Health Insurance Regulations

The business of private health insurance in Ireland is regulated by:

  • The Health Insurance Act, 1994
  • The Health Insurance (Amendment) Act, 2001
  • The Health Insurance (Amendment) Act, 2003
  • The Health Insurance (Amendment) Act, 2007
  • The Health Insurance (Miscellaneous Provisions) Act, 2009
  • The Health Insurance (Miscellaneous Provisions) Act, 2012
  • Health Insurance (Amendment) Act 2014 (Young Adult Rates)
  • Health Insurance (Amendment) Act 2015 (RES Payments and Stamp Duty)

The European Union "Third Non-Life Insurance Directive" sets out the requirements for the internal market for member states regarding non-life insurance, including health insurance. It allows individual member states to adopt these requirements in a manner most appropriate to their particular national legal systems and national healthcare systems.

The Health Insurance Acts, 1994 - 2015 legislate for the four principles of private health insurance in Ireland. They are:

  • lifetime community rating,
  • open enrolment,
  • lifetime cover,
  • minimum benefit.

The principal objective of the Authority in performing their functions under this Act is to ensure, in the interests of the common good, that access to health insurance cover is available to consumers of health services with no differentiation made between them (whether effected by income tax or stamp duty measures or other measures, or any combination thereof), in particular as regards the costs of health services, based in whole or in part on the respective age range and general health status of the members of any particular generation (or part thereof).

The Authority has produced a document which may be viewed as a Plain English guide to an insurer's responsibilities in implementing the Acts.

PDF iconCompliance checklist January 2017.pdf

PDF iconInterpretation of ordinarily resident.pdf

PDF iconGuidance note on community rated health insurance contracts.pdf