Health Insurance advice for someone accustomed to NHS free healthcare

KJK1LL3R

Good morning,

I currently work for the Civil Service in an Executive Officer grade role with the Department of Agriculture, Food & the Marine but I am due to take up new employment on June 14th with a local authority (County Council) in a Staff Officer grade role. Therefore I will remain in public service and intend to retain my existing membership with the Forsa trade union.

I am 32 years old and relocated to the Republic of Ireland from Northern Ireland 6 months ago. I am interested in learning more about Health Insurance options for public sector employees. Living in Northern Ireland meant I was registered with the NHS in the UK, so never had to worry about paying for healthcare. Therefore I am not accustomed to the idea of having to pay for private health insurance. I am currently living with my girlfriend in her parent's home, and their family are all with Laya.

I have heard about the likes of Cornmarket and Lyons so I'm confused by who actually offers advice to public sector employees on health insurance. Can you someone please point me in the right direction? There are simply far too many health insurance plans to choose from, so I need help as it is all very confusing for someone who has never needed to even consider the idea of health insurance before. But I can see that the waiting lists for public healthcare are extremely long here in the South, so I might have no choice other than to consider private health insurance.

Ohmeha

What's your budget range for private health insurance?

Bare minimum private plans that cover public but may help you you up public waiting lists will be in €500 to €650 range per annum

Plan with ok levels of private cover will cost a minimum of €1000+ per annum, probably looking at €1500+ for a plan without too many excesses/shortfalls

jahalpin

You should have a look at hia.ie, this is a govenment website that compares all of the different schemes avaliable from all of the health insurance providers in Ireland

KJK1LL3R

Ohmeha wrote: »

What's your budget range for private health insurance?

That's the problem, I have no idea how much to budgeting for such an expense as I've never needed health insurance in my life before. I've been searching online for advice but cant really find any resources or rules of thumb in terms of how much to budget in order to afford health insurance e.g. never spend more than x% of gross/net salary on health insurance.

jimmycrackcorm

The most popular plans between the main providers are 100 -120 per month, so I'd suggest that as a budget.
Don't forget also that you can claim non-insurance medical expenses against your tax annually.

Mrs OBumble

And you being public servant is totally irrelevant (except that there's no chance of you getting employer subsidised cover).

KJK1LL3R

As a trade union member, I reached out to FORSA for advice on health insurance. They put in touch with a number of brokers (Lyons, Cornmarket, Keaneys, etc.) all of whom seem to be recommending the Irish Life '4D Health 2' plan so I'm guessing it is a good option. The consensus seems to be that I should purchase cover for up to Semi-private care in a Private hospital. But I'm wondering if all these brokers have some kind of financial relationship with Irish Life, as I was surprised not to see any recommendations for plans from Laya or VHI.

I am living and working in Westmeath so need a plan that covers all local public/private midlands hospitals as I wouldn't want to have to travel too far. But I will also be travelling up to Northern Ireland regularly to visit family in County Derry, so it would be nice to have a plan that would cover me for any medical treatment/emergencies that would ever occur when I was up in the North.

Geuze

Irish Life own Cornmarket.

KJK1LL3R

So I recently organised a consultation with TotalHealthCover.ie who have recommended the following 4 plans for me based on the fact that I didn't really want to spend much more than €100 per month:



3 mid-level plans:

Laya Signify (https://www.layahealthcare.ie/productsandservices/plan/scheme/signify)
VHI EnhancedCare 250 (https://www.vhi.ie/health-insurance/plandescription?coverset=LIFEC250A&profileId=individuals)
Irish Life Health BeneFit (https://www.irishlifehealth.ie/health-insurance-plans/benefit)


They also recommended that I consider a corporate plan:

Laya Inspire (https://www.layahealthcare.ie/productsandservices/plan/scheme/inspire)


I would be interested to get some feedback or opinions from you guys in order to help me decide what direction to go towards.

