# VHI Plan A (Options) vs. BUPA HealthManager Starter...?



## Dr Moriarty (18 May 2004)

Evening all,

Just coming up to my annual renewal date, and a cursory read of the respective details suggests that I would get rather more for a bit less if I were to abandon my VHI Plan A (Options) policy in favour of BUPA's HealthManager Starter scheme. Anyone care to confirm or contradict me?

I'd need a family membership — me (40), the missus (21+) and five kids aged 5-15. I'm in secure public sector employment, so don't need much by way of PHI, etc. — my pension scheme and Income Continuance plan, thankfully, mean we'd be reasonably well looked after in a (second-)worst-case scenario, i.e. if I were 'disenabled' from working, long term (as a matter of fact, the prospect appeals to me more & more, as the years pass...  _Joke!_)

We live in Limerick City, not far from all the major hospitals — all public, so either of the above schemes covers private accommodation. We haven't had the makings of a claim in years — thank God! — and I can't foresee too many future occasions where we'd need to use any of the main private hospitals. The likelihood of needing maternity cover has been rendered, well, surgically implausible...   Kids are all in school, with good accident insurance to cover sporting injuries, etc, and are in disgustingly robust health generally. My main health outlay every year is in common-or-garden GP visits and the consequent prescription costs, and with my VHI plan I have to 'top' an excess of €480 a year before it becomes worthwhile submitting a claim. Said VHI are now quoting me a renewal premium of €1,077.60 (Plan A Options, net of 10% Group discount), whereas BUPA will do me for a shade under a grand, depending on whether I go for the HealthManager Starter or the Essentials Plus package. And I can reclaim GP fees with a much lower excess...

Am I missing something, or is this a 'no-brainer'...?

Thanks in advance

Dr. (of Philosophy) Moriarty


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## Moneybags (20 May 2004)

The [broken link removed] has produced a useful table that allows easy comparison between the different plans. 

The one thing I'd question is whether you need insurance for GP visits, prescription drugs and other out-patient costs? All of these expenses can be written off against tax at the top 42% rate, although most people don't bother claiming for them. You mention that these bills are of the common-or-garden variety so why bother to insure for them? Let the taxman pay instead.


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## rainyday (20 May 2004)

> I can't foresee too many future occasions where we'd need to use any of the main private hospitals.


This is the nub of the issue. We don't buy car insurance because we expect to have a crash. You don't get the opportunity to plan for major illness - if it happens, you need to be ready & waiting when it strikes.


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## Dr Moriarty (24 May 2004)

Thanks for that link, Moneybags — and I take your point, except I wouldn't call it "letting the taxman pay" — more like clawing back some of the taxes _I_ pay..! :| 

And yes, rainyday, I know that health insurance — like any insurance — is all about insuring against a risk. It's just that I've been suitably responsible and careful about this particular risk to the tune of several thousand euro over the past 15-20 years and — thank God! — it's been largely wasted expenditure. I'm not talking about doing without private health insurance (for me and my 6 dependants) — just seeking to compare two rival products. That €1,000-odd a year I pay is _net_ of tax relief...


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## Guest (26 May 2004)

> it's been largely wasted expenditure.

I don't think that you can judge insurance premiums to have been wasted expenditure just because the need to make a claim did not arise...


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## johnotoole (28 May 2004)

Dr. Moriarty,

We started our policy recently (2 adults) with VHI. At the time, I did some comparisons  between VHI and BUPA. I came to the conclusion that the policies were essentially very very similar, with BUPA marginally cheaper on price. The revenue guide seems to say the same (as I read it anyway), but with a few tables and charts thrown in.

So why sign up with VHI? Well there are reports of VHI having a generally older and less healthy customer base, with associated higher costs - VHI claim that this has increased their costs, which they need to recoup through higher premia. BUPA of course claim that the higher premia are being swallowed up by inefficient VHI management etc. The risk equalisation scheme was discussed where BUPA would pay VHI in effect to subsidise their additional treatment costs. To the best of my knowledge, this scheme was not implemented, but maybe someone else can confirm this?

My view is that health insurance and costs should be spread equally across all members of the population, young and old. I don't think that we should be creating a market where lower costs are being applied to younger or lower risk customers. Both being under 30, myself and my partner have paid the price for car insurance due to our "high risk" categorisation, and I am loathe to support similar market developments in health insurance. Like you, neither of us would envisage needing treatment in short term, and we would prefer to see our tax-deducted funding going to help the old folks in VHI! 

JOT


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## DR (13 Jul 2004)

*Plans*

Tax rebates for medical expenses are only for those above a certain excess ?

You could also consider HSF;
[broken link removed]

or HSA;
[broken link removed]

These are cash-plans which payout for a range of out-patient treatments such as GP visits, prescriptions, consultant visits.

You would still need at least basic cover for hospital in-patient treatment from VHI or BUPA.


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## mollser (13 Jul 2004)

*Re: Plans*

The outpatient cover under the healthmanager starter Bupa scheme is fantastic - they refund half of all your medical expenses (docters etc), with no excess and no quibles. The balance not refunded can then be claimed back from the tax relief scheme.

