Health Insurance

What is Health Insurance?

Health insurance is a coverage that provides for the payments of benefits -whole or a part of the risk- as a result of sickness or injury. It includes insurance for losses from accidents, medical expenses, or disability. In the USA, for example, every individual health insurance plan must cover 10 essential health benefits, according with the Affordable Care Act. These benefits are:

  • Outpatient care (doesn't require admission to a hospital)
  • Emergency room visits
  • Inpatient care in a hospital
  • Care before and after your baby is born
  • Mental health and substance use disorder services
  • Prescription drugs
  • Services/devices to help you recover from an injury or deal with a disability or chronic condition (including physical and occupational therapy)
  • Lab tests
  • Preventive services
  • Dental care and vision care for kids

Although these elements are the main cover offered by Health Insurance, different health insurers vary on exactly how they cover these benefits.

Health insurance is used to pay for private care in hospital or from various health professionals both in hospitals or in their practices. The arrangements vary from one company to another but most companies have agreements with hospitals that the company will pay the hospital directly. In general, for outpatient costs you pay the health professional and then claim from the health insurance company. You should check with your own company exactly what procedures they use.

How do I get the cheapest health insurance in Ireland?

Finding cheap health insurance can take a little time and effort, but it's an investment that should pay solid returns over time. To find a good health insurance offer it is recommended that you follow these steps:

Understand your alternatives to buying individual/couple/family health insurance.

Determine exactly what you need in terms of cover and what you can afford – this way you won’t get unecessary cover and will only pay for your personal choices

Shopping - InsuranceDeals will show you the health insurance options available in your county along with the premiums. The number of choices available will depend on where you live. The more insurers operating in your area, the more options you have to choose from.

If choice of provider is important to you, make sure you look carefully at the provider networks for each health insurance plan you're considering. Compare the costs of each plan- and not just the premium prices. To truly find cheap health insurance you need to consider all costs associated with the purchase.

Estimate Costs - Survey your medical costs over the past years. Calculate how much you would have spent on out-of-pocket expenses based on the deductibles, and co-insurance, plus what you would spend on monthly premiums with each plan. If you're anticipating a significant change in medical expenses you need to adjust your calculations to reflect your best guess as to what your medical costs might be over the coming year.

Do I need Private Health Insurance in Ireland?

It is very much a personal choice – It depends on your needs and what you expect from health insurance. Irish public insurance offers free treatment, but for a limited range of cover options. If you need a higher level of cover that may include treatment and drugs you can’t access on the public healthcare system you need to purchase a private insurance that best suits your requirements.

Everyone who lives in Ireland permanently is eligible for public healthcare. There are two different levels of public healthcare, though. If your income is below a certain level, you qualify for a ‘Medical Card’, which means free services. If you don’t have a Medical Card, some services - including a visit to the doctor - cost money. The amount you pay is subsidised through the public system, so it’s not the entirety of the real medical cost, but you’ll need to be prepared to face charges if you go to the GP or visit a hospital.

What is the difference between Private and Public Insurance?

A private health insurance is a health insurance run by a private company while a public health insurance is a health insurance run by a government (or government-contracted) entity.

Private health care – The private or independent healthcare sector is made up of hospitals and clinics which are run independently of the Health Service Executive (HSE). They are normally run by a company. If you want to use the services of a private healthcare provider, you are responsible for the fees payable, since the HSE does not subsidise any of the costs for private healthcare.

Since the private treatment centres are completely independent, you can, in most cases, choose to be treated wherever you like. The prices and facilities available will vary from hospital to hospital so if you are a ‘cash buyer’ (paying for treatment yourself) you may want to shop around.

Having private health insurance is an important and cost effective method of protecting against unexpected health issues and providing you with more control over your health care, choice of services, treatments and choice of doctor. A private healthcare plan is often a good way to ensure you have a high level of coverage. An average cost for an individual is around €1,925 per year (€160 per month) although it can be as low as €430 per year.

Public healthcare – is free- that is you don’t have to pay into a specific state insurance policy: it’s primarily funded through taxation. And if you qualify for a Medical Card, almost all public medical services are free to use as well. If you don’t qualify for a card there are costs for general practitioner (GP) visits, hospital stays, drugs and some other services, although the rates are subsidised. Certain services are on offer to everyone for free but you do have to sign up for them.

How does Health Insurance work in Ireland?

Health care in Ireland is two-tier: public and private sectors exist. The public health care system is governed by the Health Act 2004, which established a new body to be responsible for providing health and personal social services to everyone living in Ireland – the Health Service Executive. In addition to the public-sector, there is also a large private healthcare market.

All persons resident in Ireland are entitled to receive health care through the public health care system, which is managed by the Health Service Executive and funded by general taxation. A person may be required to pay a subsidised fee for certain health care received; this depends on income, age, illness or disability. All maternity services and child care up to the age of six months are provided free of charge. Emergency care is provided at a cost of €100 for a visit to the Accident and Emergency department.

The Medical Card – which entitles holders to free hospital care, GP visits, dental services, optical services, aural services, prescription drugs and medical appliances- is available to those receiving welfare payments, low earners, and in certain other cases. People who are not entitled to a Medical Card must pay fees for certain health care services.

Everyone living in the country, and visitors to Ireland who hold a European Health Insurance Card, are entitled to use the public healthcare system. Outpatient services are also provided without charge. The majority of patients on median incomes or above are required to pay subsidised hospital charges.

