Family Health Insurance Ireland

Health insurance built around the needs of your family

Choosing health insurance for a family involves more than placing everyone on the same plan.

Parents, children and young adults can have different medical priorities, hospital requirements and levels of outpatient usage. One adult may need maternity benefits, while another may prioritise orthopaedic or cardiac cover. Children may not require the same plan as their parents.

At Dooley Insurance Group, we help families review and compare health insurance options available through our agency appointments.

We explain the differences in premiums, hospital access, excesses, outpatient benefits, maternity cover and children’s benefits so that you can make an informed decision.

Call Aisling O’Connor on 085 851 4492 to arrange a family health insurance review.

What is family health insurance?

Family health insurance provides private health insurance cover for two or more members of a household.

A family policy may include:

• One or two adults
• Dependent children
• Young adults
• A parent and child
• A couple without children
• Different plans for different family members

Family members do not normally need to hold identical plans.

The right structure depends on the needs of each individual and the overall household budget.

Does every family member need the same plan?

No. Parents and children can be insured under different plans where appropriate.

Different family members may need different cover because:

• One adult may require maternity benefits
• One person may prefer broader private hospital access
• One person may use outpatient benefits frequently
• Children may need specific paediatric benefits
• A young adult may require a more basic level of cover
• One person may accept a higher excess to reduce the premium
• Another may prioritise orthopaedic or cardiac benefits
• Existing waiting periods may differ

Reviewing each person separately can create a more appropriate family arrangement.

What should families compare?

A family health insurance comparison should consider:

• Total annual premium
• Premium for each adult
• Premium for each child
• Hospital access
• Children’s hospital access
• Inpatient excesses
• Day case excesses
• Outpatient benefits
• GP benefits
• Consultant benefits
• Physiotherapy
• Mental health support
• Maternity benefits
• Orthopaedic cover
• Cardiac cover
• Cancer treatment
• Dental and optical benefits
• Waiting periods
• Upgrade waiting periods
• Age limits for dependent children and young adults

The cheapest family policy may not provide the benefits or access your household expects.

How much does family health insurance cost?

The cost depends on:

• Provider
• Plans selected
• Number of adults
• Number of children
• Ages of those covered
• Hospital access
• Excess levels
• Outpatient benefits
• Maternity benefits
• Additional plan features
• Lifetime Community Rating where applicable
• Available child pricing
• Employer contributions

The total family premium should be reviewed alongside the benefits available to each person.

A lower premium may involve higher excesses, restricted hospital access or reduced outpatient cover.

Family health insurance review

A family health insurance policy should be reviewed before every renewal.

Your review should examine:

• New renewal premium
• Changes to adult benefits
• Changes to children’s benefits
• Changes to hospital lists
• Inpatient and day case excesses
• Family medical priorities
• Planned treatment
• Maternity plans
• Children moving to adult rates
• Employer contributions
• Available alternatives

A plan that was suitable when your children were younger may no longer reflect the family’s current needs.

Send Dooleys your family renewal notice and we will help you understand the available options.

Health insurance for parents

Parents often focus on their children’s cover while overlooking their own requirements.

Adult cover should consider:

• Income and household responsibilities
• Preferred hospitals
• Private hospital access
• High technology hospital access
• Inpatient excesses
• Outpatient usage
• Maternity benefits
• Orthopaedic cover
• Cardiac cover
• Cancer treatment
• Mental health benefits
• Existing medical conditions
• Planned treatment

Each parent should be reviewed separately.

One person may require broader hospital cover, while the other may prefer a lower premium with a higher excess.

Health insurance for children

Children’s health insurance may provide access to private hospital treatment and benefits for eligible medical expenses, depending on the plan selected.

Parents should compare:

• Children’s hospital access
• Paediatric treatment
• Inpatient excesses
• Day case excesses
• Emergency care
• GP benefits
• Consultant benefits
• Physiotherapy
• Mental health support
• Dental benefits
• Optical benefits
• Diagnostic tests
• Child premium
• Age related plan changes

Children do not automatically need the same level of cover as their parents.

Adding a newborn baby to health insurance

Parents should contact their health insurer promptly after the birth of a child.

A newborn added to a parent’s policy within the applicable timeframe may be covered without serving the standard new customer waiting periods.

The Health Insurance Authority currently advises that a newborn should be added within thirteen weeks of birth.

If the baby is added after the applicable period, waiting periods may apply.

Confirm the child’s commencement date, plan, premium and benefits directly with the insurer or broker.

