Health insurance offers protection for healthcare expenses for the policyholder(s) and any family members named in the health insurance policy.

Health insurance will offer protection for in- patient, out- patient, day- patient and everyday medical expenses, as well as cover for consultant fees, diagnostic tests, medical and complementary treatments. 

Health cash plans offer cashback for a range of medical treatments and/ or a hospital stay.

The Irish health insurance market is complex with a wide array of plans available which offer varying levels of cover.

Health Insurance Providers Ireland

Who provides health insurance in Ireland?

There are three main providers of health insurance in Ireland:

There are two providers of health cash plans:

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VHI Health Insurance

VHI has operated in Ireland since 1957 and has one million customers. They offer health, travel, dental and life insurance.

VHI offers a range of health insurance plans with varying types and levels of cover. They offer a range of services to their customers via their VHI360 health centres.

As well as offering urgent care with rapid access, VHI360 health centres offer health screening to VHI members as well as specific women’s health, paediatric and sports and exercise medicine consultations.

Rapid access dermatology consultations are offered to their members in partnership with Allview Healthcare.

VHI offers cover for fertility care and treatment, as well as access to private maternity care.

Hospital@home is offered to VHI customers who are undergoing cancer treatments, where some cancer treatment can be undertaken in the customer’s own home.

VHI offers a range of online health supports with access to a GP, nurse, physiotherapist, speech and language therapist, and midwife for VHI customers. VHI also offers Best Doctors second opinion to their customers who have been diagnosed with a health issue.

Irish Life Health Insurance

Irish Life Health was formed in 2016 and has an emphasis on preventative benefits for the health of their customers. Irish Life Health is part of Irish Life Group, a financial services company with 1.6 million customers. 

Irish Life also provides life insurance, mortgage protection, specified illness cover, and income protection insurance as well as pensions and investment products.

Irish Life Health offers the lowest priced hospital plan, First Cover, from €41.50 per month.

Irish Life offers Digital Doctor, which provides unlimited phone or video consultations with a GP and Nurse on Call with 24/7 access to a nurse.

Irish Life offers a Female Health Benefit with access to GPs who specialise in female health.

Healthy Minds offers Irish Life Health customers 24/7 access to trained counsellors.

Irish Life Health’s Back Up service offers a consultation with a chartered physiotherapist and treatment plan for a once off fee of €50.

COPD and Cancer specific supports

The Irish Life COPD Programme is available to customers who have been diagnosed with COPD to allow them to manage their condition at home.

Foundation One CDx is an innovative program for customers who have been diagnosed with some forms of cancer. The programme provides advanced tests and diagnostics, including genetic screening, to target cancer treatments as efficiently as possible to promote better outcomes and avoid unnecessary treatments.

The Irish Life Heart Care Programme allows customers with heart insufficiency or heart failure to have their condition monitored at home.

Irish Life also offers cover for rapid access walk-in minor injury clinics at 20 locations across Ireland.

Laya Health Insurance

Laya has offered health insurance in Ireland since 1997. Laya offers health insurance as well as life insurance, mortgage protection, and travel insurance. They are the second largest health insurer in Ireland.

With Laya, kids go free on some of Laya’s health insurance policies. If you pay a premium for one child, other children in your family can be added to your plan at no additional cost.

Laya offers access to their Health and Wellbeing Clinics for their members. The clinics provide walk- in consultant-led care 365 days a year.

Laya also offers healthcare Concierge which is a health information service to answer health related questions for their members.

Laya’s Digital Hub includes a 24/7 Nurse on call, digital GP consultations and online prescriptions as well as physiotherapist, health and wellbeing experts, dietitian, and health coach online consultations.

Healthcoach offers a one to one health check along with a personalised fitness, nutrition, and wellness programme for Laya members.

Laya provides 24/7 Mental Wellbeing Support with access to qualified counsellors 24 hours a day 365 days a year.

Heartbeat cardiac screening provides each member with heart screening once every two years.

Laya also offers Money Smart Cash Back scheme, which offers money back on everyday medical expenses for individuals and families. This scheme is not inpatient health insurance and does offer cover for a stay in hospital or for private healthcare.

HSF.ie

HSF has operated in Ireland since 1949, although it started in 1873 as the Hospital Saturday Fund in the UK. The Hospital Saturday Fund was started whereby working men could pay a weekly contribution and they would be covered if they needed to go to hospital. 

HSF offers individual, family, and corporate health cash plans where, in exchange for a monthly premium, you can claim cash back on a range of medical expenses.

HSF markets their plans as a complement to traditional health insurance or as a lower cost alternative to traditional health insurance.

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Family Plan and One Scheme Health Plan

With their Family Plan and One Scheme Health Plan (individual plan), you can choose between a primary scheme which offers up to 50% cash back on a range of treatments and towards a hospital stay, or an Extra Cover Scheme, which offers up to 100% cashback on treatments. 

