As long as the two-tier system remains in place in Irish healthcare, those who want security will continue to pay for private health insurance. Almost half the population is covered by VHI and BUPA. Because of the out-patient excess, most of those people will spend as much on routine non-claimable medical expenses as they do on their annual premium.
A comparative standard annual premium for an individual is £240 (€305) with VHI and £224 with BUPA. With BUPA, a member would have to spend more than £200 a year on routine medical treatment from a GP or physiotherapist before they could claim back anything from the company. The equivalent out-patient excess at the VHI is £250. For a family, the excess is £375 with BUPA and £400 with VHI.
Recurring routine medical expenses and other expenses like optical treatment, homeopathy or chiropody can add up quickly, especially for a family.
One way of insuring against such costs is a cash plan. Cash plans have long been recommended by employee benefits specialists but public awareness of the schemes and their providers remains low. For a small weekly fee, such plans help members to recover many of the costs not provided for by VHI and BUPA.
The two main providers in the Republic are HSA Healthcare and the Hospital Saturday Fund (HSF). Claims are paid quickly in cash and can be made in conjunction with any other private medical insurance.
So how do these cash plans work? Members and their families receive a daily rate in cash if they have to go into hospital to offset loss of earnings and other costs, such as babysitters or transport.
Contributors can also claim towards their expenses for dental check-ups and treatment, sight tests and the cost of spectacles, physiotherapy and some alternative medicines.
There is a maternity grant and HSF also provides payments for personal injury, death and disability. The two organisations have a long history in Britain and HSF has been active in Ireland since 1949. Between them, they provide cover for about 120,000 people in this State, mostly through employee benefit schemes.
Their products are available to anyone up to the age of 66, provided they satisfy the health requirements and membership continues for life.
There are six levels of cover with HSA and seven with HSF, starting from £1.57/ £1.60 per week for the most basic and rising to £9.05 with HSF and £12.80 with HSA.
HSF introduced a set of schemes this week with improved benefits, priced in euros.
The amount of money an individual or family can claim for each treatment category rises with the level of weekly payment they have chosen.
The larger the family, the better value the cash plan is as a spouse and resident dependents under 18 can all claim for treatment under the single weekly payment.
HSA offers a maximum annual payment in each category per individual family member whereas HSF offers a maximum total family payment. Comparing roughly equivalent schemes - with payments of £4.33 for HSF and £4.80 per week for HSA - the dental benefit is £90 per person with HSA and £228 per family with HSF.
In a larger family with a range of routine medical needs it is likely that HSA would pay out more over the year.
One clear advantage HSF has over HSA is that its qualifying period is shorter. The qualifying period is six months for HSA and three months for HSF.
During the initial three months HSF members can keep receipts for optical, dental, chiropody and GP/emergency department treatment and claim as soon as the three months are up.
The bottom line is that you can join the HSF scheme with your first payment on a Monday and be entitled to half the cost of a filling on a Tuesday.
