Switch health insurance with long term ilness

vmb

Hi all.

I have health insurance with Laya. I want to switch to VHI because it includes more things related to my disease (MS)

Can I switch without restarting the waiting periods?

I do not have any waiting period with Laya because the dx was after the start of the insurance.

Thanks

Dacelonid

Looking at one of the benefit booklets, and I assume this is common across all VHI products it has the following

In Section 2) Joining Us

However, for other treatment, we will pay benefits if it is carried out after the customer has been insured continuously for a minimum period of time, called a waiting period. The waiting periods are as follows:
Waiting periods and pre-existing conditions


Age when included|Accident or injury|New conditions|Pre-existing conditions|Maternity**|Out-patient medical expenses|Day-to-day medical expenses (incl. Lifestage benefits)*
Under 50 years|None|26 weeks|5 years|52 weeks|None|None
50+ years|None|26 weeks|5 years|52 weeks|None|26 weeks


When determining whether a medical condition is pre-existing, it is important to note that what is considered is whether on the basis of
medical advice signs or symptoms consistent with the definition of a pre-existing condition existed rather than the date upon which the
customer becomes aware of the condition or the condition is diagnosed.
Whether a medical condition is a pre-existing condition will be determined by the opinion of our Medical Director.

d) If there is a break of more than 13 weeks in a person’s health insurance contract with us and/or another insurer registered under the Health
Insurance Acts, the application will be treated as a new application for cover.

e) If a Customer’s Policy expires or is cancelled in accordance with Rule 4(f) and 4(g)i) and the customer takes out another Health Insurance Contract
with us or another health insurer within 13 weeks of that date, then the time that he/she was insured under the previous contract(s) will be offset
against the normal joining conditions (New Conditions Waiting Periods, Pre-existing Conditions Waiting Period and Maternity Waiting Period).

f) If a person transfers from a health insurance contract with another insurer registered in Ireland under the Health Insurance Acts, benefits will only
be payable up to the level of cover offered by that contract. Additional benefits will be subject to Rule 3(b).

g) The policy is intended for people Resident in Ireland and only people Resident in Ireland are eligible to be included on the policy. You must ensure
that all persons insured on the policy satisfy this condition, otherwise the policy may be cancelled. Please refer to rule 4(g).

h) You can cancel your health insurance contract within 14 days of the date of issue of the Terms and Conditions. We will refund the premium you
have paid and will recover from you any benefit we have paid.

i) Vhi reserves the right to request a customer to provide documentary proof in support of any information provided to us at the commencement,
and/or during the course, of the policy.

j) Vhi Healthcare does not allow dual insurance for members. This means holding more than one Vhi Healthcare in-patient indemnity insurance
contract which offers the same or similar benefits.

The full booklet can be found here

From reading it, I am not sure if they mean you must have been insured for 5 years previously (no matter what insurer) before they will pay out on new claims, or if they mean you must have been with vhi for 5 years before they will pay for any treatment for an existing condition.


Your best bet is to ring them and see what they say

vmb

Thanks Dacelonid. Sadly, my symptoms were before the policy start date, so I wont be covered.

I'll keep with Laya though they just don't know anything about my MS (well, they could see a lot of GP visits)

Blinder

Hi Vmb,

The 5 year waiting period only needs to be served once, if you have continuous cover. So if you have already serve it with Laya, you won't have to serve it again with VHI. However. there is a 2 year waiting period or upgrading plans with a pre-existing condition (if over 50, this upgrade waiting period us longer).

From http://www.hia.ie/frequently-asked-questions

I have an existing condition; may I switch health insurers? Will I be covered for my condition straight away?
You may switch health insurers regardless of your existing conditions. If you have completed your new customer waiting periods, you will be covered immediately for any existing condition. However if you wish to use a benefit on the new plan which is higher than the benefit provided on the old plan, you may have to serve an upgrade waiting period before full cover for this benefit is available. Please see our section on upgrade waiting periods for more details.

I'm in same position with a pre-existing condition. Only in year 2. I only have basic policy now. But at beginning of year 4, I plan so switch to best plan for that condition, so that I when the 5 year period is up. I have access to best plan for me ( the last 2 years of the 5 years, will serve the 2 years of the upgrade waiting period)

So I think it might be worth your while looking at switching, even if there is a 2 year waiting period, if you have access to better treatments down the line, as you won't have to take a step back to do it.

byhookorbycrook

What is covered by Laya that isn't covered by VHI?

vmb

Hi byhookorbycrook

As far I know they cover drugs related with MS, like treatments (lemtrada, tysabri, etc) and other things as steroid infusions at home.

These drugs are approved by the government, but public hospitals have to use their budgets, so you can be denied after your neurologist approbation.

To be able to receive steroids at home is great, because it is dreadful to be in a big relapse and wait +8h in A&E before seeing a doctor.

vmb

Hi byhookorbycrook

As far I know VHI cover drugs related with MS, like treatments (lemtrada, tysabri, etc) and other things as steroid infusions at home.

These drugs are approved by the government, but public hospitals have to use their budgets, so you can be denied after your neurologist approbation.

To be able to receive steroids at home is great, because it is dreadful to be in a big relapse and wait +8h in A&E before seeing a doctor.


[EDIT] I've indicated what I know VHI covers and Laya does not [/EDIT]