Why MedPlan Is Rethinking How It Scores Health Insurance

MedPlan's benefit score has always worked the same way: each piece of cover earns a slice of points based on how generous it sounds. We've built a second scoring model behind the scenes, called the EAMB model (Expected Annual Monetary Benefit), and it prices every benefit in real euro instead of points.

What's Changing

• From points to probability: The old score asks how generous a benefit sounds. The new model asks how much it's actually worth, by pricing each benefit against a realistic annual chance of needing it and a realistic cost if you do, from a hospital stay to a physio visit.
• Hospital cover is priced per tier: Semi-private, private room and hi-tech hospital cover are each weighed against an assumed nightly cost, an assumed length of stay and an assumed admission probability, then netted against the plan's actual copay and nightly excess.
• Shortfalls can't hide behind a quote: A plan that quotes a flawless 0% shortfall on a hospital tier it barely covers isn't rewarded for that quote. The new model floors the shortfall at the coverage gap the tier itself implies, exactly as the current score already does.
• Some gaps only show up this way: Two insurers can look almost identical on hospital cover under the old score while one offers a private room upgrade on nearly every plan and the other on under half of them. Pricing it in euro, not points, is what surfaces that gap.

Why It Matters

A benefit score should answer the question you actually care about: not "does this plan sound generous," but "what is this plan's cover actually worth to me, in money, in an average year." Scoring every benefit against its real cost and real likelihood gets closer to that answer than a fixed points scale ever could.

What to Do

This isn't live yet. The EAMB model is an internal comparison tool while we keep testing it against real plans and double-checking every assumption it runs on, from average hospital stays to how often people actually claim orthopaedic cover in a year.

You can still compare VHI, Laya and other Irish plans side by side today at MedPlan.ie, using the score you already know.