Health Care for a single person

enfant terrible

Would this be a good plan for a single person in their mid twenties?

Is it missing anything vital?

http://www.avivahealth.ie/__uuid/2ea62262-6269-4de3-8eb1-ed1da91e318e/

"Consultant fees:

Covered for 50% of the cost set out in our schedule of benefits for professional fees"

Is this the main reason its cheaper than other plans?

"G.P visits Up to €30 per visit x 25 visits"

Does this mean you can go to your G.P 25 times per year?

"75% cover in a semi-private room in a private hospital."

Does this mean you need to pay the remaining 25% yourself if you have to go to a private hospital?

coylemj

enfant terrible wrote: »

"Consultant fees:

Covered for 50% of the cost set out in our schedule of benefits for professional fees"

Is this the main reason its cheaper than other plans?

Probably, you could be seriously exposed in terms of fees if you needed some serious work from a consultant and the likelihood is that you'd have to cough up the cash before you got the services. The whole point for most people of being in the VHI is that your GP can refer you to a consultant for run of the mill stuff like a knee operation and all of his/her fees will be covered. If you don't have this cover and you want to be referred to a consultant in his private practice i.e. you don't want to join the public queue then you will need to have 100% cover for professional fees or a very good overdraft facility on your bank account.

Also note that the cover is not 50% of what the consultant wants, it's 50% of the cost set out in our schedule of benefits meaning that if the consultant wants 750 but the insurance company says that 500 is a fair fee for the service, they will only pay you 250 (50% of the fee in their schedule) so you could be exposed even more.

enfant terrible wrote: »

"G.P visits Up to €30 per visit x 25 visits"

Does this mean you can go to your G.P 25 times per year?

Yes, after 25 visits you get no reimbursement.

enfant terrible wrote: »

"75% cover in a semi-private room in a private hospital."

Does this mean you need to pay the remaining 25% yourself if you have to go to a private hospital?

Yes. Most private hospitals that I've seen don't actually have anything less than semi-private i.e. they don't have what are called public wards with a large number of beds so this clause in the plan effectively means that if you go into a private hospital you will have to pay at least 25%, more if you end up in a private room.

One more thing to watch out for: If you jump ship from, say VHI to Aviva, the new crowd have to give you immediate cover with no break for basic cover (fees and hospital bed) but there is a sneaky clause that VHI falls back on which is that for a period of time (usually 6 months) after you sign up for extra services you can't claim any of the extra benefits i.e. they take your money for an extra layer of cover but for the first six months you can't actually claim for these services. Check the small print!

enfant terrible

coylemj wrote: »

Probably, you could be seriously exposed in terms of fees if you needed some serious work from a consultant and the likelihood is that you'd have to cough up the cash before you got the services. The whole point for most people of being in the VHI is that your GP can refer you to a consultant for run of the mill stuff like a knee operation and all of his/her fees will be covered. If you don't have this cover and you want to be referred to a consultant in his private practice i.e. you don't want to join the public queue then you will need to have 100% cover for professional fees or a very good overdraft facility on your bank account.

Also note that the cover is not 50% of what the consultant wants, it's 50% of the cost set out in our schedule of benefits meaning that if the consultant wants 750 but the insurance company says that 500 is a fair fee for the service, they will only pay you 250 (50% of the fee in their schedule) so you could be exposed even more.



Yes, after 25 visits you get no reimbursement.



Yes. Most private hospitals that I've seen don't actually have anything less than semi-private i.e. they don't have what are called public wards with a large number of beds so this clause in the plan effectively means that if you go into a private hospital you will have to pay at least 25%, more if you end up in a private room.

One more thing to watch out for: If you jump ship from, say VHI to Aviva, the new crowd have to give you immediate cover with no break for basic cover (fees and hospital bed) but there is a sneaky clause that VHI falls back on which is that for a period of time (usually 6 months) after you sign up for extra services you can't claim any of the extra benefits i.e. they take your money for an extra layer of cover but for the first six months you can't actually claim for these services. Check the small print!

Cheers coylemj,

Seems you need to move up to about €1303.00 to get consultancy fee's covered would this be right?
http://www.avivahealth.ie/__uuid/1a5e45df-6cbd-4ed3-a9cb-f160aef61051/

Consultant fees Covered up to €55 per visit
Pathology: Consultant fees Covered up to €20 per referral
Pathology: Cost of test Full cover
Radiology: Consultant fees As per schedule of benefit for professional fees
Radiology: Cost of test Full cover

Hard to see on the Quinn website if their plans cover Consultant fees fully.
http://www.quinn-healthcare.com/products_and_services/essential_plus.htm

coylemj

Don't worry too much about fees for a visit to a consultant, you pay about 100-150 to visit a consultant and the fee normally drops after the first visit though in most cases you'll only need to pay for the first consultation, the insurance company normally pays for the procedure and this fee includes the follow-up consultation.

What I'm encouraging you to pay attention to is the cover for fees charged for a procedure carried out by a consultant, if I was you I'd try to maximize the cover on this item because that will probably be the biggest item of medical expense that most young people are exposed to given that hospitals don't let you hang around for long these days and as a person in your mid-twenties you probably won't need ongoing attention from a consultant.

I wouldn't propose to comment on the different options available from the different companies, we'd be here 'til next Christmas if we tried that, you'll have to do the research yourself.

enfant terrible

coylemj wrote: »

Don't worry too much about fees for a visit to a consultant, you pay about 100-150 to visit a consultant and the fee normally drops after the first visit though in most cases you'll only need to pay for the first consultation, the insurance company normally pays for the procedure and this fee includes the follow-up consultation.

What I'm encouraging you to pay attention to is the cover for fees charged for a procedure carried out by a consultant, if I was you I'd try to maximize the cover on this item because that will probably be the biggest item of medical expense that most young people are exposed to given that hospitals don't let you hang around for long these days and as a person in your mid-twenties you probably won't need ongoing attention from a consultant.

I wouldn't propose to comment on the different options available from the different companies, we'd be here 'til next Christmas if we tried that, you'll have to do the research yourself.

Cheers

broker2008

enfant terrible wrote: »

Would this be a good plan for a single person in their mid twenties?

Is it missing anything vital?

http://www.avivahealth.ie/__uuid/2ea62262-6269-4de3-8eb1-ed1da91e318e/

"Consultant fees:

Covered for 50% of the cost set out in our schedule of benefits for professional fees"

Is this the main reason its cheaper than other plans?

"G.P visits Up to €30 per visit x 25 visits"

Does this mean you can go to your G.P 25 times per year?

"75% cover in a semi-private room in a private hospital."

Does this mean you need to pay the remaining 25% yourself if you have to go to a private hospital?

You have better outpatient than inpatient cover. Look at Level 2 Hospital (with no money back on gp - need a couple of visits to consultants before you get anymoney back because of outpatient excess) or Business Plan Plus or Business Plan Select if happy paying a bit of an excess with money back with no excess.

Sorry meant to say that the above policies will mean full bills are apid in semi private room in a private hospital with shortfall of €75 or €125 as opposed to 25% of the total bill