What is health insurance?
Health insurance pays your private medical and hospital expenses when you or your family need health care.
A health insurance plan will cover the cost of hospital accommodation and provide quicker access to health services and treatment.
What health insurance covers
Health insurance companies offer a range of policies from basic cover to premium plus plans. The benefits you receive depend on the type of scheme you choose.
Private health insurance benefits can include:
- In-patient services: This includes general hospital accommodation, hospice, mental health, and A&E overnight stays.
- Out-patient services: Day case surgery and treatment that takes place in the hospital, but doesn’t require an overnight stay.
- Everyday medical expenses: This may include cover of emergency or non-emergency dental and optical care.
- Online GP services: This is access to a GP via your phone, laptop or PC. Prescription costs are not normally covered.
- Complementary therapies: Costs may be partially covered for therapies such as osteopathy, acupuncture and homeopathy.
- Maternity benefits: Contributions towards scans, antenatal classes and consultation costs.
- Allied health services: Physiotherapy, chiropody, speech therapy, occupational therapy, and psychiatric services.
- Consultation fees: This includes referrals from your GP and a second opinion service.
- Medical tests and scans: Any tests or screening that takes place may be partially covered.
Policy exclusions or specific benefits information is often buried in the small print. Always read your policy schedule to check you’re covered for what you expect.
Do health insurers cover pre-existing conditions?
A pre-existing condition is an ailment, illness or condition that has existed at any time in the 6 months prior to the date you take out your policy.
The waiting period before you’re allowed to claim for a pre-existing condition is typically five years, so you will need to serve this time period before you’re fully covered.
Will I be covered straight away?
When you take out medical insurance for the first time you may have to serve a waiting period before you’re fully covered.
Initial waiting periods
|Pre-existing condition||5 years|
|New condition||26 weeks|
|Accident or new injury||Immediately|
|Maternity benefits||52 weeks|
If you upgrade your plan to include higher in-patient benefits, the insurance company will insert a two year Upgrade Rule for any pre-existing medical conditions.
This means if you have a pre-existing condition, you will not gain from the upgraded benefits for the first two years. You will still be covered by the benefits of your existing plan so you won’t lose cover.
If it’s a new medical condition the higher-level benefits will be covered immediately.
Types of health insurance plans
The type of plan you choose will affect how comprehensively you are covered. There are three main types of health insurance cover.
- Health insurance: These plans cover all or part of your in-patient, hospital costs and will typically include other out-patient benefits.
- Cash benefit: A cash plan provides fixed reimbursement for a range of medical events but does not include claim back for in-patient costs.
- Out-patient only: This type of policy will cover your out-patient expenses, for example, online GP consultations or emergency dental care.
How much is health insurance in Ireland?
The average annual cost of Irish health insurance was €2,059 in 2019 according to a survey by the Health Insurance Authority. This figure includes both family and individual policies.
However, monthly premiums for individual health insurance can be as little as €16 for a basic cash only scheme or as high as €737 per month for a fully comprehensive plan.
What about European health insurance?
If you’re travelling somewhere in Europe, taking a European Health Insurance Card (EHIC) with you will get you access to free or low cost health care.
Find out more about what the EHIC covers, how to use the card, and how to get one.
How to find the best health insurance
The best health insurance policy is one that’s affordable and best protects the health needs of you and your family.
However, there are currently over 300 different policies so finding the right scheme can be time-consuming and confusing.
Choosing the right type of health insurance plan
The following factors can help you decide which health insurance plans work best for you and your loved ones:
- Age - this will affect the price you pay and the type of cover you need
- Affordability - how much can you afford to pay on a regular basis?
- Locality - what services are available in your area?
- Lifestyle - think about what benefits you may need, e.g. if you’re a keen sportsperson, you may need physiotherapy
- Future plans - if you are planning to start a family in future, you may need maternity services
It is important when you are obtaining a quote to provide accurate personal information.
Where you can buy health insurance
There are four health insurance providers in Ireland, although there are other companies that provide health insurance schemes for some select groups.
You can start your comparison here by checking out these health insurance providers. Comparing providers helps you get the best private insurance available at a price you can afford.
Can anyone get health insurance?
Insurers cannot refuse to accept or renew your policy on the basis of your health or age but they may restrict your cover or specify exclusions.
Lifetime Cover guarantees everyone the right to renew their policy, regardless of age, health status or claims history.
Will my age affect the cost of health insurance?
Yes, the Lifetime Community Rating means that a 2% loading on premiums is applied to new members aged 35 years or over who buy insurance for the first time. Furthermore, an extra 2% loading applies for every additional year over 35.
For example: If you take out a private health insurance policy for the first time, aged 44, you will pay an additional 20% on your annual premium every year. The loading will apply for a maximum of 10 years.
Is health insurance worth it?
If you find an affordable policy that fits your needs, health insurance will give you peace of mind and confidence that you and your family will get the best care available in your time of need.
However, if you are over the age of 35 when you first take out a policy, be aware the Lifetime Community Rating will increase the cost of your premium.
Just remember to read the terms and conditions carefully to check for exclusions, policy excesses, and restrictions.
Do you need private health insurance in Ireland?
Private health insurance in Ireland is optional, but can offer valuable peace of mind should you or a loved one fall ill.
If you live in Ireland, you are entitled to public in-patient and out-patient hospital services, although they are not always free.
If your income is low, you may qualify for a Medical Card and will have access to most health services for free. If you don’t qualify, you’re entitled to free hospital services but may have to pay for charges and GP services.
Looking for life insurance too?
If you haven’t sorted out life cover yet, it’s better not to put it off.
Our guide: How to find the best life insurance in Ireland, explains everything you need to know about the different types of life cover, how it works, and what it covers.
The earlier you start a policy, the cheaper it will be, plus, you’ll have peace of mind that your loved ones will be protected financially if the worst happens.
Health Insurance FAQs
Are surgical appliances and hearing aids covered?
Sometimes. Medical appliances are partially or fully covered, but it’s advisable to check with a provider directly. Most providers will supply a specified appliances list on request.
Can I change my insurer or switch my plan?
Yes. However, if you are upgrading or switching to a health insurance plan with enhanced benefits there may be a waiting period before the new benefits apply. It is best to switch your plan at the renewal date to avoid penalties or cancellation fees.
Can I claim tax relief on my health insurance premiums?
If you take out private health insurance or long-term care insurance, you may get a tax credit. This tax credit is normally granted directly by the insurance provider. This is known as Tax Relief at Source (TRS).
Does my insurance cover overseas travel?
Medical emergencies abroad are usually covered as standard. However, if you intend to travel regularly or work and study abroad you can choose a plan tailored to your specific needs, which will be more comprehensive. Your travel insurance policy may provide the cover you need.
Do I need private health insurance for maternity services?
No. The public Maternity & Infant Care Scheme provides GP and hospital care to all expectant mothers who live in Ireland. The mother is entitled to free in-patient, out-patient, accident & emergency services in a public hospital throughout pregnancy and birth.
What are restricted membership schemes?
Health insurance schemes which are only available to specific employees, for example, health workers or Gardai. The four main providers operate under the Open Membership principle.
What is the Health Insurance Levy?
The Government charges health insurers a Health Insurance Levy for every health insurance policy taken out. The levy forms a set amount of your health insurance premium and accounts for approximately 33% of your total premium.
Who regulates health insurance providers?
Health Insurance providers are financially regulated by the Central Bank of Ireland and legally and statutorily regulated by the Health Insurance Authority. Providers will need to display a registered address on their website.
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