Health insurance
What is health insurance?
Health insurance helps cover medical and hospital costs if you get sick or injured. This page explains the types of cover available in Ireland, how inpatient and outpatient benefits work, what to check before choosing a policy and why factors like waiting periods, allowable expenses and Lifetime Community Rating can affect your costs. It also outlines how to review or switch your cover and where to compare plans.
Why consider health insurance?
Health insurance can help reduce the cost of private medical treatment and hospital care, giving you financial protection if something unexpected happens. It may also give you faster access to diagnostics or specialist appointments, depending on the plan you choose.
The health insurance market in Ireland is regulated by the Health Insurance Authority (HIA), which provides information on consumer rights and plan benefits.
What is Lifetime Community Rating?
You need to enter the health insurance market before age 35 to avoid an extra premium called a loading. From 1 May 2015, a loading of 2% applies for each year over 35 when taking out insurance for the first time, up to a maximum of 10 years.
Previous health insurance cover may reduce or remove this loading – visit the Health Insurance Authority website for details.
In this section you will find information on the following:
What health insurance options are available?
There are two basic types of private health insurance:
- Inpatient hospital cover: Pays for services if you are admitted to hospital, including treatment, accommodation, tests, and surgery.
- Outpatient or primary cover: Covers treatment when you are not admitted to hospital, such as GP visits, consultant appointments, physiotherapy or specialist care.
You can take out inpatient and outpatient cover separately or choose a packaged policy. Some plans may have limited or no outpatient cover, only covering part of your expenses (the ‘allowable expense’).
What are some examples of cover?
- A GP visit may now cost €60–€70, and in some areas it can go up to €90, but the allowable expense under your policy might only be €20–€30.
- Some policies refund a percentage of expenses after you pay an excess.
- Hospital cover varies – some plans cover semi-private rooms in public hospitals, while others cover private rooms in private hospitals.
Always check your policy’s allowable expenses before booking appointments so you know what you’ll pay.
How do you get the right cover?
As well as offering different benefits, the packages on offer from health insurance providers vary in cost. The policy offering the lowest premium may not always be the best value for money, so it makes sense to get quotes from each provider and compare the benefits on offer to decide what suits you best.
You can find out more information on the different health insurance packages and costs from health insurance providers in Ireland from the Health Insurance Authority.
When comparing policies, consider:
- The level and type of cover you need
- Whether you want basic cover or are willing to pay more for private hospital treatment
- The mix of inpatient and outpatient cover
- Which product suits your stage of life (e.g. maternity benefits, sports cover, family cover)
- Services available in participating hospitals in your area
- Cost comparisons between products
- Whether you need cover for yourself or your family
Even with private hospital accommodation cover, availability of private beds is not guaranteed.
You should always be aware of the conditions of your cover and any restrictions that apply. These will be outlined in your policy document.
What should you check before signing up?
Ask yourself:
- Does the policy cover all treatments you may need (e.g. dental, outpatient, experimental, medical treatment abroad)?
- Do you understand all policy details? Read the small print and ask for explanations.
- Is there a waiting period for pre-existing conditions?
- What happens if the main policyholder dies on a family policy?
Generally, you cannot take out private medical insurance for treatments you know you will need. Some policies may not cover fertility treatment, elective procedures or may have limited cover for mental health.
Who provides health insurance in Ireland?
There are many different health insurance providers in Ireland, offering a wide range of plans and benefits. The Health Insurance Authority (HIA) is the official regulator for private health insurance in Ireland. It offers a free Comparison tool to help you review plans from all registered providers and check benefits, costs and restrictions.
Some employers and membership groups arrange health insurance schemes for their employees or members, offering access to specific plans or discounts. Check if your employer or union offers a health insurance scheme – you could save money or get extra benefits.
What other health-related insurance is available?
Private health insurance will not provide an income or cash sum while you are ill. It only covers actual medical costs. There are other policies that may pay out a cash sum or regular income in certain circumstances if you become ill or incapacitated:
It is very important to check the Health Insurance Authority’s (HIA) website before you switch.
Should you review or switch your health insurance?
Review your cover at least once a year when you receive your renewal notice. You may save money by changing your level of cover or switching providers. You can switch provider during your policy term but check for charges or waiting periods for extra benefits.
Why would you review your cover?
- Changes in your life (e.g. children, planning a family)
- Need for extra precautions against ill health
- Changes in your health
- Over-insurance (you could save money by reducing cover)
- Wanting better value
How can you save money on health insurance?
- Opt for a cheaper corporate plan (available to all consumers)
- Put children on a different plan to yourself
- Get quotes from different providers
- Pay an excess on claims
- Downgrade your cover (consider if savings are worth any loss in cover)
If you upgrade your cover, waiting periods of up to two years may apply for extra benefits.
Compare costs and benefits using the Health Insurance Authority’s comparison tool.
What do you need to do when switching provider?
- Read your new policy documents carefully and ask questions if needed
- Cancel the direct debit to your old insurer by writing to your bank
- Contact your old provider to confirm cancellation
