How health insurance works
Health insurance can help pay for medical treatment, including hospital visits and stays when you’re ill or injure yourself.
In Ireland, you’re protected by a Lifetime Cover scheme that allows you to buy and renew your health cover, regardless of your age, gender or health status.
Can you get free healthcare in Ireland?
If you’re an Irish resident with a low income, you can apply for a medical card that gives you free access to a range of medical services, including:
- GP services
- Inpatient public hospital services
- Maternity and infant services
- Dental, optical and hearing services
- Counselling services
You also only have to pay a small charge for prescriptions.
Don’t qualify for a medical card? You may be eligible for a GP visit card which gets you free access to GP services; children under six automatically qualify.
Types of healthcare plans
There are three main types of plan to choose from and three cover levels:
- Inpatient hospital cover These plans cover inpatient hospital costs, including day patient care and overnight stays. It can pay in full or part for tests, treatment, surgery and hospital accommodation.
- Outpatient cover These plans can cover treatment from a GP, consultant or specialist care, e.g. physiotherapy.
- Cash plans These plans pay out a set amount for a huge range of medical expenses but don’t cover inpatient costs.
Cover levels
- Level 1 cover Is the most basic and offers care in public hospitals.
- Level 2 cover Offers care in private hospitals but a semi-private room.
- Level 3 cover Offers care in private hospitals in a private room.
If you want to be treated at a top of the range hospital like The Blackrock Clinic, you’ll need to look for a high-level plan that lists it.
When does the cover kick in?
It depends. If it’s your first health insurance plan or it’s been over 13 weeks since your last policy ended, a waiting period may apply.
What are the waiting periods?
Whoever you decide to buy your health insurance from, these are the maximum waiting periods for new customers:
| Cover for | Max waiting period |
|---|---|
| Accidents and injuries | Immediate cover |
| New condition | 26 weeks |
| Pre-existing condition* | 5 years |
| Maternity claims | 52 weeks |
*A pre-existing condition is an illness or a medical condition you had within six months of taking out your healthcare plan.
If you’re switching to a new insurer, any waiting periods (in part or full) you’ve already served will carry forward.
When should you get cover?
The earlier, the better because of the Lifetime Community Rating, which recognises younger people tend to make fewer claims.
If you wait until you’re 35 or older, you’ll have to pay a premium known as loading.
This means paying an extra 2% on your health insurance premium for every year over 34 you are.
For example, if you take out your first plan at 40, you’ll pay an extra 12% each year, for a maximum of 10 years.
If you had health cover previously but stopped your cover, insurers can consider this if you can provide proof.
How to compare health insurance
It’s tricky finding the right cover for your needs. Here are some pointers to consider:
- Type of cover e.g. inpatient, outpatient or both. Cash plans are also an option to pick and mix the services and cover you want.
- Level of cover e.g. basic or with bells on. Your age, current health and affordability may affect which you choose.
- What your budget is e.g. how much you can afford each month.
- Lifestyle needs e.g. if you play sports regularly or have a physical job, you may want physiotherapy included.
- Future plans e.g. if you’re planning a baby you may want particular maternity services.
- Who the cover is for e.g. individual, couple or family cover.
- Inpatient room type e.g semi-private or private hospital room.
- Hospital type e.g. public or private hospital.
Check that there’s enough outpatient cover for your needs, as this is often somewhat limited.
How much does health insurance cost?
There are a tonne of factors that affect how much you’ll pay, so you’ll need to get a personalised quote.
A basic cash plan could be as little as €12 a month, while an all singing all dancing fully comp plan could cost an eye-watering €753 a month!
The key is picking the right benefits for your circumstances, so you’re not paying more than you need to.
If you’re a bit strapped for cash, it could still be worth having a basic plan to avoid the hefty loading charges you’ll get hit with if you wait until you’re 35 or above.
How to make it cheaper
Here are some ways of cutting the cost down:
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What about the excess?
The excess is the amount you’ll pay per claim, and you can choose the level it’s set at.
The lower the excess, the more you’ll pay for the plan, but a higher excess means paying more when you claim.
Do you really need health cover?
If you can’t get a medical card and don’t have health insurance, charges are capped if you need medical assistance.
So, you may prefer to pay for the care you need as you go if it’s an affordable option for you.
For example, inpatient hospital services cost €80 a day or €800 max in a 12-month rolling period, for any number of public hospital admissions.
This covers all procedures needed in that time, including follow up outpatient treatment.
Health Insurance FAQs
Can I get tax relief on my health insurance?
Yes, it’s your insurer that grants tax relief on your private health cover at source.
What’s a European Health Insurance Card (EHIC)?
An EHIC is free to apply for and can cover medical bills if you fall ill or are injured while visiting another European country.
Who is the Health Insurance Authority (HIA)?
The HIA is the private health insurance regulator in Ireland. They can help you understand your rights and offer information on different health care plans and benefits.
Can I switch to another health insurer?
Yes, absolutely. It’s best to wait until your plan’s up for renewal to avoid any early exit fees unless your provider allows you to switch mid-way through penalty-free.