There may be a group scheme through your employer and you will be able to have the cost deducted from salary.
Check with your payroll.

jahalpin

KJK1LL3R wrote: »

So I recently organised a consultation with TotalHealthCover.ie who have recommended the following 4 plans for me based on the fact that I didn't really want to spend much more than €100 per month:



3 mid-level plans:

Laya Signify (https://www.layahealthcare.ie/productsandservices/plan/scheme/signify)
VHI EnhancedCare 250 (https://www.vhi.ie/health-insurance/plandescription?coverset=LIFEC250A&profileId=individuals)
Irish Life Health BeneFit (https://www.irishlifehealth.ie/health-insurance-plans/benefit)


They also recommended that I consider a corporate plan:

Laya Inspire (https://www.layahealthcare.ie/productsandservices/plan/scheme/inspire)


I would be interested to get some feedback or opinions from you guys in order to help me decide what direction to go towards.

You will also get a 20% tax credit (up to EUR 200 per annum) on payment for private medical insurance

Have you considered getting a policy that would also cover everyday medical expenses?

Ohmeha

KJK1LL3R wrote: »

So I recently organised a consultation with TotalHealthCover.ie who have recommended the following 4 plans for me based on the fact that I didn't really want to spend much more than €100 per month:



3 mid-level plans:

Laya Signify (https://www.layahealthcare.ie/productsandservices/plan/scheme/signify)
VHI EnhancedCare 250 (https://www.vhi.ie/health-insurance/plandescription?coverset=LIFEC250A&profileId=individuals)
Irish Life Health BeneFit (https://www.irishlifehealth.ie/health-insurance-plans/benefit)


They also recommended that I consider a corporate plan:

Laya Inspire (https://www.layahealthcare.ie/productsandservices/plan/scheme/inspire)


I would be interested to get some feedback or opinions from you guys in order to help me decide what direction to go towards.

I'm on Laya Inspire signed up earlier in the year, it's a balanced plan that has ok coverage on the main aspects Private/High Tec/Cardiac/Day Case/Outpatient and excess isn't too bad. It was coming in just under 100 p/m though I think it has been subject to another price increase recently

Signify and Benefit were also on my radar and are cheaper, come renewal time I may revisit those plans

KJK1LL3R

I am still considering the mid/corporate level range of plans. I recently had to get my first prescription for migraine medication since living here in the South, and got quite a shock when I realized it was going to cost me €20 having previously been used to getting this same medication for free up North. So I definitely think a plan that includes refunds of day-to-day medical expenses would be helpful.

I was wondering is there any health insurance schemes that would typically be used by local authorities or public service staff / FORSA members? Can I ask, are there any health insurance schemes that allow deduction at source so that the money is already taken out of my wages before they reach me? It would also be good to know if there was a scheme that allowed tax relief at source so that I wouldn't need to worry about claiming tax back via filing a tax return each year.

Mrs OBumble

KJK1LL3R wrote: »

I am still considering the mid/corporate level range of plans. I recently had to get my first prescription for migraine medication since living here in the South, and got quite a shock when I realized it was going to cost me €20 having previously been used to getting this same medication for free up North. So I definitely think a plan that includes refunds of day-to-day medical expenses would be helpful.

I was wondering is there any health insurance schemes that would typically be used by local authorities or public service staff / FORSA members? Can I ask, are there any health insurance schemes that allow deduction at source so that the money is already taken out of my wages before they reach me? It would also be good to know if there was a scheme that allowed tax relief at source so that I wouldn't need to worry about claiming tax back via filing a tax return each year.

All schemes include tax relief at source.

Whether there is a deduction at source is up to your employer, not a health insurance scheme. AFAIK, government organisations here typically don't provide this type of cash management for you.

