FAQ

Yes. Any person who is ordinarily resident in the Republic of Ireland can buy health insurance regardless of age, gender, health status or medical history. However, you may have to serve waiting periods when you first buy health insurance.

Yes. You can have a medical card and private health insurance at the same time. If you get a referral from your GP, you will need to decide whether you want to be treated as a public patient or a private patient. Similarly, if you are admitted to hospital, you will need to tell the hospital whether you want to be admitted as a public patient or a private patient.

The main benefits include:

• Cover for semi-private or private rooms in hospital;
• Cover for inpatient consultant services as a private patient;
• Other types of cover including maternity, overseas, psychiatric, and outpatient benefits.

Lifetime Community Rating is a system where the older you are when you first buy health insurance, the more expensive it will be. This applies only to people aged 35 and above.

• If you are aged 35 or above but you already have health insurance, the cost of your health insurance will not change based on your age.
• If you are aged 35 or above when you first buy health insurance, you will usually have to pay an extra 2% of the gross cost of your policy for each year above the age of 34 that you didn’t have health insurance. This additional charge is called a Lifetime Community Rating loading.

For example, 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 €1,220 for a health insurance policy with a gross cost of €1,000. For more information, go to Lifetime Community Rating.

There are two types of private health insurer in Ireland:

• Open membership insurers provide insurance to everybody who wants to buy it from them. Currently, there are four open membership insurers operating in Ireland: Irish Life Health, Laya Healthcare, Vhi Healthcare, and HSF Health Plan. However, HSF Health Plan offers only cash plans. Cash plans don’t include any inpatient cover.
• Restricted membership insurers provide insurance to people who are members of a particular group. This is normally a vocational group or employees of a particular organisation and their dependants. For example, there are restricted membership schemes for members of An Garda Síochána.

Generally, no. The health insurance system in Ireland adopts what is called Lifetime Community Rating. This means that everyone who buys a particular health insurance policy pays the same amount regardless of age, gender, health status or medical history. However, there are some exceptions:

• If you buy health insurance for the first time when you are aged 35 or over, or if you have a break in health insurance cover of longer than 13 weeks while you are aged 35 or over, you will have to pay an additional Lifetime Community Rating loading on top of the cost of your policy.
• The cost of a policy can be reduced by up to 10% for members of group schemes.
• The cost of a policy for children must be no more than 50% of the adult premium.
• The cost of a policy for those aged 18-25 may be reduced.
• The cost of a policy for pensioners who are members of restricted membership insurers can be reduced.

No. These policies provide fixed amounts of money regardless of the actual cost of your medical expenses. These types of insurance are not licensed by the Health Insurance Authority, they are regulated by the Central Bank of Ireland.

No. Anyone can buy health insurance regardless of age, gender, health status or medical history. However, you may have to serve waiting periods when you first buy health insurance or when you move to a policy with higher benefits.

Yes.

You may have to serve waiting periods when you buy health insurance for the first time. For more information, go to waiting periods.

Yes. You can buy health insurance when you become ordinarily resident in the Republic of Ireland. However, you may have to serve waiting periods when you first buy health insurance. If you are an EU national and you become sick or have an accident during a visit to any EU country, you can get free or reduced cost healthcare if you show a European Health Insurance Card. You can get this card from your country of usual residence (www.ehic.ie).

If you are aged 35 or older when you move to Ireland you must buy health insurance within the first nine months of living in Ireland, otherwise you will have to pay an additional Lifetime Community Rating loading on top of the cost of the policy.

For more information, go to Moving to Ireland.

If you are switching from a restricted membership insurer, the time spent with your current insurer will be taken into consideration when you switch to an open membership insurer. You may have to serve upgrade waiting periods if you move to a policy with higher benefits.

You may have to serve waiting periods if:

• You have not completed your new customer waiting periods;
• You move to a policy with higher benefits.

For more information, go to waiting periods.

You may have to serve upgrade waiting periods if you move to a policy with higher benefits.

Yes. If you have completed your new customer waiting periods, you will be covered immediately for any pre-existing condition. However, if you move to a policy with higher benefits, you may have to serve upgrade waiting periods.

In general, health insurance policies are 12-month contracts. You can switch insurer or policy at your next renewal date. All insurers must provide a 14-day cooling-off period from the renewal date. During these 14 days, you can cancel and get a full refund. If you switch insurers mid-contract, you may be charged a cancellation fee.

In some cases, insurers will allow you to switch policies mid-contract. For example, you might be able to move from one Laya Healthcare policy to a different Laya Healthcare policy. Contact your insurer directly to find out more about switching policies mid-contract.

You might have to serve waiting periods if you move to a policy with higher benefits. For more information, go to upgrade waiting periods.

