Returning to Ireland and buying private health insurance

Introduction

If you are returning to live in Ireland and you intend to take out a private health insurance plan, you need to be aware of a number of issues, in particular:

  • Private health insurance in Ireland is optional
  • There is no recognition of health insurance previously held abroad (however, in some cases, your health insurer may waive waiting periods at their discretion)
  • There are age-related loadings for people aged 35 and over
  • Waiting periods apply for new customers

If you have decided to purchase health insurance but don’t know which policy to choose, the Health Insurance Authority has useful information about the private health insurance market in Ireland, including a plan comparison tool of the schemes available. You can also read more in our document on Private health insurance.

Tax relief is available for premiums paid for private health insurance and for long-term care insurance. The insurance company grants this tax relief at source. You can read more in our document on Tax relief and medical expenses.

Do you have to buy private health insurance in Ireland?

Private health insurance in Ireland is optional. If you are ordinarily resident in Ireland, you are entitled to receive public in-patient and out-patient hospital services. This means that you do not have to take out private health insurance to access hospital services. You can read more about establishing ordinary residency.

If you do not buy private health insurance, you are entitled to services in the public hospital system on the basis of clinical need.

The main benefits of private health insurance are:

  • Cover for hospital accommodation in a private or shared room
  • Cover for inpatient consultant services as a private patient
  • Other cover including maternity, overseas, psychiatric and outpatient benefits

Even if you have private health insurance you can still access public health services. For example, if your GP refers you to a specialist consultant in a hospital, you can decide if you want to be treated through the public or the private system. Similarly, if admitted to hospital, you will need to tell the hospital whether you want to be admitted as a public or a private patient.

I’m over 35. Will I have to pay an aged based loading?

The cost of health insurance is made up of a premium (the basic price) and a loading (an additional amount which depends on your individual circumstances). People who are aged 35 or over when they buy health insurance in Ireland for the first time pay an age-based loading called the Lifetime Community Rating.

If you lived outside Ireland on 1 May 2015 and buy your health insurance within 9 months of returning to Ireland, you do not have to pay the Lifetime Community Rating loading.

If you moved to live outside Ireland after 1 May 2015, a credited period is given for any periods abroad, of 6 months or more, provided you take out insurance within 9 months of returning.

It is your responsibility to prove to the insurance company that you were living abroad and that you moved to Ireland within the last 9 months. You can do this by providing copies of bank statements opened while abroad, evidence of accommodation lease arrangements or utility bills paid while abroad. Travel documentation or application for a PPS number would be accepted as proof of taking up residency in Ireland.

Will I have to serve a waiting period?

When you take out health insurance for the first time, you may have to serve waiting periods before you are fully covered. However, accident and injury will be covered immediately.

The maximum initial waiting period is 26 weeks. For maternity-related claims the waiting period is 52 weeks.

If you have a pre-existing condition (an illness that existed in the 6 months before buying health insurance), the maximum waiting period is 5 years before that condition will be covered by your insurance.

If you become ill or have an accident during your initial waiting period, you can still access healthcare in Ireland as a public patient.

Recognition of health cover held abroad for waiting periods

Irish health insurance providers do not have to recognise health insurance cover held abroad with an international health insurance provider.

However, a health insurer may waive the waiting period at their discretion, because the law imposes a maximum on waiting periods that an insurer may require, but no minimum. Some insurers routinely waive waiting periods if you have previously held health insurance in Ireland or if you were covered by certain types of health insurance while abroad.

The Health Insurance Authority website has more information on waiting periods for health insurance.

What is the waiting period for maternity-related claims?

If you are buying health insurance in Ireland for the first time, there is a waiting period of up to 52 weeks for maternity cover. This means that your insurance policy does not cover you for maternity-related issues for the first 52 weeks.

Depending on your plan, your insurance may pay the cost of some or all of the following:

  • Out-patient private consultant fees, which cover the routine visits to your consultant before the birth
  • Hospital accommodation in a private room or a semi-private (shared) room in a public hospital
  • Delivery consultant’s fees incurred at the time of delivery
  • Other consultants' fees incurred at the time of delivery
  • Fees associated with a home birth

If you have a baby and are not covered for maternity services under private health insurance, you will still be able to access maternity care through the public healthcare system. All expectant mothers who are ordinarily resident in the State are entitled to free maternity care. This includes antenatal visits, labour and delivery, and postnatal care.

You can read more in our document on Returning to Ireland and having a baby. The Health Insurance Authority website has more information on waiting periods for health insurance. They also have a useful health insurance comparison tool.

Page edited: 20 August 2020