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October 31, 2023

What is the Waiting Period for Health Insurance In Ireland?

Discover how long you have to wait to obtain health insurance benefits in Ireland and find answers to common questions about waiting periods.

Aine Kavanagh

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Aine Kavanagh

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In Ireland, you’ll have to undergo a 26-week initial waiting period when obtaining your first health insurance cover. 

However, prospective policyholders must also consider other types of waiting periods.

We'll cover all the health insurance waiting periods you need to know about in Ireland, as well as waiting periods that different providers impose. We'll also answer some FAQs about these waiting periods.

Further Reading:

What are the Health Insurance Waiting Periods that Apply in Ireland?

Insurers in Ireland and around the world use waiting periods to prevent the abuse of health services and policy benefits.

Ireland has waiting periods for:

  • New customers

  • People with pre-existing conditions

  • Maternity claims

  • Switching and upgrading plans. 

Here's everything you should know about these waiting periods:

1. Waiting Periods for New Customers

You must serve a waiting period (regardless of your plan) if you're a new health insurance customer.

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

You don't have to serve this waiting period again if you switch to a different insurer or your health coverage doesn't lapse for more than 13 weeks. 

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

You can only claim benefits for injuries and accidents during the initial waiting period. 

Illness-related claims won't be approved.

Further Reading

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 pre-existing condition waiting period.

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 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 healthcare needs change. 

However, when you do switch plans, you'll have to go through a waiting period before you 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?

You'll still be at the same level of cover as your previous policy during this period. However, you won't be eligible to receive any higher benefits.

Is there anything else I should know?

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

  • If you're switching or upgrading your cover after initially serving the 5 years, you won't have to serve a waiting period again. However, you must switch within 13 weeks from the end of your previous cover. 

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

    • For example, if you have diabetes and you switch plans after two years —- you'll have to serve just three more years under your 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 you're buying a new plan, you won't have access to any maternity benefits until the waiting period ends. 

If you're switching/upgrading to a new plan, you'll have the same level of cover as the maternity benefits in your previous plan.

Is there anything else I should know?

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

5. Waiting Periods for Repatriates

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

However, certain insurers can waive your waiting period depending on the health coverage you had 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 expect to serve waiting periods of:

  • 26 weeks for illnesses if you'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.

So, what are the specific waiting periods for each insurer in Ireland?

Let's find out.

Waiting Periods of Irish Health Insurance Plans

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

1. Irish Life Health (ILH)

  • 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

If you're an employer looking to obtain an ILH plan for your employees, look no further than Kota!

Kota is a new way to manage employee health insurance with minimal hassle and paperwork. 

With Kota, you can:

  • Provide competitive health insurance packages to your team.

  • Assign budgets and let your team manage their benefits.

  • Minimise paperwork with easily scalable plans. 

  • Integrate your existing human resources (HR) & payroll tools to reduce administrative overheads.

Kota works with ILH, the largest life insurance provider in Ireland, to provide a range of health insurance plans

Sign up for Kota today to make health insurance administration a breeze!

Yonder Technology Limited, based in Dublin, Ireland and trading as Kota, is a Tied Intermediary of Tailored Finance Limited for Insurance and Pensions. The Central Bank of Ireland regulates Tailored Finance Limited.

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

Have more questions about health insurance waiting periods?

We’ve got answers!

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 to Waiting Periods?

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

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

  • Any claims related to accidents or injuries.

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

2. Does My Age Affect Waiting Periods?

Yes. 

As mentioned in our waiting period comparison section above — your 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 they can claim 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 age can also affect the insurance premiums you pay. 

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.

Obtain Insurance Early and Continue Coverage to Minimise Waiting Periods

Health insurance waiting periods in Ireland can seem long —- especially when you 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. 

If you're an employer looking for the best way to minimise waiting periods for your employees, be sure to sign them up early for private health coverage.

Aine Kavanagh

Article written by

Aine Kavanagh

👋🏻 Hi I'm Aine, Head of Customer Success at Kota. Whether you're a Kota customer, a Kota user, or you're just browsing, I hope to help educate and empower those who want to know more about owning their own benefits, and building financial autonomy 📚

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