Consumer Watch: health insurance season

Health insurance season is upon us. Over 2.3 million people in Ireland (46% of the population) have private health insurance and between the months of December and February, one million people renew their policy.

In January alone, half a million people sign up again. So is it time for you to spring clean your finances?

Even if your health insurance was up for renewal earlier this month, you still have time to shop around.

That’s because every health insurance policy in the country has a 14-day cooling-off period in which you can change your mind.

It doesn’t matter if you already paid your premium. You can shop around and if you change providers, you will get a refund or if you stick with the same provider but find a better deal then you will get your premium reduced.

Even if you are outside the 14-day policy, you still have options. Laya and Irish Life Health both allow you to change your policy throughout the year. You won’t be able to switch providers but you will be able to switch to another of their policies. Unfortunately, though, Vhi does not offer this leniency.

So what’s the best deal out there? As consumer editor, I get asked this question all the time. And I’m going to tell you what the very best policy is... it’s the one that suits your age and medical needs as well as your budget.

If you’re someone in your 20s or 30s, perhaps thinking about taking out a health insurance policy for the first time, then you’re probably in good health and the over-riding factor when choosing a policy is price.

Dermot Goode from Total Health Cover is an expert on the different policies. He says: “Many young people who are just starting out want a fairly basic package to cover them for hospital stays. A lot of people think staying in a public hospital is free but it’s not, unless you are on a medical card. It costs €80 a night to a maximum of €800 per year but your health insurance policy will cover it.”

Another major factor to bear in mind, if you are starting out on your health insurance journey is your age. In 2015, lifetime community rating (LCR) was introduced which means there is a 2% loading every year for people who are over 34 years old and don’t have health insurance.

What does that mean? If you decide to wait until you are in your 40s to take out health insurance, you are going to be hit with a penalty.

For example, if you take out health insurance at 44, you’ll have 10 years of that 2% loading which amounts to 20%. So whatever policy you then take out will cost an extra 20%, and this penalty stays in place for 10 years. So even taking out an entry level policy will put you in the health insurance game.”

Some good entry level policies on the market at the moment include:

As people move into their 30s and 40s and start to have families, their health insurance policy needs start to change. There may be more trips to the GP or a sports injury may mean you need to see a consultant or physio regularly. Mid-level policies allow you to claim back on these everyday expenses.

Dermot says: “When you are taking out health insurance for your family, tailor each policy for each member of your family.

“One of the big mistakes that I see is people putting the kids on a better policy than themselves. Unless there is a specific medical reason for this, it’s the wrong approach. The parents are older and therefore, more of a risk in terms of health needs. But do have a think about the health of the child. We’d often have people say, ‘Our kids are healthy.’ But when you dig deeper, they might tell you, ‘The oldest has childhood asthma and we were in the GP 12 times last year’. She has just turned seven which means she no longer has free GP care so a package that covers everyday expenses would work better for her. Then the younger child (four) may have no health issues and gets free GP anyway so they would be on a more basic package.”

The following are good policies for two adults and two children:

Vhi

Laya

- Put Mom, Dad and first child on this plan as Laya have free cover for second child under 14.

Irish Life Health

As we move into our 50s, 60s, 70s and beyond, our health needs may become even more complex.

Dermot says: “When getting a quote, tell the insurance company everything. People think they shouldn’t tell them about their bad hip or heart condition because they’ll be penalised. That’s not true, the policy price is the policy price.

“It’s up to you which one you take out but you want to get the one that gives you the best cover for your individual health needs.

“Another myth is people think that if they claim on their health insurance, ie putting through receipts for GPs, or consultants they will be penalised the following year. Again, this isn’t true, it’s not like car insurance.

“It is the same price whether you put through receipts for one trip to the GP or 10 (some policies offer money back on more or less) so claim back everything you can.

“Another thing older people need to be aware of is that on many mid-level policies there is a 20% shortfall on certain procedures, that generally affect people more as they age.

“These include hip replacements, knee replacements, shoulder replacements and cataract removal. If for example, the hip is starting to give you trouble and you think a surgery may be down the line in a few years, it is worth moving from a mid-level plan to a high level plan (there is a waiting period for pre-existing conditions).

“Otherwise, if you have to have the surgery and you are still on a mid-level plan that doesn’t cover these procedures, you could be looking at forking out €2,000 to €3,000 yourself.”

Some good-value policies for seniors include: