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Ireland

Health Insurance (Amendment) Act 2023

In short

This law amends the Health Insurance Act 1994 to update various financial amounts related to health insurance, including premiums from the Risk Equalisation Fund, hospital utilisation credits, and definitions for high-cost claims. These changes primarily take effect from April 1, 2024.

What it regulates

  • The amount of premium to be paid from the Risk Equalisation Fund for certain classes of insured persons.
  • The amount of the hospital utilisation credit for in-patient services.
  • The amount and percentage used in definitions related to high-cost claims.
  • A consequential amendment to the Stamp Duties Consolidation Act 1999 regarding specified rates.

Who it concerns

  • Insured persons with health insurance contracts.
  • Health insurance providers.

Key points

  • The updated hospital utilisation credit is €163 per night for overnight accommodation and €81 for day case services, applicable to contracts entered into or renewed on or after April 1, 2024.
  • Premiums paid from the Risk Equalisation Fund vary by age, gender, and type of cover (non-advanced or advanced), with specific amounts listed for different age groups from 65 years and over, applicable on or after April 1, 2024.
  • The amount for the definition of "high cost claim threshold" is €50,000, and the high cost claim quota share is 45 per cent, applicable to contracts entered into or renewed on or after April 1, 2024.
  • For contracts renewed or entered into between January 1, 2024, and March 31, 2024, the specified rates for stamp duty vary from €36 to €146 for insured persons under 18, and €109 for insured persons 18 or over, depending on the cover type.
Legal text
Legal text

Health Insurance (Amendment) Act 2023 Skip to content Disclaimer Feedback Helpdesk Gaeilge Léim go dtí an t-ábhar Séanadh Aiseolas Deasc chabhrach English Gaeilge English Produced by the Office of the Attorney General Táirgthe ag Oifig an Ard-Aighne Home Legislation Acts of the Oireachtas Statutory Instruments Pre-1922 Legislation Constitution External Resources Bills (Houses of the Oireachtas) Iris Oifigiúil / Official Gazette Revised Acts (LRC) Classified List of Legislation (LRC) Translations (acts.

  1. ie)Translations (Houses of the Oireachtas) Government Publications for Sale EU Law (EUR-Lex) FAQ Disclaimer Feedback Helpdesk Search Baile Reachtaíocht Achtanna an Oireachtais Ionstraimí Reachtúla Reachtaíocht Réamh-1922 Bunreacht Acmhainní Seachtracha Billí (Tithe an Oireachtais) Iris Oifigiúil Achtanna Athbhreithnithe (CAD) (An Coimisiún um Athchóiriú an Dlí) Liosta Rangaithe Reachtaíochta Aistriúcháin (achtanna.
  2. ie)Aistriúcháin (Tithe an Oireachtais) Foilseacháin Rialtais ar Díol Dlí AE (EUR-Lex) CCanna (Ceisteanna Coitianta) Séanadh Aiseolas Deasc chabhrach Cuardach TitleTeideal Year(
  3. s)or rangeBliain nó blianta nó raon TypeCineál All Legislation Acts Statutory Instruments Advanced SearchCuardach Casta HomeBaile ActsAchtanna 2023 Health Insurance (Amendment) Act 2023 Health Insurance (Amendment) Act 2023 Permanent Page URL View by SectionAmharc de réir Ailt View Full ActAmharc ar an Acht Iomlán Bill History Stair Bille Commencement, Amendments, SIs made under the Act Tosach Feidhme, Leasuithe, IRí arna ndéanamh faoin Acht Open PDFOscail PDF Print Full ActPriontáil an tAcht Iomlán Number 36 of 2023 HEALTH INSURANCE (AMENDMENT) ACT 2023 CONTENTS Section 1. Definition 2. Amendment of section 11C of Principal Act 3. Amendment of amount specified for purposes of definition of hospital utilisation credit 4. Amendment of Schedule 4 to Principal Act 5. Amount and percentage specified for purposes of definitions relating to high cost claims 6. Amendment of section 125A of Stamp Duties Consolidation Act 1999 7. Short title, collective citation, construction and commencement Acts Referred to Health Insurance Act 1994 (No. 16) Health Insurance Acts 1994 to 2022 Stamp Duties Consolidation Act 1999 (No. 31) Number 36 of 2023 HEALTH INSURANCE (AMENDMENT) ACT 2023 An Act to amend the Health Insurance Act 1994 to specify the amount of premium to be paid from the Risk Equalisation Fund in respect of certain classes of insured persons from 1 April 2024; to make other amendments to that Act to specify the amount of the hospital utilisation credit applicable from 1 April 2024 and to specify the amount and percentage applicable for the purpose of definitions relating to high cost claims; to make a consequential amendment to the Stamp Duties Consolidation Act 1999 ; and to provide for related matters. [14th December, 2023] Be it enacted by the Oireachtas as follows: Definition 1. In this Act, “Principal Act” means the Health Insurance Act 1994 . Amendment of section 11C of Principal Act 2. Section 11C of the Principal Act is amended, in subsection

