New customer waiting periods
You may have to serve waiting periods if:
- You take out health insurance for the first time.
- It has been more than 13 weeks since you last held private health insurance.
You won’t have full cover until your waiting periods are over. However, there are some exceptions to the waiting periods:
- There is no waiting period for emergency care for accidents and injuries.
- Children and infants that are added to a policy within 13 weeks of their birth or adoption do not have to serve waiting periods.
The maximum waiting periods are:
| Accident and injuries | Illnesses that start after you join | Pre-existing conditions | Maternity-related claims |
|---|---|---|---|
| None | 26 weeks | 5 years | 52 weeks |
Once you serve these waiting periods you will not have to serve them again if you switch to another insurer as long as you don’t have a break in cover of more than 13 weeks. If you switch insurers while you are serving new customer waiting periods, the amount of time you have served with the first insurer will be taken into account and you will finish off your waiting periods with the new insurer. You will only have to serve additional waiting periods if you switch to a policy with higher benefits. For more information, go to switching/upgrading waiting periods.
The insurers don’t always apply the maximum waiting periods. The tables below show the current waiting periods for Irish Life Health, Laya Healthcare, and Vhi Healthcare.
Current market practice
| Age | Outpatient medical expenses | Day-to-day medical expenses | Inpatient new condition | Inpatient pre-existing condition |
|---|---|---|---|---|
| Under 55 | None | None | 26 weeks | 5 years |
| 55+ | None | 26 weeks | 26 weeks | 5 years |
| Age | Outpatient medical expenses | Inpatient new condition | Inpatient pre-existing condition |
|---|---|---|---|
| All age groups | None | 26 weeks (currently waived) | 5 years |
| Age | Outpatient medical expenses | Inpatient new condition | Inpatient pre-existing condition |
|---|---|---|---|
| All age groups | None | 26 weeks | 5 years |
| Age | Outpatient Medical Expenses | Day to day medical expenses | Inpatient New Condition | Inpatient pre-existing condition |
|---|---|---|---|---|
| Under 50 | None | None | 26 weeks | 5 years |
| 50+ | None | None | 26 weeks | 5 years |
| Benefit | Waiting Period |
|---|---|
| Dental and Optical | 3 months (6 months for laser eye surgery) |
| Dental Trauma | No waiting period |
| GP and A&E | 3 months (no waiting period following an accident) |
| Prescription | 3 months |
| Practitioner | 3 months |
| Wellbeing and Alternative Treatments | 3 months |
| Consultations | 3 months |
| Medical Tests | 3 months |
| Birth and Adoption Grant | 10 months, also applies to maternity claims |
| Hospital-General and Hospice | 3 months |
| Hospital-Accident | No waiting period |
| Hospital-Elderly and Mental Illness | 3 months |
| Recuperation | 3 months |
| Day Case | 3 months |
| Surgical Appliances and Hearing Aids | 3 months |
| Personal Accident | No waiting period |
| HSF Assist | No waiting period |
| Pre-existing conditions and health problems | If anyone has a pre-existing condition, there will be a waiting period for claims under the Practitioners, Wellbeing and Alternative Treatments (excluding chiropody/podiatry), Consultations, Medical Tests, Hospital and Day Case, Recuperation and Surgical Appliances & Hearing Aids categories. The waiting time will be 5 years from date of first registration. |
Switching/upgrade waiting periods
If you are switching policies to a policy with lower cover, you won't have to serve any waiting periods (unless you are currently serving new customer waiting periods).
If you are switching policies to a policy with higher cover, the following maximum waiting periods may be applied to any higher benefit on the new policy:
Any higher benefit: 2 years
Maternity benefits: 52 weeks
During the waiting periods, you will be covered to the level of cover of your previous policy.
The insurers don’t always apply the maximum waiting periods. The tables below show the current waiting periods for Irish Life Health, Laya Healthcare, and Vhi Healthcare. With all insurers, there is a 52-week waiting period for higher maternity benefits.
| Age | Outpatient medical expenses | Day-to-day medical expenses | Inpatient pre-existing condition |
|---|---|---|---|
| Under 55 | None | None | 2 years |
| 55+ | None | 26 weeks | 2 years |
| Age | Outpatient medical expenses | Inpatient pre-existing condition |
|---|---|---|
| All age groups | None | 2 years |
| Age | Outpatient medical expenses | Inpatient pre-existing condition |
|---|---|---|
| All age groups | None | 2 years |
| Age | Outpatient medical expenses | Day-to-day medical expenses | Inpatient pre-existing condition |
|---|---|---|---|
| Under 50 | None | None | 2 years |
| 50-54 | None | None | 2 years |
| 55-64 | None | None | 2 years |
| 65+ | None | None | 2 years |
Cash plan waiting periods
The same rules around waiting periods, upgrading, and switching your policy apply to cash plans as inpatient health insurance policies.
New customer waiting periods
You won’t have full cover until your waiting periods are over. The maximum waiting periods are:
| Accident and injuries | Illnesses that start after you join | Pre-existing conditions | Maternity-related claims |
|---|---|---|---|
| None | 26 weeks | 5 years | 52 weeks |
Switching/upgrading waiting periods
If you are switching policies or upgrading to a policy with higher cover, the following maximum waiting periods may be applied to any higher benefit on the new policy:
Any higher benefit: 2 years
Maternity benefits: 52 weeks