Health Insurance Waiting Period.

A health insurance waiting period is the length of time you need to wait before your health insurance plan covers you for a claim or will offer a benefit for your medical expense or treatment.

Where you may have to serve a waiting period, cover on your policy may be restricted in certain circumstances and you may not be fully covered for all claims.

If any ailment, illness, or condition has presented signs or symptoms within six months of taking out health insurance, it is deemed a pre existing condition i.e. the ailment, illness or condition existed in those six months.

Waiting periods are quite complex and may apply when you

Generally, waiting periods do not apply if you require emergency care for an injury or accident.

For new born babies or children that have been adopted, there is usually no waiting period provided they are added to your health insurance policy within 13 weeks of birth or adoption.

The following companies provide private health insurance cover in Ireland subject to waiting periods:

There are two companies that offer health cash plans:

All health insurers offer cover for health related care and expenses (cash plans do not cover inpatient treatment) subject to waiting periods.

If you take out health insurance for the first time, or you have a break in cover of more than 13 weeks since you were covered by a health insurance plan, you will have to serve an initial waiting period.

Generally, you will have to serve an initial waiting period of 26 weeks after taking out a health insurance policy to avail of the cover provided by that policy.

Emergency care for an injury or accident is usually covered immediately by most insurers.

If you have a pre existing condition then you will have to wait for maximum waiting period of 5 years to avail of cover where your treatment relates to that condition only. Health insurance benefits or cover for any new condition that arises should be covered after 26 weeks.

Generally, maternity cover has a waiting period of 52 weeks.

Some insurers offer fertility benefits only after a waiting period of 2 years.

A switching or upgrade waiting period may apply either:

If you have a new condition and you have already served your 26 week waiting period with another insurer, you will not have to serve the waiting period again.

You can also claim immediately from you new health insurer if your new level of cover or the benefit provided on the new plan is the same as or lower than that offered by your current insurer.

A waiting period will apply where you have upgraded your cover with your existing insurer or purchased a health insurance plan with a higher level of cover or additional benefits with a new insurer and you have a pre existing condition.

Generally, you will have to wait 2 years to avail of the additional benefit or higher level of cover to apply to your pre existing condition only. You should still be covered at the level of your previous policy for that condition.

When you switch health insurers, you do not have to serve waiting periods again from scratch if there is less than 13 weeks break. The waiting period only applies if there is an increase in cover or in the benefit that you can claim.

If you switch insurers during the initial waiting period, the time spent with your previous insurer should be included in the waiting period and you would finish the waiting period with your new insurer.

For example, if you switched insurers after two years while serving a 5 year waiting period for a pre existing condition, you would serve the remaining three years with your new health insurer.

Laya cash plans are subject to a twelve week waiting period when you initially take out cover.

A Laya cash plan is considered to be continuous cover in terms of serving a waiting period for private health insurance.

HSF health cash plans have a waiting period of 3 months for new claims and 10 months for the birth and adoption grant. There is a waiting period of 6 months for laser eye surgery and implantable contact lenses.

With HSF, you are covered immediately if your expenses are related to an accident.

Where you have a pre existing condition, there is a maximum waiting period of 5 years for a new customer, and 2 year waiting period applies to any increase in cover with HSF. If you have served waiting periods with a HIA insurer, you may not have to serve these waiting periods with HSF.