Paul Sanchez
In the Republic of Ireland, it is possible to have a medical card and private health insurance simultaneously. If you have a referral from your GP, you can choose to be treated as either a public or private patient. Private health insurance in Ireland operates according to four principles: community rating, open enrolment, restricted membership, and lifetime cover. Community rating means that insurance companies must charge the same rate for the same level of service, regardless of age, sex, health status, or medical history. Open enrolment means that health insurance companies must accept anyone who wishes to join, regardless of age, sex, or health status. Restricted membership schemes must accept everyone who is qualified to join, and the final principle, lifetime community rating, means that the price of health insurance depends on the age at which you first took out health insurance.
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What You'll Learn
It is possible to have both a medical card and private health insurance
Private health insurance in Ireland operates according to four principles. Firstly, health insurance companies must accept anyone who wishes to join, regardless of age, sex, or health status. This is known as open enrolment. Secondly, restricted membership schemes must accept everyone who is qualified to join. Thirdly, community rating means that insurance companies must charge the same rate for a particular level of service, regardless of age, sex, health status, or medical history. So, all adults pay the same amount for the same benefits. Finally, private insurers must offer a minimum level of cover. For example, companies that offer inpatient hospital services must, at a minimum, offer semi-private rooms in public hospitals.
If you are ordinarily resident in the Republic of Ireland, you can buy health insurance regardless of age, sex, health status, or medical history. The European Health Insurance Card is also an option to consider. This card gives you access to medically necessary, state-provided healthcare during a temporary stay in another EU/EEA country.
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Private health insurance minimum coverage
Private health insurance refers to health insurance plans marketed by private insurance companies or offered by self-insured employers. It is separate from government-run insurance programs such as Medicare, Medicaid, and CHIP. In the US, private health insurance covers more than half of the population.
There are a variety of minimum standards for private major medical health insurance, imposed by both the federal and state governments. These include a federal requirement that employer-sponsored plans with 15 or more employees must provide coverage for maternity care. The Affordable Care Act (ACA) has also imposed regulatory changes on individual and small-group health insurance plans, which must now cover essential health benefits. Large-group plans must provide minimum value to avoid the employer mandate penalty. All non-grandfathered, non-grandmothered plans, in both the individual and group markets, have to cap in-network out-of-pocket costs (with an upper limit of $9,200 for a single person in 2025).
In addition, federal laws such as the Civil Rights Act of 1964 and the Americans with Disabilities Act of 1990 have created protections against discrimination based on race, color, national origin, sex, age, and disability. These standards apply to employers with 15 or more employees and regulate their group health plan coverage.
Most types of private health insurance are considered minimum essential coverage, including employer-sponsored health coverage, ACA-compliant plans sold in the individual market, and grandmothered or grandfathered plans. However, some types of less-regulated private health insurance are not considered minimum essential coverage, such as short-term health plans, fixed indemnity plans, and accident supplements. These types of coverage are generally only suitable as supplemental coverage rather than a person's primary health insurance.
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Private health insurance and medical cannabis
In the United States, most public and private insurance companies do not cover medical marijuana recommendations or use, even in states where it is legal. This is because, at the federal level, cannabis is still a Schedule 1 substance with no recognised medicinal use and a high potential for abuse. As a result, medical marijuana is difficult to research, and even if the DEA rescheduled it, it would take years for it to be added to health insurance formularies.
However, some states, cities, and dispensaries offer assistance and reduced-cost programs for medical marijuana patients. For example, New York offers Medicaid services reimbursement for patient evaluation and certification, while New Hampshire and New Mexico allow for the reimbursement of medical marijuana purchases at the state level. Additionally, some entrepreneurial companies, like Novus Cannabis MedPlan, are working to provide insurance coverage for medical marijuana.
