What is a waiting period?

A waiting period is the time you may need to wait after joining Level Health before you can claim certain benefits.

Why do waiting periods exist?

Waiting periods prevent people from joining health insurance only when they need medical treatment and then cancelling their policy afterward. This ensures that the system is fair for all.

What are the waiting periods If you have not previously had health insurance (or have a break in cover of more than 13 weeks)?

For treatment needed as a result of an accident or injury: No waiting period, covered immediately

For treatment needed in relation to a new conditions that starts after you join Level Health: 26 weeks (6 months)

For treatment of conditions that existed at the time you started your cover (“pre-existing conditions”): 5 years

For maternity benefits: 12 months

What are the waiting periods if you are switching from another health insurer

If you are switching to Level Health from another health insurer, you will be covered for any Level Health benefits that you already had cover for at your previous insurer.If you are still subject to waiting periods (for example for pre-existing conditions), those waiting periods will continue with Level Health.

What happens if increase my cover when I switch to Level Health?

If the cover on your Level Health plan is higher than the cover that you had with a previous insurer, there is a two year waiting period for the enhanced benefits for any pre-existing conditions only.You will have cover for Level Health benefits up to the amount of cover that you had with your previous insurer.

What Can I claim for during a waiting period?

You are always covered immediately for any accidents or emergencies which includes cover for urgent care centres

You can also access QuickClinic services such as video doctor appointments, messaging a doctor, and claim for day-to-day benefits such as GP cover or physiotherapy

Do waiting periods apply to children on my policy?

For newborns or newly adopted children added to your policy within 13 weeks of birth or adoption, waiting periods do not apply. For other children added later, standard waiting periods apply.

What happens if I have a gap in cover?

If you let your health insurance lapse for more than 13 weeks before joining Level Health, full waiting periods will apply again, even if you had similar coverage before. If you had a gap in cover of less than 13 weeks, your previous cover will be recognised for the purposes of serving waiting periods.

How do I know if I have served all my waiting periods?

If you have had continuous cover for five years or more, you will have served all of your waiting periods with your existing insurer.If you have had continuous cover for less than five years, you can switch to Level Health and your previous time of cover will be recognised.

How will I know if I upgraded my cover?

You can compare the hospital cover on your previous plan to the hospital cover on the new Level Health plan and if the benefits on your new Level Health plan are better, an upgrade waiting period may apply for these better hospital benefits for pre-existing conditions only.A good way to compare your old plan with the new Level Health plan is using the HIA comparison tool at https://www.hia.ie/comparison-tool?#/

Some case studies to explain waiting periods for upgrades in cover

Simon upgrades his cover:

Simon is 42 years old and was covered with another insurer on a mid-level plan that has an orthopaedic co-pay of €2,000 (he would pay the first €2,000 of an orthopaedic claim). Simon switches to Level Health’s Plan D which has full cover for orthopaedic procedures.Simon has had hip pain and hip damage for some years (so this is a pre-existing condition).Simon’s consultant recommends he gets a hip replacement. There would be a two year waiting period in relation to the upgrade. This means that if Simon had a hip replacement during his first 2 years with Level Health, his cover would be the same as it was on the previous plan: he would pay the first €2,000 of costs.

Rachel upgrades her cover:

Rachel switches to Level Health’s Plan C from a lower level of cover from her previous insurer.A year after Rachel switches to Level Health, she develops symptoms and is diagnosed with heart issues.It is clear that signs and symptoms of the heart condition did not exist prior to Rachel switching to Level Health.On Plan C, Rachel is covered for cardiac procedures in Blackrock Clinic and Mater Private, but her previous plan did not cover these hospitals.However, as the heart condition was not a pre-existing condition when Rachel moved to Level Health, she would be covered for cardiac treatment in these hospitals.