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Health Insurance Cover

Dáil Éireann Debate, Tuesday - 3 December 2013

Tuesday, 3 December 2013

Questions (418, 433)

Brian Stanley

Question:

418. Deputy Brian Stanley asked the Minister for Health the reason there is a legal requirement for maternity cover to be mandatory in all health insurance policies regardless of the age of the policy holder, even for those who will never require such cover. [51541/13]

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Brian Stanley

Question:

433. Deputy Brian Stanley asked the Minister for Health if it is Government policy that women, regardless of age, must carry insurance for maternity cover and all other related maternity issues; his views on whether it is unfair to expect persons to pay for insurance cover of which they will never have to avail; and if he will give a commitment to resolving this issue as soon as possible. [51707/13]

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Written answers

I propose to take Questions Nos. 418 and 433 together.

The inclusion of maternity benefit in all health insurance products is a statutory requirement, as part of a legal obligation on health insurers to provide a specific minimum level of benefit in all health insurance products sold.

Minimum benefit is one of the key principles on which the Irish private health insurance regulatory system is based. Minimum Benefit Regulations, made under the Health Insurance Acts, require insurers to offer a minimum benefit to every insured person. The key purpose of the Regulations is to ensure the continued availability of the type of broad hospital cover traditionally held as a minimum by the insured population and to ensure that individuals do not significantly under-insure. Minimum Benefit Regulations were introduced in 1996, under Section 10 of the Health Insurance Act, 1994 and cover in-patient, out-patient and day-patient services provided by publicly funded hospitals, private hospitals, registered nursing home and hospital consultants.

The Minimum Benefit Regulations ensure that all consumers obtain an appropriate minimum level of health insurance cover regardless of what plan they purchase and that every plan available is inclusive of a minimum suite of benefits/procedures, some of which are available to the market as a whole and some of which will be applicable specifically to either men or women. By way of example, the Regulations include provision for such medical treatments as a prostatectomy or testicular biopsy (in the case of men) and cervical biopsy or maternity services (in the case of women). Importantly, under Community Rating everybody is charged the same premium for a particular health insurance plan which includes this minimum suite of benefits, irrespective of age, gender and the current or likely future state of their health. Thus, the broad base line of procedures provided by minimum benefit should not be looked at in gender specific terms, but rather as a cohort of procedures that are important to the community of the insured population and thus should be protected and provided as a minimum base to all.

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