Independent TD for Offaly, Carol Nolan, has said she is “deeply disappointed” by the Minister for Health’s refusal to consider any legislative change that would prevent elderly policyholders being forced to pay for maternity and addiction‑related mental health cover they will never use.
Deputy Nolan was speaking after receiving replies to a series of parliamentary questions she submitted following a case she had recently highlighted involving an Offaly woman in her eighties who is being charged for maternity cover under her VHI plan.
The Minister has now confirmed that she intends to maintain the current regulatory model in full, despite acknowledging that “not all benefits required under the Regulations apply to every insured person,” and that “some benefits relate to particular life stages, age groups or genders.”
Deputy Nolan said the Minister’s position borders on the “contradictory and incoherent,” pointing in particular to the Minister’s reliance on the Central Bank’s Consumer Protection Code:
“On the one hand, the Minister insists that elderly people must continue paying for benefits they will never need. On the other hand, she cites the Central Bank’s consumer‑protection rule stating that insurers must only offer the most suitable plan available. How can a plan be considered ‘suitable’ for an 80‑year‑old woman when it contains maternity cover? The tension here is obvious. The Minister and indeed the industry are having it both ways,” she said.
The Offaly TD said the replies show a government unwilling to confront the real‑world consequences of rigid minimum benefit rules:
“The Minister has doubled down on a system that is clearly outdated. She says the model is fair, yet she refuses to address the fact that elderly people are being charged for services that have no relevance to their lives.”
“Since raising this case, I have debated the matter on Midlands 103 and the response has been overwhelming. People are genuinely shocked that this is happening. The commentary I have received has been hugely supportive, with many people telling me they have faced similar problems.”
“The Minister and the insurance industry may be content to leave elderly and indeed younger people trapped in unsuitable plans, but I am not. I will keep challenging this incoherent policy until we see a system that respects people’s circumstances and applies basic cop‑on. All policyholders deserve better than being told to simply accept unfair charges,” Deputy Nolan said.
The Offaly TD had asked the Minister for Health if she would consider amending legislation to allow insurers to provide refunds or tailored adjustments for elderly policyholders who are obliged to pay for maternity or addiction related mental health cover despite having no need for such services.
In reply, Minister for Health, Jennifer Carroll MacNeill, said she is responsible for the legal framework governing the voluntary private health insurance market in Ireland.
“This market operates on the principles of community rating, open enrolment, lifetime cover and minimum benefits. These principles help achieve the policy objective of keeping private health insurance more affordable for older and sicker consumers. In a community-rated private health insurance market, everyone pays the same price for a particular health insurance policy. The system is designed on the basis of risk-sharing across the entire insured community. In a risk-rated market, older and sicker people would pay much more for health insurance than they do currently,” she said.
“One of the key pillars of our community-rated market is minimum benefits. Under the Health Insurance Act 1994 (Minimum Benefit) Regulations, all insurers must provide a specified minimum level of benefits in each plan. This ensures that all insured persons have access to a baseline level of cover for essential health services and prevents insurers from selling policies with very limited benefits that may leave people underinsured when they need care.”
“This approach is designed to be equitable and fair by ensuring that all consumers receive an appropriate minimum level of health insurance cover, regardless of the plan they purchase. Not all benefits required under the Regulations apply to every insured person. Some benefits relate to particular life stages, age groups or genders. Nevertheless, the package of benefits prescribed by the Regulations is considered important and beneficial to the insured population as a whole and is protected as part of a minimum base level of cover available to all policyholders. Accordingly, the inclusion of a specified level of maternity benefits and addiction-related mental health services in all health insurance policies forms part of this minimum level of cover. There are no current plans to exclude these services from the suite of minimum benefits,” she said in her reply to Deputy Nolan.
“The inclusion of prescribed minimum benefits in all health insurance plans does not constitute mis-selling or inappropriate product bundling. Insurers are prohibited from offering plans without the benefits specified in the legislation. In addition, community rating means that everyone pays the same price for the same product. Accordingly, insurers cannot offer customers refunds or discounts in exchange for waiving or opting out of any benefits.”
“As well as the consumer protections provided by the Regulations, open enrolment and lifetime cover requirements, there are several other protections available to private health insurance customers in Ireland. Under the Central Bank’s Consumer Protection Code, private health insurers must ensure that consumers are only offered the most suitable plan available. Consumers can contact their insurer to ensure that their current plan remains suitable for their needs and if they believe they have been mis-sold a health insurance policy they can complain through their insurer’s internal complaints process. If they are still unhappy with the outcome, they can contact the Financial Services and Pensions Ombudsman to escalate their complaint. The Financial Services and Pensions Ombudsman is an independent body that helps resolve disputes between consumers and financial service providers, including private health insurers,” she said.