Healthcare costs - not insurance Orthopaedic & Ophthalmic Procedures: 20% shortfall

F

fred123456

Registered User
Messages
55
Hi All,

Thinking of switching to level health insurance plan c and maybe day to day, cost is 3,315 for two adults (50)+ 1 student (19) + 1 child and 3864 with day to day. Now Plan c comes with a 2000 euro co payment on orthopaedic procedures which i think i will have to accept as family insurance is becoming outrageous - rant over.

I am currently with laya on precision connect 150 for my self and my wife and my two kids are on signify plus, (has family excess of 450 on day to day - annoying when i went to claim back money). I always kept the orthopaedic full cover as i thought as me and my wife get older its always the knees or hips that start to go first.

Overall i cant afford these plans but somehow i am managing to keep them going, health insurance is becoming such a huge cost to families now.

Anyway back to my question does anyone know what 20% shortfall is. For instance could we say in the beacon a hip replacement is 10,000 euro on average and its 20% of that fee, or in blackrock its 5,000 for a knee replacement and its 20% of that fee. I know its hard to make that call, but if we had an average stay and average operation cost it would make it easier. I would like to be able to compare each plan and consider what 20% means, maybe it could be better to take another plan, its just so confusing leaving it open ended at 20%. I am thinking just make the move to level health plan c and take the chance with orthopaedic cover.

Kind Regards
Fergal.
 
It's very hard to know, I'd prefer the set 2k co payment than a percentage amount. I rang VHI last week and they have a couple of different percentages, example she gave me was on one of them I would pay 8k extra and on the other 10k for hip op, now that's a bad deal no matter what way you look at it!

I know my father's hip op maybe 15 yrs ago cost his insurer 40k, it had to be done twice and reading through the small print on the co payment plans it seems they would have treated that as 2 separate procedures and been subject to the excess on both.
 
There was an earlier thread on this, which may be useful, however information may have been superseded:

Health Insurance - 20% shortfall on specified orthopaedic procedures.

How much are these shortfalls costing the insured person. Are we talking several thousand euro here? If a hip replacement cost for argument sake €30,000, it means the patient must fork out 20% of the cost, a total of €6000. It's a huge cost down on top of any other excesses the patient has to...
www.askaboutmoney.com
 

Health Insurance - Shortfalls in Orthopaedic & Ophthalmic Procedures.

I have received my Laya Simplicity quote, up from €1665 to €2003. Ouch. I've looked at alternatives and see that Optimum Premium is cheaper and has better day to day cover. It also has a 20% shortfall for the above procedures where Simplicity has none. It has been mentioned here in the past...
www.askaboutmoney.com

This is a thread I started a few months back. Note in particular post 18 which may answer some of your questions.
 
Last edited:
Thanks All, at least with level health it stays at 2,000 euro. I think i will just make the switch.
Everyone is giving out about car insurance, if you ask me health insurance is an absolute mess and going to get worse. Where will it end, family health insurance being more costly than your mortgage.
 
Not sure if it helps your situation but until now I had the Laya Advantage 500 Explore plan (just myself, no family), and this year it covered my hip replacement operation in full (€12,000). The cost of the plan for me was around €1,000p.a., going up to €1,200 next year. I'm thinking of sticking with that plan, because of the Level Health co-payment of €2,000 for such a procedure.

I mentioned it already in this thread:

Health Insurance - New Health Insurance provider launches

Just had another look and Simply Connect Plus is attractive too. I especially like the 50% refund of dental fees. This sentence jumped out at me while reading up as must renew this week. Anyway I had SCP this year and was very disappointed with the dental bit, I had an expensive appointment...
www.askaboutmoney.com
 
You must log in or register to reply here.
Back
Top