Will I pay more for health insurance because I moved here in my forties?

What the rule actually is

Irish private health insurance is community rated, which means everyone of any age pays the same price for the same policy. Lifetime Community Rating is the exception that keeps that possible: it adds a loading for people who leave it late to buy cover at all.

The numbers, from the Health Insurance Authority:

• It applies from age 35.
• The loading is 2% of the gross cost of the policy for each year above the age of 34 that you did not have health insurance.
• The maximum loading is 70%.
• You pay it for a maximum of 10 years.

So someone buying their first Irish policy at 45 is looking at a loading in the region of 22% on every premium for a decade. On a family policy that is not a rounding error.

And here is the part that is about you

You did not skip Irish health insurance in your thirties. You were living in another country, where the question did not arise.

The rule accounts for that, and the wording matters:

If you lived outside of Ireland on 1 May 2015 and you buy health insurance within nine months of making Ireland your principal residence, you won’t have to pay a LCR loading.

If you moved to Ireland after 2015 — which is everyone this page is for — you were living outside Ireland on that date. So there is no loading waiting for you provided you buy cover within nine months of making Ireland your principal residence.

Nine months from making Ireland your home. Not nine months from your first quote, not nine months from the day you finally had time to think about it.

Why this catches people specifically

The first nine months after a move are the nine months when private health insurance feels least urgent. You are young enough, or well enough, or simply too busy — there is a PPSN to get, a tenancy to find, a job to start, and a public system that exists and that you have not yet needed.

Then a year passes. You look at insurance in month fourteen, you are 41, and the quote has a number on it that nobody explained.

The loading is not a penalty for being new. It is the ordinary rule catching someone the exception was written for, who did not know the exception had a clock on it.

What to do about it

• Work out your date. Nine months from when Ireland became your principal residence. Put it in a calendar now, while you are reading this.
• If the date is close and you are over 34, take out a policy before it passes even if it is a basic one. Getting cover in place stops the clock; you can change level or insurer later. A cheap policy bought in month eight is worth considerably more than a good policy bought in month ten.
• If you are under 35, you have until the year you turn 35 rather than nine months, so there is no urgency from this rule. Your urgency, if any, is elsewhere.
• If you have had cover before, credits exist for previous periods of insurance, and they change the arithmetic. Ask the insurer to tell you in writing what loading, if any, they will apply to you before you buy.

What this rule does not do

It does not decide whether you need private health insurance at all. That is a separate question with a real answer on both sides — public healthcare here is not a fiction, and a loading on a policy you do not want is not a reason to buy one.

It also has nothing to do with your right to public healthcare, which turns on being ordinarily resident rather than on insurance. What the rule decides is only this: if you are going to buy private cover at some point, the price depends on whether you bought it before the window closed.