Dáil Éireann Debate, Tuesday - 9 June 2015
837. Deputy Michael McGrath asked the Minister for Health the position regarding an issue concerning private health insurance raised in correspondence by a person (details supplied) in County Cork; and if he will make a statement on the matter. [22182/15]
View answerTaking out health insurance is optional. Anyone ordinarily resident in Ireland is entitled, subject to certain charges, to receive public in-patient and out-patient hospital services. People who do not take out health insurance continue to have the same entitlement to services in the public hospital system.
Community rating, reflecting the principle of intergenerational solidarity, is a fundamental cornerstone of the health insurance system. This means that people who are old or sick do not have to pay more than the young and healthy, whereas in other health insurance systems the level of risk that an individual presents directly affects the premium paid. Under community rating, premiums for younger or healthier lives are typically higher than their expected claims would require, whereas for older or less healthy lives, premiums are typically lower than the expected claims would require. In effect, older people who have been paying health insurance premiums for many years will have supported the older generation when they were younger and can reasonably expect to benefit in a similar way as they themselves now become older.
When an individual takes out health insurance for the first time in this country, they may have to serve waiting periods before they are fully covered, but accident and injury will be covered immediately. The application of waiting periods helps to support community rating and is 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 system.
In the same way, a person who previously lived abroad who becomes resident in Ireland is subject to waiting periods when taking out health insurance for the first time in this country. Periods of cover on health insurance plans held outside the State are not taken into account for the purposes of waiting periods, as such plans do not comply with the Irish private health insurance regulatory system.
