What Is a Waiting Period?

A waiting period is the length of time you need to have health insurance before you can make a claim.

There are three different types of waiting periods:

• Initial waiting period - this applies when you take out health insurance for the first time or when you take out health insurance after your health insurance has lapsed for 13 weeks or more.
• Pre-existing condition waiting period - this applies when you make a claim that relates to a pre-existing condition.
• Upgrade waiting period - this applies when you upgrade your cover, i.e. purchase a plan with more comprehensive cover than your previous plan.

More information below: 

Initial waiting periods:

Initial waiting periods apply when you take out health insurance for the first time or when you take out health insurance after your health insurance has lapsed for 13 weeks or more. You will not be covered during your initial waiting period. Initial waiting periods do not apply in the following circumstances:

• To claims made in respect of children who have been added to your policy within 13 weeks of the date of their birth
• To claims made in respect of adopted children who have been added to your policy within 13 weeks of the date of their adoption
• To claims in respect of emergency care for accidents and injuries

The table below sets out our initial waiting periods, which apply from the date you took out health insurance with Irish Life Health or another insurer for the first time or, from the date you took out health insurance with Irish Life Health or another insurer after your health insurance had lapsed for 13 weeks or more.

Pre-existing condition waiting periods:

Where you make a claim which relates to a pre-existing condition, a pre-existing condition waiting period will apply. A pre-existing condition is an ailment, illness or condition, the signs or symptoms of which existed at any time in the six months before you took out health insurance for the first time or before you took out health insurance after your health insurance had lapsed for 13 weeks or more.

You will not be covered for a pre-existing condition during your pre-existing condition waiting period. Our medical advisers will decide whether your claim relates to a pre-existing condition. Their decision is final.

Pre-existing condition waiting periods do not apply in the following circumstances:

• To claims made in respect of children who have been added to your policy within 13 weeks of the date of their birth
• To claims made in respect of adopted children who have been added to your policy within 13 weeks of the date of their adoption.

The following table sets out the pre-existing condition waiting periods applied by Irish Life Health. These waiting periods will apply from the date you took out health insurance for the first time (with Irish Life Health or another insurer), or from the date you took out health insurance (with Irish Life Health or another insurer) after your health insurance had lapsed for 13 weeks or more.

Upgrade waiting periods

An upgrade waiting period will apply when you upgrade your cover (i.e. you purchase a plan with more comprehensive cover than your previous plan). This may happen if you change your plan with us or when coming to Irish Life Health from another health insurer. We will apply an upgrade waiting period to claims where your treatment relates to a pre-existing condition. Where an upgrade waiting period applies, we will cover you up to the level that was available under the benefit that you are claiming of your previous plan. Where the benefit you are claiming was not available on your previous plan, you will not be covered. A pre-existing condition is an ailment, illness or condition, on the basis of medical advice, the signs or symptoms of which existed at any time in the six months:

• before you took out health insurance for the first time
• or before you took out health insurance after your health insurance had lapsed for 13 weeks or more.
• or before you upgraded your cover to a higher level plan

In these circumstances, you will be covered up to the level of cover that was available on the plan that you previously held before upgrading your cover. Please see the upgrade waiting period table below for the details of upgrade waiting periods by benefit type. Our medical advisers will determine when your ailment, illness or condition commenced. Their decision is final. The table below sets out the upgrade waiting periods applied by Irish Life Health. These waiting periods will apply from the date you upgraded.