Dáil Éireann Debate, Thursday - 30 April 2015
152. Deputy Seán Ó Fearghaíl asked the Minister for Health with regard to health insurers, if a company may refuse to provide cover to a person with a pre-existing condition for a set period of time, while providing cover for other illnesses that have not previously occurred; and if he will make a statement on the matter. [17060/15]
View answerOpen Enrolment Regulations, made under the Health Insurance Acts, provide for maximum waiting periods for eligibility for payment under a health insurance contract in relation to first time entry to health insurance (initial) and for pre-existing conditions.
As part of my commitment to supporting the sustainability of the Private Health Insurance market, on 2 March 2015, I signed into law new measures updating the Open Enrolment Regulations that apply to all new health insurance contracts entered into on or after 1 May 2015. The amendments include an updated definition of a pre-existing condition to reflect the onset of ‘signs and symptoms’ in the 6 months prior to taking out insurance. I believe that the revised definition is clearer and will result in less claim disputes. I have also equalised the prescribed waiting periods to be served for all, irrespective of age, to a 26 week initial waiting period, and 5 years for a pre-existing condition that commenced before a person buys health insurance. This amendment will significantly lessen the prescribed waiting period for an older person in particular, in some cases from 10 to 5 years.
The provision of waiting periods help to support community rating by providing an important tool for insurers to combat practices where someone could potentially take out a health insurance policy to avail of a particular treatment and then cancel the policy once treatment had been received, without either penalty or sustained contribution to the community rated model.