Health insurance for young adults

Health insurance pricing and dependent status can change as a child becomes a young adult.

Families should review:

• Age based pricing
• Student status
• Dependent status
• Hospital access
• Current plan
• Whether the young adult needs separate cover
• Available young adult rates
• Employer health insurance
• Breaks in cover
• Lifetime Community Rating implications later in life

A young adult may not require the same plan as their parents.

The family should review the options before the renewal date on which the price or status changes.

Maternity health insurance

Maternity benefits should be reviewed before they are needed.

Plans may differ in relation to:

• Public hospital maternity cover
• Private hospital maternity cover
• Semi private accommodation
• Consultant benefits
• Pre and postnatal benefits
• Fertility benefits where included
• Pregnancy related outpatient expenses
• Newborn cover
• Other maternity services

A waiting period may apply before maternity benefits become available.

Moving to a plan with higher maternity benefits shortly before treatment is required may not provide immediate access to those benefits.

If you are planning a family, review maternity cover in advance.

Family outpatient benefits

Families can incur regular day to day medical expenses.

Depending on the plan, outpatient cover may contribute towards:

• GP appointments
• Consultant visits
• Physiotherapy
• Diagnostic tests
• Dental treatment
• Optical treatment
• Mental health services
• Speech and language therapy where included
• Other eligible expenses

Plans may provide fixed refunds, percentage refunds or benefits after an annual excess has been reached.

The practical value of outpatient cover should be compared with the additional premium.

Family hospital cover

Hospital access can differ between family plans and between individual members of the same family.

A review should consider:

• Public hospital access
• Private hospital access
• High technology hospital access
• Children’s hospitals
• Private accommodation
• Semi private accommodation
• Inpatient excess
• Day case excess
• Specific treatment centres

If your family has a preferred hospital, this should be identified during the comparison.

Family health insurance excesses

An excess is the amount you may need to pay towards an eligible claim.

A family plan may include:

• Inpatient excess
• Day case excess
• Outpatient excess
• Excess per admission
• Excess per claim
• Annual excess

A high excess can create a significant household cost if more than one family member requires treatment during the same policy year.

The possible saving on the annual premium should be compared with the amount the family could need to pay when claiming.

Can family members use different providers?

It may be possible for different family members to use different health insurance providers.

This could be considered where one provider or plan is more suitable for a particular person’s requirements.

However, using multiple providers can mean:

• Separate renewal dates
• Separate payments
• Different claims procedures
• More administration
• Different waiting period records
• Different customer service contacts

The practical benefits should be weighed against the additional administration.

Can a couple have different plans?

Yes. Couples do not normally need to hold the same health insurance plan.

Different plans may be appropriate where:

• One person needs maternity benefits
• One person prioritises outpatient benefits
• One requires broader hospital access
• One prefers a higher excess
• Medical priorities differ
• Employer benefits differ
• One person has planned treatment

Each person’s cover should be reviewed individually.

Health insurance for single parent families

A single parent family can arrange cover for the parent and dependent children.

The review should consider:

• Adult hospital cover
• Children’s hospital cover
• Child pricing
• Family budget
• Outpatient usage
• Maternity requirements where relevant
• Mental health benefits
• Excesses
• Employer contribution
• Existing waiting periods

The parent and children may be placed on different plans where appropriate.

Health insurance for blended families

Blended families may have different insurers, renewal dates, waiting period histories and employer benefits.

A review can help identify:

• Who is currently covered
• Current provider for each person
• Plan names
• Renewal dates
• Premiums
• Employer contributions
• Dependent status
• Waiting period history
• Preferred family structure

It may not be practical or appropriate to move everyone to one policy immediately.

The available options should be considered around existing renewal dates and cover.

Family health insurance through an employer

An employer may pay all or part of an employee’s health insurance premium.

The employee should understand:

• Employer contribution
• Benefit in Kind
• Plan provided
• Options to add a partner
• Options to add children
• Additional personal cost
• Hospital access
• Excesses
• What happens if employment ends
• Whether another family plan already exists

The employer’s plan may provide good value for one adult but may not automatically be the most appropriate option for every family member.

Switching family health insurance

A family can switch health insurance provider or move to different plans at renewal.

Before switching, check:

• Benefits for each person
• Hospital access
• Children’s cover
• Maternity benefits
• Inpatient excesses
• Day case excesses
• Outpatient benefits
• Existing waiting periods
• Upgrade waiting periods
• Planned treatment
• Claims in progress
• Cancellation and start dates

You should not cancel the existing family policy until replacement cover and dates have been confirmed.