You may have to serve waiting periods if you have a break in cover of more than 13 weeks. However, the insurer may waive the waiting period at their discretion. Some insurers routinely waive waiting periods if you have previously had health insurance in Ireland or if you were covered by certain types of health insurance while abroad. Contact the insurer directly to find out if you will have to serve waiting periods.

If you are aged 35 or above when you come back to Ireland, a Lifetime Community Rating loading may also be added to the cost of your policy if you do not buy private health insurance within nine months of returning.

Foreign health insurance is not always taken into account when calculating your waiting periods. However, the insurer may waive the waiting period at their discretion. Some insurers routinely waive waiting periods if you have previously had health insurance in Ireland or if you were covered by certain types of health insurance while abroad. Contact the insurer directly to find out if you will have to serve waiting periods.

If you are aged 35 or above when you come back to Ireland, a Lifetime Community Rating loading may also be added to the cost of your policy if you do not buy private health insurance within nine months of returning.

If you have a break in health insurance cover of more than 13 weeks, you may have to serve new customer waiting periods again. If you are aged 35 or above, a Lifetime Community Rating loading may also be added to the cost of your policy.

Your outpatient benefits depend on your level of cover. Before accessing a health service or getting a referral from a GP for a particular hospital or clinic, you should contact your insurer directly to check that the health service and hospital or clinic are actually covered under your policy. If you are not covered by your insurance, you may have to pay for the treatment yourself.

Once you have checked your level of cover, you may be able to claim for a portion of the cost of outpatient services such as GP visits, outpatient consultant visits, dental visits, diagnostic tests, and physiotherapy. Check your health insurance policy documentation for full details of your level of cover.

Depending on your policy, you may get cover for a semi-private or a private room. However, this is subject to availability in the hospital.

Most health insurance policies cover the cost of consultant services provided during a stay in hospital. Depending on your policy, you may also get some cover for outpatient consultant services, but you may have to pay an excess.

No. As of April 2023, if you are admitted to a public hospital as a public patient, there is no charge for treatment.

No. When you are admitted to the hospital, the hospital may ask you to sign a public hospital waiver form. If you sign this form, you will be treated as a private patient. If you don’t sign the form, you will be treated as a public patient.

Private patients are charged €659-€813 per night for a semi-private room, and €800-€1000 per night for a private room in addition to consultant fees. If you have private health insurance, your insurer may cover some or all of these costs depending on your level of cover.

If you are pregnant and you are ordinarily resident in Ireland, you are entitled to free maternity care under the Maternity and Infant Care Scheme. After you have your baby, your baby can also get some health checks, vaccinations, and developmental checks free of charge. For more information about the Maternity and Infant Care Scheme and what it covers, go to the Citizens Information Board website.

There are no private maternity hospitals in Ireland. Private health insurance covers some of the costs of private maternity services in a public hospital. A semi-private room costs up to €813 per night, and a private room costs up to €1,000 per night. Most health insurance policies cover three nights in a private room (subject to availability). However, some policies have limited cover or cover only a semi-private room. Your policy may also include a home birth grant of €2,000-€5,000. Depending on your level of cover, your health insurance may not fully cover the total cost of your stay in hospital.

All policies cover your inpatient delivery consultant’s fees. Policies with higher cover also cover the anaesthetist, pathology, and a paediatric consultation in hospital.

Outpatient private consultant fees, which cover routine visits to your consultant before the birth, may be partly covered by the pre- and post-natal benefit or the outpatient maternity consultant fees benefit in your policy. However, you should be prepared to pay a shortfall, as most policies cover only a portion of the fees, and the outpatient consultant fees may cost some several thousand euro more.

No. If you are unsure, you should contact your insurer directly.

Yes. You can buy health insurance regardless of your age, gender, health status or medical history. However, you may have to serve waiting periods if you have a pre-existing condition.

A pre-existing condition is an illness that you had in the six months before you bought your health insurance policy. As of 1 May 2015, the definition of a pre-existing condition is the following:

"‘Pre-existing condition’ means an ailment, illness or condition, where, on the basis of medical advice, the signs or symptoms of that ailment, illness or condition existed at any time in the period of 6 months ending on the day on which the person became insured under the contract.”

If you pay your insurer directly for your health insurance, medical insurance tax relief is available at source and is applied by the insurer to reduce the gross cost of your policy. This means that the tax relief is automatically given as a discount on the cost of your policy. You don’t need to claim the tax relief from Revenue.

If your employer pays for your health insurance as a benefit-in-kind, you will be taxed on the gross value of your policy. This means you will need to claim medical insurance tax relief from Revenue. 

Yes. If you have health insurance, you can claim tax relief on the portion of your medical costs not covered by your insurer. For example, if you paid €60 for a GP visit and you already got €20 from your health insurance, you can claim tax relief on the remaining €40. You must keep copies of your receipts to claim back this tax relief. For more information, go to www.revenue.ie.

