you pay by instalments.





VHI HEALTHCARE

The following plans are worth considering with VHI Healthcare;

Adult Options

1.   PMI  05 11;                   Price per adult;   1244pa  -  Public,private and hi-tech hospital cover,higher outpatient cover,no hosp excess.
2.   PMI  25 11;                   Price per adult;   1172pa  -  same as pmi 05 11, but with a hospital excess 75.
3.   Well Plus 1 Excess        Price per adult;   1049pa  -  Public,private and hi-tech hospital cover,limited outpatient cover,hospital excess 75.

www.hia.ie/ci/comparison/step3?68&232&276&196/


All the above VHI plans are similar to Plan B Options re hospital cover except for 1 difference only -  they all have an 80% restriction for 
orthopaedic and cataract eye surgery in a private or hi-tech hospital.  This means that VHI will only pay 80% of the bill for this surgery, and the 
patient would have to pay 20% shortfall.(which could be 2k to 4k depending on the type of surgery.

NOTE; This restriction does NOT apply to public hospitals. 
Since 2008, hi-tech hospitals Mater Private and Blackrock Clinic are NOT charging the 20% shortfall to patients on mid range plans (plans with 
 45%-65% hi-tech cover).

So, to avoid this 20% charge, a person can have this type of surgery in a hi-tech or public hospital fully covered.


KIDS OPTIONS with VHI;

1.  One Plan Starter;            Price per child;          200pa  - Public hospital cover only and limited outpatients.
2.  One Plan Choice;            Price per child;         244pa - Public,private and hi-tech hospital cover and limited outpatients.
3.  Company Plan Starter;   Price per child;          268pa - Public hospital cover only and outpatient cover.
4.  PMI 14 11;                     Price per child;          355pa  - Public,private and hi-tech hospital cover and good outpatient cover.

www.hia.ie/ci/comparison/step3?68&103&290&87&257&246/



GLOHEALTH
Adult Options;

1.  Best Plan;                          Price per adult;     1039pa  -  Public,private and hi-tech cover, limited outpatients,no hospital excess.
2.  Better Plan;                        Price per adult;       842pa  -  Public,private and hi-tech cover, limited outpatients,100 hospital excess.
3.  Better Plan Ultra Cash;       Price per adult;    1142pa  -  Public,private and hi-tech cover, good outpatient,100 hospital excess.

www.hia.ie/ci/comparison/step3?68&299&298&324/

Kids Options;

1.  Good Plan;                    Price per child;       160pa  -  Public hospital only,limited outpatient.
2   Better Plan;                   Price per child;        206pa -  Public,private and hi-tech hospital cover,limited outpatient,100 hospital excess.                    

www.hia.ie/ci/comparison/step3?297&298/

 NOTE; Glohealth plans have a co-payment of 2000 for orthopaedic surgery in a private or hi-tech hospital.
This co-payment does NOT apply to public hospitals.  



AVIVA
Adult Options;

1.  Level 2 Health Excess;              Price per adult;      899pa   -   Public,private and hi-tech hospital cover,limited outpatients,125 hosp excess.
2.  Level 2 Health Excess with day to day;  Price per adult;  1058pa - public,private and hi-tech hospital cover,good outpatient,125 hosp excess.
3.  Health Plan 05;                          Price per adult;     952pa  -   Public,private and hi-tech hospital cover,good outpatient,75 hospital excess.

www.hia.ie/ci/comparison/step3?68&249&251&307/

Kids Options;

1.  Level 2 Health Excess;             Price per child;    209pa  -  public,private and hi-tech hospital cover,limited outpatients,125 hosp excess.
2.  Level 2 Health Excess with day to day;   Price per child;  323pa  - public,private and hi-tech hospital cover,good outpatients,125 excess.

www.hia.ie/ci/comparison/step3?68&249&251/

NOTE; Aviva plans have a co-payment of 2000 for orthopaedic surgery in a private or hi-tech hospital.
This co-payment does NOT apply to public hospitals.



As you can see, there's plenty of alternative options to choose from with all  4  health insurance providers.
Some plans shown above are half the price  of Plan B Options, so you may be wondering   'where is the catch?'
I can assure you there is absolutely no catch involved,  in fact,  the only catch is called  'Plan B Options - double the price.


NOTE;  Each member of the family can be on a different plan, with the same company, if you wish.

