Tell me about... Health Insurance

07 September 2011 - Which Way to Pay

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Tell me about... Health Insurance

Private health insurance may seem unnecessary given the fact we are fortunate enough to live in a country with a state-funded healthcare system, however in the eventually of illness many find that the investment in a health cover plan proves invaluable.

Many providers offer health cover in Ireland; however, it is worth noting that BUPA withdrew from the Irish market in 2006. BUPA’s business was later taken over by insurance group Quinn, operating as QUINN-healthcare.

Health insurance is used to pay for private care in hospital or from various health professionals in hospitals or in their practices. The minimum accommodation level is semi-private in a public hospital. At present, companies that are offering cover for in-patient hospital services must offer a minimum level of benefits. They must provide a minimum level of cover in respect of:

  • Day care/in-patient treatment
  • Hospital out-patient treatment
  • Maternity benefits
  • Convalescence
  • Psychiatric treatment and substance abuse

There are three important general principles that apply to health insurance:

(1.) Open enrolment - at present, health insurance companies must accept anyone who wishes to join, subject to any applicable waiting periods before cover takes effect, regardless of age, sex or health status; 

(2.) Lifetime cover - once you join and continue to pay your premiums, the insurance company cannot refuse to provide you with cover and; 

(3.) Community rating - means that the insurance company must charge the same rate for a given level of service, regardless of age, sex or health status. So all adults pay the same amount for the same benefits. Unlike motor insurance or life insurance, matters such as age, sex, sexual orientation, health or past record of claims do not affect the price charged for insurance.

However, insurers are allowed to offer contracts limited to certain health service (e.g. dental and optical services) without being subject to the general requirements about community rating, open enrolment and lifetime cover. They may also offer contracts in relation to GP and out-patient services without having to meet minimum benefit requirements.

Information above obtained from the Health Insurance Authority (HIA).



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