Your Personal Finance Questions – How Can I Avoid Shortages on My Health Insurance Plan?
Q I am enrolled in the Laya Care Select program and need to renew soon. I see that I now have a 20% shortfall on some major orthopedic and ophthalmic procedures. Is there a way to avoid this?
A The shortfall can be avoided, according to Dermot Goode of Totalhealthcover.ie. The cost of the renewal will be € 1,591 per adult. Mr Goode said it was still a good business plan for a private bedroom, but may no longer be suitable if the member wishes to maintain full coverage for these procedures. He recommends contacting Laya and checking out the alternative Simplicity program, which costs € 1,535 per adult. This is a similar plan covering the same hospitals, up to private room accommodation, but there is no 20% shortfall on these procedures on this plan. Outpatient reimbursements will be subject to an annual deductible in the future which the reader should be satisfied with before changing. If the member doesn’t mind taking a slightly higher deductible for private hospital admissions, there is another alternative program called Connect Simplicity, which costs € 1,415 per adult and is also worth considering.
Q I am applying for a home renovation loan from my credit union. I have read that they can help finance home energy retrofit projects. I received my grant from the Sustainable Energy Authority of Ireland (SEAI) of 35pc and I have my quote from my contractor. Do I have to borrow the entire amount or can I use part of my savings to offset my monthly payments?
A It’s okay to contribute some of your savings towards your upgrade costs and it’s a great way to get your monthly repayments to a manageable level, according to the chief executive of the Credit Union Development Association, Kevin Johnson. If you are partially funding your home renovation through your credit union, you are offered low rate loans through the ProEnergy Homes program. This is a program where homeowners can receive a grant of up to 35 pc for a range of home improvement measures including attic insulation, exterior wall insulation, installation solar panels, upgrading the boiler, and upgrading windows and doors, with the remaining cost funded either through savings or a low-cost loan from your credit union (if you participate in the program) , or a mixture of both. Some credit unions offer loan rates as low as 4.25%, especially when you have savings to “pledge” against your loan. For participating credit unions, an interest rate of less than 7pc applies to amounts over € 20,000, while a slightly higher rate applies to smaller loans. For example, if after saving on cost you borrowed € 5,000 at 10.48 pc over five years, your monthly repayments would only be € 107.42, Mr Johnson says.
Q I just purchased dental coverage from DeCare Dental. Do I use the dentists listed on their direct payment network, or can I use any dentist? I also have health insurance and am wondering if I am overinsured?
A You don’t have to rely solely on their direct payment network, according to Mr. Goode of Totalhealthcover.fr. You can go to any dentist for your treatment but the advantage of using their network is that your benefit will be payable directly to the dentist and you will only have to pay the balance. If you go to another dentist, you must pay the full amount and then claim your reimbursement directly from the insurer. When it comes to overinsurance, no health insurance plan covers major dental treatments such as orthodontics, root canals, crowns, etc., Mr Goode said. While these benefits are important, he recommends that you maintain a certain level of dental coverage in addition to your health insurance plan.
Q I sent my outpatient request to Irish Life Health, but some receipts were excluded because they were not submitted on time. Is it correct?
A All Irish Life Health members have a six-month window after their renewal date to submit all eligible outpatient expenses for the previous insurance year, according to Mr Goode. These receipts can be submitted either in a block application at the end of the year, or they can be submitted online using their “scan and send” feature. However, if the requests are not submitted within the six-month deadline, they will be denied, Mr. Goode said.