Health Insurance Waiting Periods in Ireland Explained

When your employees take out health insurance for the first time in Ireland, they may face a waiting period of up to 26 weeks before certain benefits become available.

But that’s not the only waiting period they might encounter.

Different health insurers apply various waiting periods depending on factors like pre-existing conditions and switching policies.

We’ll break down the key waiting periods your employees should be aware of, how they vary between providers, and answer common questions — so you can help your team understand their coverage better.

Further Reading

• Are you familiar with insurance excess? Read our guide on Excess in Irish Health Insurance to understand what it means for your team.

• Learn about Ireland’s Lifetime Community Rating (LCR) system and how it affects health insurance costs for your employees.

What Is a Waiting Period in Irish Health Insurance?

A waiting period is the time frame during which your employees may have limited or no coverage for specific health insurance benefits after enrolling in a plan.

This means that certain treatments or services may not be covered until the waiting period has elapsed.

Insurers in Ireland and around the world use waiting periods to prevent the abuse of health services and policy benefits. These waiting periods help ensure people don’t take out a policy only when they need treatment, keeping insurance financially stable while providing long-term health protection.

What Health Insurance Waiting Periods Apply in Ireland?

Ireland has waiting periods for:

• New customers
• People with pre-existing conditions
• Maternity claims
• Switching and upgrading plans

Here's everything your employees should know about these waiting periods:

1. Waiting Periods for New Customers

If your employees are new health insurance customers, they must serve a waiting period (regardless of their plan).

How long is the waiting period?

A maximum of 26 weeks.

Who does it apply to?

People who:

• Buy a health insurance cover for the first time OR
• Had a lapse in health insurance coverage for more than 13 weeks

Your employees don't have to serve this waiting period again if they switch to a different insurer or their health coverage doesn't lapse for more than 13 weeks.

What services are and aren't covered during the waiting period?

Your employees can only claim benefits for injuries and accidents during the initial waiting period. Illness-related claims won't be approved.

Further Reading

• Discover Private Health Insurance in Ireland and how it can give your employees access to quality healthcare.

• Own a small business in Ireland? Learn about the intricacies of Small Business Health Insurance.

2. Waiting Periods for Customers with Pre-Existing Conditions

Insurance vendors define pre-existing conditions as a condition, ailment or illness that the customer had at any time during the six months before they:

• Took out a private health insurance policy for the first time
• Obtained a policy after a lapse of 13 weeks
• Switched/upgraded their cover

A good example of this would be a chronic disease like diabetes or an injury that left permanent damage.

Customers with such a medical condition must serve a special waiting period for pre-existing conditions.

How long is the waiting period?

A maximum of 5 years.

Who does it apply to?

Anyone who has a pre-existing condition according to the criteria mentioned above.

What services are and aren't covered during the waiting period?

Any insurance claim unrelated to your employees’ pre-existing condition will be honoured — subject to the other waiting periods and conditions imposed by the health insurers.

3. Waiting Periods for Switching/Upgrading Plans

It's normal to switch or upgrade plans as your employees' healthcare needs change.

However, when they do switch plans, they'll have to go through a waiting period before they can enjoy higher benefits.

How long is the waiting period?

A maximum of two years.

Who does it apply to?

Anyone who switches or upgrades their health insurance plan.

What services are and aren't covered during the waiting period?

During this period, your employees will still have the same level of coverage as their previous policy. However, they won't be eligible to receive any higher benefits.

Is there anything else your employees should know?

Here are some things your employees need to know about their coverage for pre-existing conditions when switching plans:

• If they switch or upgrade their cover after initially serving the 5 years, they won't have to serve a waiting period again. However, they must switch within 13 weeks of the end of their previous cover.

• If they switch cover during the 5-year waiting period, they won't have to serve the completed portion of their waiting period.

• For example, if your employee has diabetes and switches plans after two years — they'll have to serve just three more years under their new plan before being eligible for diabetes-related claims.

4. Waiting Periods for Maternity Benefits

Ireland imposes a maximum waiting period for maternity benefits. This helps prevent people from taking advantage of private health insurance plans.