I've recently had to sign up again to health insurance, and it certainly seemed to me a no-brainer to go with this particular bupa policy, for the outpatient expenses as described above.


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## OhPinchy (15 Jul 2004)

*cover while abroad*

yeh, I agree that its a no brainer between BUPA Health manager and VHI...the outpatient cover is fantastic.

However, I went for the full Health Manager as I don't believe that Starter covers you when abroad (pretty sure I saw this in some comparison matrix).


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## halenhearty (21 Jul 2004)

*important questions*

I'm interested in this comparision too because I need to take out health insurance for the first time.

Given that there's a 6 month waiting period for most services, is it cost effective to choose the lowest cover for the first year, then upgrade on renewal?

Also, can someone point out whether men and women pay the same rates?  Are men automatically covered for maternity costs?  Equally, can a woman choose to opt out of maternity cover?


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## Guest (21 Jul 2004)

*important questions*

> Also, can someone point out whether men and women pay the same rates? 

With VHI and BUPA yes. Not sure about other alternative or complementary plans (e.g. Hospital Saturday Fund etc.).

> Are men automatically covered for maternity costs? 

Er, why would men be covered for maternity costs!?

> Equally, can a woman choose to opt out of maternity cover?

Not as far as I know although different plans have different levels of cover.


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## sol (21 Jul 2004)

*...*

It mightnt concern anyone posting here but i dont think BUPA cover patients in St John of Gods hospital.


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## terrysgirl33 (21 Jul 2004)

*maternity*

Interesting debate.  All women are entitled to free maternity care (though obviously it's public), so you have the option not to use you insurance for maternity.


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## halenhearty (21 Jul 2004)

*a la carte cover*

Motor insurance offers different options of cover e.g. 3rd party fire & theft, comprehensive, additional driver, driving abroad, etc and the buyer can pick and choose what level of cover they want and the premium is calculated accordingly.

My query about whether men pay the same premium as women do yet patently cannot avail of the materity cover offered, was to do with the ability to choose what cover one requires.  Similarily, some women do not require maternity cover (e.g. unable to concieve, sexual preference, post menopause.)  
In other words, when paying their premiums, it would appear that men and women in the categories amentioned above are subsidising maternity cover for women health cover clients.  

Thanks for the useful information Terry'sgirl.  I did not know that.  

Back to first time health cover buyer - basic plan or not?


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## Guest (21 Jul 2004)

*maternity*

> All women are entitled to free maternity care (though obviously it's public), so you have the option not to use you insurance for maternity.

All individuals are entitled to free public hospital care (bar some capped accommodation expenses) generally so private health insurance is not necessarily a nor brainer. 



Of course for elective procedures where you want to skip the waiting lists and/or where the risk factors suggest that you may need such cover then it may be.


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## Tommy (21 Jul 2004)

*Re: maternity*

Hi Dr Moriarty

I have edited your posts above to remove your vipersig icons. Please don't use them in future as they cause concern to some AAM users. 

The content of your posts remains otherwise totally intact.


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## terrysgirl33 (21 Jul 2004)

*comunity rating*

Well, I think you're into the land of community rating.  If you want to charge women extra based on maternity cover, then surely you need a different rate for men as they are susceptible to different diseases?  Older people will need more expensive healthcare, so they obviously need to pay higher premiums.  Where does it end?


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## rainyday (22 Jul 2004)

*Re: comunity rating*

Any good reason why VHI/BUPA shouldn't charge more to smokers?


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## Dr Moriarty (10 Aug 2004)

*Re: comunity rating*

Evening all,

Just checking up on this post after a long interval (the "e-mail notification of replies" function doesn't seem to be working for me...(?)

At the time of writing, I'm still with the VHI plan — largely out of pure inertia, plus a sense that the difference in premiums/cover is not so great as to keep me awake at night! — but I think I'll probably move, once the nice lady that looks after our group scheme returns from holidays.

And in reply to a couple of previous posts —
(a) Yes, I consider those premiums "wasted", in the sense that they've amounted over the years to far more than I've actually expended on healthcare (or caused to be expended) and — if I'd invested the same money some other way — I'd have enough now to splash out on at least a major cat-scan/prolonged hospital stay or two...

OK, I'm joking, at some level — but I do believe there is such a thing as being over-insured. At a "philosophical" level, I also believe — while continuing to fork out their premiums — that the whole life/health insurance industry is ultimately predicated upon fear. That old reliable...

(b) rainyday, the vipersig is gone — sorry for any unintended concern caused ('though users of bulletin boards — even "anonymous" ones — really shouldn't forget how "un-anonymous" their postings actually are..!)

And yes, VHI & BUPA really shouldn't charge more to smokers, unless they also intend to screen members for a whole host of other risks (again at a "philosophical" level...  _"Estimate your weekly/monthly cholesterol intake / rate of exercise / propensity to walk/cycle to work, etc...."_)


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