Health Insurance Ireland

Clear advice before you choose, switch or renew your cover

Health insurance in Ireland can be difficult to compare.

There are hundreds of plans, different hospital lists, excesses, outpatient benefits, waiting periods and levels of cover. Two plans with similar names and prices can provide very different benefits.

At Dooley Insurance Group, we help individuals, families and businesses understand their health insurance options and make informed decisions about their cover.

Whether you are taking out health insurance for the first time, reviewing an existing policy or approaching renewal, our health insurance team will explain the available options, benefits, exclusions and costs in clear language.

Renewal coming up? Call Aisling on 085 851 4492 and let Dooleys review your current plan before you renew.

Health insurance advice in Ireland

Health insurance should reflect your actual medical needs, preferred level of hospital access and available budget.

The lowest priced policy may not provide the benefits you expect. The most expensive policy may include cover that is not relevant to you or your family.

Our health insurance review considers:

• Your current health insurance provider
• Current plan
• Renewal premium
• Hospital access
• Private and semi private accommodation
• Hospital excesses
• Day case excesses
• Outpatient benefits
• GP and consultant benefits
• Physiotherapy and other day to day expenses
• Maternity benefits
• Mental health benefits
• Orthopaedic and cardiac cover
• Cancer care
• Children’s benefits
• Existing waiting periods
• Previous health insurance cover
• Your preferred budget

Our role is to help you understand what you are paying for and whether the available cover remains suitable for your circumstances.

Compare health insurance before you renew

Health insurance should be reviewed at every renewal.

Insurers can change:

• Premiums
• Plan benefits
• Hospital lists
• Excesses
• Outpatient allowances
• Treatment benefits
• Child pricing
• Corporate plan availability
• Plan names
• Terms and conditions

Automatically renewing the same plan each year could mean paying more for cover that no longer reflects your needs.

Before renewing, ask:

• Has my premium increased?
• Have any important benefits changed?
• Has my hospital access changed?
• Am I paying for benefits I do not use?
• Would a higher excess reduce the premium?
• Are there plans with similar cover at a different cost?
• Have my family’s needs changed?
• Are the children on the most suitable level of cover?
• Do all family members need to be on the same plan?
• Would switching provider affect any benefits or waiting periods?

Dooleys can review your current policy and explain the options available through our agency appointments.

Request a Health Insurance Review

What should a health insurance comparison include?

A health insurance comparison should examine more than the annual premium.

It should compare:

Hospital access

Plans can provide different levels of access to public, private and high technology hospitals.

The hospitals and treatment centres available will depend on the plan selected.

Inpatient excesses

An inpatient excess is the amount you may need to pay when admitted to hospital.

The excess may apply per admission, per claim or according to another structure stated in the policy.

Day case excesses

Some plans apply a separate excess for eligible day case procedures.

A lower premium may come with a higher day case or inpatient excess.

Outpatient benefits

Outpatient benefits may contribute towards eligible expenses such as:

• GP visits
• Consultant appointments
• Physiotherapy
• Diagnostic tests
• Dental treatment
• Optical treatment
• Other eligible health expenses

The amount refunded, number of visits and claim conditions vary between plans.

Maternity benefits

Maternity benefits can differ significantly between health insurance plans.

Waiting periods, hospital access, consultant cover and other maternity related benefits should be checked before relying on a policy.

Orthopaedic and cardiac cover

Some plans may provide reduced cover, restricted hospital access or higher personal contributions for certain orthopaedic or cardiac procedures.

The terms should be checked carefully, particularly where these benefits are important to you.

Mental health benefits

Mental health cover can differ between plans in relation to inpatient treatment, outpatient support and approved providers.

Children’s cover

Children do not always need to be placed on the same plan as their parents.

Different plan structures or child pricing may be available, depending on the provider and family’s requirements.

Health insurance providers in Ireland

Ireland currently has four private health insurance providers:

• Vhi Healthcare
• Laya Healthcare
• Irish Life Health
• Level Health

The Health Insurance Authority provides information and a comparison facility covering private health insurance plans available in Ireland.

Dooley Insurance Group provides advice on health insurance options available through our agency appointments.

Any recommendation will be based on your circumstances, stated requirements and the products available to us.

Switching health insurance provider

You are entitled to review and switch your health insurance provider.

Your medical history does not prevent you from applying to another insurer. However, waiting periods may apply to new or increased benefits in certain circumstances.

Switching is normally considered at renewal.

Before moving, you should compare:

• Current and proposed premiums
• Hospital access
• Inpatient excesses
• Day case excesses
• Outpatient benefits
• Maternity cover
• Orthopaedic and cardiac benefits
• Mental health benefits
• Existing waiting periods
• Upgrade waiting periods
• Treatment already planned
• Claims currently being processed

You should not cancel your existing policy until the replacement cover and commencement date have been confirmed.

Dooleys can help you compare the relevant details and understand how a proposed switch may affect your cover.

Can I switch health insurance with a medical condition?

A medical condition does not normally prevent you from switching health insurer.

