The common gaps
Irish health insurance is strongest on the big events: hospital treatment, surgery and specialist care. The gaps sit in the everyday costs around them:
- GP visits — many plans refund nothing; others refund a fixed €20–€30 against a €55–€75 fee, often only after you pass an outpatient excess.
- Everyday prescriptions — usually paid out of pocket, softened by the Drugs Payment Scheme cap or a medical card.
- Routine dental and optical — check-ups, fillings, glasses and contact lenses are generally excluded or limited to small fixed refunds.
- Physiotherapy and similar therapies — frequently capped at a small number of sessions or a low refund per visit.
- Public hospital charges — the emergency department charge and inpatient charges apply to everyone; insurance may refund them, but you pay first.
Read the outpatient table
The outpatient benefits table in your policy — not the headline — tells you what everyday care is actually refunded. Look for the per-visit refund, the annual cap and the excess.
What everyday care actually costs
| Item | Typical cost | Usually covered by insurance? |
|---|---|---|
| GP visit | €55–€75 | No, or part-refunded after excess |
| Online Doctor appointment | Around €50 | Rarely; some plans part-refund |
| Everyday prescriptions | Varies; capped by the Drugs Payment Scheme | Usually no |
| Dental check-up and clean | €60–€120 | Usually no |
| Glasses / contact lenses | €100–€300+ | Usually no |
| Emergency department (no GP referral) | €100 public charge | Paid first; some plans refund |
For a household that mainly uses everyday care, it is common to pay a full year of premiums and still pay for every GP visit, prescription and dental check-up yourself.
Waiting periods and the small print
- Initial waiting period — commonly around 26 weeks before you can claim for new conditions.
- Pre-existing conditions — commonly excluded for around 5 years on a new policy.
- Maternity — benefits typically require around 52 weeks of cover before they apply.
- Outpatient excess — an annual amount of outpatient spend you must reach before any refund starts.
- Caps per visit and per year — refunds are often limited both per appointment and in total.
Exact terms vary by insurer and plan, so check your own policy documents before relying on any figure.
A worked example
| Item | Cost | Refunded by a typical mid-range plan? |
|---|---|---|
| 4 GP visits at €65 | €260 | €0 — below the outpatient excess |
| Prescriptions across the year | €300 | €0 |
| Dental check-up, clean and one filling | €180 | €0 |
| New glasses | €180 | €0 |
| Total | €920 | €0 refunded |
Claim the tax relief
Whatever insurance does not refund, you can usually claim 20% income tax relief on qualifying medical expenses through Revenue — GP fees, prescriptions and many dental treatments count. Keep every receipt. It is one of the most commonly unclaimed reliefs in Ireland.
Covering the gap
A sensible setup for most households is two layers:
- Insurance for the big events — hospital treatment and surgery, if you choose to hold it.
- A healthcare access membership for the everyday — the GP-level care, prescriptions and advice that insurance rarely refunds.
ViscaCare is the second layer. It is not health insurance: members book an online Doctor at a member rate of €39 during the launch offer, get prescriptions where clinically appropriate, and keep their records and travel cover in one place — with no waiting periods, no excess and no claim forms.
Employed? Ask your employer
Employers can provide ViscaCare as a staff benefit. Because it is not health insurance, there is no benefit in kind for employees — see our guide to BIK and healthcare benefits.
Already have insurance? Keep it for hospital care and add everyday access alongside it — the two do different jobs.
Common questions
Does health insurance cover GP visits in Ireland?
Often not, or only partly. Many Irish policies refund nothing for GP visits, and those that do usually refund a fixed amount per visit (for example €20–€30 against a €55–€75 fee) with an annual cap or an outpatient excess you must exceed first. Check your policy’s outpatient benefits table.
Does health insurance cover prescriptions?
Usually not for everyday prescriptions. Some policies refund part of the cost above an outpatient excess, but most households pay for medicines themselves, helped by the Drugs Payment Scheme cap or a medical card. The 20% income tax relief on qualifying medical expenses can also be claimed through Revenue.
Does health insurance cover dental and optical care?
Routine dental and optical care is generally excluded or limited to small fixed refunds. Hospital-based dental surgery may be covered, but check-ups, fillings, glasses and contact lenses are normally paid out of pocket.
What is a waiting period in health insurance?
A period at the start of a policy during which you cannot claim. New conditions typically have a waiting period of around 26 weeks, pre-existing conditions around 5 years, and maternity benefits around 52 weeks, though exact terms vary by insurer and plan.
What is an outpatient excess?
The amount of outpatient costs (GP visits, scans, specialist consultations) you must pay yourself each year before the insurer refunds anything. If your excess is €300 and you spend €250 on outpatient care in a year, you get nothing back.
Is an online Doctor covered by health insurance?
Some policies now include or part-refund online consultations, but many do not, and refunds may count towards your outpatient excess. An online Doctor appointment with ViscaCare costs members €39 during the launch offer, whether or not you hold insurance.
If I have insurance, do I still pay for A&E?
Yes. The public emergency department charge (currently €100 without a GP referral, unless you hold a medical card or another exemption) applies to everyone attending a public emergency department. Insurance does not remove it, though some policies refund it afterwards.
Where these figures come from
- HIA — comparing health insurance plans
- Citizens Information — private health insurance
- Citizens Information — GP services
- Revenue — tax relief on medical expenses
Charges and thresholds change. We check these figures regularly, but always confirm the current rate with the official source before you rely on it. This page explains entitlements, costs and process — it is not medical advice.
Cover the everyday gap
ViscaCare is not health insurance — it covers the everyday care insurance leaves out. Members book an online Doctor at €39 during the launch offer (a typical online appointment is closer to €50), with prescriptions where clinically appropriate.
Related guides
Online doctor in Ireland
What it costs (typically around €50), what can be prescribed, and how booking works.
Read moreGP visit card
Free GP visits on higher income limits than a medical card.
Read moreMedical card Ireland
Medicines at €1.50, hospital care, dental and optical cover — and the income limits.
Read more