Lifetime Community Rating (LCR) has been signed into law by the Minister for Health to support sustainability and competitiveness in the health insurance market from 1st May 2015. The planned outcome from this measure by the Government is to encourage people to take out health insurance earlier in life and to control premium inflation across the health insurance market. The introduction of Lifetime Community Rating (LCR) will see customers over the age of 34 pay an extra 2% loading per year in addition to their health insurance premium.

Up to now a person could enter the health insurance market at any age and be charged the same premium regardless of age. With the implementation of Lifetime Community Rating (LCR) you need to enter the health insurance market before the age of 35 to avoid loadings. If you take out private health insurance earlier in life, and retain it, you will pay lower premiums compared to someone who joins when they are older (over 35).

Loadings apply on health insurance policies written from 1st May 2015 for anyone aged 35 or over.  Some reductions and exceptions are allowed.  

Currently

In Ireland, everybody is charged the same price for a particular health insurance scheme, irrespective of a person’s age, gender or state of their health. This is called community rating.

Under the proposed new system of lifetime community rating, community rating will be changed to reflect the age at which a person takes out private health insurance. You may be charged an additional loading if you join the health insurance market at age 35 or over.

The primary reason for introducing Lifetime Community Rating (LCR) is to encourage younger people to purchase health insurance. Encouraging more people to join the market at younger ages helps spread the costs of claims by older and less healthy people across the market, helping to support affordable premium levels for all.  

The level of loading will depend on the age at which you take out private health insurance. The only way to avoid paying this loadings is to take out private health insurance before reaching the age of 35. 

For example if you are 45 and have never held private health insurance you will pay a 22% loading on your premium for life (11 years from the age of 35 to 45 x 2%).  

No. The loading that applies, depending on your age, if you purchase private health insurance will apply for a maximum of 10 years.

Yes. Everyone who has health insurance on or before 30^th April 2015 will be assumed to have a continuous period of cover and therefore no loadings will apply once you maintain your cover.

Time spent as a dependant paying the adult rate on a health insurance policy is credited towards potential LCR loadings from age 18 onwards; however, time spent as a dependant on a policy paying the child rate / student rate does not count towards your credited period.

The government considers 35 to be the most appropriate age to allow young people sufficient time to complete education and to achieve secure employment for a number of years.

In order to totally avoid the loadings you must not have a break in cover in excess of 13 weeks. If you have a break in cover in excess of 13 weeks loadings may apply to your premium. The level of loading will be reduced by the number of previous years health insurance cover you have.

You can reduce your loadings where you have a qualifying credited period. A credited period can apply where individuals previously had health insurance.

In addition, provision is made for a credited period (in total not exceeding 3 years) for individuals who previously had health insurance cover, but who stopped their cover since 1^st January 2008 because of unemployment.

Yes.

If you are under 35 years of age you will pay no loading.  If you are 35 and over, you may be subject to a loading depending on your circumstances and any credited periods you have built up.

Please be aware that if you are over 35 and have a break in cover in excess of 13 weeks, you will incur a 2% loading per year on top of your premium. The 2% loading will increase every year of your life you spend without health insurance.

The maximum loading that can apply is 70% of the total premium. A loading of 70% will only arise on very rare occasions, where a person aged 69 or older is purchasing private health insurance for the first time. 

The loadings increase with age reflecting the higher claims experience in older age groups. If the loadings did not apply to older persons, the rate of loading for young persons would be far higher, and be disproportionate and end up being a financial disincentive.

As of 1st September 2018, any person serving in the Defence Forces will receive a credited period. Any period (including periods prior to this provision coming into effect) is to be considered a credited period, if health insurance is purchased within 9 months of leaving the Defence Forces. There is no minimum service time required in the Defence Forces to qualify for this.

Please contact us on 021 202 2000 to apply Defence Forces LCR credits to your policy.

As of 1st September 2018, any person who resides in Ireland and is insured under the Joint Sickness Insurance Scheme of the EU is entitled to a credited period for LCR. Any period (including periods prior to this provision coming into effect) is to be considered a credited period, if health insurance is purchased within 9 months of leaving the EU scheme.

