3250. Deputy Carol Nolan asked the Minister for Health her views on whether the current regulatory framework governing minimum benefits under the Health Insurance Act 1994 provides sufficient flexibility for older or vulnerable policyholders who do not require maternity or addiction related mental health cover (details supplied); and if she will make a statement on the matter. [55417/26]

3251. Deputy Carol Nolan asked the Minister for Health if she will consider initiating a review of the minimum benefit regulations to assess whether mandatory maternity and mental health cover should continue to apply uniformly to all policyholders, including elderly customers who have no realistic prospect of availing of such benefits (details supplied); and if she will make a statement on the matter. [55418/26]

3252. Deputy Carol Nolan asked the Minister for Health if her Department has received any representations from private health insurers regarding the need for greater flexibility in the application of minimum benefit requirements, particularly in cases where policyholders can demonstrate that certain benefits are unnecessary or unused; and if she will make a statement on the matter. [55419/26]

3253. Deputy Carol Nolan asked the Minister for Health if she is aware of concerns that older policyholders may be effectively paying for benefits they neither need nor use due to rigid minimum benefit rules (details supplied); the steps she intends to take to ensure that consumers are not subject to inadvertent mis-selling or inappropriate product bundling; and if she will make a statement on the matter. [55420/26]

3254. Deputy Carol Nolan asked the Minister for Health if she will engage with the Health Insurance Authority to ensure that stronger consumer protection measures are in place to prevent situations where policyholders feel they are being charged for benefits that do not reflect their actual healthcare needs; and if she will make a statement on the matter. [55421/26]

3255. Deputy Carol Nolan asked the Minister for Health the recourse that is available to policyholders who believe they have been mis-sold or incorrectly assigned benefits within their health insurance plan; and if she will make a statement on the matter. [55422/26]

3256. Deputy Carol Nolan asked the Minister for Health if she will clarify whether private health insurers have any discretion under existing legislation to offer partial refunds or premium adjustments to policyholders who can demonstrate that they did not require or avail of mandatory minimum benefits; and if she will make a statement on the matter. [55423/26]

3257. Deputy Carol Nolan asked the Minister for Health if she will consider amending legislation to allow insurers to provide refunds or tailored adjustments for elderly policyholders who are obliged to pay for maternity or addiction related mental health cover despite having no need for such services (details supplied); and if she will make a statement on the matter. [55424/26]

I propose to take Questions Nos. 3250 to 3257, inclusive, together.

As Minister for Health, I am responsible for the legal framework governing the voluntary private health insurance market in Ireland. This market operates on the principles of community rating, open enrolment, lifetime cover and minimum benefits. These principles help achieve the policy objective of keeping private health insurance more affordable for older and sicker consumers. In a community-rated private health insurance market, everyone pays the same price for a particular health insurance policy. The system is designed on the basis of risk-sharing across the entire insured community. In a risk-rated market, older and sicker people would pay much more for health insurance than they do currently.

One of the key pillars of our community-rated market is minimum benefits. Under the Health Insurance Act 1994 (Minimum Benefit) Regulations, all insurers must provide a specified minimum level of benefits in each plan. This ensures that all insured persons have access to a baseline level of cover for essential health services and prevents insurers from selling policies with very limited benefits that may leave people underinsured when they need care.

This approach is designed to be equitable and fair by ensuring that all consumers receive an appropriate minimum level of health insurance cover, regardless of the plan they purchase. Not all benefits required under the Regulations apply to every insured person. Some benefits relate to particular life stages, age groups or genders. Nevertheless, the package of benefits prescribed by the Regulations is considered important and beneficial to the insured population as a whole and is protected as part of a minimum base level of cover available to all policyholders. Accordingly, the inclusion of a specified level of maternity benefits and addiction-related mental health services in all health insurance policies forms part of this minimum level of cover. There are no current plans to exclude these services from the suite of minimum benefits.

The inclusion of prescribed minimum benefits in all health insurance plans does not constitute mis-selling or inappropriate product bundling. Insurers are prohibited from offering plans without the benefits specified in the legislation. In addition, community rating means that everyone pays the same price for the same product. Accordingly, insurers cannot offer customers refunds or discounts in exchange for waiving or opting out of any benefits.

As well as the consumer protections provided by the Regulations, open enrolment and lifetime cover requirements, there are several other protections available to private health insurance customers in Ireland. Under the Central Bank’s Consumer Protection Code, private health insurers must ensure that consumers are only offered the most suitable plan available. Consumers can contact their insurer to ensure that their current plan remains suitable for their needs and if they believe they have been mis-sold a health insurance policy they can complain through their insurer’s internal complaints process. If they are still unhappy with the outcome, they can contact the Financial Services and Pensions Ombudsman to escalate their complaint. The Financial Services and Pensions Ombudsman is an independent body that helps resolve disputes between consumers and financial service providers, including private health insurers.

In addition, the Health Insurance Authority provides consumers with free information about private health insurance so that they can make informed choices. This includes a free online comparison tool at www.hia.ie/health-insurance-comparison, which allows consumers to compare active plans in the market and prioritise coverage categories based on their needs.