Written answers

Tuesday, 6 February 2018

Department of Health

Health Insurance Community Rating

Photo of Richard Boyd BarrettRichard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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402. To ask the Minister for Health his plans to extend the lifetime community rating scheme to make credits available to persons on low incomes who qualified for medical cards from 2008 and to those who had health insurance prior to 2004 in cases in which insurance companies no longer hold records of these persons; and if he will make a statement on the matter. [5794/18]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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Lifetime Community Rating (LCR) was introduced in 2015 as a way to strengthen Ireland’s community rated-health insurance market, where people who are old or sick do not have to pay more than the young and healthy when taking out a health insurance policy. The aim behind LCR was to ensure sufficient balance in the market overall between older people and younger people, between those who tend to claim more and those who tend to claim less, and thereby ensure the sustainability of the community rated approach. LCR encourages more young people to take out health insurance as a way to avoid late entry loadings of 2% per annum which may apply at age 35 and older.

While approximately 45% of Irish people hold private health insurance, everyone – with or without insurance - is entitled to access healthcare via the public health system.

Under the legislation, credits are available in certain circumstances, but only to persons who have held private health insurance. Currently, provision is made for an allowance of up to three years for persons who held insurance in the State but then had to give up their insurance as a result of redundancy for a period occurring after 1 January 2008.

The Health Insurance (Amendment) Act 2017 and forthcoming regulations will enhance the existing system of Lifetime Community Rating loadings: by extending this existing redundancy provision to apply to other scenarios; by ensuring that anyone living or travelling abroad for more than 6 months will not be loaded upon their return (provided they become insured upon their return); by ensuring that members of the Defence Forces are credited for their time in service; and by applying any loadings incurred for 10 years rather than for life, as is currently the case.

Health insurers are required to hold records for 6 years, in line with the legal obligation for retention of such records as part of general data protection requirements. For the purposes of Lifetime Community Rating beyond this 6 year timeframe, the onus is on the individual to provide evidence that satisfies the insurer of their previous health insurance cover.

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