The health insurance regulations give insurers the discretion to impose waiting periods on the payment of benefit in respect of persons taking out insurance cover for the first time. The regulations, however, set maximum waiting periods which cannot be exceeded by insurers. In the normal course, the maximum waiting period is 26 weeks if the person is under the age of 55 or 52 weeks if the person is over 55. Where the person suffers from a pre-existing condition at the time of taking out cover, the maximum waiting period for the payment of benefit which relates to claims arising from that condition is five years if the person is under 55, seven years for those aged 55 to 60 and ten years for those aged 60 to 65.
It is important to note that the periods of exclusion in relation to pre-existing conditions do not apply to claims which are unrelated to these conditions. Such claims are subject only to the initial waiting periods of 26 weeks or 52 weeks, depending on age. An insured person, therefore, can avail of health insurance benefits for conditions which are not pre-existing once the initial waiting period has passed.
In relation to hepatitis C, as the Deputy is aware, secondary health care services for persons who contracted hepatitis C through the administration within the State of blood and blood products have been provided without charge since February 1994 in designated units. These units are based in Beaumont Hospital, the Mater Hospital, St. James's Hospital and St. Vincent's Hospital in Dublin, St. Luke's Hospital in Kilkenny, Cork University Hospital, and University College Hospital in Galway. These services include access to in-patient and out-patient services as required, including access to a hospital bed. The services also include prompt primary referral from a liver consultant to another consultant for the purposes of testing, investigation or treatment of any known or suspected condition related to hepatitis C, or any condition which, while not related to hepatitis C, requires special treatment or care as a result of the person's infection with hepatitis C. Such appointments are given as a priority, normally within two weeks. Follow-up appointments are arranged on the basis of medical need.
I have not received a request from the representative groups, namely, Positive Action, Transfusion Positive, the Irish Haemophilia Society or the Irish Kidney Association, to address the hepatitis C health service needs of their members in the context of health insurance. In my opinion this is because the standard of care being provided through the designated units is of the highest quality, access is readily available and the services are provided without charge. There is also a high level of user satisfaction with the services. The representative groups are aware of my commitment to further develop existing services to meet the on-going needs of persons infected with hepatitis C. The person referred to by the Deputy is entitled to these services, and should she have any concerns in relation to the services available to her, she should contact the blood policy division in my Department.
My Department has contracted with Mercer Limited, actuaries and consultants, to provide expert advice in relation to difficulties being experienced in obtaining insurance cover, including the issue of health insurance cover, by certain persons infected with hepatitis C. The representative groups are participating in this exercise and the report from the consultants is expected to be completed next month.
