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Waiting Periods
Switching from another health insurance provider
If you have held private health insurance within the past 13 weeks and the level of cover was higher or is the same as that of your new policy with us, then you are covered immediately with no waiting periods.
If you are still serving your 5 year waiting period for pre-existing conditions*, you may serve the balance with laya healthcare. We will fully recognise the length of time you’ve spent with your previous insurer.
Should you require additional cover or benefits, a 2 year waiting period must be served before you can avail of the higher level of cover for any pre-existing conditions for which the signs or symptoms of the ailment, illness or condition began before you changed your level of cover.
Not sure about whether waiting periods apply to you? Chat to our award-winning team on 021 202 2000
New to health insurance
When taking out health insurance for the first time, or if it has been 13 weeks since you last held private health insurance with an Irish health insurer, then a 5 year waiting period applies for any pre-existing conditions.
In addition, when taking out health insurance for the first time, or if it has been 13 weeks since you last held private health insurance with an Irish health insurer, a 52 week maternity waiting period also applies.
Your guide to waiting periods with laya healthcare
| The following waiting periods will apply if you are aged | Under 55 | 55-59 years | 60-64 years | Over 65 years |
|---|---|---|---|---|
| How long before you can claim for accident or injury? | Immediately for all age groups | |||
| How long before you can claim for any disease, illness or injury which began or the symptoms of which began after membership started? | 26 weeks for all age groups | |||
| How long before you can claim for any disease, illness or injury which began or the symptoms of which began before membership started? | 5 years for all age groups | |||
| How long before you can claim benefit for maternity cover? |
1 year for under 55 |
Not applicable | ||
| In addition, if you're changing your level of cover/benefits, the following waiting periods will apply, regardless of how long you have been insured | ||||
| You have health insurance and want to get an additional level of cover/benefits. How long before you can avail of the better cover/benefits for any disease, illness or injury which began or the symptoms of which began before you changed your level of cover? | 2 years for all age groups | |||
| You are already pregnant and you wish to improve your cover/benefits, how long before you can avail of the better cover/benefits? |
1 year for under 55 |
Not Applicable | ||
| The following waiting periods will apply for fertility treatment | ||||
| Waiting periods for fertility |
The first 52 weeks of membership The first 52 weeks of membership for existing members that transfer or change between schemes to avail of this benefit The first 52 weeks for existing members on the schemes that have this benefit. The waiting period shall be reduced by a person's continuous period of cover (if any) on that scheme. |
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| Waiting periods for First Steps Fertility Benefit |
The first 104 weeks of membership The first 104 weeks of membership for existing members that transfer or change between schemes to avail of this benefit |
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Useful Definitions
*Pre-existing condition: an ailment, illness or condition, where, on the basis of medical advice, signs and symptoms/onset of symptoms of that ailment, illness or condition existed at any time in the period of 6 months preceding:
a) the day you took out a Health insurance contract for the first time;
or
b) the day you took out a Health insurance contract again after your previous Health insurance contract had lapsed for 13 weeks or more;
or
c) the day you changed your scheme and gained additional cover/benefits.
Our medical advisors will determine the signs and symptoms/onset of symptoms of your ailment, illness or condition in conjunction with your medical records. Their decision is final.
Signs and Symptoms/Onset of Symptoms: When determining whether a medical condition is a Pre-existing condition we look to ascertain, on the basis of medical advice, when the signs or symptoms of the ailment, illness or condition first existed, rather than the date upon which You become aware of the ailment, illness or condition. The date of first existence or onset of these signs or symptoms can predate the date that the ailment, illness or condition is diagnosed. Please note that our medical advisors will determine whether an ailment, illness or condition is a pre-existing condition.
Please Note: This information is issued as a guide only and does not form part of a contract. You will receive a copy of your rules booklet when you join or you can request one in advance. Your rules booklet is also available in your personalised Member Area.
Need help?
If you're unsure about whether waiting periods apply to you, or what it means if they do, we're here to help.
Call us on 021 202 2000 and our award-winning team will chat through everything with you.