lifetime community rating

Lifetime Community Rating (LCR)

If you are aged 35 or over and did not have health insurance prior to 1st May 2015, your premium may cost more

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What does Lifetime Community Rating mean? 

Rules governing the price of private health insurance came into effect on 1st May 2015. 
From this date, anyone aged 35 or over buying private health insurance for the first time will pay an additional charge, although there are exemption to this (see below).
This charge is based on your age at entry into health insurance, otherwise known as LCR.

 

If you already have health insurance, they won’t affect you at all.

 

However, from 1st May 2015, if you are aged 35 or over when you first take out private health insurance you will pay an additional charge of 2% for each year that you are aged 35 and over, up to a maximum of 70% for those joining at age 69 or over.

 

Also from 1st May 2015, changes to the rules around waiting periods and pre-existing conditions will come into effect for anyone buying private health insurance for the first time or anyone renewing or upgrading their cover from 1st May 2015.

 

The definition for pre-existing conditions has been amended and waiting periods applying to pre-existing conditions have been standardised for all age groups to 5 years for new joiners and 2 years for cover upgrades.

 

LCR loadings will apply for a maximum period of 10 years.

 

 

If you take out a private health insurance plan before you are over 35, you will avoid the additional charge on your premium for as long as you remain a paid up private health insurance customer.

 

If you are aged 35 or over and don't have health insurance, there are some things that may reduce your additional charge: 

 

  • Credit for breaks in the past when you had private health insurance as an adult. 
  • Credit for breaks in private health insurance of at least 6 months duration, up to a cumulative total of 3 years credit. This credit may only be claimed if a person has had cumulative 3 years coverage in the PMI market before break in cover credit can be given.
Credit also applies if...
  • Credit for periods while you were a member of Permanent Defence Forces or the Joint Sickness Insurance Scheme of the European Union, provided you become an insured person on or after 1st September 2018 and within 9 months of ending your membership. 
  • Credit for periods where in certain specified circumstances, you gave up your private health insurance due to unemployment.  
  • If you lived overseas on the 1st May 2015 and subsequently returned to Ireland, you will be entitled to a grace period of 9 months within which you can buy private health insurance without any age at entry loadings.
  • Credit for those who have resided outside the state provided they take up PMI within 9 months of ceasing to reside outside the state.

Find out more about how these special considerations may apply to you through the HIA.