VHI Healthcare is to introduce a stand-alone primary healthcare product, which will allow members to claim cash back for visits to GPs and dentists. HealthSteps has been introduced on a limited, phased basis to a selection of VHI's corporate clients. The insurance product for day-to-day medical expenses will go on general release in the New Year.
The new product provides cover for everyday medical expenses and can be purchased alone or in addition to a hospital plan. No medical examination is required and, for those under 45 years, there is no waiting period. However, a six-month waiting period applies to those aged 45 to 54 years. This rises to one year for those aged 55 or over.
In common with all current health insurance products available in the Republic, only those up to 65 years can buy HealthSteps.
However, the legislation governing health insurance allows individuals, regardless of age, to transfer from one health insurance product to another. VHI will not be recommending that older customers switch, because HealthSteps has not been designed to be a substitute for hospital cover. Since July, everybody over 70 years is entitled to a medical card.
The new primary healthcare product only covers out-patient expenses and will not provide members with any hospital cover. There will be no policy excess on the new product and no overall limit to what can be claimed. Tax relief will apply and the premiums will be community rated - one price for all.
HealthSteps benefits are paid directly to the member, with the exception of fees for GP procedures (as distinct from surgery or home visits), which are paid directly to the GP.
Claims can be made six months after joining the scheme and it's expected that claims will be accepted quarterly from then on. The price for this primary care cover has not been fixed but is set to be around £170 (€216) per year for an adult, net of the standard rate of income tax. The premium for children will be around £85.
Visits to a general practitioner, optician, consultant or physiotherapist will be covered by the new plan up to stated limits. The cash reimbursement is £19.69 for GP visits. Treatment with a chiropodist, occupational therapist, speech therapist, osteopath, chiropractor and acupuncturist will also be covered. Any treatment which is "not medically necessary" will not be covered by the new insurance product.
VHI's new product bears some similarity to the cash plans available from the Hospital Saturday Fund and HSA. These non-profit organisations pay ongoing cash reimbursements to members for day-to-day medical expenses. They also provide daily payments for time spent in hospital and lump sums for personal injury.
HealthSteps is different from BUPA Ireland's HealthManager, which offers a package of out-patient benefits combined with hospital cover. With BUPA's product, members can claim up to half their out-patient costs from a list of treatments covered, with no excess.
Treatments from practitioner therapists - acupuncture, homeopathy, chiropractic and osteopathy - are covered by BUPA.
Only one non-emergency dental treatment each year is paid for under the BUPA plan, up to a maximum of £15.
But it has the unique feature of paying for child counselling by an approved therapist, up to a maximum of eight visits per year.
This new departure by VHI will provide more options to most of its existing 1.5 million members and others. It will be particularly welcomed by members of hospital plans, whose everyday medical bills can cost more than their annual premium, because of high out-patient excesses.
