Q We have been participating in the VHI Family Plan Plus Level 1 program for many years, but have heard that this plan is now withdrawn from the market. What alternatives would you suggest for a family of two adults and two children who are both under the age of 18 and all generally in good health? Maria, County Wicklow
A Family Plan Plus Level 1 is a good semi-private plan but since it has been on the market for some time it is quite expensive – at a price of â¬ 1,670 per adult and â¬ 535 per child.
You are correct that this plan will no longer be available as of your next renewal, which means you will have to look for alternative coverage.
I suggest you first consider the excellent semi-private business plan PMI 3613 which is also available from VHI and which will lower your costs to â¬ 1,405 per adult and â¬ 347 per child. It covers the same public hospitals as your current plan – up to a private room and it also covers the same standard private hospitals – up to semi-private accommodation. Like your existing plan, the PMI 3613 includes a small deductible of â¬ 75 per claim in a private hospital.
As the PMI 3613 is a comprehensive business plan, it includes guaranteed reimbursements for a range of eligible outpatient expenses such as GP, physiotherapy, consultant fees, and more, with no excess to pay first.
The Family Plan Plus Level 1 and PMI 3613 plans both include limited coverage at high-tech hospitals for certain approved procedures.
You will therefore still have the shortfall of 20pc on 22 orthopedic and ophthalmic procedures restricted in private hospitals on PMI 3613.
Health insurance options have been reduced by 20%
Q We have been insured with Laya Healthcare for many years under their Simply Health Plus program. While we are happy with the coverage, we find that we now have a 20% shortfall on a range of orthopedic and ophthalmic procedures that we are keen to avoid as we are both 70 years old. Can you recommend any alternatives that might be more suitable?
Paddy, County Clare
A While the Simply Health Plus at â¬ 1,328 per adult is still a great semi-private business plan, you’re right that the benefits of this plan have changed as of December 2020. That means a shortfall 20% gain now applies to 13 restricted procedures – but only when performed in private hospitals and the hospital in question does not exempt you from the shortfall. These procedures include hip, knee and shoulder replacements, but also some eye procedures such as cataract removal.
If you prefer full coverage for these procedures, I suggest you first consider the Laya Simply Connect program which costs â¬ 1,361 per adult. It covers the same public and private hospitals as your existing plan – and also has similar limited coverage for high-tech facilities. You will still have a private hospital deductible on your plan but it is slightly lower on the Laya Simply Connect scheme at â¬ 150 on the first two admissions each and â¬ 50 for each day case procedure.
You will still be able to claim 50% reimbursements on a range of eligible outpatient expenses under your existing plan, but the maximum claim payable will be reduced to â¬ 500 each.
If you’re concerned about this, you can also consider the next step, the Simply Connect Plus program (costing â¬ 1,471 each). Simply Connect Plus includes guaranteed reimbursements on outpatient expenses – up to â¬ 1,000 each. The main advantage of these alternatives is that you will keep your full coverage for these restricted procedures. However, whenever you consider a plan change, consider the upgrade rule, which means that any existing conditions will still be assessed as part of your previous plan for the next two years. Any new condition occurring after the entry into force of the new coverage will be assessed under the new regime.
Is our free travel coverage acceptable for short trips abroad?
Q We are insured with Irish Life Health as part of their 4D Health 2 business plan, which includes free travel insurance. Is this a good policy and is the travel coverage adequate for short stays abroad?
A The 4D Health 2 plan is an excellent semi-private business plan that currently costs $ 1,394 per adult.
Unique to this insurer, this plan includes two free personalized packages per member, one of which is a free travel insurance policy taken out by Allianz. The 4D Health 2 policy itself also includes emergency medical cover worth â¬ 100,000 abroad – up to a maximum of 31 days for travel.
While this plan combined with the free travel insurance policy provides good overall coverage, I still recommend that all aspects of your coverage be fully checked before any overseas travel. So, before traveling, you should first contact your health insurance and tell them exactly where you are going. the length of your trip; Give it details of any activities you might be involved in (such as sailing, hiking, etc.) and ask your insurer to explain exactly what is and is not covered. In particular, check your coverage for everything related to Covid and above all, have them explain exactly what the procedure is for recording any loss. You must then take exactly the same steps with your travel insurer to make sure you know exactly what coverage you have before your trip and, above all, that you know what measures to take in the event of illness or accident abroad causing a loss. Claim.
I think I might need help with my dental expenses
QI have good health insurance, but I have no coverage for major dental expenses. Can you suggest any alternative coverage that I should consider as I think I’m going to need some serious dental care over the next few years. Also, how long will I have to wait for the cover to snap into place?
Ciaran, County Donegal
A The cost of major dental treatment in Ireland can be prohibitive and many people don’t realize that no health insurance plan is covered for things like crowns, root canals, orthodontics, etc. The good news is that there are a number of insurers with separate dental plans that are worth considering.
VHI offers a small range of dental plans, but the main dental coverage provider in Ireland is DeCare Dental. The cost of these plans may vary depending on your age, but typically a high tier plan will cost around $ 370 to $ 400 per adult for the year. Wait times on these plans are lower than with private health insurance – so exams are covered immediately upon enrollment, basic treatments such as fillings and extractions are covered after three months, along with treatments more expensive such as crowns and root canals covered after 12 months.
The orthodontic benefit of these plans is limited and must always be verified beforehand with the insurer.
Another option is a health cash plan like HSF Health Plan. Although their plans offer capped benefits for a range of outpatient expenses, they allow you to include most dental expenses in their plans, subject to annual policy limits.