Regarding all the kids options recommended,  I included both basic plans(public hospital cover only) and plans with full private cover upto
hi-tech hospitals.  There are no private children's hospitals in Ireland so basic cover is adequate for a child.  However,  as an extra option
if required, Mater Private and Blackrock Clinic offer a list of typical paediatric surgery fully covered for children aged 3 years +,
if your plan includes hi-tech cover.   Some of these plans also include good outpatient cover.

My personal favourite plan  is Company Care Plus 1090pa, it ticks all the boxes, identical to Plan B Options, note this plan will increase
 to 1201pa on 1 April 2013.  A very good price at the moment.

I know your probably a bit iffy about switching providers,  all the VHI plans recommended are equally good, just a bit more expensive, but 
still a lot cheaper  than Plan B Options - still well worth considering.

Hope you find something suitable.
Snowyb


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## AlbacoreA (6 Mar 2013)

What are the restrictions on orthopaedic surgery. I queried this with VHI and couldn't get a clear answer.


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## snowyb (6 Mar 2013)

AlbacoreA said:


> What are the restrictions on orthopaedic surgery. I queried this with VHI and couldn't get a clear answer.



Hello AlbacoreA,

Do you mean what procedures are restricted?

Operations such as total hip replacement, knee replacement, shoulder 
replacement surgery and variations on the above.  Also, cataract eye surgery is included.

Or do you mean how much does the 20% shortfall mean in euros for orthopaedic surgery?

From personal experience with a family member, in March 2012, a total hip replacement operation in a hi-tech hospital cost 14,000.
  So, 20% of 14,000 would be 2800.  As it was a hi-tech hospital, this shortfall wasn't collected, surgery was fully covered.
Not sure of the cost of other operations.

Hope this answered your query.

Snowyb


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## AlbacoreA (7 Mar 2013)

Maybe I should ask what does restricted mean?


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## snowyb (7 Mar 2013)

Insurance cover for orthopaedic surgery in a private or hi-tech hospital  is restricted to 80% cover with VHI - this means that VHI will only pay the hospital 80% of the full cost of the operation.  
So the word 'restricted' means 'limited' to 80% cover with VHI.

The patient will have to pay the 20% balance.
This 20% balance could be between 2000 to 4000+ depending on the type of surgery ie.
knee or hip replacment etc, and depending what hospital is involved.

Snowyb


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## phoenix (7 Mar 2013)

Thanks for all this information snowyb.  I just need some more time to read it through and show to husband.

Looks like Layla is a great alternative.  Just need to get my head around the fact that the world won't fall apart if I change provider.  Is it just a matter of calling them or is there form filling to take place?  And will full cover be available immediately,ie, no waiting period?

Thanks for your steer through what feels like very muddy waters to me.

I will come back on shortly and let you know what we have decided to do.

Old nick, glad to see your wife is saving you from yourself.  I understand exactly how she feels.  Also nice to have someone looking out for you.

P


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## snowyb (8 Mar 2013)

Hi phoenix,

You have plenty of time to mull over your decision,  sure there's two weeks to go before your renewal date,  no rush.

To answer your questions - full cover is available immediately with Laya Healthcare,  no waiting time applies either for 
inpatient hospital cover or for outpatient day to day expenses.

Everything can be arranged over the phone with Laya Healthcare.
If you pay through a salary scheme, you can ask them(Laya)  to send you out a form to complete,  in relation to that.
Otherwise,  bank details etc are dealt with over the phone.

There is always the option of one person + kids switching provider while the other person stays  with VHI( maybe on a new plan)
if that suits.   It just means an extra phone call.
Remember a health insurance policy is just for one year,  you can change your mind every year if you please.

If you are switching to Laya Healthcare,  they would normally change the renewal date  to the 1st of the month.
So, your renewal date for 2014 would be 1st March 2014 and  your premium adjusted accordingly.

Take all the time thats required to consider your options before making a decision - its a win/win whatever you decide.


Snowyb


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## phoenix (15 Mar 2013)

Hi snowyb

A question for you please.

I have been on to the vhi as I am having problems accessing the member site and while on to them they confirmed the following figs for 2013/14.

Plan b options (all 4 of us) - €4468.50
Plan b options (adults) parents and kids plan (kids) - €4290
Plan b (adults)parents and kids plan (kids) - €3607

There is no doubt that Laya is coming across as a better option cost wise with

Company care plus (same as b options) for adults €2118 and
Total health choice for kids €546 giving a total of €2664 for all of us with Laya.

My question is that when on to vhi, they mentioned that if I reduce my plan with them to plan b this year and then want to increase it to b options next year we will have to wait the 26 week period before the full benefit applies so does that mean if I go to Laya this year and back to vhi next year the same waiting period will apply?  I don't really understand why Laya would take us on over the phone without a waiting period and yet moving plan within vhi itself warrants waiting periods although we have been with them 30 years......