Private insurance is regulated by the Health Insurance Authority (HIA), which is the independent statutory regulator for the private health insurance market in Ireland. It monitors the operation of health insurance business in the country and advises the Minister for Health in this regard, including assessing the effect of any regulations or new legislation on consumers.

What are the Health Insurance Providers in Ireland?

Currently four companies offer private insurance in Ireland: HSF Health Plan (provides cash benefit plans but not in-patient health insurance); Irish Life Health (formerly Aviva Health); Laya Healthcare and VHI Healthcare.

What is the best health insurance company in Ireland?

All companies are equally safe. The best health insurance provider is one that offers the policy that best matches your needs. Comparing Health Insurance in Ireland is not an easy task. The average cost of a private health insurance policy in Ireland- according to a 2017 survey by the Health Insurance Authority – was €1858 a year.

A search done by the institution in Jan 2018 - for cover providing a private room in a private hospital showed up 68 different health insurance price plans available for a single adult. Prices ranged from the cheapest at €852 per adult per year to the most expensive at €4778 per adult per year.

The variety of plans and levels of cover is huge. There are also several other minor differences – between the policies that should be considered before signing up a new contract. So in order to get the plan that best suits your demands you need to be clear in your mind about the cover that is essential for you, your budget and be mindful of the terms and conditions of each proposal.

Each company must abide by the general rules established by the Health Insurance Authority (HIA) but, after that, they are free to make their own rules. The level of cover available and the rates charged vary from one company to another. It is a general principle in insurance that you must give all relevant information to the insurance company. If you do not, then the entire contract may be void. Health insurance policies are usually 12 month contracts. If you want to switch insurer or insurance plan, you may do so at your next renewal date. Insurers may have restrictions on switching plans during the 12 month term.

To find out which company offers the most complete policy to meet your needs, log on to our website - InsuranceDeals, select the product menu and check out results.

What is the best health insurance package in Ireland?

InsuranceDeals should be the first stop. The website gathers information on all insurers -and insurance products – available in the market, which enables you to see how your existing plan stacks up against other policies. You should also ask your insurance company for further information if you deem it necessary. Make sure your questions are very specific and that you get all the answers you need before making a decision.

A good way to start is checking if the company has any plans - including corporate plans - which are equivalent to the plan you are on and how much they cost. It is essential that you understand every detail of the plan you are signing up to – that everything is clear.

Research! Always do your “home work”researching first so that when you phone the Insurance company you’re asking for a specific plan or plans by name. Also check exactly what cover, services and facilities are at your disposal: hospital cover, excesses, MRI scan centres near where you live. Disclose any existing conditions or pending treatment; consultant cover and upgrading terms. If you’re happy that the plan meets your requirements, then sign up.

In case of switching providers, make sure you cancel the old policy once the new cover is in place. Otherwise you will find yourself paying for two insurance policies!

What is covered when I get a Health Insurance?

Health insurance is used to pay for private care in hospital or from various health professionals in hospitals or in their practices. At present, companies that are offering cover for in-patient hospital services must offer a minimum level of benefits. They must provide a minimum level of cover in respect of:

  • Day care/in-patient treatment
  • Hospital out-patient treatment
  • Maternity benefits
  • Convalescence
  • Psychiatric treatment and substance abuse
  • The minimum accommodation level is semi-private in a public hospital.

Does Health insurance go up every year?

No. The health insurance policy premiums are determined by age. The age brackets are as follows:

  • 0–18
  • 19–30
  • 30–35
  • 35–40 and so on

The risk level increases with an increase in age. Critical illness cover is allowed only after the first 24 months (48 months in case of pre existing diseases) from the start of the policy hence it is good take out health insurance from an early age. The premiums can also change subject to conditions such as: a person smokes - then there is 5% increment, or if there is any preexisting disease – 4 years exclusion for 4 years before the claim pertaining to that disease is paid.

How do I claim health insurance?

The procedure varies from company to company. Some Insurers have direct payment agreements with all of their listed hospitals so they can settle the bill directly with the hospital for all eligible costs, covered by your plan. In general, for outpatient costs you pay the health professional and then claim from the health insurance company.

Before going into hospital, you should always check what cover your policy provides for a particular hospital or treatment centre by calling the company’s customer service team. To confirm this in most cases you will need to provide them with information about the consultant name, hospital name and procedure code.

Why Should you have Health insurance?

In Ireland around half of the population believe health insurance is essential. With health insurance private patients get access to consultants faster – even getting faster access to consultants working out of public hospitals if they are allowed see patients privately. They also get private and semi-private rooms in public hospitals and can avail of treatment in private hospitals which significantly reduces waiting times for many procedures – both elective and otherwise.

How can I get free health insurance?

The Irish public health system is very well equipped, with heavily subsidized care for almost everyone in the country. Some complex aspects of the system, however, can make the difference between care that costs next to nothing and care that can cost a great deal.

Everyone who lives in Ireland permanently is eligible for public healthcare. There are two different levels of public healthcare, though. If your income is below a certain level, you qualify for a ‘Medical Card’, which means free services - including GP services, inpatient and outpatient hospital costs, maternity care, dental and optical services.

If you don’t have a Medical Card, some services - including a visit to the doctor - cost money. The amount you pay is subsidised through the public system, so it’s not the entirety of the real medical cost, but you’ll need to be prepared to face charges if you go to the GP or visit a hospital.

Want to learn more about Health Insurance?

Learn more about: How to Save Money with Health Insurance in Ireland.