Health Insurance Act, 1994

Obligation to provide health insurance.

8.—(1) A registered undertaking, other than a restricted membership undertaking, shall not refuse to effect a health insurance contract with or for a person who is under the age of 65 years or such a person and his or her dependants under that age except in such cases (if any) or in such circumstances (if any) as may be prescribed.

(2) A restricted membership undertaking shall not—

(a) impose as a condition of qualification for membership of the undertaking a requirement as to age in relation to a person who is under the age of 65 years,

(b) refuse to admit to membership of the undertaking a person who is under the age of 65 years and is qualified for such membership and requests to be so admitted, or

(c) refuse to effect a health insurance contract with or for such a person as aforesaid or with or for such a person and his or her dependants under the age of 65 years,

except in such cases (if any) or in such circumstances (if any) as may be prescribed.

(3) The Minister may prescribe the maximum waiting periods for eligibility for payment under a health insurance contract which a registered undertaking may impose in respect of the person effecting the contract or his or her dependants and, in particular, but without prejudice to the generality of the foregoing, in respect of a person who—

(a) is of or over the age of 55 years and under the age of 65 years,

(b) is suffering from a medical condition when the contract is effected,

(c) effects such a contract without previously having effected a health insurance contract in the State, or

(d) effects such a contract with that undertaking having previously effected such a contract with the undertaking whether in respect of the same or different services.

(4) (a) Subject to paragraph (b), where a health insurance contract effected by a person with a registered undertaking ceases to be in force for any reason, that or any other registered undertaking shall not refuse to effect another health insurance contract with the person, irrespective of his or her age, in respect of the same services except in such cases (if any) or in such circumstances (if any) as may be prescribed.

(b) A restricted membership undertaking may refuse to effect a health insurance contract with a person referred to in paragraph (a) if the person is not entitled to membership of the undertaking.

(5) Where a health insurance contract effected by a person with a registered undertaking ceases to be in force for any reason and the person effects such a contract with another registered undertaking within such period after such cesser as may be prescribed—

(a) the waiting period for eligibility for any payment to the person under that contract shall not be longer than it would have been if the person had effected the latter contract at the time he or she effected the former contract, and

(b) there shall be deemed to have expired so much of that period as is equal to so much of the like period under the first-mentioned contract as had expired at the time of the cesser aforesaid.