Private Health Insurance: Reviewing Your Plan
Dermot Goode
Dermot Goode

Dermot Goode is a leading expert on healthcare benefits in Ireland and Health Cover Analyst with Total Health Cover. We check in with Dermot to see where our focus should be on health cover and managing healthcare costs.

Having quality private health insurance cover in place has never been more important. The waiting lists for elective medical treatment are now at record levels and are increasing almost monthly. In the case of a hospital stay, for those with no health cover, using the public system will cost you up to €800 every 12 months (10 nights at €80), which applies to children and adults equally unless you hold a medical card. Unfortunately, the only way around this is to have private health cover or a lot of money on deposit.

This market is constantly changing and there are nearly 350 plans to choose from. New corporate plans are being launched almost monthly for the lucrative employer market but every consumer can access these plans if they wish. Even though rates have stabilised over the past year with some plans decreasing in cost, we estimate that at least two out of three members are still insured on the wrong plans. Unfortunately, too many consumers fail to review their options properly prior to the renewal date and they miss out on valuable cost savings.

Health insurance – is it necessary at all?
Health insurance is a discretionary purchase and many consumers are still happy to rely on the public system. Below are some of the points you need to consider when deciding whether you need to join or not;

  • All plans cover the public hospital charge of up to €800 per year
  • Most plans cover private treatment in all public and private hospitals such as Beacon Hospital, Hermitage Clinic and Whitfield Clinic
  • Private cover also enables you to select the consultant, ward type, and timing of your treatment depending on the plan held
  • Corporate plans give you guaranteed refunds on all your out-patient expenses such as GP, physiotherapy, routine dental, consultant fees and many more with no excess to pay first
  • Other benefits on most plans include maternity, emergency cover whilst abroad, psychiatric, MRI scans and convalescence to name a few.

If you are approaching 35 with no cover, you need to consider joining to avoid the new age-related loadings that were introduced from May 2015. For example, a 40 year joining for the first time will be liable for a 6 year loading at 2% per year (12%). The insurers have no discretion on this loading which must be applied to all policies and this applies for every year thereafter. If you have just moved or returned to Ireland, you may be able to avoid this loading completely if you take out cover within 9 months of moving.

So what are the essentials for quality health cover?
The ideal plan will cover you for both public and private hospitals to give you the best access possible in the event of an illness or accident. Don’t be afraid to take on a small excess which could reduce your costs by 10-20%. If you want cover for your everyday outpatient expenses, check out a good corporate plan which normally includes guaranteed refunds of approx. 50% with no excess to pay first. Finally, you should have cover for the major cardiac and day-case procedures that are specific to the likes of the Mater Private and Blackrock Clinic. These plans are available from all health insurers and typically cost between €1,100 – €1,250 per adult for semi-private cover or €1,350 – €1,600 for private room cover.

How do I know if I’m over-insured?
If you are on the same plan for two years or more and you haven’t considered a corporate plan for your individual, family or group scheme cover, then you are likely to be overpaying and should consider a full review of your cover prior to your next renewal date. If you have all the family on the same plan, then you are missing out on potential savings from splitting your cover into different plans. Finally, if you do not have a small excess on your plan; if you are not getting “young adult” rates for your 18-24 year old dependents; or if you’re not getting guaranteed refunds on your outpatient expenses, then a comprehensive review is long overdue.

The savings may be well worth it!

All prices quoted are net of tax relief at source and are correct as of 01/9/18 as per (Health Insurance Authority). However, prices and benefits are subject to change and consumers should confirm all details directly with the insurer in question. Any comparisons are for information only and should not be considered exact equivalents to the plan held. Before changing plan or provider, please refer to the policy terms and conditions and check everything with the health insurer before switching cover.

PHI Consulting (Ireland) Ltd trading as Total Health Cover is regulated by the Central Bank of Ireland.

Please note this article represents the views of the author and is not intended to and does not constitute personal recommendations/investment advice nor does it provide the sole basis for any evaluation of products or services discussed.

To speak with a Portfolio Manager or your Account Executive today, please phone the Cantor Fitzgerald dealing desk on 01 633 3633.