New Customer Waiting Periods

When you take out health insurance for the first time, or it has been more than 13 weeks since you last held private health insurance, you may have to serve waiting periods before you are fully covered, but accident and injury will be covered immediately. The maximum waiting periods are:

New Customer Maximum Waiting Periods
Accident and Injuries Illnesses that start after you join Illnesses that existed in the 6 months before you join 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 haven't had 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 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 plan with higher benefits. See our section on switching for further details. 

Infants born to policyholders will not serve a waiting period if they are added to a policy within 13 weeks of their date of birth.

Illnesses that existed in the 6 months before you join are called pre-existing conditions and from 1 May 2015, a pre-existing condition is defined as:

"Pre-existing condition” means an ailment, illness or condition, where, on the basis of medical advice, the signs or symptoms of that ailment, illness or condition existed at any time in the period of 6 months ending on the day on which the person became insured under the contract.

Current Market Practice

Vhi: Waiting periods for new customers
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 26 weeks 26 weeks 5 years
Irish Life Health: Waiting periods for new customers
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
Laya Healthcare: Waiting periods for new customers
Age Outpatient Medical Expenses Inpatient New Condition Inpatient Pre-existing Condition
All age groups None 26 weeks 5 years
HSF Health Plan: Waiting periods for new customers - All age groups
Benefit Waiting Period
Dental and Optical 3 months except for Laser Eye Surgery which is 6 months
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 plans, the following maximum waiting periods may be applied to any higher benefit on the new plan:

Any higher benefit 2 years
Maternity benefits 52 weeks

 

Current Market Practice

* All insurers apply a 52 week waiting period for higher maternity benefits.

Vhi Healthcare Upgrade waiting periods
Age Outpatient Medical Expenses Day to day Medical Expenses Inpatient Pre-existing conditions
Under 50 None None 2 years
50-54 None 26 weeks 2 years
55-64 None 26 weeks 2 years
65+ None 26 weeks 2 years
Irish Life Health Upgrade waiting periods
Age Outpatient Medical Expenses Day to day Medical Expenses Inpatient pre-existing conditions
Under 55 None None 2 years
55+ None 26 weeks 2 years

Laya Healthcare

No waiting period for higher outpatient benefits. 2 year waiting period for higher inpatient benefits when used for a pre-existing condition.

 

Cash Plan Waiting Periods

Rules surrounding waiting periods, switching and upgrading of your cash plan are governed by the same legislation that applies to inpatient health insurance plans as described in our pages on "New Customer Waiting Periods" and "Switching/Upgrading waiting periods".

Cash Plan New Customer Waiting Periods

New Customer Maximum Waiting Periods
Accident and Injuries Illnesses that commence after you join Illnesses that commence before you join Maternity related claims
None 26 weeks 5 years 52 weeks

*Rules concerning pre-existing conditions do not apply to Dental and Optical, General Practitioner and Emergency Department, Prescriptions and Chiropody/Podiatry

Cash Plan Upgrade/Switching Waiting Periods

If you are switching plans, the following maximum waiting periods may be applied to any higher benefit on the new plan:

Any higher benefit

2 years

Maternity benefits

52 weeks