Waiting Periods - Explained

The majority of health insurance policies in Ireland come with waiting periods – but what are they? Who has to serve them? And how long for?

Here’s everything you need to know about waiting periods in Ireland.

What is a Waiting Period?

Essentially, a waiting period is the pre-determined length of time you’ll need to wait before your full health insurance cover kicks in. While access to many treatments and procedures may be restricted during your waiting period, accidents and emergencies will be covered immediately when you take out health insurance.

Who Has to Serve a Waiting Period?

You’re likely to serve a waiting period when you take out health insurance for the very first time, or if you haven’t been covered for 13 consecutive weeks or more.

For new-born children, no waiting period will apply if they’re added to your health insurance plan within 13 weeks of birth.

There is no waiting period on day-to-day medical expenses for members under 55. Some providers have a 26-week waiting period on day-to-day benefits when members are over 55.

How Long Are Waiting Periods?

Most often, the standard waiting period for illnesses that start after you take out health insurance is 26 weeks.

However, the waiting period is usually much longer for pre-existing conditions. Any ailments, illnesses or conditions that existed in the 6 months prior to taking out health insurance will not be covered for the first 5 years of your policy – which is one of the many reasons it’s important to get insured sooner rather than later.

It’s important to note that you will only have to wait 5 years for cover relating to that specific pre-existing condition. The rest of your cover will kick in after your initial waiting period of 26 weeks.

For maternity and fertility benefits, there is a 52-week waiting period. As long as you’ve been on the plan for 52 weeks when you give birth, you will be covered for maternity; while some plans have a two-year waiting period for fertility cover. Find out more about maternity and fertility insurance by reading our recent blogs.

What if I Change Insurer?

As long as you don’t have a break in cover of more than 13 weeks, you won’t be required to serve these waiting periods again – even if you change insurance providers. If you switch to a new insurer during your waiting period, the amount of time already served will be carried over and you’ll finish the waiting period with the new provider.

If you upgrade your cover and you have an existing medical condition at the time of the upgrade, a two-year waiting period will apply for any additional cover relating to the pre-existing condition.

The waiting period will only apply to the extra coverage, so you maintain the same level of cover from before you upgraded. If you upgrade your cover and don’t have any existing conditions at the time of the upgrade, you can avail of the increased cover immediately.

We know this can be very confusing – particularly with so many other variables to consider when choosing your health insurance. For advice from our health insurance experts, get in touch using the form below, and we’d be happy to help you find the plan the works best for you!