Does my question make sense?

Cost wise we should move and cost is important, I just don't want to jeopardise future years for 1 year.

Also, are Laya known for quick payment of claims in Ireland?

Many thanks

Antoinette


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## snowyb (15 Mar 2013)

Hi Antoinette,

I refer to  your question re VHI conversation about switching to Plan b for 1 year and then a 26 weeks waiting time applying if you
go back to B Options the following year.  

VHI are great for telling people there will be waiting times and not going on to explain in detail what exactly they mean in real terms.

OK, I'll try to explain it as best I can, without causing more confusion.
The criteria for waiting times in relation to hospital treatment for upgraded hospital cover is as follows;  A waiting time is applied to a 
pre-existing condition only in respect of the higher benefits only.
So, if a person does not have a pre-existing condition,  there is no waiting time applied to the higher inpatient benefits.
If a person upgrades hospital cover and requires surgery for a new condition, this new condition will be covered straight away for all higher
benefits on the new plan.

That is the criteria that is used by all 4 providers.

However, on Jan 1 2012,  VHI brought in an extra waiting time for higher hospital benefits.
They apply a waiting time for any new conditions that arise in respect of the higher benefits.
This is the 26 weeks that they are talking about in your case. 

Details of this VHI waiting time is shown on HIA website, it doesn't apply to the other 3 providers.
Under the heading, 'Current Market Practice'  the first chart - waiting period for higher inpatient benefits when used for illnesses that develop
after the upgrade(Applied from date of upgrade).

www.hia.ie/consumer-information/waiting-periods/switching-upgrade-waiting-periods/



The amazing thing about it is, if you actually compare Plan B and Plan B Options, there is practically no difference in hospital cover at all. 
The only one difference is under Cardiac Procedures in Blackrock Clinic,Mater Private and Beacon;  B Options 100% covered; Plan B  90% cover.
Everthing else is identical so no waiting time applies to everything else.

www.hia.ie/ci/comparison/step3?68&67/

You would still have 90% cover while waiting 26 weeks.  
Also,  re cardiac cover in hi-tech hospitals - Blackrock Clinic and Mater Private are NOT collecting shortfalls such as a 10% like this or 20%
shortfalls for orthopaedic surgery for plans with 80% restriction - so it would be fully covered regardless.  

By saying that 26 week waiting times would apply if you switch and not explaining exactly what that actually means, causes worry and fear 
and could have a person thinking that no surgery would be covered for 6 months, which is completely untrue.
Conversations like this confuse people and they don't switch as a result.


So, regarding your question about moving to Laya for 1 year and returning to VHI the following year,  again if you compare B Options and 
Company Care Plus re hospital cover and pick out any extra benefits with laya as follows;

1.  Private Hospital semi private room;   extra 10% cover in Hermitage and Galway Clinic for special procedures(orthopaedic + cataract surgery)
2.  Private Hospital private room;  50 euro per night shortfall;  -  the shortfall with B options would be 300-400per night.
3.  Special Procedures in Blackrock Clinic, Mater Private and Beacon;  extra 10% cover 
4.  Lower shortfall of 175 per night,  shortfall with 55% cover is 260 per night with VHI.
5.  Convalescence cover 9euro extra per night.

www.hia.ie/ci/comparison/step3?68&198/

Switching to Company Care Plus;
If you have a pre-existing condition - a 2 year waiting period would apply to the pre-existing condition ONLY in respect of the above list of 
extra benefits only.  While waiting, your pre-existing condition would be covered under your existing hospital cover - Plan b options for the 
2 years.  So there is no loss of cover overall.

If you have no pre-existing condition,  any new conditions would be fully covered straight away including all the above list of extra benefits.

The following year if you switched back to Plan B Options,  you would actually be downgrading ie. losing the above list of extra benefits.
As you would be downgrading cover, no waiting time would apply.

Regarding your last query re Laya and quick payment of claims in Ireland,  to be honest I don't know the answer to that question.
I've only switched myself before Christmas so I've no personal experience of making a claim yet.

I hope my explanation above makes some sense and eases some of your concerns.

Snowyb


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## phoenix (16 Apr 2013)

Update -  just to let you know we went with Laya at our renewal.  Many thanks to snowyb for doing a lot of the initial leg work and pointing us in a direction we could finally make sense of.

Now here's hoping we won't need to use it!

Regards

Phoenix


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