An insurer can offer a group discount of up to 10% on any policy to a group of people. Some insurers automatically include this discount in their prices. If an insurer has decided to automatically include this discount, it will be reflected in the price shown on our comparison tool. In most cases the price on our comparison tool does not include a discount. It is important to speak with the insurer directly before you buy a policy to understand how any part of the policy may be discounted.

No. However, if you are aged 18-25 you may get a young adult rate on certain policies. You don’t need to be a student.

Insurers decide the cost of their policies. The cost of the policy must be the same regardless of your age, except in the case where children and young adults may be entitled to discounts. If you are unhappy with the cost of your health insurance, you can switch policies or insurers at your renewal date. In some cases, your insurer may allow you to switch contracts during the term of your 12-month contract.

The health insurance system in Ireland is called Lifetime Community Rating. This means that everyone who buys a particular health insurance policy pays the same amount regardless of age, gender or medical history.

The Irish state supports the community-rated system by providing age-related health credits for older people and less healthy people to help meet the expected higher cost of health insurance for this group. These tax credits are funded by a health insurance levy (also referred to as Stamp Duty) paid by the insurers. The credits and levy are administered by the insurers and the Risk Equalisation Fund.

Fertility cover is not included in all policies. To find a policy with fertility cover, use our free comparison tool.

Yes. Maternity cover is included in all health insurance policies.

There is a 52-week waiting period for maternity cover if you buy health insurance for the first time or if you upgrade your existing maternity cover.

If you are pregnant and you are ordinarily resident in Ireland, you are entitled to free maternity care under the Maternity and Infant Care Scheme. After you have your baby, your baby can also get some health checks, vaccinations, and developmental checks free of charge. For more information about the Maternity and Infant Care Scheme and what it covers, go to the Citizens Information Board website.

There are no private maternity hospitals in Ireland. Private health insurance covers some of the costs of private maternity services in a public hospital. A semi-private room costs up to €813 per night, and a private room costs up to €1,000 per night. Most health insurance policies cover three nights in a private room (subject to availability). However, some policies have limited cover or cover only a semi-private room. Your policy may also include a home birth grant of €2,000-€5,000. Depending on your level of cover, your health insurance may not fully cover the total cost of your stay in hospital.

All policies cover your inpatient delivery consultant’s fees. Policies with higher cover also cover the anaesthetist, pathology, and a paediatric consultation in hospital.

Outpatient private consultant fees, which cover routine visits to your consultant before the birth, may be partly covered by the pre- and post-natal benefit or the outpatient maternity consultant fees benefit in your policy. However, you should be prepared to pay a shortfall, as most policies cover only a portion of the fees, and the outpatient consultant fees may cost some several thousand euro more.

If you have a complaint about your insurer or your health insurance policy, you should first speak directly to your insurer. If your complaint isn’t resolved after speaking to your insurer, you should contact the relevant regulator.

Health insurance cash plans provide fixed amounts of money for a range of medical events. Unlike inpatient health insurance policies, they don’t provide cover for a hospital stay as a private patient. You may be able to claim back a fixed amount for a hospital stay, but this amount is not linked to the cost of your hospital stay. For example, you may be able to claim €50 for every night spent in hospital. Some cash plans provide money back for outpatient expenses such as GP visits or physiotherapy. Some cash plans also provide personal accident cover.

The same rules around waiting periods, upgrading, and switching your policy apply to cash plans as inpatient health insurance policies. Health insurance cash plans are not subject to Lifetime Community Rating loadings. Time spent covered under a health insurance cash plan will not exempt you from a Lifetime Community Rating loading if you buy an inpatient health insurance policy after the age of 35.

Cash plans don’t provide cover for a hospital stay as a private patient. You may be able to claim back a fixed amount for a hospital stay, but this amount is not linked to the cost of your hospital stay.

Cash plans may include:

• A fixed amount of money for each day in hospital
• A maternity grant

You may have to serve a waiting period before you have cover for maternity benefits.

You can buy a cash plan from HSF Health Plan, Irish Life Health, Laya Healthcare or Vhi Healthcare.

Most cash plans offer significant outpatient benefits. A cash play may be useful for you if you don’t have inpatient health insurance or if your inpatient health insurance policy doesn’t have good outpatient cover. However, if you already have inpatient health insurance, check your cover before you buy a cash plan, as many inpatient health insurance policies include outpatient benefits.

No. The health insurance system in Ireland is community rated. This means that everyone who buys a particular health insurance policy pays the same amount regardless of age, gender or medical history. However, there are some exceptions:

• The cost of a policy may be reduced by up to 10% for members of group schemes.
• The cost of a policy for children must be no more than 50% of the adult premium.
• The cost of a policy for those aged 18-25 may be reduced.

You won’t have cover for inpatient consultant services provided during a stay in hospital. Depending on your policy, you may get some money back for outpatient consultant services.