Please contact us on 021 202 2000 to apply EU Joint Sickness Scheme LCR credits to your policy.

Example 1

Example 2

Example 3

I am 50 years old and had health insurance previously for 10 years but lost my job in 2010 and have three years qualifying periods of unemployment - if I take out health insurance , will I have to pay loadings and if so how much?

No, applying the loadings will be mandatory and cannot be waived by an insurer. 

Switching from one insurer to another or from one policy to another does not affect the applicable loading. Loadings, if any, will continue to apply and insurers are required to supply each other with proof of an individual’s prior cover. 

Laya healthcare can provide you with all the information you need in regards to Lifetime Community Rating (LCR), we will also be able to provide a suitable level of cover for your own circumstances based on the excellent schemes we offer.

Independent information can be sought from the Health Insurance Authority www.HIA.ie

All cash plans in the market do not fall under the definition of an inpatient private health insurance plan. Therefore Lifetime Community Rating (LCR) will affect you if you take out a health insurance policy. 

If you are purchasing a private health insurance policy for the first time at age 35 years or older you will pay a 2% loading on top of your premium for every year you are aged over 34, regardless of having a cash plan in the past.

If your employer covers the total cost of your health insurance premium including the loading then yes.  Below is an example of how this will work.

Example:

Employee aged 40 entering the health insurance market for the first time with no credits. 

Example gross health insurance premium: €1,200

Total LCR loading: 6 years x 2% = 12% (€144)

Anybody who lived within the State on 1 May 2015 and subsequently moved to live outside Ireland on or after 1 November 2018 will receive a credit for their time living outside Ireland, provided they purchase inpatient private health insurance within 9 months of returning to Ireland.

This credit is only given to periods of 6 months or more that begin on or after 1 November 2018.

Please contact us on 021 202 2000 to apply Out of State LCR credits to your policy.

Credited Period

In some instances a person will have credits applied to their loadings. These can be the sum (in years and months) of any period of previously held Health Insurance and/or a recognised period of unemployment( link to next paragraph)  So your loading will be dependent on your age as well as any credited period you may have.  The more credited periods you have, the less the loading that is applied.

Please note:

1. Such credit only applies to those aged 18 and over who are/were paying a full adult premium rate.
2. Such credit is not applicable if the person aged 18 and over is/was in receipt of a student rate/YAR-applied product.

Recognised Period of Unemployment

Where a person had insurance on or after 1^st January 2008 and subsequently cancelled their Health Insurance as a result of unemployment (either their own, or a person they were dependent on) and either they or the person they were dependent on were in receipt of social welfare, they can receive a credited period from 6 months to 3 years. The periods of unemployment do not need to be consecutive and can continue to be earned after 30th April 2015.    You will need to tell us what your periods of unemployment were when you are buying health insurance from us so we can discount any loadings by the appropriate amount.

Age at Entry

You may hear this term a lot when Life Time Community Rating (LCR) is discussed.This is the age of the insured person in years and months when they take out a Health Insurance contract, minus any applicable credited period (see above for more information on this). The age of entry is the determining factor in deciding what loading a person receives on their health insurance premium. The age of entry is always rounded down to the nearest whole month. So if your age of entry is 37 years and 7 months, this will be rounded down to 37 years.  If a person is 40 and has a credited period of 3 years due to having health insurance for 3 years previously, then their age of entry is 40-3 = 37.  So they pay 6% loading ( 3 years x 2%) 

Overseas Waiver

If you lived outside the state on 1^st May 2015 and subsequently return to live in Ireland, you will have a 9 month grace period to buy health insurance, where no loadings apply. If you lived within the state on 1^st May 2015 and subsequently moved to live overseas on or after 1^st November 2018, you will receive a credit for your time living outside Ireland, provided that you buy health insurance within 9 months of returning to Ireland. This credit is only given to periods of 6 months or more that begin on or after 1^st November 2018. Once this grace period has expired, if you are over the age of 34, then loadings will be applied as normal.