Réada Cronin (Kildare North, Sinn Fein)
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697. To ask the Minister for Health his plans to ensure that gene immunotherapy is covered by health insurers; and if he will make a statement on the matter. [42587/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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Ireland has a voluntary community rated private health insurance market. One of its key principles is minimum benefit, whereby insurers are required, under the Health Insurance Act 1994 (Minimum Benefit) Regulations 1996, to offer a minimum level of cover in every insurance policy. This approach ensures that all consumers obtain an appropriate minimum level of health insurance cover, regardless of what plan they purchase.

Health insurance companies are free to impose certain terms and conditions in their policies, provided that they comply with these Regulations. Beyond this, I have no role to play in the commercial decisions of any health insurer and so am not in a position to direct any insurer to provide cover for any procedure, service or treatment, or how that cover is to be provided. I am not currently considering plans to make changes to the Regulations.

In general, an insurer may refuse to cover any care or treatment if it does not deem it to be medically necessary. If a claim is declined by an insurer, the insured person should initially avail of the insurer’s complaints process and if they are not satisfied with the outcome, they can take a case to the Financial Services Pensions Ombudsman (FSPO).