Health Insurance FAQ

Do health insurance companies charge more for riskier customers?

No. They cannot charge you a higher premium simply on the basis of it being more likely that you might make a claim. Community Rating means that a health insurance company must charge all its consumers the same premium for a given level of cover, regardless of age, sex and other risk factors.

There are some exceptions to this rule, including:

  • If you have children under 18. The premium for them must be waived altogether, or reduced to less than half the standard premium.
  • If you have dependants who are students over 18 and under 23. Here, the premium cannot be more than 50% of the standard premium.

Members of group schemes can also have reduced premiums, as can pensioners who are members of restricted membership insurers.

Can a private health insurance company refuse to take me on?

Consumers' interests are protected under "open enrolment". This means insurers cannot refuse to provide cover for anyone under 65, regardless of their risk status, except in very limited circumstances.

But what if I'm over 65?

It depends on whether you were still insured in the 13 weeks leading up to the switch. "Lifetime cover" is a system giving all consumers (irrespective of their age, risk status or claims history) the right to renew their policy.

This obligation applies to all insurers and all insurance products, and means you are entitled to switch your insurers/products at any age if you have kept up the old policy. You lose this right if the policy has lapsed for more than 13 weeks.

If I switch insurance companies, will there be a waiting period?

You can transfer from one health insurer to another one offering the same benefits (or a lower level) without having to serve any extra waiting period. But if your new policy has extra, higher benefits the new company can insist on a waiting period before you are eligible for these. There is a maximum limit on this new waiting period, depending on your age when you are first named on the higher contract. This maximum is:

  • Up to two years if you are under 65
  • Up to five years if you are over 65

The maximum waiting can vary depending not just on your age but on whether or not you already had a particular medical condition when you started serving the waiting period. Different maximum waiting periods are also specified for maternity benefits.

Generally speaking, though, if you are switching insurer the new company cannot impose an extra waiting period if:

  • You have no gap in cover or the gap is less than 13 weeks, and
  • There is no upgrade of cover; and
  • You have served all your waiting period with your old insurer

If you haven't quite finished your waiting period with your old insurer, your new one must give you credit for the amount of waiting time you have already served.

Supposing the gap in my cover is more than 13 weeks?

Then you'll need to serve a waiting period as if you'd never had insurance before.

Why it is important to choose the private health system over the public health system?

  • Faster access to consultants
  • Hospitals & procedures
  • Choice regarding consultant
  • Choice regarding accommodation

What are the benefits of having a health scheme?

  • Paying your Health Insurance through Salary Deduction
  • Benefit of having Broker/Aviva Health looking after your Health Insurance
  • Offering Corporate plans which have 10% Discount built in at Source
  • Potential of further Discount if numbers hit 30/40 lives
  • Claims Clinic/Nurse on site/Employment Assistance Programme

What is the strength and security of Aviva Health Insurance?


  • 43 million customers globally
  • Over 300 year heritage
  • Ireland’s largest composite insurer

Aviva Ireland:

  • 100 years of heritage in Ireland
  • 1.2 million Irish customers
  • 18% market share
  • Fully Solvent and regulated by Central Bank
  • Committed to proactive health management

Why should a customer deal with a broker for Health Insurance

  • Personal Service that you can give to customers either Face to face or over the phone (If customer asks for you, they get you, develop Personal Relationship)
  • No charge to the customer for expert Health insurance advice
  • Broker can offer greater range of plans (Consumer & Corporate)
  • Mix & Match Plans to suit Individual/Family needs
  • Broker can view almost 300 plans in the market and advise the customer based on there needs (HIA allows Broker to view all plans in the market)
  • Broker has Relationship with that customer (May have other products with you, local connection in the area)
  • Broker has expert Knowledge of the Health Insurance Industry (Compare & Contrast plans), Give guidance on claims (Give customer Corporate enquiries phone number etc)
  • Broker can advise on particular offers for adults/Children as they happen
  • Broker can give the customer the right plan at the right price with the right Benefits
Health Insurance Ireland
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