In the United Kingdom, medical cannabis was legalised in November 2018, but it is only available through the NHS for three specific conditions and must be prescribed by a specialist doctor. Private health insurance companies in the UK rarely cover medical cannabis expenses, but there are exceptions. Some private insurers may provide coverage if it is prescribed by a specialist and deemed medically necessary.
While it is challenging to obtain insurance coverage for medical cannabis, studies have shown that medical cannabis laws can lower individual market health insurance premiums. Research has found that seven years after the implementation of medical cannabis laws, health insurance premiums were significantly lower in states with such legislation compared to those without. This reduction in premiums is beneficial for both cannabis users and non-users in states with medical cannabis laws.
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European Health Insurance Card
The European Health Insurance Card (EHIC) is applicable in all French overseas departments (Martinique, Guadeloupe, Réunion, and French Guiana) as they are part of the EEA, but not non-EEA dependent territories such as Aruba or French Polynesia. The card exists because the right to health care in the European Union is based on the country of legal residence, not the country of citizenship. The EHIC is provided free to all legal residents of participating countries. However, in some cases, even if a person is covered by the health insurance of an EU country, they are not eligible for an EHIC. For example, in Romania, a person who is currently insured must have been insured for the previous five years to be eligible.
The EHIC is not a replacement for private travel and medical insurance. It is recommended that you have a UK Global Health Insurance Card (GHIC) or EHIC and private travel and medical insurance for the full duration of your trip. The EHIC only covers healthcare that is normally covered by a statutory health care system in the visited country; additional costs can be met by taking out travel insurance. Before travelling, you should check the state-provided healthcare services in the country you're visiting and any potential charges you may face.
The UK was a participant in the EHIC scheme as an EU member until its withdrawal from the union. It continued to participate provisionally until the end of the Brexit transition period on 31 December 2020. The EU–UK Trade and Cooperation Agreement grants continued reciprocal healthcare access between the EU and the UK. Since 2022, some UK citizens and permanent residents are eligible for a new UK-issued EHIC valid for visits to these countries as well as Switzerland. Eligible persons are those who have been living in the European Union, Switzerland, Norway, Iceland, or Liechtenstein since before 1 January 2021, with a registered S1, E121, E106, or E109 form issued by the UK.
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Private health insurance and age
In Ireland, private health insurance is regulated by the Health Insurance Authority (HIA). The HIA website has a comparison tool to help individuals find the right option for them. Private healthcare remains a popular option in Ireland, although numbers have fallen in recent years due to increasing insurance prices. It is a way to avoid the long waiting times typical of public healthcare.
In Australia, Lifetime Health Cover (LHC) is a government initiative that encourages citizens to purchase and maintain private patient hospital cover earlier in life. If an individual has not taken out and maintained private patient hospital cover from the year they turn 31, and they decide to take it out later in life, they will pay a 2% LHC loading on top of their premium for every year they are aged over 30. For example, if an individual takes out private patient hospital cover when they are 40 years old, they may pay an extra 20% on the cost of this cover per year for 10 years. The maximum LHC loading that can be applied is 70%.
In Ireland, to be eligible for public healthcare, individuals do not need to sign up. However, if they are moving to the country, they may need to prove that they are or will be 'ordinarily resident' in Ireland and planning on staying for at least a year. They can access the Irish healthcare system in one of two ways:
- By applying for a medical card, which is means-tested and issued to those with a weekly income below a certain figure for their family size.
- By paying a fee for some services, which depends on their circumstances.
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Frequently asked questions
Yes, you can have a medical card and private health insurance at the same time. If you have a referral from your GP, you can choose to be treated as a public or private patient.
The European Health Insurance Card gives you access to medically necessary, state-provided healthcare during a temporary stay in another EU/EEA country.
Community rating means that the insurance company must charge the same rate for a particular level of service, regardless of your age, sex, health status or medical history.
No, most public and private insurance companies do not cover medical marijuana recommendations or use, even in states where it is legal. This is because cannabis is still considered illegal at the federal level.