How long is the waiting period?

A maximum of 52 weeks.

Who does it apply to?

People who:

• Buy a private health insurance plan for the first time OR
• Had a lapse in health insurance coverage for more than 13 weeks
• Switch/upgrade their plans

What services are and aren't covered during the waiting period?

If your employees buy a new plan, they won't have access to any maternity benefits until the waiting period ends.

If your employees are switching/upgrading to a new plan, they'll have the same level of coverage as the maternity benefits in their previous plan.

Is there anything else your employees should know?

If your employee has a baby while covered by health insurance, they won't have to serve the waiting period as long as they add the baby to their plan within 13 weeks of birth.

5. Waiting Periods for Repatriates

If your employees plan to obtain health insurance in Ireland after living abroad, they generally have to serve the new customer waiting period.

However, certain insurers can waive their waiting period depending on your employees' health coverage while living abroad.

6. Waiting Periods for Cash Plans

Cash plans in Ireland follow the same rules as standard health insurance plans regarding waiting periods.

So your employees must expect to serve waiting periods of:

• 26 weeks for illnesses if they’re a new customer or had a break-in cover for 13 weeks
• Five years for pre-existing conditions
• 52 weeks for medical expenses related to maternity

Remember: These waiting periods are the maximum amounts stipulated by Irish law. If health insurance companies wish to, they could technically offer waiting periods with a shorter amount of time.

What are the specific waiting periods for each insurer in Ireland?

Let's find out.

Health Insurance Waiting Periods by Provider in Ireland

The major health insurance providers in Ireland offer waiting periods with slight differences:

1. Irish Life Health

• Out-patient benefits — No waiting period
• Day-to-day benefits — No waiting period for policyholders under 55, 26 weeks for policyholders 55 and above
• In-patient benefits — 26 weeks
• Maternity benefits — 52 weeks
• Pre-existing conditions — 5 years
• Upgrade waiting period for in-patient benefits — 2 years

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2. Laya Healthcare

• Out-patient benefits — No waiting period
• In-patient benefits — 26 weeks
• Maternity benefits — 52 weeks (Not applicable for customers over 55)
• Pre-existing conditions — 5 years
• Upgrade waiting period for in-patient benefits — 2 years

3. VHI Healthcare

• Out-patient benefits — No waiting period
• Day-to-day benefits — No waiting period for policyholders under 50, 26 weeks for policyholders aged 50 and over
• In-patient benefits — 26 weeks
• Maternity benefits — 52 weeks
• Pre-existing conditions — 5 years
• Upgrade waiting period for pre-existing conditions — 2 years

2 FAQs about Health Insurance Waiting Periods in Ireland

Here are some of the most common questions about waiting periods.

1. Are There Exceptions or Waivers for Employees' Waiting Periods?

There are a few instances where your employees can waive an initial waiting period:

• Any claims made on behalf of the employee's child who was added to their health insurance policy within 13 weeks of their birth or adoption.

• Any claims related to accidents or injuries.

In addition to these waivers, repatriates may have their initial waiting period waived if they were covered by insurance while living abroad.

2. Does an Employee’s Age Affect Their Waiting Periods?

Yes.

As mentioned in our waiting period comparison section, your employee’s age can affect waiting periods for some benefits/plans in Ireland.

For example, new customers aged 55 and above must wait an extra 26 weeks before claiming day-to-day benefits on ILH plans, while the same applies to customers aged 50 and older on Voluntary Health Insurance (VHI) plans.

Moreover, your employees’ age can also affect their insurance premiums.

Ireland follows the Lifetime Community Rating (LCR) system — which means people over 34 have to pay a higher premium if they obtain health insurance for the first time or after a lapse of 13 weeks.

Enrol Employees Early and Maintain Coverage to Minimise Waiting Periods

Health insurance waiting periods in Ireland can seem long —- especially when your employees first take out a health insurance plan or have pre-existing conditions.

However, they're necessary to prevent the abuse of health insurance plans and ensure sufficient care is available to those who need it most.

As an employer aiming to minimise your employees' waiting periods, enrol your team early for private health coverage.