Dáil Éireann Debate, Tuesday - 16 June 2026
829. Deputy Michael Healy-Rae asked the Minister for Health if a company (details supplied) is allowed to change all policies so that it no longer covers 100% for orthopaedic procedures and that the company can leave patients to pay the 20% short fall; and if she will make a statement on the matter. [44902/26]
View answerAs Minister for Health, I am responsible for the legal framework governing the private health insurance market, which operates on the principles of community rating, open enrolment, lifetime cover and minimum benefit. These protections are designed to support fairness and keep health insurance as affordable as possible for all consumers.
The Health Insurance Act 1994 (Minimum Benefit) Regulations 1996 require insurers to provide a minimum level of cover to every insured person, regardless of what insurance policy has been purchased. Private health insurers operate as commercial entities within a competitive market, and where a procedure or service is not designated as a minimum benefit under the Regulations, insurers may determine themselves whether to include it on particular plans.
Beyond the scope of these regulations, I do not have a role in the commercial decision making of any private health insurer and therefore cannot direct any insurer to provide cover for any particular procedure or service, or direct how that cover is to be provided.
The Health Insurance Authority (HIA) maintains regulatory oversight of insurers and ensures compliance with community rating, open enrolment, and lifetime cover requirements, which helps to keep the health insurance market fair, accessible and sustainable for all consumers. The HIA also provides a free online comparison tool that allows individuals to compare active plans in the market and prioritise coverage categories based on their needs. The comparison tool is available at []www.hia.ie/health-insurance-comparison.
The Central Bank of Ireland (CBI) is responsible for regulating health insurance undertakings as financial service providers under the consumer protection framework, including the Consumer Protection Code. This role includes overseeing how insurers conduct their business with consumers, the provision of information, disclosure requirements and overall fair treatment of customers. The CBI requires insurers to highlight changes in cover clearly at renewal. It is important that consumers review their renewal letters in advance of renewing a policy to ensure that it meets their needs and requirements.
