Why is the average cost of health insurance higher for the over 65’s age group? 

The main reason for the price disparity appears to be the increased cover for orthopaedic procedures that older people are more likely to have included in their premiums, hence the higher prices paid by this age group. 

The report suggested that 66% of health insurance members have policies that offer restricted orthopaedic and/ or ophthalmic cover. This may entail limited cover for orthopaedic procedures or ophthalmic procedures or shortfalls or copayments applying when claiming for these procedures.

There are several reasons why some policies are more expensive than others. These relate mostly to private accommodation and treatment in private and high-tech hospitals.  

The high-tech hospitals are private hospitals that offer more advanced treatments, either inpatient, or outpatient. 

Factors leading to higher priced plans often include:

The high-tech hospitals offer private hospital accommodation rather than multi occupant hospital rooms.  

The high-tech hospitals include The Blackrock Clinic, the Mater Private, Dublin, and The Beacon, Dublin.

A variety of specialist procedures will increase the price of your health insurance if they are included in your cover. 

Examples include orthopaedic procedures such as joint replacement, ophthalmic procedures such as cataract removal, cardiac treatment in a high-tech hospital, and advanced cancer and other treatments.

If you wish to avail of private treatment, either as an inpatient or outpatient, without paying a high excess yourself then your health insurance premium will reflect this.  

Low excesses and, sometimes, generous outpatient limits will push the price of your health insurance much higher than the average premium.

The key factor determining the highest health insurance premiums seems to be inpatient cover for high tech hospitals.  

However, if you choose a policy with a high level of cover for everyday benefits you will see your premium increase.

Some of the higher priced policies are older policies which are still on the market, having been available for many years. 

If you have had a health insurance policy for a number of years, it is always advisable to shop around and consider switching as you will routinely face premium increases and you may get better value by switching.

Taking the average figures above, a rough estimate or ballpark figure for an average health insurance policy price for someone under 65 would be in the region of €1,500, (and €2,100 for someone 65 and above who may wish to have higher cover for orthopaedic or ophthalmic procedures). 

So, what types of cover might be available around the €1,500 price point? Here are some examples:

€125.29 per month (€1503.52 per year) 

Inpatient excess €150 

This policy covers semi-private accommodation in a private hospital. 

This policy does not include a lot of cover for outpatient expenses but does offer 50% cover for unlimited GP visits and 50% cover for consultant visits. 

Maternity cover on this policy includes 3 nights hospital accommodation or €3,500 towards a home birth.

As the above examples illustrate, in this price range it is possible to find cover for private hospital treatment and limited cover for high-tech hospital treatment, although you may face nightly shortfalls and you may be required to pay significantly towards the cost of orthopaedic treatment. 

The above plans all include reasonably low excesses, with the highest being €250. You may be able to find a slightly cheaper plan if you choose a higher excess although you will have to pay this excess should you need to claim for inpatient treatment. 

These plans also offer some cover for outpatient expenses, although it is not as generous as some higher level plans on the market. In choosing cover for outpatient expenses, it is a good idea to start by considering the types of treatment you are most likely to need and find a plan which offers cover for those particular expenses.

As the above examples illustrate, in this price range it is possible to find cover for private hospital treatment and limited cover for high-tech hospital treatment, although you may face nightly shortfalls and you may be required to pay significantly towards the cost of orthopaedic treatment. 

The above plans all include reasonably low excesses, with the highest being €250. You may be able to find a slightly cheaper plan if you choose a higher excess although you will have to pay this excess should you need to claim for inpatient treatment. 

These plans also offer some cover for outpatient expenses, although it is not as generous as some higher level plans on the market. In choosing cover for outpatient expenses, it is a good idea to start by considering the types of treatment you are most likely to need and find a plan which offers cover for those particular expenses.

Be aware though, that it is best to switch at the time of your yearly renewal in case you face additional charges when switching during the year. 

You may also face switching waiting periods of 2 years if your new plan includes additional cover to your old health insurance policy. The waiting periods should only apply to the increased cover, however, so you should remain covered at your current level of cover during the waiting period.