You cab try asking your union if there are any schemes they recommend to members. I have no idea what their position in health insurance might be.

jahalpin

KJK1LL3R wrote: »

I am still considering the mid/corporate level range of plans. I recently had to get my first prescription for migraine medication since living here in the South, and got quite a shock when I realized it was going to cost me €20 having previously been used to getting this same medication for free up North. So I definitely think a plan that includes refunds of day-to-day medical expenses would be helpful.

I was wondering is there any health insurance schemes that would typically be used by local authorities or public service staff / FORSA members? Can I ask, are there any health insurance schemes that allow deduction at source so that the money is already taken out of my wages before they reach me? It would also be good to know if there was a scheme that allowed tax relief at source so that I wouldn't need to worry about claiming tax back via filing a tax return each year.

Day-to-day medical expenses refers to GP visits, glasses, routine dental etc, I don't think any of the schemes offer much in the way of prescription rebates (i think one of the Laya ones offers something like EUR 30 a year for prescriptions)

Tax refief at source is not possible, to claim the (upto EUR 200) relief you just have to tick the box on revenue.ie

KK Supercats

Irish Life Health are the only health insurance company that deal with the broker market. Laya and VHI won't deal with brokers so to get a quote from these you would need to go direct or use someone like totalhealthcover

Bicyclette

Forsa have an Income Continuance Plan. The sooner you sign up the better. I unfortunately didn't sign up immediately and got caught with something that developed after I joined the Civil Service.

My husband is in the Public Service, they have a scheme. But as far as I am aware there is nothing similar in the Civil Service. Work out what is best for you. And see which of them have international travel policies as well. We use the VHI multi-trip policy - and hope to do so again next year!!

With regards to drugs etc. remember you can fill out the cyber equivalent of the Med1 form and get 20% tax credits on all of the prescriptions and medical (but not dental) appointments you paid for.

The Med2 Form deals with atypical dental work such as braces, crowns and implants and again gives you 20% credits against what you have paid.

The Drug Payment Scheme means that if you have prescribed medicines which cost above a certain amount each month, you don't pay anything for costs over the threshold. https://www2.hse.ie/services/drugs-payment-scheme/drugs-payment-scheme-card.html

Wesser

Health insurance will not cover your drug costs....

KJK1LL3R

Apologies for following up again but unfortunately I have still been unable to pull the trigger on a health insurance plan.

I was all set to go with a semi-private Laya corporate plan like Inspire or Simple Connect.

But unfortunately my HR department here at Local Authority County Council have informed me that if I want to set up deduction at source then the only group salary deduction schemes here at the local authority are with VHI or Irish Life exclusively so Laya is not an option. I must confess I would prefer a deduction at source from my salary, as I am not used to having to pay for health insurance having been spoiled by the NHS up North. Therefore I think having to now shell out for health insurance might be a little bit easier to stomach if it is already paid for before my wages reach my bank account.

Can you recommend the best semi-private corporate plans from VHI and Irish Life to try to help me decide on a suitable plan between the two? It would also be interesting to know what the difference is between the two in terms of additional perks and hospitals/clinics covered in both the Midlands and County Derry if I was visiting the North.

KJK1LL3R

Hi folks, having put this on the long-finger I am finally having to pull the trigger on it this year given that I'll be turning 35 years old in August and want to avoid the LCR loading fees. I had thought about leaving it as close to my 35th birthday as possible but wasn't sure how long the process takes so thought I would be best to get it sorted out early in the year. I also heard that prices are expected to increase from March. I wish there was more guidance on deciding an affordable budget for health insurance, I couldn't find any rule of thumb that applies (there was American articles suggesting 10% of gross annual salary) but the consensus for Ireland seems to be that a minimum of €100 per month for good quality cover. I had a near-drowning scare at Lahinch beach in Co.Clare back in the summer, and although I was relatively fine the doctor suggested I go to A+E for a check-up as a precaution. I ended up losing a full day of my summer holiday in Limerick A+E for something that could've been sorted out quickly had I bothered about private health insurance. Needless to say, I knew I would have to sort out my health insurance this year for a host of reasons.

