Medical bills need a regular check-up

Irish patients spend more than twice the EU average on private health every year — but careful research can bring those costs down, writes Mark Channing.

People in Ireland are coughing up more money on private medical bills than any other EU country, according to new research.

Figures compiled by the Organisation for Economic Co-operation and Development, and seen by The Sunday Times, show that individuals spent €1,209 on private health expenditure last year. The figure, which includes money spent on health insurance, drug prescriptions and doctors’ visits, is double the EU average of €604.

The research comes as a separate study shows that one in two Irish families are massively overpaying for health insurance. An analysis of more than 500 health insurance policyholders in Ireland by Total Health Cover, an adviser, found that Irish households overpaid on their health insurance by an average of more than €700. The figure for some families was €1,300 on like-for-like plans.

Dermot Goode, the managing director of Total Health Cover, says: “We’re back to the bad old days of increasing health insurance premiums. Irish families are still paying well over the odds for their health cover by not shopping around.”

We tell you how to stop your healthcare costs from spinning out of control.

HEALTH INSURANCE

The cost of health insurance is increasing again, with prices for some plans going up by double digits this year. According to Goode, it is possible to beat the hikes by switching to newer plans, many of which offer the same or better benefits at a lower cost.

He provided a number of cases where families can save on their premiums, without sacrificing their level of cover. For example, VHI’s Family Plan Plus Level 1 costs €4,458 a year for a family of two adults and two children. This compares with its PHI 41 15 plan costing €3,159 — a saving of almost €1,300.

Laya Healthcare’s Health Excess Plan costs €3,952 compared with its Simply Connect Plus plan, which is at €2,992, saving €960. Irish Life Health’s Health Plan 16 costs €4,152 compared with its Health Plan 16.1, which is more than €1,000 cheaper at €3,147.

All of these savings can be made without switching insurers. Simply challenge your provider to offer you a similar plan to the one you are on, but at a lower price.

“There is huge price variation across the industry for plans with similar or equivalent cover, often with the same insurers,” says Goode. “If you have been on the same plan for more than two years, you are most likely paying too much.”

DOCTORS’ FEES

So-called “telemedicine”, where you see a doctor via a video link on your smartphone or tablet, could save you money. Video appointments make up 40% of all consultations in America. Many of the 24m annual GP consultations in Ireland could take place by video, says the National Association of General Practitioners.

The association is piloting a telemedicine service called GP-Online, which has face-to-face video consultations and sends prescriptions to a local pharmacy. The organisation estimates that a video consultation will cost €30-€35 compared with the €50 average to see a GP, according to a 2014 survey by WhatClinic.com.

Aiden Callaly, chief executive of GP-Online, says: “While relatively new to Ireland, video appointments are suitable for a wide variety of health complaints as well as repeat prescriptions.”

Other providers have begun providing virtual GP visits to Irish customers. MeeDoc, an app launched in Ireland last year, charges €15 for a first GP consultation and €34 thereafter.

PRESCRIPTION COSTS

Prescription charges for pensioners were cut by €5 a month in the October budget but this will do little to help families, who spend €1bn a year on drug prescriptions, according to 2015 research published by Fianna Fail.

Under the Drugs Payment Scheme, families pay a maximum of €144 in a calendar month for approved prescribed drugs, the equivalent of €1,728 a year.

Those needing repeat prescriptions can save by joining Limitless Health, a subscription-based pharmacy with outlets in Limerick and Dublin. The firm also delivers nationwide.

Membership of Limitless Health costs €20 a year for single people, €35 for a couple and €45 for families. The firm claims its prescriptions are 60% cheaper on average than other pharmacies. Daire Scanlon, the founder of Limitless Health, says: “My customers are saving anywhere from €300 to €600 a year on prescriptions.”

Scanlon says he can cut costs because of the volume of sales and negotiating deals directly with wholesalers. For example, 10mg of cholesterol drug Atorvastatin costs €3.75 from Limitless Health, compared with the €9.50 charged by retail pharmacies. Scanlon also says he sells a Symbicort 200/6mg inhaler for €45, compared with the €70 price at more expensive rivals. Meanwhile, 5mg of blood pressure drug Amlodipine costs €3.35 from Limitless Health, compared with €13.50 in a regular pharmacy.

TAX RELIEF

Money spent on GP visits, consultants’ fees, prescriptions and other medical expenses is eligible for 20% tax relief. A medical expense of €250 qualifies for €50 cashback from Revenue. Fewer than one in five people claim it, according to the tax refund company Taxback.com, which says millions of euros are unclaimed each year.

Medical expenses going back four years can be claimed using Revenue’s PAYE Anytime online service. You need the receipts but do not need to submit them.

Christine Keily, head of direct taxes at Taxback.com, says: “Claiming tax relief on medical expenses is one of the most straightforward things you’ll ever do, in terms of personal admin. It’s easier than shopping online.”

Anyone whose health insurance is paid by their employer is also likely missing out on tax relief, experts say. When you buy health insurance privately, the relief is granted at source and already factored into the premium you pay. However, if your employer pays the premium, you must claim the relief yourself — worth up to €200 a year per adult.

“Employees working in companies that fund the cost of the healthcare don’t realise they are missing out on valuable tax relief on their premium,” says Goode. “They think it’s granted at source or organised by their employer, which is not the case.”

CASH PLANS

Health cash plans give you money back on the cost of routine medical expenses such as prescriptions and visits to the GP and dentist. According to Goode, cash plans are “still very good value” but should not be seen as a substitute for someone who wants private health insurance.

Ireland’s main cash plan provider is the Hospital Saturday Fund, which increased the cost of its cash plans by 10% this month. Scheme FDA, the fund’s most popular family plan, costs €62.15 a month and covers 100% of the price of dental and optical visits up to €500 a year, and 100% of practitioner visits up to a €350 a year. You can also claim €19 back per GP visit.

PRSI BENEFITS

The state’s treatment benefit scheme offers dental, optical and aural services to those with the required PRSI contributions. The scheme was extended in the budget to include the self-employed for the first time. They will qualify from March.

Under the scheme, you can claim for the full cost of one dental examination a year and an eye test every two years.

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