Lifetime community rating (LCR)

Lifetime Community Rating was introduced to encourage people to join the health insurance market at a younger age. It helps to balance out the cost of health insurance for everyone because younger people usually make fewer claims compared to, for example, older claimants who may use health services more often. The community rating system generally bases premiums on the average cost of the risk to insure all persons on a policy rather than basing the premium on the risk it may cost to insure each individual person on the basis of their age, gender, health risk status or prior history of cover.

Lifetime Community Rating loadings were introduced for the first time after 30 April 2015. They apply to people aged 35 and above who buy health insurance for the first time after April 2015.

The Lifetime Community Rating loading is 2% of the gross cost of your health insurance policy for each year that you spent aged 35 or above without health insurance. For example, if you buy health insurance for the first time when you are 49, you spent 15 years without health insurance when you were aged 35 or above. 15 years x 2% = 30%, so you will have to pay a Lifetime Community Rating loading of 30% on top of the gross cost of your policy.

No. You will have to pay the loading for a maximum of 10 years.

The maximum loading is 70%. This applies to people aged 69 or above buying health insurance for the first time.

No. Only inpatient health insurance policies are included in the Lifetime Community Rating. Cash plans won’t reduce your Lifetime Community Rating loading at all.

Yes. Your previous periods of cover will be taken into account when the insurer is calculating your Lifetime Community Rating loading. For example, if you are 40 years old and you don’t currently have health insurance, but you had health insurance for five years when you were aged 25 to 30, five years will be taken off your Lifetime Community Rating loading.

No. You won’t get credit for any cover that you had as a child.

If you buy health insurance within nine months of becoming resident in Ireland, you won’t have to pay a Lifetime Community Rating loading. If you don’t buy health insurance within nine months and you are aged 35 or above, you will have to pay a Lifetime Community Rating loading.

For more information and examples, go to Moving to Ireland. 

If you lived outside of Ireland on 1 May 2015 and you buy health insurance within nine months of moving back to Ireland, you won’t have to pay a Lifetime Community Rating loading. If you lived in Ireland on 1 May 2015 and you moved abroad on or after 1 November 2018, you will be given credit for the period of time you spent abroad. You will not have to pay a Lifetime Community Rating for this qualifying period of time if you buy health insurance within nine months of returning to Ireland.

For more information and examples, go to Moving to Ireland. 

It is your responsibility to prove that you were not resident in Ireland. Some examples of evidence include:

• Foreign rental agreements
• Foreign bank statements
• Foreign utility bills
• Travel documents
• An application for a PPS number within the last nine months

For more information, go to Moving to Ireland. 

You can get a credit for up to three years if you had health insurance but you had to cancel it because you were made redundant. To receive this credit, you must have been:

1. Receiving social welfare payments or been financially dependent on someone who was receiving social welfare payments in the period right after you were made redundant;
2. Unemployed for at least six months.

If you previously had cover for three years or more but you cancel your insurance, you will be given credit for any periods without cover that began on or after 1 February 2019. The minimum period of cover that you can get credit for is six months. The maximum credit that you can receive is for one or more periods of six months or more adding up to a maximum of three years.

The three years don’t need to be made up of consecutive six-month periods. You can combine different periods of six months or more. The maximum amount of credit you can get is three years. The reason why you cancelled your insurance doesn’t matter under this provision.

Yes, you can have a break in cover of up to 13 weeks without being charged a Lifetime Community Rating loading.

Yes, all insurers will apply the Lifetime Community Rating loading to their inpatient health insurance policies.

Switching insurer will not affect the Lifetime Community Rating loading you pay unless you have a break in cover of more than 13 weeks. If you are paying a Lifetime Community Rating loading with one insurer and then you switch, you will continue to pay the remaining portion of the loading with your new insurer.

You might be asked to show evidence of previous periods of cover. You can contact your previous insurer to ask for a confirmation of cover letter. 

If you buy health insurance within nine months of leaving the Permanent Defence Forces, you will get credit for the time that you were a member of the Permanent Defence Forces. This will reduce your Lifetime Community Rating loading. 

For example, if you were a member of the Permanent Defence Forces for two years from age 40 to 42, and you buy health insurance at age 42 within nine months of leaving the Permanent Defence Forces, you will get credit for two years. You will have to pay a loading for the other six years that you didn't have health insurance while you were above the age of 34.

If you buy health insurance within nine months of ceasing to have insurance under the Joint Sickness Insurance Scheme of the European Union (JSIS), you will get credit for the time that you were resident in Ireland and insured under the scheme. This will reduce your Lifetime Community Rating loading. 

For example, if you were resident in Ireland and insured under JSIS for two years from age 40 to 42, and you buy health insurance at age 42 within nine months of leaving the scheme, you will get credit for two years. You will have to pay a loading for the other six years that you didn't have health insurance while you were above the age of 34.

If you are 45 years old and you have had health insurance since you were 28, you will pay the same amount as someone aged 28 or aged 75 with the same health insurance policy. However, if you buy health insurance for the first time when you are 45, you will have to pay a Lifetime Community Rating of 22% (11 years x 2%). This means that you will have to pay €1220 for a health insurance policy with a gross cost of €1000.

Appendix A - Examples of Lifetime Community Rating Loadings in Practice

Appendix B – Table of Applicable Relevant Increase by Age