Ireland’s health insurance system operates under an acceptance guarantee, which means insurers must generally offer cover regardless of age, health or claims history, subject to limited exceptions for certain restricted schemes.

However, switching to a plan with higher benefits may result in an upgrade waiting period applying to the increased level of cover for a pre existing condition.

Your existing level of cover may continue to apply during that period, subject to the relevant rules and policy terms.

If you have an ongoing condition or planned treatment, your existing and proposed benefits should be reviewed carefully before switching.

Health insurance for families

Family health insurance should be reviewed around the needs of each family member.

Parents and children do not always need the same level of cover or the same plan.

A family health insurance review may consider:

• Private hospital access
• Children’s hospital benefits
• Paediatric services
• GP expenses
• Consultant visits
• Physiotherapy
• Maternity cover
• Mental health support
• Emergency care
• Orthopaedic cover
• Policy excesses
• Family budget

We help families understand the available plan structures and whether each person’s cover remains appropriate.

Health insurance for children

Health insurance for children may provide access to private hospital treatment and benefits for eligible day to day medical expenses, depending on the plan.

Parents should review:

• Child premium
• Hospital access
• Paediatric cover
• Inpatient excess
• Day case excess
• Outpatient benefits
• GP and consultant benefits
• Physiotherapy
• Emergency care
• Mental health benefits
• Dental and optical benefits where included

Newborn children should be added to a policy promptly.

The applicable deadline, waiting periods and cover commencement should be confirmed with the insurer or broker.

Health insurance for individuals

An individual health insurance plan should reflect your health priorities, preferred hospital access and budget.

Important considerations may include:

• Public or private hospital access
• High technology hospital access
• Inpatient accommodation
• Hospital excesses
• Outpatient expenses
• Consultant benefits
• Physiotherapy
• Mental health cover
• Orthopaedic cover
• Cardiac cover
• Cancer treatment
• Maternity cover
• Travel benefits where included

A policy should not be selected solely because it has the lowest premium or the longest list of benefits.

The benefits need to be relevant and accessible under the conditions of the plan.

Health insurance for couples

Couples do not always need to be insured under the same plan.

One person may prioritise maternity, outpatient or mental health benefits, while the other may require different hospital access or a lower level of day to day cover.

Reviewing each person separately can help identify whether:

• Both plans remain suitable
• One person needs higher hospital cover
• Different excesses would be appropriate
• Maternity benefits are required
• Different outpatient benefits are needed
• Both people need to remain with the same provider

The final structure should reflect the needs of each individual and the overall household budget.

Health insurance for people over 50

Health insurance requirements often change with age.

Someone over 50 may place greater importance on:

• Private hospital access
• Orthopaedic procedures
• Cardiac treatment
• Cancer care
• Consultant access
• Diagnostic tests
• Inpatient excesses
• Outpatient benefits
• Travel cover where included
• Treatment in high technology hospitals

The plan should be reviewed before renewal to ensure that important benefits have not changed and that the premium remains appropriate for the cover provided.

Health insurance for self employed people

A self employed person may depend on continued access to treatment and a timely return to work.

Health insurance can form part of a wider protection strategy that may also include:

• Income protection
• Specified illness cover
• Life insurance
• Pension planning
• Business protection
• Emergency savings

Health insurance helps with eligible medical and hospital costs. It does not replace income if illness prevents you from working.

Self employed people should consider both medical cover and financial protection.

Corporate health insurance

Health insurance can form part of an employee benefits package.

A company health insurance arrangement may help:

• Attract employees
• Retain staff
• Strengthen employee benefits
• Support access to eligible medical treatment
• Provide a consistent benefit structure
• Support employee wellbeing

We help businesses understand the corporate health insurance options available through our agency appointments.

The company should also consider:

• Employee eligibility
• Employer contribution
• Payroll treatment
• Benefit in Kind
• Cover for dependants
• New employee enrolment
• Leavers
• Renewal administration
• Employee communication

Professional accounting and tax advice may be required in relation to employer paid premiums.

Health insurance waiting periods

Waiting periods may apply when:

• Taking out health insurance for the first time
• Returning after a break in cover
• Upgrading to higher benefits
• Adding maternity benefits
• Adding a child outside the relevant timeframe
• Moving from a lower level of cover

Waiting periods do not necessarily mean that you have no cover.

Where an upgrade waiting period applies, your previous level of benefit may continue for a pre existing condition while the waiting period applies to the increased cover.

The exact position depends on your history, policy and the applicable health insurance rules.

Lifetime Community Rating

Lifetime Community Rating can increase the cost of health insurance for someone who first takes out cover after a specified age.

The loading is based on the age at which cover begins and may apply for a defined period.

Previous health insurance, time spent living outside Ireland and certain other circumstances may affect whether a loading applies.

If you are taking out health insurance for the first time or returning to Ireland, Dooleys can help you understand the information that needs to be considered.

Health insurance excesses

An excess is the amount you may need to pay yourself when making an eligible claim.

