Taking out health insurance for the first time can be confusing. There are approximately 325 plans available to choose from, which is why it is important to understand waiting periods and what they mean to you before you buy a health insurance plan.
If you take out health insurance for the first time and have a pre-existing condition, you will have to wait 5 years before you are covered for benefits relating to that condition. If you develop a new condition and have just purchased a plan, the rule is that you will have to wait 26 weeks before your health insurance kicks in. For a health insurance policy that covers maternity benefits, you will have to wait 52 weeks before you can avail of this cover.
Aged 35 or over
If you are over the age of 35, and don’t currently have health insurance, then you will be effected by the Lifetime Community Rating (LCR) loading. This means that for every year over the age of 35, you will have to pay a 2% loading per year on top of your premium. The way to avoid this loading is to take out health insurance before you turn 35.
Before you decide on health insurance, ask yourself these questions:
1. What hospitals are important to you?
Hospitals are categorised into 3 broad categories; public, private and hi-tech. Entry level plans offer cover for public hospitals only, and while these plans are competitively priced, they may offer no cover in private hospitals and only cover in selected public hospitals. Your geographical location may influence the importance of hi-tech hospitals to you (hi-tech hospitals are in Dublin only), so it may not be worthwhile paying extra premium for cover in these hospitals. Level 2 or 3 health insurance plans are the most popular plans, which cover clients for a semi-private or private room in a private hospital.
2. What excess are you willing to pay for treatment?
All health insurers offer plans with different levels of excess. An excess is the first part of the claim you are required to pay yourself. Excesses can range from €50 per claim to €500 per claim. If you choose a higher excess, then this will allow a reduction in your premium, however it is important to note that if you claim then you will have to pay this excess upfront. A health insurance excess can apply to both in-patient treatment (which involves an overnight stay), as well as, day case treatment / or procedures.
Paying a higher in-patient (overnight) excess such as over €300 can be quite restrictive, as this is the amount you will have to pay yourself upfront. However, the most common claims are for day case treatment in a private hospital. Examples of day case procedures are wisdom teeth removal, colonoscopy, mole removal, as well as certain types of cancer treatments such as chemotherapy. There are health plans available where the day case excess you have to pay is significantly less than the overnight in-patient excess. Be sure to check this out before you decide on a suitable plan.
3. Do you want to claim money back on everyday medical expenses such as GP & physiotherapist visits?
It is a common misconception that all health insurance plans allow members to claim back money on everyday medical expenses. Only certain plans provide this benefit. It is worth sitting down and doing the maths before deciding if it is prudent to opt for a plan which gives money back on these visits. Calculate how often you went to a GP, Physio, Consultant etc., in the previous year and the cost of each visit versus the additional cost of taking out a plan which includes this type of cover. Remember too, free GP care is available to all kids under 6, with some health insurers also offering online GP as a member benefit across their plan range, at no extra cost. Did you know that all health insurers offer ‘corporate plans’ which are not directly marketed to all consumers? These corporate plans tend to allow members to claim back an average of 50% - 75% on GP, specialist consultant visits, as well as visits to A&E. It might be worthwhile looking into a corporate plan, if this is a benefit which is important to you.
Before you buy
Given the complexity of health insurance in Ireland, it is difficult to compare plans. The Health Insurance Authority website is a fantastic tool showing the benefits available across all plans on the market. However, without knowing what you’re looking for, it can be difficult to find the right plan for your needs. Comparing plans for the first time is a difficult task as there are so many options available. That’s why it is useful to get expert advice from a health insurance broker.
Once you decide on a plan, you can change your mind up to 14 days after purchasing it. However, if it goes over this time frame, then you are locked into a 12 month contract and you will face financial penalties if you cancel your policy mid-term. To help you make an informed decision, shop around and seek expert advice before choosing the right plan for you!