There are a range of plans within each level, which offer different amounts of cash back and a range of treatments, including a hospital stay, day surgery, GP and consultant fees, as well as alternative therapies and a birth or adoption grant.

HSF also offers Assist + to their customers which includes access to a GP advice line, Virtual Doctor, Private Prescription Service, Medical Information helpline, Stress Counselling Helpline, and Legal helpline.

Factors to consider when choosing a policy

There are so many plans and price points when choosing health insurance it is easy to be overwhelmed by the range that is available. 

Here are some points that you may need to take into account in choosing a plan:

Your age will affect the type of health insurance you choose and it may affect the price you pay for health insurance. 

For example, you may choose a plan with higher cover for orthopaedic or ophthalmic procedures or a plan with better cover for cardiac procedures if this is a concern for you as you age. A younger person may be more inclined to choose cover for everyday medical expenses or maternity or fertility benefits.

Your age may also affect how much you pay for health insurance. Lifetime community rating means that health insurers have to charge the same amount for the same cover regardless of the insured person’s age. However if you are aged 35 and older when taking out insurance for the first time in Ireland, you will face a 2% loading on your premium. This loading will increase by 2% for each year over 35.

If your family is grown up, choosing a plan based on maternity or paediatric benefits would make less sense for you. You may choose a plan with better cover for private inpatient and outpatient care for faster access.

Likewise, if you are choosing a plan for yourself as an individual, it would make more sense to choose a plan based on your own health needs. For example,you may have an interest in complementary therapies and may choose a plan with better cover for those.

Hospitals are generally divided into public hospitals, private hospitals, and high- tech hospitals and, although your budget will also determine the plan you choose, you may choose to prioritise private or high tech hospital cover over increased cover for everyday medical expenses or vice versa.

If you have children, cover for consultations such as medical consultants, physiotherapy, speech and language therapy or occupational therapy may be a priority for you.

Likewise, if you have a family history of, for example heart disease, you may prioritise cardiac screening and/ or treatment cover in choosing health insurance.

There is little point choosing a health insurance provider based on a state of the art walk-in clinic if you live too far away for it to be accessible when you or your family are ill.

If you are ill, you may not be able to access healthcare that is not in your area, so you may choose cover based on what is available to you where you live.

Your health insurance must be affordable for you as you will need to continue to pay your premiums to remain covered. 

It is likely that you will have to think about your priorities in choosing health insurance as your health insurance must work with your budget. 

Rather than choosing a plan with cover for private hospitals, you may choose a plan that covers private care in a public hospital as these plans will be more affordable.

Likewise, unless you visit your GP or another healthcare professional often, eg. a physiotherapist, you may choose to scale back on cover for everyday medical expenses and save on your premium.

A cash plan may make more financial sense for you as the monthly premiums can be much more affordable than traditional health insurance. This would, however, mean that you will not have hospital cover to be treated privately as an inpatient. You could, however, use the plan to be reimbursed some of your medical expenses.

All health insurance includes an excess and most have various different excesses within one policy. An excess in any insurance policy means that you have to pay a certain amount out of pocket before you can be covered by the insurance policy.

For example, your policy will have an in-patient excess where, for each admission to hospital you have to contribute a set amount towards each hospital admission. Choosing a higher excess may seem like a good way to save money on your health insurance premium but beware, if you develop a health condition where you are admitted to hospital say a couple of times a year, the amount that you pay in excesses will quickly add up.

You may also have a different day patient excess within the same policy. An excess may also apply out- patient charges, for example, pathology fees, radiology fees, or consultant visits. Look at the small print in your policy as you may have to spend above a certain yearly threshold in order to be able to claim any rebate on fees that you pay.

You will face waiting periods when you first take out health insurance and if you choose to upgrade your health insurance cover. The following waiting periods will apply:

  • For any pre- existing condition, you will face a waiting period of 5 years.
  • If you are diagnosed with a new condition, the waiting period on first taking out health insurance is 26 weeks.
  • You will be covered for an accident or new injury immediately.
  • For maternity benefits, you will face a waiting period of 52 weeks on first taking out health insurance. 
  • If you upgrade your health insurance plan for higher levels of cover, you will face a 2 year waiting period for the increased level of cover to apply to any pre- existing conditions.

It is worth noting, however, that open enrollment means that insurers must offer cover to all who apply regardless of their health or age.  Lifetime cover means that health insurers must continue to cover you, once you continue to pay premiums, regardless of how many times you need to claim.

Contact Us

Health insurance is complex and there are many factors to consider in choosing a health insurance plan.

Health insurance will give you peace of mind that you will not face high and unexpected costs for healthcare and that you and your family will be protected should you be ill or need healthcare.

Speak to us today about health insurance and for all of your insurance needs and we can steer you in the right direction. 

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