Facebook Twitter Instagram
    Facebook Twitter YouTube
    Latest Articles
    • Recruitment Section at the 50 Plus Show
    • Life is for living….
    • Your chance to win the Fantastic Finger Puppet Story Set with Nursery Rhymes from mimitoys.ie
    • Mimitoys.ie, one the largest selection of children’s puppets in Ireland are exhibiting at the 50 Plus Show
    • Improve your Digital Skills at The 50 Plus Show
    • Seniorline are celebrating 25 years at the 50 Plus Show
    • Driving Life with Conor Faughnan. Episode 36: Conor meets Charlie McGettigan
    • Alix Gardner Cooking Demo’s at the 50 Plus Show
    Senior Times
    Podcasts
    • Home
    • News
    • Features
      1. Driving Life
      2. Fashion & Beauty
      3. Finance
      4. Food & Wine
      5. Further Education
      6. Galleries
      7. Gardening
      8. IRISH GEN POD SERIES
      9. Health
      10. Hobbies & Pastimes
      11. Legal
      12. Literature
      13. Nostalgia
      14. Profiles
      15. 50 Plus Show
      16. Sport
      17. Travel
      18. What’s On
      Featured
      February 15, 20230

      SeniorTimes Rewind – Mike Murphy talks to Author, Deirdre Purcell

      Recent
      March 21, 2023

      Your chance to win the Fantastic Finger Puppet Story Set with Nursery Rhymes from mimitoys.ie

      March 19, 2023

      Driving Life with Conor Faughnan. Episode 36: Conor meets Charlie McGettigan

      March 19, 2023

      Alix Gardner Cooking Demo’s at the 50 Plus Show

    • Podcast
    • Competitions
    • 50 Plus Show
      • Whats On
      • Register
    • Magazine
      • Previous Issues
      • Subscribe
      • Advertise
    • Meeting Place
    • Contact
    Senior Times
    You are at:Home»Features»Health»Is your health insurance policy up for renewal?

    Is your health insurance policy up for renewal?

    0
    By Senior Times on January 26, 2023 Health

    Advice from The Financial Services and Pension Ombudsman (FSPO)

    As we start a new year and all the intentions and resolutions that come with it, health insurance may be the last thing on your mind, but many people’s policies have a renewal date approaching so it is a good time to think about reviewing your cover.

    The Office of the Financial Services and Pensions Ombudsman (FSPO) is an independent, impartial, fair and free service that helps resolve complaints from consumers, including small businesses and other organisations, against financial service providers and pension providers. As Deputy Financial Services and Pensions Ombudsman, I have adjudicated on many health insurance related complaints, and it has allowed me to see the difficult circumstances experienced by consumers which lead to a complaint to this Office.

    At this time of year, many people will be thinking about reviewing or renewing their private health insurance, or indeed perhaps switching providers, particularly in light of the current cost of living pressures. Health insurance can represent a significant amount of a household’s budget, on average being in the order of €1,410 per adult, per year. It is vital that consumers take some time, before starting the renewal process, to make sure they understand the impact of any decisions they make in upgrading or downgrading their cover.

    Recent research carried out on behalf of the FSPO revealed that 51% of participants reported having private health insurance. However, some consumers who purchase private health insurance are not familiar with their cover or do not understand how waiting periods can affect their ability to make a claim on their policy. As with all financial products, it is so important to understand what you are buying and to be aware that not all insurance policies are the same.

    The level of hospital cover and outpatient cover is at all times determined by the type of plan chosen by the consumer. With more than 300 different plan options available, there is tremendous choice in the health insurance market, but it can be a challenge to select the best level of cover to suit individual needs. Our recent market research also revealed that 27% of participants who held health insurance felt they had a poor understanding of the cover on their plan, in contrast to 15% who felt they had a very good understanding. The highest level of understanding was amongst the over 65s.

    Complaints brought to the FSPO highlight that, very often, people are not aware that medical investigations, X-rays or blood tests, which they had before they took out cover, can result in a condition being identified as being pre-existing. The policy holder may not believe that there was a pre-existing condition, because the issue which led to them having an x-ray or other test, wasn’t named or diagnosed, at the time of the investigations. It is important for consumers to be aware that a pre-existing condition can exist, without a formal diagnosis, and it is the signs and symptoms within the period, which are relevant.

    To highlight some of the difficulties that can arise in understanding the complexity around waiting periods, the FSPO has produced a Digest of legally binding decisions, on health insurance complaints, which is available on the FSPO website at www.fspo.ie

    This Digest contains some examples of decisions which explain the concept of a ‘pre-existing condition’, and how that issue impacted consumers who bought new health insurance, or who upgraded their level of cover, for example a complaint concerning a claim for €10,892 for a robotic procedure undertaken by Matthew to treat prostate surgery, where he recovered only part of the cost, because the illness was considered to have existed, prior his upgrade in policy level.

    MaryRose McGovern, Ombudsman at Financial Services and Pensions Ombudsman

    The Digest also includes some examples of issues that can occur when seeking approval of cover, for example a direction made by the Ombudsman to pay a claim of €67,778 and compensation of €2,000 to Debbie, who complained that her request for pre-approval to get treatment in another EU country was declined. There are also details of a direction to pay €3,000 to Alice who rang her insurer to confirm cover for her dental work, which was due to cost €7,000, but she was not given the right information.

    Health insurance policies will not cover you for every eventuality, so it is worth taking some time now, to familiarise yourself with your cover and its associated waiting periods, before you need it. Customers who take out private health insurance after they have already developed symptoms, may find that they have no cover for treatment which they ultimately need, if the condition was pre-existing.

    If you do have a complaint against your health insurer, first make a complaint directly to it, to give your insurer the opportunity to resolve the complaint. If you are unsatisfied with their response, you may then make a complaint to the Financial Services and Pensions Ombudsman.

    Financial Services and Pensions Ombudsman, Lincoln House, Lincoln Place, Dublin 2. www.fspo.ie 01-5677000 

    Spread the love
    health Insurance
    Senior Times
    • Website
    • Facebook
    • Instagram
    • LinkedIn

    Senior Times publishes Senior Times magazine and are producers of the SeniorTimes Podcasts. They are also organisers of The 50 Plus Show run throughout the country

    Related Posts

    Researchers in UCD would like your assistance

    How my company went from saving bees to helping people enjoy pain free movement

    Driving Life with Conor Faughnan Episode 33 – Professor Donal O’Shea

    Comments are closed.

    Driving Life Podcasts

    Gen Pod Series

    Search the Site
    Spotify

    Subscribe

    Our Podcasts

    Senior Times Podcast Platform · Next Up
    Subscribe to our Newsletter
    * indicates required
    Dublin
    March 26, 2023, 2:24 pm
    Mostly cloudy
    Mostly cloudy
    8°C
    real feel: 2°C
    wind speed: 6 m/s N
    sunrise: 7:14 am
    sunset: 7:49 pm
    Forecast March 26, 2023
    day
    Partly sunny with showers
    Partly sunny with showers
    8°C
    wind speed: 4 m/s NNE
    night
    Intermittent clouds
    Intermittent clouds
    1°C
    wind speed: 2 m/s NW
     
    Follow Us On Facebook
    Follow us on YouTube
    Follow us on Twitter
    Tweets by @seniortimesmag
    Copyright © 2023 Sports & Leisure. Designed by clikcreative.com.

    Type above and press Enter to search. Press Esc to cancel.