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:

Maximum waiting periods
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

Irish Life Health
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
Age Outpatient medical expenses Inpatient new condition Inpatient pre-existing condition
All age groups None 26 weeks (currently waived) 5 years
Vhi Healthcare
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
HSF Health Plan - All age groups
Benefit Waiting Period
Dental and Optical 3 months (6 months 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 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

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.

Irish Life Health
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
Laya Healthcare
Age Outpatient medical expenses Inpatient pre-existing condition
All age groups None 2 years
Vhi Healthcare
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:

Maximum waiting periods
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