(1)(b), by the substitution of “1 April 2024” for “1 April 2023”. Amendment of amount specified for purposes of definition of hospital utilisation credit 3.
(1)The Principal Act is amended by the substitution of the following Schedule for Schedule 3: “SCHEDULE 3 AMOUNT SPECIFIED FOR PURPOSES OF DEFINITION OF ‘HOSPITAL UTILISATION CREDIT’
  1. For the provision of in-patient services on overnight accommodation basis – €163 per night.
  2. For the provision of in-patient services on day case basis – €81.”.
(2)Schedule 3 to the Principal Act, as substituted by subsection
(1), only applies in the case of a health insurance contract entered into or renewed on or after 1 April 2024 and, accordingly, that Schedule, as in force immediately before that date, shall continue to apply in the case of a health insurance contract entered into or renewed on or after 1 April 2021 but before 1 April
  1. Amendment of Schedule 4 to Principal Act
  2. Schedule 4 to the Principal Act is amended by the substitution of the following Table for Table 2: “Table 2 AMOUNTS APPLICABLE ON OR AFTER 1 APRIL 2024 Class of Insured Person Amount of premium to be paid from Fund Male aged 50 years and over but less than 55 years on the date the relevant contract (being a relevant contract (non-advanced cover)) is renewed or entered into, as the case may be Nil Male aged 50 years and over but less than 55 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be Nil Female aged 50 years and over but less than 55 years on the date the relevant contract (being a relevant contract (non advanced cover)) is renewed or entered into, as the case may be Nil Female aged 50 years and over but less than 55 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be Nil Male aged 55 years and over but less than 60 years on the date the relevant contract (being a relevant contract (non-advanced cover)) is renewed or entered into, as the case may be Nil Male aged 55 years and over but less than 60 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be Nil Female aged 55 years and over but less than 60 years on the date the relevant contract (being a relevant contract (non advanced cover)) is renewed or entered into, as the case may be Nil Female aged 55 years and over but less than 60 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be Nil Male aged 60 years and over but less than 65 years on the date the relevant contract (being a relevant contract (non-advanced cover)) is renewed or entered into, as the case may be Nil Male aged 60 years and over but less than 65 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be Nil Female aged 60 years and over but less than 65 years on the date the relevant contract (being a relevant contract (non advanced cover)) is renewed or entered into, as the case may be Nil Female aged 60 years and over but less than 65 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be Nil Male aged 65 years and over but less than 70 years on the date the relevant contract (being a relevant contract (non-advanced cover)) is renewed or entered into, as the case may be €250 Male aged 65 years and over but less than 70 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be €850 Female aged 65 years and over but less than 70 years on the date the relevant contract (being a relevant contract (non advanced cover)) is renewed or entered into, as the case may be €150 Female aged 65 years and over but less than 70 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be €425 Male aged 70 years and over but less than 75 years on the date the relevant contract (being a relevant contract (non-advanced cover)) is renewed or entered into, as the case may be €425 Male aged 70 years and over but less than 75 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be €1,375 Female aged 70 years and over but less than 75 years on the date the relevant contract (being a relevant contract (non advanced cover)) is renewed or entered into, as the case may be €300 Female aged 70 years and over but less than 75 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be €925 Male aged 75 years and over but less than 80 years on the date the relevant contract (being a relevant contract (non-advanced cover)) is renewed or entered into, as the case may be €600 Male aged 75 years and over but less than 80 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be €2,025 Female aged 75 years and over but less than 80 years on the date the relevant contract (being a relevant contract (non advanced cover)) is renewed or entered into, as the case may be €475 Female aged 75 years and over but less than 80 