Switching with a family medical condition

An existing medical condition does not normally prevent a family member from switching provider.

However, an upgrade waiting period may apply to higher benefits for a pre existing condition.

The family member’s existing level of cover may continue during the upgrade period, subject to the applicable rules and policy terms.

Any planned or ongoing treatment should be checked before switching.

Reducing the cost of family health insurance

Potential ways to manage the family premium may include:

• Reviewing each person separately
• Using different plans within the family
• Reviewing hospital access
• Considering a different excess
• Reviewing outpatient benefits
• Checking child pricing
• Reviewing young adult rates
• Checking employer contributions
• Comparing available options before renewal
• Removing benefits that are no longer required

Cost reductions should not be made without understanding what benefits or access may be lost.

What to send Dooleys

To review family health insurance, provide:

• Current provider
• Plan name for each person
• Renewal date
• Renewal premium
• Number of adults
• Number of children
• Ages
• Preferred hospitals
• Important benefits
• Planned treatment
• Maternity requirements
• Employer contributions
• Available family budget
• Copy of the renewal notice

Detailed medical records should not be sent unless specifically requested through an appropriate secure process.

How Dooleys reviews family health insurance

We review each person

We identify the current plan, benefits and priorities of every family member.

We understand your family budget

We discuss the annual premium and the excesses you could reasonably afford.

We compare relevant options

We review suitable options available through our agency appointments.

We explain the differences

We explain hospital access, outpatient benefits, children’s cover, maternity benefits, excesses and waiting periods.

You decide

You receive the information needed to make an informed decision before renewal.

Speak to Aisling O’Connor

Aisling O’Connor, CIP APA, is a Director of Dooley Insurance Group and heads the Health Insurance Section.

Aisling joined Dooley Insurance Group in 2009 and provides health insurance advice to individuals and families.

Phone: 085 851 4492

Email: aisling@dooleyinsurances.com

Family health insurance questions

Does every family member need the same health insurance plan?

No. Adults and children can be placed on different plans where appropriate.

Can family members use different providers?

It may be possible. The benefits should be weighed against the additional administration of separate providers.

How much does family health insurance cost?

The cost depends on the number and ages of those covered, plans selected, hospital access, excesses and available pricing.

Can children have a cheaper plan than their parents?

Children can have a different plan. The suitability of a lower cost option depends on the cover provided.

When should I add a newborn?

A newborn should generally be added within thirteen weeks of birth to avoid standard waiting periods. Confirm the current rules with the insurer.

Do children need private health insurance?

That is a personal decision. Parents should consider hospital access, paediatric benefits, excesses, budget and available public care.

Can my partner and I have different plans?

Yes. Each adult’s cover can be based on their individual needs.

Should I review maternity cover before pregnancy?

Yes. Maternity waiting periods may apply, so cover should be reviewed before the benefits are required.

Can we switch with an existing medical condition?

Yes. An existing condition does not normally prevent switching, but higher benefits may be subject to an upgrade waiting period.

Will switching restart waiting periods?

Not necessarily. Completed waiting periods are generally recognised where there is no significant break in cover.

Can an employer pay for family health insurance?

An employer may contribute to an employee’s health insurance and may allow dependants to be added. Tax treatment and scheme rules should be checked.

What happens when a child becomes an adult?

Pricing, dependent status and plan options may change. The cover should be reviewed before the relevant renewal.

How can we reduce our family premium?

Review individual plans, excesses, hospital access, outpatient benefits, child pricing and employer contributions before renewal.

How do I request a family review?

Call Aisling on 085 851 4492 or email aisling@dooleyinsurances.com with your current plans and renewal notice.

Review your family health insurance before renewal

Every person in your family may not need the same health insurance plan.

Send Dooleys your renewal notice and let our health insurance team review the needs, cover and cost for each family member.

Call Aisling: 085 851 4492

Email: aisling@dooleyinsurances.com

Naas office: 045 431642

Edenderry office: 046 973 1218

The information on this page is general and does not constitute personal medical, financial, legal or tax advice. Health insurance premiums, benefits, hospital lists, excesses, waiting periods and policy conditions may change. Cover remains subject to the insurer’s terms and conditions.

Dooley Insurances Ltd t/a Dooley Insurance & Mortgage Brokers and Dooley Insurance Group is regulated by the Central Bank of Ireland.