Take your family history and lifestyle into consideration when choosing your health cover, writes Laura Slattery.
Picking the right health insurance plan is almost as complex a business as staying healthy itself.
VHI's most basic hospital plan, Plan A, costs €463 for an adult, while its highest level of cover, Plan E, has an annual premium of €2,035.
With prices varying that wildly, paying for cover you're probably not going to need is expensive: most young, fit and healthy people aren't going to insure themselves to the hilt "just in case".
But although we can't know exactly when health problems will strike, there are circumstances where people might reasonably believe that there is a significant likelihood they will need hospital care at some point in the medium term.
Making sure that a lack of insurance doesn't add financial stress to medical troubles will prevent a few headaches down the track.
Below, we examine three common procedures and run through the type of cover you need.
•YOU HAVE A HIGH RISK OF HEART DISEASE:
A family history of heart disease or being male and over the age of 35 will mean you have a higher risk of developing heart disease than the general population.
High cholesterol levels, smoking, being overweight, eating a high-fat diet, drinking excessive alcohol, high blood pressure and diabetes are also risk factors that might prompt people to ensure they have a high level of hospital cover.
Last year, the Republic's biggest insurer, the State-owned VHI, paid out €116 million for 41,800 claims relating to cardiac conditions.
The key issue for patients with heart trouble is often where they are treated.
People who want the option of treatment in the Mater Private and the Blackrock Clinic - sometimes known as the high-tech hospitals - or the private Galway Clinic or Beacon Hospital, need to make sure their insurance plan fully covers them for these hospitals, as otherwise bills for heart procedures and treatment can run into tens of thousands of euro.
For example, the VHI-negotiated price for a cardiac stent procedure - which is used in cases of heart blockage that do not require a bypass - is more than €3,000.
Add in accommodation costs, consultants' fees and the price of other tests and treatments, and it is easy to see how someone without the right level of insurance who opts for treatment in a high-tech hospital could have to take out a loan to pay for it.
So which plans provide cover for these hospitals and which don't?
First of all, VHI's newer generation of plans, the LifeStage Choices plans, don't include any cover for either the Blackrock Clinic, Mater Private or the private Beacon Hospital in Sandyford. For that, its members need to go to its Plan A-E and A-E Options range.
Plan A provides just 35 per cent cover for certain major heart surgery and specified procedures at those hospitals, while Plan B and C provide 90 per cent cover. The Options versions of these plans provide full cover for major heart surgery and other procedures at these hospitals. But it is Plan D and E that provide the most comprehensive cover, as they also insure a range of other fees.
The difference between the two, apart from the €652 extra that it costs to buy Plan E instead of D, is that Plan D gives full cover for a semi-private room in these hospitals, while Plan E gives access to a private room.
At Quinn Healthcare, which took over the running of Bupa's schemes, major heart surgery procedures in Blackrock, the Galway Clinic and the Mater Private are covered under all of its hospital plans, with the exception of Health Manager Starter, which does not cover the Blackrock Clinic.
Hospital charges for day-case treatment and surgical outpatient treatment from the Mater Private and Blackrock are not covered under the Essential scheme or Health Manager Starter. Under Essential Plus, these fees are covered, but members pay the first €80 of the claim, while under Health Manager, members pay the first €126 of the claim. Health Manager Gold has full cover for these fees.
Finally, at Vivas Healthcare, to get the highest levels of cover for the high-tech hospitals, members need to go to Levels 4 and 5 of the "I" and "We" plans which, like Plan D and E, give cover for a semi-private room and full private room cover respectively.
•YOU ARE PLANNING TO HAVE A BABY AND WANT TO UPGRADE YOUR MATERNITY COVER:
It is too late if you are already pregnant. If you are taking out a health insurance plan for the first time or upgrading to a higher level of maternity cover, you will have to wait 52 weeks before you are eligible for the new cover.
That won't help parents-to-be who had other things than health insurance on their mind in the months leading up to conception, but for people who do plan every detail of their pregnancy in advance, upgrading their health plan would be a smart move.
Younger people with no history of health problems will often be members of the cheapest plans, such as VHI's Plan A, Quinn's Essential plan or the Vivas "Me" plan.
But these plans have significantly less maternity cover than more expensive plans. In fact, Vivas states that its "Me" plan is "specifically designed for a lifestyle without the responsibilities of parenthood", providing only minimal maternity care, while Quinn's new Personal Care plan issues the same warning.
Taking the example of VHI, all of its members are fully covered for treatment and up to three days' private accommodation in a public hospital. If members want to go private, VHI will contribute the costs of a three-day stay, with the maximum amount paid depending on the chosen plan.
