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Do I Need Serious Illness Cover if I Have Health Insurance?


Okay, so you might think that Serious Illness Cover and Health Insurance are the same thing.

I mean, they’re pretty similar: insurance that covers you if you get sick – but that’s not entirely the case.

Think of it like Batman. So Batman is a bad-ass, but even he goes into battle with his trusty gadgets: his Batsuit, his Batmobile, and his utility belt.

In this metaphor, his Batsuit is Life Insurance: it’s his most important defence.

His Batmobile is the extra protection in his daily life – or his Health Insurance. His utility belt, then, is Serious Illness Cover. It’s gotten him out of a few sticky situations – but it’s not critically important.

Holy insurance, Batman!

The difference between Health Insurance and Serious Illness Cover

Health Insurance basics

Health Insurance is a comprehensive plan that may cover things like hospitalization expenses, maternity benefits, surgery, or treatments. The extent of coverage generally relates to the cost of your plan: the more expensive your plan, the more that’s covered.

With VHI, for example, the basic One Plan for one adult between 26 and 34 costs €92 a month and covers the following:


Laya Healthcare’s ‘Flex 250 Explore’ is €77.90 a month and includes the following:


With Health Insurance, you could end up in hospital for any number of reasons – maybe you crash your Batmobile or you fall ill or your appendix starts acting up. Treatment ranges from minor day-to-day and outpatient stuff to a more serious hospital stay – again, the specifics will depend on your policy and whatever terms your insurer has in the small print.

Making a claim is usually pretty easy. For outpatient treatment, you’ll log into your insurer’s online portal and submit the receipts.

To quote modern philosopher, Kanye West: Keep the Receipt.

You’ll probably have to pay an excess and if the claim is approved, you’ll be credited the dollar bills.

Hospital stays are a bit more complicated. If you know you’re in for a hospital stay, you’ll need to let your insurer know. You’ll give them the hospital’s name, the consultant, and the procedure code (you can get this from your consultant’s secretary). You’ll fill out a claims form in the hospital and the insurer will pay the hospital directly.

Obviously, the system works a little differently if your hospital stay is unexpected – but it’s still fairly painless.

Say what you will about insurers being blaggards and schemers, but they do tend to make the claim process pretty handy – especially if they have an online portal.

The internet, making everything easier since Al Gore invented it.

Further reading: How getting older affects the cost of life and health insurance differently.

Serious Illness Cover basics

Serious Illness pays out a tax-free lump sum (?) if you’re diagnosed with one of the specific illnesses or disabilities that your policy covers (?).

You can claim on your policy if:

  • The illness is covered by your policy. (Not all illnesses are. #)
  • You’ve been given a medical diagnosis that satisfies the definition provided by the insurer in your policy T&Cs.
  • You survive for a period of time after you’re diagnosed. (Yeah, I know that’s a bit scaldy.)

Your claim could potentially be rejected if the illness is self-inflicted, if you had it before you applied for insurance and tried to sneak it in, or you live somewhere that’s not covered in your policy.

The list of illnesses covered varies a good bit, but usually includes strokes, heart attacks, MS, kidney failure, and some types of cancer.

Basically, any number of illnesses that you really don’t want.

Make sure you understand what’s in the cover before you start doling out your moolah.

Permanent total disablement is also sometimes included in Serious Illness Cover, but even just typing that gives me the heebie-jeebies.

Other ‘sometimes-included’ are children’s Serious Illness (see above about heebie-jeebies) that kicks in if one of your kids got one of the covered illnesses, and overseas surgery benefits, which is pretty much what it sounds like.

The cost

Health Insurance is one of the most expensive types of insurance you can get – because of the associated risk. There’s a pretty high chance that you’ll get sick at some point during your cover. It is what it is.

With Irish Life, the cheapest basic cover starts at around €40 a month while the enhanced cover costs over €300 a month. With VHI, the current cheapest cover starts at €37 a month, and rises to €85, for basic cover.

The cost of Serious Illness Cover will depend on the sum assured, who the cover is for (single or joint), and the terms of the policy.

With Zurich, a quote for €40,000 cover over 20 years will cost €10 a month, for a woman in her mid-twenties who doesn’t smoke.

Do you really need both?

It depends.

You might never actually need Serious Illness Cover. You could breeze through life with little more than a mild case of man-flu. You could also fall ill with one of the illnesses covered.

It can feel like throwing away money until you need it – then it’s a godsend.

Look if you’re young, footloose and fancy-free, you’ll probably be grand without both.

But definitely consider Serious Illness Cover if you have no Health Insurance at all, or if you don’t have Income Protection. It’s also worth thinking about if you have a mortgage, loans, or any debts.

You know the regulatory text that banks have at the end of their products? Like this beaut from AIB:

It’s way down the bottom of the page, so you don’t see it unless you scroll the whole way.

Imagine how useful that tax-free lump sum will be if you get one of the serious illnesses covered and are out of work for a couple of months.

Yeah, exactly.

Over to you…

Got any questions on Serious Illness Cover but can’t find the answer in our FAQs?

You can fill in this short form and I’ll be right back or give me a call on 057 93 20836.

Further Reading: How a Serious Illness Can Drain Your Savings (even if you have health insurance)

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