Claiming for surgery after switching insurance provider?

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toby2111

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Snowyb-Need your advice!!(And anyone else who knows!)

I'm due for surgery(total hip replacement) in September in SSC Santry.My insurance is due for renewal 1st August,I'm with Laya on their Aspire scheme,got 3 months free last year but now its over €1100 so dont fancy paying that.I'll have served my 2 year upgrade waiting period by then,was on Avivas Business Plan Select Plus before Laya.
I rang VHI and GloHealth,they said I'll be covered if I take out similar policy but I have to pay €2000 co-payment and €125 excess which I'm prepared to pay.Might switch to GloHealth Better Plan,but will they pay roughly €8000(€10k-my €2k) for my surgery even though I'll only be their customer for less than 2 months?Basically,is there a hidden catch/clause somewere that I'm not being told about?
 
Hello toby2111,

There are no hidden catches, your thinking is correct. Whatever company you decide to renew with, they will pay for your surgery - even
if its a new company and you're only 2 months with them.
In fact if your renewal date was also the date of your surgery - ie 1 day with the new company,
the new company would pay for surgery. Its just the way it works.
Best of luck in September.

Snowyb
 
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As far as I understand when you change Health insurance cover the New Agency must cover you as the old company has,

provided you have not increased your level of cover.
 
Hi toby2111,

Good news! Further to your query yesterday regarding impending hip surgery in September 2013, I did a bit of fact finding
with the Health Insurance Authority and came up trumps.

I was reading back over old posts over the past few years relating to your health insurance queries and it shows that you were
with Aviva from 1 August 2011 to 31 July 2012 - Business Plan Select Plus.
When Aviva first brought out this co-payment of 2000, it only applied from 1 Jan 2012 onwards. It did not apply to your policy as you
already renewed 1 August 2011. I confirmed this information with the HIA.

Then you changed to Laya Aspire plan from 1 Aug 2012 to 31 July 2013, which also doesn't have any co-payments for hip surgery.

So, the good news is if you stay with Laya Healthcare from 1 August 2013 to 31 July 2014, you will NOT have to pay the 2000 co payment as
Laya don't have co-payments for orthopaedic surgery. The only amount payable will be 125 excess.

There are a few different plans with Laya worth considering, but you still have a full month to choose and decide.
They have an offer on at the moment with 2 months free on Health Smart plan.
Also if you wanted to go for a plan with good outpatient cover for any follow-on consultant visits,physio etc Total Health Choice or
Simply Health Excess are well worth considering. 50% refund for any visits with no waiting time for claiming outpatient expenses.

Details as follows;
www.hia.ie/ci/comparison/step3?294&323&279/


There is also going to be a release of new plans from Laya soon in competition with Aviva's recent announcement of new plans with restricted
list of hospitals etc.. The new plans may or may NOT suit your current situation, especially if they introduce co payments for hip surgery.
However, there may be something suitable for your six month old at a good price. Not sure when they are due on the market, hopefully before
August 2013.

So, if you choose a plan with Laya from 1 August 2013 to 31 July 2014 with no co-payment for orthopaedic surgery, you'll save yourself 2000.

If you have any further questions or need help with deciding on a plan when the time comes, fire away, no problem.

Regards Snowyb:)
 
Snowyb,you are a legend!!Thank you so much for your great work,do you work in health insurance industry?Your knowledge is astounding!

Yes,I'll wait and see what comes up in the next few weeks before I make a decision.Even if new plans are released 1st August,am I right in thinking I've got 14 days cooling off period-so I could still switch to a different Laya plan within first 2 weeks of August?

Have Laya any decent baby plans at the moment?Some friends of mine say its a waste of time putting newborns and infants on health insurance policies,whats your opinion?
 
Yes you're right about the extra 14 days cooling off time after 1st August 2013 to change your mind if you wish.

A basic plan covering public hospitals is enough for kids, as there are no private children's hospitals in Ireland. Laya's cheapest plan for children at present is Essential Secure price 200pa.

www.hia.ie/ci/comparison/step3?299/

However, it will be interesting to see what the new Laya plans are like, pricewise for children.

It's a personal choice, whether to take out health insurance for children. I suppose its the security of knowing if a bed for surgery is required, it bypasses long waiting lists - 2 years etc for different operations. People would really only appreciate the value of having it, if they had to use it(touch wood). Then the reality would fully kick in.

When the new state of the art children's hospital in St James Hospital is eventually built, children's health insurance will hopefully become a thing of the past.

As another option, if your other half also has health insurance, she could switch to Glohealth Better Plan at renewal date and include the baby for free until age 3, while you stay with Laya. If not, Laya for the baby would be the
only option.

Finally, no I don't work in the health insurance industry, I've no connections whatsoever. I'd probably end up being sacked for giving out too many money saving tips. LOL.

Regards, Snowyb
 
snowyb said:
I'd probably end up being sacked for giving out too many money saving tips. LOL.
Click to expand...

