Mark Gilmore

Protecting What
Matters to You.




17 Jul

Is your Health Insurance Plan Due a Health Check?

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Recent figures from the National Treatment Purchase Fund show that there are approximately 50,000 people awaiting inpatient and day case procedures so going public isn't an option for people who can't afford to wait for procedures. Also you have to bear in mind going the public route isn't exactly free unless you're a medical card holder you will have to pay the public hospital levy of €75 per night up to a maximum stay of 10 days in any 12 months period, so that's €750 to stay in hospital for a short to medium term.

So what can people and in particular the elderly do to help try and keep a hold of their medical insurance having paid into it for years without claim and just when they need it most they are being priced out of the market?

1/ Be prepared to take a small excess on your policy, the excess is the amount you will pay for any claim it can be as little as €75 on being admitted to a private hospital or as large as €500 depending which plan and company you are with and it can bring down the cost of your annual premium. There is no excess for public hospital and check with your insurer that the excess isn't a daily excess as that will work out very expensive.

2/ Get rid of the extras, most people want to be covered for the big medical emergencies in public hospitals with access to private hospitals if needs, if your plan covers day to day expenses and you aren't claiming them best move to a hospital only plan, day to day expenses would include getting money back for GP visits consultants etc.

3/ Ask your health insurance company for the corporate plan equivalent (plans that are offered to large companies) don't be put off by the names of the plans Company Plan etc. these plans are available to all and in a lot of cases have better benefits and cheaper premium than the plans offered to the general public. Most of the older clients I speak to are in the traditional old Plan B space that most were covered on at one stage moving from that to a Corporate Plan can mean big savings without reducing your cover.

4/ Look to the newer plans that may limit your access to the high tech hospitals Blackrock, Maher etc. but still cover you for all public and a lot of other private hospitals. Depending on where you are in the country you may never end up using one of the high tech hospitals but you are paying for them with your annual premium.

5/ Don't be afraid to split cover when renewing a family plan or a plan for a couple if one member of the couple is more likely to be using a private hospital in the coming year they need to be on the correct level of cover but the other person may consider a reduced plan or taking on an increased excess to keep costs down.

Health cover is a huge concern for the elderly but if you know the right questions to ask your provider will be able to help you maintain a decent level of cover by trimming off some of the fat i.e. benefits, hospitals you may not be currently using. But as always let the buyer beware there are pitfalls when changing cover and you must understand the up-grade rule if you reduce your cover and want to go back to a higher level plan you may have to wait 2 years if you are under 65 and 5 years if you are over 65 for the higher benefits to kick in.

In my experience a lot of older people are still on the old legacy plans and are paying for the private room in the private hospital and by switching plans you may give your policy the health check that it is long overdue. Seek out independent advice speak to your health insurance company and use the Health Authority website which is a very useful guide to comparing plans.

Mark Gilmore is a Qualified Financial Adviser who owns MG Financial Solutions and can be contacted on 087-6788975 or by email at This email address is being protected from spambots. You need JavaScript enabled to view it.

Mark Gilmore trading as MG Financial Solutions is regulated by the Central Bank of Ireland

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