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Saturday 28 January 2023 Dublin: 5°C
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Opinion Considering health insurance? The devil is in the detail.
We can’t be blamed for being confused about health insurance schemes, the market has undergone significant change in the last few years.

THE IRISH HEALTH insurance market has undergone significant change in the last few years. The market continues to contract with over 250,000 consumers cancelling their cover since 2008. However, there is potential good news for those consumers thinking of taking out cover once again.

Thankfully, we have now active competition with four health insurers, Vhi Healthcare, Laya Healthcare, Aviva Health and GloHealth in the market. Whilst they are launching new plans almost monthly, cost is king and they are being forced to trim back on benefits and hospital coverage in an effort to keep cover affordable. We now have plans with variable excesses, co-payments and hospital networks and two insurers are trying to empower their customers to ‘build’ or ‘tailor’ their own plan.

The devil is in the detail

This is good news for those looking for good quality cover at lower cost, but the devil is in the detail and consumers need to check their plan benefits to ensure they meet their requirements.

On the issue of hospital networks, Aviva Health were the first to market with their Focus products in July 2013. In return for a lower premium, consumers are covered for most public and private hospitals and take on co-payments for certain cardiac/orthopaedic procedures. Their First Focus plan is available now for €849 per adult which is good value.

Laya Healthcare followed suit and in January, they launched their Advantage and Flex products. These offer the option of reduced hospital cover and a choice of excesses (€125, €250, €500) in return for a lower premium, eg their Advantage 500 Explore covers public hospitals and a selection of private hospitals with a €500 excess on all private hospital admissions. This plan costs €658 per adult (plus 3% if you pay by direct debit). Sometimes, a further 10% discount can be obtained by buying online.

Laya have also added a ‘create your plan’ option to their website which is quick and simple to use. However, with these options you are allowing the insurer to decide which plan to offer you based on the data you enter. Our recommendation is to do your own research first and then tell the insurers which plans you want to review.

Vhi Healthcare have a number of ‘One Plan’ options in the market. Their One Plan 250 and One Plan 500 are attracting more interest as consumers chase lower cost. Both cover public and private hospitals and the €250/€500 excess applies to the first two private hospital claims in any one year per person insured. The One Plan 500 costs €689 per adult whilst the One Plan 250 is available from €807. There is also a One Plan 150 option if these excesses are too high.

When GloHealth entered the market in July 2012, they were the first to allow you customise your cover through their eight personalised packages. Their new suite of ‘Net’ products takes this customisation to the next level by allowing you to select various optional extras depending on your needs. For example, the Net Most 300 scheme covers most public and private hospitals and costs €760 per adult (€300 private hospital excess per admission). You can reduce this cost further to €660 if you opt for the €500 excess option (Net Most €500). You then have the option of adding on a private room, and/or high-tech cardiac cover to each of these plans at an additional cost. You can also add on cover for certain routine medical expenses such as GP or physiotherapy if you require this benefit. Whilst this gives the consumer more choice and control, we expect that most will be attracted to the core hospitals plans with the lowest cost.

Consumers need to shop around

So, are these plans good value and are they worth looking at? The answer is yes, but as always consumers need to shop around for the best offers. Start with how much you can afford to spend on cover, then decide which type of hospitals must be included on your plan. For example, you might be happy with good public hospital coverage and certain private hospitals close to where you live or work.

If you are planning a family and if private maternity cover is a key consideration, make sure this is included. Finally, consider any extras that might be important to you (GP, dental, consultants’ fees, travel cover) and establish what additional cost might apply to include these on the policy. With over 275 options on the market, there’s bound to be a plan to suit your personal requirements

In deciding whether to take out cover or not, many consumers forget that public treatment is not free even for those with no health cover. Unless you hold a medical card, you will be charged €75 per night (adults & children) to a maximum of €750 in any 12 months. Given that all plans cover this in full, they are definitely worthy of consideration. Another key point is that anyone can fall ill at anytime, irrespective of their age. Health insurance covers any accident, illness or injury and the premiums are community-rated which means there is no discrimination based on your age, gender or medical history.

If you’re putting off joining until universal health insurance (UHI) arrives, bear in mind that it will be 2019 at the earliest before this new system becomes a reality.

In summary, there is still excellent value cover on offer even after all the rate hikes. The key message is ‘shop around’ – chances are you’ll be pleasantly surprised at some of the options on the market.

Dermot Goode is General Manager of Cornmarket’s Healthcare Division &