Thats for sure!!You've certainly saved numerous people lots of money on this forum so I personally want to thank you for your trojan work on our behalf,its really appreciated.

My wifes insurance is also up on 1st August,she likes to be able to claim for GP expenses etc but I dont see the point in shelling out an extra €200 odd for a policy to claim back 3 or 4 visits to a GP( getting €100 back).I dont think theres any special family policies out there,is there?

Anyway,we'll prob select 2 of the policies you have listed above.I might go with Laya,she might go with GloHealth.We'll continue to watch this and other forums you post and hopefully companies will release new,good value plans soon.Thanks again,keep up the good work snowyb!
 
Just to update you on the latest position re choosing plans etc.

Firstly, the offer on Health Smart plan will end on 31 July 2013, its also going up in price, so thats a non runner.

The good news is that Laya announced 2 new plans today, starting on 1st August 2013;

1. Simply Health Connect; price 960per adult; good hospital cover + good outpatient cover 50% refund for gp, consultants etc.
(highly recommended for you)

2. Health Sense Connect; price per adult 920pa; good hospital cover, not so good outpatient cover, high outpatient excess 220.

www.hia.ie/latest-news/latest-news/...nnect-and-health-sense-connect-on-01.08.2013/


Another new plan announced today is with Glohealth called 'Better Plan Excess Cash' also starting on 1st August 2013.
This plan has good hospital cover( but with a 2000 co payment for orthopaedic surgery so this is NOT suitable for you).
It also includes good outpatient cover with a 50 euro excess per person.
Price per adult is 999pa and kids are free upto age 3 yrs. This would be recommended for your wife and baby( if the 50 outpatient excess is ok).

www.hia.ie/latest-news/latest-news/glohealth-launch-new-plan-better-plan-excess-cash-01.08.2013/


The full detailed information about these plans will not become available on HIA.ie until 1st August 2013, they have a limited amount of info
available now, which is not that helpful when you need to know in advance to make a fully informed decision.
However, a few phone calls and emails should sort that out. I'll be checking these out for some family members so I'll update again when I
know more info.

Its still early days and there may be more announcements in the coming weeks.

Also, just to confirm, you MUST renew with Laya to avoid the 2000 co payment.
Your wife + baby have the option of Glohealth or Laya or any other provider.
What plan is she on at the moment?

Regards, Snowyb
 
Hi snowyb-
She's on Simply Health(excess) at the moment with a renewal date of 1st August also.
I saw that new Laya plan on hia website last night,looks to be the one for me...and her!Can we then switch our son to that other laya policy you recommended above?
Also can we wait until 1st August to choose our new plan or do we have to choose before the renewal date?

Edit-Theres a Laya price change coming into effect 1st August-
[broken link removed]

I see the Family Care plan for a child is dropping to €212 and has great outpatient benefits with €1 excess.If I take out a new Laya policy,can I put my son on this new Family Care plan?
 
Hi toby2111,

You don't have to choose before renewal date, you can wait until 1st Aug '13
to decide.

The 'Family Care' option for your son is a good bargain including the outpatient cover. You can certainly choose this for your son, kids can be on a different plan to their parents, with the same company.

Unless Laya's release of basic plans comes up with something better, this is probably best value for kids at the moment.

Laya will not have full details of Simply Health Connect plan until nearer to release date 1/8/2013.

Snowyb
 
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Great,I'll keep an eye on the hia website.In the meantime if anything else pops up,feel free to post here.I'll have to make the big decision on 1st August so I'll run my decision by you before......if thats OK with you of course!
 
That's no problem at all, its just a case of wait and see 'til then.

Regards, Snowyb
 
Hi toby2111,

Just to update you on the latest position regarding new Laya plans on offer since July 2013.

Their new plan called 'Connectcare' released today 9/8/2013, is well worth considering and is highly recommended for both yourself and your wife.

Prices in brackets includes 3% charge if you pay by instalments.

Details as follows;
Connectcare; price per adult 990(1017)pa - good hospital cover, lower private and hi-tech hospital excess, good outpatient cover 50% refund, 1euro excess.

www.hia.ie/ci/comparison/step3?351/

Note; Even though the excess for a private hospital on this plan is only 50euro, you will be charged 125 on admission to Santry Clinic for your surgery in September, because its a pre-existing condition. This figure of 125 is on your current plan Aspire.

The 50euro excess would apply to both of you in future if you are admitted for any new illnesses.


The children's plan 'Family Care' is still the best on offer with good hospital cover and good outpatient cover, 50% refund.

www.hia.ie/ci/comparison/step3?50/

Overall Family Price

2 adults x 1017 = 2034
1 child = 218
Total = 2252pa

You have upto next Wed 14 August 2013 to renew your plan.

All the best in September,
Snowyb:)
 
Thanks so much snowyb.I'll be changing over to that Connectcare plan tomorrow and will put my son on that Family Care plan.Keep up the good work!
 
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