Plans may include:

• Inpatient excess
• Day case excess
• Outpatient excess
• Excess per admission
• Excess per claim
• Excess per policy year

A higher excess may reduce the annual premium, but it can increase the amount payable when treatment is required.

The correct balance depends on your budget, likelihood of claiming and ability to meet the excess.

Public, private and high technology hospitals

Health insurance plans can provide different levels of access to:

• Public hospitals
• Private hospitals
• High technology hospitals
• Approved treatment centres

A plan name or price does not automatically confirm access to a particular hospital.

The current hospital list and treatment rules should be checked before selecting or switching a plan.

If access to a specific hospital or consultant is important, this should be raised during the review.

Health insurance outpatient benefits

Outpatient benefits may contribute towards eligible day to day medical expenses.

These can include:

• GP appointments
• Consultant visits
• Physiotherapy
• Diagnostic testing
• Dental treatment
• Optical treatment
• Alternative therapies where included
• Other eligible expenses

Some plans provide fixed refunds. Others apply an annual excess before benefits become payable.

The practical value depends on the benefits you are likely to use and the premium charged for the plan.

Why review health insurance every year?

A plan that was suitable last year may not remain the most appropriate option.

You should review your health insurance if:

• The renewal premium increased
• Your family circumstances changed
• You had a child
• You are planning a pregnancy
• Your medical needs changed
• A preferred hospital is important
• You are approaching retirement
• Your employer benefits changed
• A child became an adult
• You are returning to Ireland
• You have remained on the same plan for several years

A renewal review can help you understand what has changed before the policy renews.

What to send Dooleys for a health insurance review

To review your current cover, it is helpful to provide:

• Current provider
• Current plan name
• Renewal date
• Renewal premium
• Number of adults
• Number of children
• Preferred hospitals
• Important benefits
• Existing or planned treatment
• Budget
• A copy of your renewal notice

The more accurate the information provided, the more useful the review can be.

Send Your Renewal Notice to Dooleys

Meet 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 has extensive experience across health insurance, management and business development.

She also advises clients on life assurance, specified illness cover, income protection and mortgage protection.

Phone: 085 851 4492

Email: aisling@dooleyinsurances.com

Speak to Aisling About Your Health Insurance

Why choose Dooley Insurance Group?

Dooley Insurance Group is an established Irish insurance brokerage founded in 1957.

Our health insurance service provides:

• Personal health insurance advice
• Family health insurance reviews
• Individual plan reviews
• Switching guidance
• Renewal support
• Corporate health insurance advice
• Clear explanations of benefits and excesses
• Support with health insurance queries
• Access to an experienced health insurance team
• Offices in Naas and Edenderry

Our aim is to help you understand your cover before you make a decision.

Health insurance questions

What is private health insurance?

Private health insurance helps cover eligible medical and hospital expenses according to the benefits, limits and conditions of the selected plan.

What is the best health insurance plan in Ireland?

There is no single best plan for everyone. The right plan depends on your hospital preferences, medical needs, family circumstances, required benefits and budget.

Can Dooleys compare health insurance plans?

Dooleys can review your existing policy and compare relevant options available through our agency appointments.

When should I review my health insurance?

Health insurance should be reviewed before every renewal and whenever your family, health requirements, employment or budget changes.

Can I switch health insurance provider?

Yes. You can switch provider, normally at renewal. Existing benefits, upgrade waiting periods and planned treatment should be checked first.

Can I switch with a pre existing condition?

A pre existing condition does not normally prevent you from switching. However, an upgrade waiting period may apply to higher benefits.

Will I need to serve waiting periods again?

You will not necessarily repeat all waiting periods when switching without a break in cover. Waiting periods may apply to new or increased benefits depending on your circumstances.

Do all family members need the same plan?

No. Adults and children can have different cover levels or plans where appropriate.

Does health insurance cover GP visits?

Some plans provide outpatient benefits for eligible GP expenses. The amount refunded and applicable excess depend on the plan.

Does health insurance cover private hospitals?

Many plans provide private hospital cover, but the hospitals, accommodation and excesses vary.

What is a health insurance excess?

An excess is the amount you may need to pay towards an eligible claim before or alongside the insurer’s contribution.

Can I take out health insurance with an existing medical condition?

Yes. Insurers must generally offer cover, but waiting periods may apply before benefits are available for a pre existing condition.

What is Lifetime Community Rating?

Lifetime Community Rating is a loading that may increase the premium where someone first takes out health insurance after the applicable age.

Should I automatically renew my existing plan?

Not without reviewing it. Premiums, benefits, hospital access and personal circumstances can change.

How do I request a health insurance review?

Contact Aisling O’Connor on 085 851 4492 or email aisling@dooleyinsurances.com with your current plan, renewal date and renewal notice.

Review your health insurance before you renew

Do not wait until after the renewal date to discover that your premium or benefits have changed.

Send Dooleys your current plan or renewal notice and let our health insurance team review the cover available before you make a decision.

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 benefits, premiums, hospital lists, excesses, waiting periods and policy conditions may change. Cover is subject to the terms and conditions of the insurer and selected plan.

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