New to Health Insurance

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New to Health Insurance - here's what you need to know

Taking out health insurance for the first time can be a headache – with hundreds of plans across the three providers (Irish Life Health, Laya Healthcare and VHI Healthcare). It’s very important to be aware of waiting periods you will serve initially on cover for pre-existing conditions (5 years), new conditions (26 weeks) and maternity benefits (52 weeks). Also, since the introduction of May 2015’s Lifetime Community Rating, if you’re over 34 and taking out health cover for the first time, you may have to pay a penalty on top of your premium. Before making enquiries as to what plan you should choose you should ask yourself the following 3 questions? Call our friendly experts to find the best plan to suit your needs.

1. Which hospitals are important to me?

Hospitals are categorised into three broad types – public, private and hi-tech. Entry level plans offer cover for public hospitals only. These plans are competitively priced but might offer no cover in private hospitals and only cover selected public hospitals. Depending on where you live, hi-tech hospitals may not be a priority (hi-techs are in Dublin only), and the extra cost unnecessary. Most people choose cover level 2 or 3 – these cover you for a semi-private or private room in a private hospital.

There are now ‘network’ plans available which provide cover in selected public and private hospitals only – these are often cheaper than plans covering all hospitals. But if you’re opting for one of these plans, make sure your local hospitals are covered.

2. What excess am I willing to pay?

All health insurers offer plans with varying levels of excess. This is the first part of the claim you are required to pay yourself. Excesses can range from €50 to €500 per claim. While a higher excess will reduce your premium, an in-patient excess over €300 can be quite restrictive. One of the most common health claims is for day case treatment in private hospitals. There are plans available where this excess is significantly less than the overnight excess. Day case procedures include wisdom tooth removal, colonoscopy, mole removal plus certain types of cancer treatments like chemotherapy.

3. Do I want cover for everyday medical expenses (like GP or physiotherapist visits)?

Not all health insurance plans allow members to claim back on these expenses. But all providers offer ‘corporate plans’, not directly marketed to consumers. These corporate plans usually offer better value, allowing you to claim back an average of 50% - 75% on GP, specialist consultant and A&E visits. Some plans will also allow you to claim for back on visits to private A&E facilities like Beacon amd Mater Private. It’s worth doing the sums on whether you need this cover. Generally if you and your family had less than five or six everyday visits, it’s not worth paying the extra premium for this cover. Also remember GPs are free for children under six – and some providers offer an online GP free in their plans.

So get advice from an insurance expert before making a decision because all health insurers tie you into a 12 month contract, with financial penalties for mid-term cancellations. Entry level plans are available from as little as €550* a year, while the most expensive plans can cost over €5,000 per person.

* VHI's One Plan Starter €504.29 per adult, Irish Life Health's Select Starter €504 per adult, Laya Healthcare's Assure Protect €482.40 per adult. Pricing correct from 1st July 2018, Source HIA

Waiting periods when new to Health Insurance

All ages
Initial Waiting Period
Accident of Injury
Immediate Cover
New Conditions
26 Weeks
Pre-Existing Conditions
5 years
52 weeks
Day to Day Benefits
Immediate Cover*

*26 week waiting period if aged 55 or over

Late entry loadings

If you join health insurance for the first time aged 35 or over having never held cover before you will be penalised 2% for every year you are aged over 34. See table below for examples:

Age at Joining PMI
Loading amount
No Penalty
2% Loading
14% Loading
56% Loading
70% loading. The maximum loading payable is 70%. The loading is payable every year at renewal for a period of 10 years. Credits are given for time served on previous cover - for more information speak to our team of experts