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Laya Healthcare

Simply Health Choice

Prices per Annum

Date current version of plan commenced

Info

Adult

Info
€1,150.00

Child 1

€276.00

Child 2

€276.00

Child 3

€276.00

Child 4

€276.00

Young Adult

€507.50

Newborn

€0.00

In Patient

Private Patient in a multi-occupancy (which may include semi-private) room in a public hospital and day case.

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Covered

Public Hospital Private Room

Covered

Private Hospital Semi-Private Room

Covered with €50/€175 excess per claim.; No excess applies to 5 orthopaedic procedures (hip and knee replacement) in 12 private hospitals

 

Private Hospital Private Room

Covered with €50/€175 excess per claim and shortfall of €165 per night. No shortfall in the Mater Private Cork; No excess/shortfall applies to 5 orthopaedic procedures (hip and knee replacement) in 12 private hospitals

 

The Blackrock Clinic, the Mater Private and the Beacon Hospital, certain Cardiac Procedures

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Covered

The Blackrock Clinic, the Mater Private and the Beacon Hospital, certain Special Procedures

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Beacon covered with €175 excess per claim (private room carries shortfall of €165 per night). Covered in Blackrock Clinic and Mater Private with €175 shortfall per night and €250 excess per claim; No excess/shortfall applies to 5 orthopaedic procedures (hip and knee replacement)

 

The Blackrock Clinic, the Mater Private and the Beacon Hospital procedures other than Cardiac and Special

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Beacon covered with €175 excess per claim (private room carries shortfall of €165 per night). Covered in Blackrock Clinic and Mater Private with €175 shortfall per night and €250 excess per claim. 

Day Case Private Hospitals

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Covered with €50/€175 excess per claim

Day Case The Blackrock Clinic, the Mater Private and the Beacon Hospital

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Beacon covered with €175 excess per claim. Covered in Blackrock Clinic and Mater Private with €250 excess per claim. 

Convalescence

€50 x 14

Cancer Support Benefit

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€100 per night; Cover for 1 hairpiece per year following cancer treatment; Cover for first breast prosthesis following inpatient claim, second prosthesis assessed in accordance with surgical appliance list; Genetic testing consultation for cancer, 50% of costs for initial consultation - subject to prior approval; Genetic screening for cancer risk, full cover in the Mater Private Dublin - subject to prior approval; Sleeping caps, full refund for 1 sleeping caps per membership year; Eyebrow tattooing (following cancer treatment), full refund up to €60 once per membership year

Maternity

Hospital Costs Up To 3 Nights

Full cover

Home Births

€3,500

Delivery Consultant Fees

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Covered up to agreed charges incurred on day of delivery for participating consultants

Outpatient Maternity Consultant Care

€450 

Post-Natal Home Help

Not covered

Post Natal Home Nursing

€1200 following 1 night's stay or €600 following 2 nights

Child Home Nursing

50% up to €2,800 per year

Pre/Post-Natal Care

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Up to €325 combined receipts for a range of benefits including; car parking benefit-max €20 refund, new parent's food allowance-max €20 refund for up to 2 months before & 3 months after delivery & paediatric first aid course-max €20 refund

Child Healthcare Benefit

Child Healthcare Support Benefit up to €250 for GP's, consultants, physiotherapy, radiology, pathology, child counselling, speech & language therapy, dietician, occupational therapy following 3 nights in hospital; ask laya for details.

Parent Accompanying Child

€105 x 14 not incl. first 3 days

Partner Benefit

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Not covered

Breastfeeding Consultancy

Part of Pre/Post natal care benefit

Other Maternity Benefits

Not covered

Fertility Benefits

€1,000 twice per lifetime for benefit towards IVF, IUI, ICSI, please contact Laya Healthcare for further details.

Out-patient Benefits

Individual Excess

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€1

Family Excess

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€1

Consultant Fees

50%

GP Visits

50%; GP Helpline; 4 consultations for online GPLive or Prescription Consultation Service;Full cover for 2 HSE GP out of hours visits

Physiotherapist

50%; Physioline

Emergency Dental Care

50% up to €510

Non Emergency Dental

50% up to €300

Home Nursing

50% up to €950

A & E Charge

50% up to €50; Quickcare-up to €175 for approved minor injuries and illness centres

Alternative Medicines-Acupuncture, Chiropractor, Osteopath

50% for each therapy

Dietician, Occupational Therapist, Chiropodist, Speech Therapist

50% for each therapy

Psycho-Oncology Counselling

Not covered

Manual Lymph Drainage

€500 - not subject to outpatient excess

Hearing Test

50% up to €40 per year

Optical

50% up to €150

Prescription Costs

Not covered

Employee Assistance Programme

Covered

Other Day To Day Practitioners

Reflexologist 50%; Homeopathy 50%; Healthcoach online assessment and personalised programmes - unlimited use; Healthcoach face-to-face consultation - full cover for 1 consultation every 2 years.

Child Speech And Language Therapy

50% x 8 plus 50% up to €60 for 1 assessment

Vaccinations

Travel Vaccinations 50% up to €60

Outpatient Policy Limit

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€7,650

Out-patient Radiology

Approved Centres

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MRI, CT and PET-CT covered in full in direct payment centres except cardiac CT's which are covered by non-direct payment terms. 50% refund on costs in non direct payment centres.

Non-Approved Centres

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Not covered

Radiology Consultants' Fees

50% of costs

Radiology Test Fees

50% of costs

Health Screening

Full cover for Mammograms and Dexa scans in certain centres. Men and Women's Cancer Screening 50%. Full cover for 'HeartBeat' cardiac screening, no excess; Home testing kits, 50% up to €20

Overseas

Benefit Abroad For Surgical Procedures Available In Ireland

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Covered in the EU subject to approval

Benefit Abroad For Surgical Procedures Not Available In Ireland

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Covered in the EU subject to approval

Hospital Bill

€100,000

Repatriation Expenses

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€2,000,000

Companion Repatriation Expenses

€1,000

24 Hour Telephone Assistance

Covered

Expenses For Companion

€1,000

Psychiatric Cover

Inpatient Psychiatric Non Alcohol Drug

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100 days

Inpatient Psychiatric Alcohol Related

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91 days per 5 years

Outpatient Psychiatric Care

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50% x 12 Mental Health Consultations in Dean Clinic; Child Counselling 8 visits up to €50 following 3 days in hospital-part of Child Healthcare Support Benefit; 50% x 12 eating disorder consultations at Lois Bridges; Counselling Support Benefit 24/7 Telephone Counselling, full cover; Face to face/Video/Phone Counselling, full cover for 5 visits per issue; Cover for specific support services, full cover for 1 session per presenting issue for legal, consumer & health advice, career guidance, life coach & mediation.