I have narrowed my search down to a number of semi-private corporate plans between VHI and Laya:

VHI

• PMI 36 13
• Company Plan Plus 1.3
• ​PMI 52 10
• PMI 60 10
• PMI 53 10

Laya

• Inspire
• Inspire Plus
• Simply Connect

I am starting to lean slightly more towards VHI as I'd ideally prefer monthly payments as opposed to a lump sum. Laya charges an extra 3% fee for direct debit monthly instalments whilst VHI don't charge any extra for choosing to pay monthly. I have heard that Laya offers a 10% discount for Credit Union members but I didn't think that was true as I understood that health insurance prices are fixed for everyone with minimal scope for discounts. Perhaps that isn't necessarily the case? I am a FORSA trade union member and my employer (Local Authority) has a group scheme through VHI but I don't believe it offers any cheaper prices on a specific plan, I think it is purely a deduction scheme which enables staff to pay their premium through their payslip. The ability to setup a deduction through payroll as a small advantage to VHI but this is not crucial for me.

Beyond price, I am wondering what else I should consider when comparing between the two providers. I currently live in Westmeath so which provider would cover most hospitals\clinics in the Midlands to save my travelling to Dublin all the time? I am originally from Northern Ireland, so it would be great if there was a provider who also covered hospitals/clinics in the North if I required some form of medical treatment whilst visiting family. I am also wondering if there is much difference in the smartphone apps from both providers or are they both fairly similar?

At the moment my health is relatively fine, these are the only potential considerations:

• I am prescribed sumatriptan typically once or twice per year at most to treat migraine headaches, but they are not a regular occurrence. I did purchase light-filtering migraine glasses in 2022 from an American firm named Avulux which were quite expensive so it would have been nice to have had some of those fees covered particularly if I ever needed to replace these glasses, but again I purchased these of my own decision rather than on a doctor’s recommendation. They seem to have helped but it could just be placebo effect.
• I had some minor issues with haemorrhoids in 2021 and since then, the doctor recommended I go for a colonoscopy every second year purely as a pre-cautionary measure due to family history as I have an uncle who had survived bowel cancer in his late 60's. 
• I enjoy walking and hiking, and in 2022 I had to purchase €85 orthotics to help treat plantar fasciitis. I am not sure if I will need to keep purchasing these going forward or not, I haven't transferred them to my current walking shoes as of yet and the issue has not reappeared so I cannot say for certain if the plantar fasciitis pain will return again or not.

Taking everything I have said into consideration, it would be great to get some feedback and thoughts on which plan I should look to go with.

Citrus_8

https://www.boards.ie/discussion/2058187269/health-insurance-advice-for-someone-accustomed-to-nhs-free-healthcare

In my opinion, health insurance is the waste of money. GP cost around 60 Euro. How many times do you visit a GP in a 3 years' time? One, two? If referred to the hospital by a GP, then a hospital is for free (with some exception when you need to pay for something premium, if you want). The biggest problem with the health system is Ireland is that it's something between the US and the EU model: state owned, but partly private. Ideally, we pay taxes, so we should have similar to the NHS system, but sadly funding to the HSE is poorer. If you want a primate insurance, simply ask yourself, what is the value you will be getting of this? To me, as I said, it's the waste of money. I'm more tempted to use the public service as I'm already paying for it.

Geuze

https://www.boards.ie/discussion/comment/120237625#Comment_120237625

There are no "premium" payments as a public patient in hosp.

There are just two possible fees:

arrive into ED = 100 euro

stay overnight = 80 pn, to be abolished this year

By the way, funding to the HSE is greater than to the NHS, we spend more on healthcare here.

Mrs OBumble

If you are referred to public hospital for a non urgent scan, you could be waiting years. Vs weeks or a low number of months privately.

Without that scan you don't have a diagnosis, so you don't get any treatment.

