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Money Times - April 14, 2015

Posted by Jill Kerby on April 14 2015 @ 09:00

NO HEALTH INSURANCE? OVER 34? TIME IS RUNNING OUT

With just two weeks to go before the deadline for the introduction of Lifetime Community Rating, anyone who is 35 or over needs to decide soon whether it is in their long term interests to buy health insurance now, or accept a permanent cost ‘loading’.

After April 30th, if you are uninsured and over age 34, you will have to pay an additional 2% premium loading for every year you are over 34 for any health insurance you may purchase in the future.

Work the numbers yourself: a 38 year old who misses the deadline will pay an additional 8% (4 years x 2%) and a 50 year old will pay 32% more. If a health plan normally costs €1,000 their respective bills will be €1,080 and €1,320.

The health insurers, who have lost 300,000 customers since 2008, have been galvanised by the change to Community Rating, which up to now, let us all pay the some price for the same plan, regardless of our age or health. They are all now offering very low cost ‘entry’ plans for as little as €409 a year (with GloHealth). Low family rates are also available.

Many question whether they are worth it, even at this price.

The specialist healthcare broker, Dermot Goode of TotalHealthCare.ie partly agrees. The low cost plans do not cover all public hospitals; they require bills to be paid directly by the patient who must claim the amount back from the insurer and there are very limited outpatient benefits, including jumping the queue to see a consultant.  

“However, the low price membership (by April 30) does avoid the risk of lifetime loading, and the €75 a night public hospital charge (up to €750 for any 12 month period) that is payable by everyone except medical card holders.”

For higher benefits, says Goode, “you need to consider buying a more expensive, plan, usually costing at least €800 or €900 a year (€15.38-€17.31 per week). Not only will you access consultants and treatment faster, but in private as well as public hospitals.”

For under 34’s, in particular, these entry level policies are ‘good’ value in that this age group make very few claims regardless of the cost of their insurance. But even they need to understand that all health insurance plans impose waiting times for new members.

If you are under age 55, you cannot make any claim in the first 26 weeks of membership except for an accident or injury. Claims for pre-existing conditions cannot be made for five years. If you are aged 55-59, or 60-64, those initial waiting times rise to 52 weeks and for pre-existing conditions 7 years and 10 years respectively. If you are 65 or over, and a new member, those waiting time rise are 52 weeks and 10 years, respectively.

All new health conditions will be treated and benefits paid once you complete your initial “joining” waiting period is completed.

But Dermot Goode warns that if you remain on one of the low cost entry plans after your initial waiting period is over – assuming you have no pre-existing condition - and you then develop a serious medical condition, your plan may not pay for quick access to a consultant or allow you to be treated in anything but a public hospital. Even if you were willing to upgrade to a more expensive plan, the pre-existing waiting time (at least 5 years) will apply all over again.

He suggests that older people joining before April 30th buy the best plan you can afford. Even if you are healthy now, medical issues arise more frequently from your mid-40s onwards.

A week before Easter my husband had a medical emergency – his first ever - that landed him in St James’s A & E. Hours later, still waiting and getting sicker from a virulent infection diagnosed by the out-of-hours GP that Saturday morning, at 3.30pm I contacted the emergency A&E at the Blackrock Clinic. They told me bring him in ASAP (private hospital A&E’s keep ‘business’ hours only.)

Within 45 minutes two A&E nurses and the A&E consultant had seen him. Blood tests were ordered. An hour and a half later he was receiving a blast of intravenous antibiotics. He was sent home with more antibiotics but by Wednesday, he was still unwell and was admitted, treated and tested in a private en-suite room at the Blackrock until he was well enough to go home on Easter Monday.

The cost? €140 for A&E, €120 for the A&E blood test and a €200 excess payment for access to a ‘high tech’ hospital.

His Laya Healthcare policy costs less than €25 a week. It will pay €110 of the A&E costs. The €350 balance, not covered by Laya, qualifies for 20% tax relief. 

Our share of the final bill – which ran into many thousands - for seven days treatment and five nights in the finest private hospital in the country… will be €280. 

Buy health insurance.

If you have a personal finance question for Jill, please email her at jill@jillkerby.ie or write to her c/o this paper.

 

 

 

 

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