FAQs

How will I decide who to switch to?

If you are thinking of switching health insurer, it would be worthwhile to ask some key questions such as the following:

1. What type of hospital accommodation do you want?
   Unless there is a particular benefit that is important to you, it is usually best to start by considering the core benefits of in-patient/day patient hospital treatment and consultant treatment.
2. What benefits would be of most value to you?
   Because of your lifestyle or future plans some benefits may be of interest to you such as overseas cover or maternity.
3. How much risk are you willing to accept?
   Some policies carry an excess so you need to consider carefully whether you want to take on a lower premium with an excess or possibly a higher premium with no excess.

Who are the main Health Insurance providers operating in Ireland?

VHI Healthcare, Quinn Healthcare and Aviva Health are the only insurers providing cover for hospital in-patient costs.

Will my age affect my insurance premium?

No. The health insurance system which applies in Ireland is called community rating. In a community rated system, each adult pays the same premium for a given health insurance plan. Your age may affect the length of waiting periods you serve.

What is a waiting period?

A waiting period is the period of time during which you cannot make claims.

When do waiting periods apply?

These apply if:

• You are a new member to health insurance
• You are still subject to a waiting period with another health insurer.
• Your previous membership under another health insurance contract ended more than 13 weeks before joining your new plan.
• You upgrade your cover but you have an existing medical condition.

I have never had health insurance before, how long will I have to wait until my health insurance commences?

The maximum waiting periods that an insurer may apply in these circumstances are as follows:

• 26 weeks in respect of a person who is under the age of 55 years.
• 52 weeks in respect of a person who is 55 years of age or over and under the age of 65 years.
• 104 weeks in respect of a person who is 65 years and over.
• They impose a waiting period of 52 weeks in respect of maternity benefits.
• Please note that accident cover applies immediately on all policies.

What happens if I have a break in cover of more than 13 weeks?

If you have a break in cover of more than 13 weeks, you are considered a new member and will have to re-serve all of your waiting periods again.

I have a medical condition. Do I have to serve an additional waiting period before I am covered for this?

If you are taking out health insurance for the first time and have a pre-existing condition, the health insurer can impose a waiting period in respect of cover for treatment for this condition. The maximum waiting periods that the health insurer may impose in this case are as follows:

• 5 years, for a person who is under the age of 55 years.
• 7 years, for a person who is 55 years of age or over and under the age of 60 years.
• 10 years for a person who is 60 years old or over.

What happens if I find out that I have a medical condition and I decide to upgrade my level of cover?

If you decide to increase the level of your cover, an exclusion period will apply. The exclusion period is 2 years for anyone up to the age of 65 and 5 years for anyone who is 65 years and over. Benefits for treatment for such conditions during this period will be paid up to the amount that would have been covered under your old plan.

Will my baby have to complete a waiting period?

Infants born to policy holders will not serve a waiting period if they are added to a policy within 13 weeks of their date of birth.

What happens if I switch from my current insurer and wish to return to them at a later date?

If you switch insurer and later decide you want to switch back, you may do so. In some cases, the insurer will only permit this from your next renewal date. The insurer may only impose waiting periods for any extra benefits available on your new plan (upgrade rule). One insurer has now introduced a minimum waiting period of 6 months which must be served before any upgrade will apply. If you have not served all other waiting periods, these will still have to be served with the new insurer.

If I find a better plan can I switch health insurance providers before my renewal date?

Normal practice is to amend your cover at renewal only. Two insurers will permit mid year changes without penalty assuming there have been no claims paid under the policy. One insurer will now charge you a fee to cover their expenses if you cancel your contract with them mid-term. As these terms are subject to change, always seek independent advice before making any changes.

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