Citrus_8

https://www.boards.ie/discussion/comment/120238373#Comment_120238373

I new about the 100, but didn't know the per night 'hotel' fee. Glad it will be gone. But a question then how do we need to pay for a GP if the HSE funding is greater? That's news to me.

Citrus_8

https://www.boards.ie/discussion/comment/120238449#Comment_120238449

Yes. That's sad. Those who need a decent healthcare with a prompt reaction time eventually pay twice: tax to support the system and extra to be seen timely. I would expect better. Ideally, health insurance shouldn't be such a big thing here. Germany is a good example.

Geuze

https://www.boards.ie/discussion/comment/120238834#Comment_120238834

We pay higher prices, and get lower volumes.

For example, we spend more per person on branded drugs, as we don't do as much generic prescribing, and we don't negotiate hard on pharma prices.

COVID vaccine: we paid twice what the UK paid to GP to administer the vaccine.

We overspend on healthcare here, relative to the age profile of the pop.

A consultant in France charges 46-60, here they charge maybe 175 on first visit.

The GP fee in France is 26.

Geuze

https://www.boards.ie/discussion/comment/120238834#Comment_120238834

Here is a table of expenditure, this is public + private expenditure:

Jim2007

https://www.boards.ie/discussion/comment/120240570#Comment_120240570

Ireland has a per capita GDP of about $100k while France and the UK are at around $43k, that makes Ireland a much more expensive country than either of them and on top of this Ireland spends about 5% less that France, so you need to start comparing like with like, otherwise you might as well compare it to second world countries.

Switzerland is closer to Ireland, but still spends more according to your chart, in fact close to France actually. We don't have a public healthcare system and the last COVID vaccine I got last summer cost me about 60 Euro and yes, you can expect to pay about 150 - 200 Euro for a visit to a consultant. This should not be surprising because countries with a high GDP per capita are expensive places.

Citrus_8

Thanks for the explanation, it's very interesting. I've never thought of number re Irish health system. I just love to complain about it a lot for obvious reasons. A question then, would Germans pay for a GP visit? As far as I can remember, they don't. However, I can see Germany has the highest spendings for health. I wonder, what EU country can we compare Ireland with in regards to spendings for a health system and the value/return to the people. The higher tear income is high, but what do we get? Creche is still very expensive, insurance is a money leach, GP is no free to the tax payers, public transport is no good, infrastructure generally (not just road, but a water quality and things like the Internet availability, even mobile reception isn't great...) is just average... And yet we still have to pay for some of this privately. This makes me sad.

I don't mind paying higher tax, but in return getting better return, like Scandinavians. If everyone contributes through tax, we could get a better value rather than paying for everything individually.

Geuze

The Germans pay health insurance, about 15% of wages, split roughly 50/50 between ee and er.

GKV insurance premium is 14.6 - 15.6% of salary, subject to a cap, that covers your family also.

With the insurance, you pay as follows:

• Up to €10 per quarter for a doctor visit.
• The first €10 of most prescription medication.
• Approximately €10 per day for hospital stays, for a maximum of 28 days per year.
• The full price for prescription vision aids, such as glasses or contacts.

https://www.germany-visa.org/insurances-germany/health-insurance/

KJK1LL3R

So I called up both Laya & VHI today to try to get advice.

Laya asked me a few questions and recommended I go with their Inspire plan.

It sounded like a very good value plan but I was put off by their 3% admin fee for opting to pay monthly and they said they no longer offer 10% to credit union members.

So I called VHI looking to get something as close as possible to the Laya Inspire plan. They asked a lot more questions than Laya so perhaps their algorithm is a little more complex. Based on my responses, they recommended I go with PMI 5210 or Company Plan Plus Level 1.3 so after lengthy discussions we decided that Company Plan Plus Level 1.3 was the better value in going from 60% orthopedic/opthalmic cover to 80% for an extra €5.30 per month. I know I am only 34 years of age so perhaps the 60% cover with PMI 5210 would have been more than sufficient but I just felt that Company Plan Plus Level 1.3 was that little bit more comparable to the Laya Inspire offering.