Under VHI's Plan A/A Option and First and Forward plans, the allowance for accommodation in a private maternity hospital is €2,100. But this jumps to €2,900 for Plan B/B Option and Plan C/C Option, and higher rates again for its Family, D and E plans. (Similarly, Quinn's Essential plan provides €2,100 cover, jumping to €3,100 on Essential Plus.)
How much cover is needed will depend on the hospital you choose, and each hospital should be able to furnish future patients with a detailed list of their charges and indicate the likely balance that must be paid by the patient based on their insurance plan.
For example, a three-day semi-private stay at the National Maternity Hospital in Holles Street will cost €540 per day, meaning even the cheapest plans will suffice. On the other hand, three nights' accommodation in a private room at the private Mount Carmel Hospital will cost €5,500.
As the highest ceiling on private maternity cover is €3,500 - under Level 5 of the Vivas "I" and "We" plans and Quinn's Health Manger Gold - there will be a shortfall to pay.
There are also consultants' fees to remember, and these range from about €550 to €4,500.
Most plans will cover up to about €870 toward doctors' fees incurred while in hospital - with lower levels again on the Vivas "Me" plan and Quinn's Personal Care.
Other benefits to look out for include cover for home births and contributions toward the cost of pre- and post-natal care, while Vivas is the only insurer to provide a benefit for post-natal home help.
There will always be some costs that can't be recovered under an insurance plan, but up to 41 per cent of this money can be recovered through tax relief by filling out the Revenue form Med 1.
Finally, if you are thinking about having a baby, now might be a good time to sign up to a cash plan such as those sold by HSA Healthcare and HSF - often through trade unions - as these pay a cash grant when you have a baby that's almost as much as the first year's premium, while the plans also give a wide range of additional insurance benefits.
Full details on the cover provided under each health insurance plan is available from VHI, Quinn Healthcare and Vivas Health. A comparison of the main plans is also available from the Health Insurance Authority at www.hia.ie.
•YOU ARE AT RISK OF GETTING CANCER:
Smokers and people who know they carry the genes for hereditary cancers will probably fear developing cancer more than most, but with one in three people diagnosed with some kind of cancer at some stage in their lives, it is hardly an exclusive disease.
Cancer-related illnesses are the most common condition for which treatment is covered by health insurers. Last year, VHI paid out €144 million on 73,300 cancer claims.
One reason why insurance claims are so high for cancer is the increased use of high-cost drugs, such as the breast-cancer drug Herceptin. In 2006, VHI paid 1,863 members who required this drug a total of €5.2 million, or an average of €2,793 per claim.
The bowel cancer drug Avastin, the lymphatic cancer drug Mabthera and the lung cancer drugs Taxotere and Oxaliplatin complete the top five drugs for which VHI paid out last year.
The newer generation of drugs thankfully prolongs overall cancer survival rates. But as the treatment for cancer often takes place over a long term, on a daycare admissions basis, it will be the finer details of a health-insurance plan that will come into play: private health-insurance members should look in particular at the list of outpatient benefits included with their plan.
Is all of the cost of consultants' fees covered or are there limits per visit? Is there full cover for scans or do "excesses" apply - ie, do you have to pay the first part of the claim yourself? Other things to look out for include cover for manual lymph drainage, breast prosthesis and hairpieces.
Travel expenses are a relatively new area to be covered by health insurers, but in the days of centralised healthcare they seem set to be even more valued by their members. Quinn Healthcare's Essential plans now give €100 per night toward the cost of accommodation for members who have to travel more than 40 miles to a treatment centre for outpatient chemotherapy and radiotherapy, while VHI's Life Stage plans give a similar benefit up to a limit of €1,500 a year.
Claiming to have identified a gap in cover on other health plans, Vivas provides a benefit for psycho-oncology counselling, "in recognition of the stress cancer treatment can cause". It will contribute up to €40 per visit up to a maximum of five visits to a psychologist following chemotherapy.
When it first opened for business, Vivas made it a policy to focus on prevention as well as treatment or, as it says, it "champions pro-active health management".
Apart from sponsoring this month's inaugural national health screening month, this means offering cover for many types of cancer scans, part-payment for full health screens and contributions towards procedures, such as smear tests for cervical cancer, at certain private clinics.
The other insurers are now also paying greater attention to screening benefits. For example, Quinn Healthcare now pays in full for breast mammograms, PET/CT scans and colon cancer screening at a range of facilities, while at VHI, the LifeStage Choices plans provide screening cover up to annual limits of up to €350.