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be €1,450 Male aged 80 years and over but less than 85 years on the date the relevant contract (being a relevant contract (non-advanced cover)) is renewed or entered into, as the case may be €700 Male aged 80 years and over but less than 85 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be €2,425 Female aged 80 years and over but less than 85 years on the date the relevant contract (being a relevant contract (non advanced cover)) is renewed or entered into, as the case may be €500 Female aged 80 years and over but less than 85 years on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be €1,600 Male aged 85 years and over on the date the relevant contract (being a relevant contract (non-advanced cover)) is renewed or entered into, as the case may be €700 Male aged 85 years and over on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be €2,425 Female aged 85 years and over on the date the relevant contract (being a relevant contract (non-advanced cover)) is renewed or entered into, as the case may be €500 Female aged 85 years and over on the date the relevant contract (being a relevant contract (advanced cover)) is renewed or entered into, as the case may be €1,600 ”. Amount and percentage specified for purposes of definitions relating to high cost claims 5.
(1)The Principal Act is amended by the substitution of the following Schedule for Schedule 5: “SCHEDULE 5 Section 6A AMOUNT AND PERCENTAGE SPECIFIED FOR PURPOSES OF DEFINITIONS RELATING TO HIGH COST CLAIMS
  1. Amount specified for the purposes of paragraph (a) of the definition of ‘high cost claim threshold’ - €50,
  3. Percentage specified as the high cost claim quota share - 45 per cent.”.
(2)Schedule 5 to the Principal Act, as substituted by subsection
(1), only applies in the case of a health insurance contract entered into or renewed on or after 1 April 2024 and, accordingly, that Schedule, as in force immediately before that date, shall continue to apply in the case of a health insurance contract entered into or renewed on or after 1 April 2022 but before 1 April 2024. Amendment of section 125A of Stamp Duties Consolidation Act 1999 6. Section 125A of the Stamp Duties Consolidation Act 1999 is amended by the substitution of the following definition for the definition of “specified rate”: “ ‘specified rate’ means?— (
  1. a)in respect of relevant contracts renewed or entered into on or after 1 January 2024 and on or before 31 March 2024?— (
  2. i)€36 in respect of an insured person aged less than 18 years insured under a relevant contract which provides for non advanced cover, (
  3. ii)€146 in respect of an insured person aged less than 18 years insured under a relevant contract which provides for advanced cover, (iii) €109 in respect of an insured person aged 18 years or over insured under a relevant contract which provides for non advanced cover, and (
  4. iv)€438 in respect of an insured person aged 18 years or over insured under a relevant contract which provides for advanced cover, and (
  5. b)in respect of relevant contracts renewed or entered into on or after 1 April 2024?— (
  6. i)€35 in respect of an insured person aged less than 18 years insured under a relevant contract which provides for non advanced cover, (
  7. ii)€140 in respect of an insured person aged less than 18 years insured under a relevant contract which provides for advanced cover, (iii) €105 in respect of an insured person aged 18 years or over insured under a relevant contract which provides for non advanced cover, and (
  8. iv)€420 in respect of an insured person aged 18 years or over insured under a relevant contract which provides for advanced cover.”. Short title, collective citation, construction and commencement 7.
(1)This Act may be cited as the Health Insurance (Amendment) Act 2023.
(2)The Health Insurance Acts 1994 to 2022 and this Act, other than section 6 , may be cited together as the Health Insurance Acts 1994 to 2023 and shall be construed together as one.
(3)Subject to subsection
(4), this Act shall come into operation on 1 January 2024.
(4)Sections 2 , 3 , 4 and 5 shall come into operation on 1 April 2024. Privacy Statement Accessibility European Legislation Identifier (PDF) Open Data License Ráiteas Príobháideachais Inrochtaineacht Aitheantóir Eorpach Reachtaíochta (ELI) Ceadúnas Sonraí Oscailte Liosta Fianán © Government of Ireland. Oireachtas Copyright Material is reproduced with the permission of the Houses of the Oireachtas © Rialtas na hÉireann. Atáirgtear ábhar faoi Chóipcheart le cead ó Thithe an Oireachtais

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