Hopefully it wasn't overkill and I am just really hoping that I've made a good choice. I listened to all the radio interview done by Dermot Goode over the last two years and he name-dropped Company Plan Plus Level 1.3, PMI 3613, Inspire & Inspire Plus the most. If I've made a bad choice at least I still have the 14-day cooling off period to make a change. I had asked about PMI 5310 but they said it didn't appear as a suitable plan in their search results based on my responses to their initial questions.

The only slight disappointment with VHI is that they didn't offer any discounts as they said my group scheme through work was for salary deduction only. The lady on the phone also mistakenly told me it would be more tax-beneficial as the health insurance deduction would reduce my taxable income but then she corrected herself when I told her that I thought the tax-relief was already built into the plan fee.

Citrus_8

https://www.boards.ie/discussion/comment/120245648#Comment_120245648

If you pay a health insurance through an employer via your payslip less than the regular price as your employer covers a part of it, or all, then you will pay benefit in kind and will be able to get back I think up to 200 Euro through the Revenue Commissioners. If you pay for insurance yourself as an individual and there's no employer contribution, then a tax-relief is already calculated to your final price.

I read in the news a few months ago that the government wants to reduce this tax-relief, but haven't heard anything since so I guess nothing changed in that regard.

However, I still stand to my opinion that I'd rather pay a few % more tax off my income rather than making a profit to the insurance companies in order to get a proper public health service in return.

walterking

https://www.boards.ie/discussion/comment/120245648#Comment_120245648

It has taken you 2 years to sort it out?

I shall refrain from making any jokes about the civil service

Health insurance is an added extra - it allows you skip a queue if needed. It gets you a better bed, maybe better coffee too. You'll get a better choice of consultants. If you have any health issues or your family have a history of issues, its nice to have at your age.

But if you are healthy I'd be keeping it to the absolute minimum for the moment and then revisit it at the age of 40.

If you have an emergency, you will be treated that same as everyone else in an emergency situation. No better and no worse.

FledNanders

https://www.boards.ie/discussion/comment/120245648#Comment_120245648

I work in the health insurance industry, and Company Plan Plus Level 1.3 is a good plan in terms of value for money and has very good benefits if you ever need to use them. It's probably overkill on the orthopedic and ophthalmic cover based on your age but it's no harm to have it there I guess.

Also just to comment on some people mentioning brokers earlier in the thread such as Cornmarket etc, they are generally all tied to Irish Life and will not recommend Laya or VHI plans.

Marcusm

https://www.boards.ie/discussion/comment/117533393#Comment_117533393

I think you are confusing apples and oranges. None of the Irish health insurance plans will deliver equivalence to the NHS. Irish health insurance plans are a jump the queue scheme rather than NHS-style services. You might get better secondary and tertiary care as you’ll “jump the queue” but no primary care cover nor medications.

https://www.boards.ie/discussion/comment/120258306#Comment_120258306

However, I still stand to my opinion that I'd rather pay a few % more tax off my income rather than making a profit to the insurance companies in order to get a proper public health service in return.

What an utterly bizarre attitude to have, especially when it comes to a matter of life and death. The insurance companies allow people faster access to healthcare compared to the HSE. We already spend far too much on Health and you want to give the HSE more? Willing to languish in pain , possibly die, just to stick it to the insurance companies shareholders?

Citrus_8

https://www.boards.ie/discussion/comment/120437008#Comment_120437008

HSE should provide an equally effective and efficient health care, rather then us relying on the private businesses. Health care shouldn't be private as isn't an essential social benefit. We already pay tax and HSE get them a lot. So why should we not expect the HSE system to work well for our money?

Jim2007

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