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Laya Healthcare

Simply Connect Plus

Prices per Annum

Date current version of plan commenced

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Adult

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€1,250.00

Child 1

€280.00

Child 2

€280.00

Child 3

€280.00

Child 4

€280.00

Young Adult

€625.00

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 €150 excess per claim on the first private hospital claim per member per year; No excess applies to 5 orthopaedic procedures (hip and knee replacement) in 12 private hospitals

Private Hospital Private Room

Covered with shortfall of €165 per night with a €150 excess on the first private hospital claim per member per year. No shortfall in 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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Covered with €150 excess per claim on the first private hospital claim per member per year. Blackrock Clinic and Mater Private also have a shortfall of €175 per night; 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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Covered with €150 excess per claim on the first private hospital claim per member per year. Blackrock Clinic and Mater Private also have a shortfall of €175 per night.

Day Case Private Hospitals

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Covered with €50 excess per claim

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

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Covered with €50 excess per claim

Convalescence

Up to €60 x 14 (not subject to €1,000 outpatient cap)

Cancer Support Benefit

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€100 per night (not subject to €1,000 outpatient cap); 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), 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

Up to €500 per year (not subject to €1,000 outpatient cap)

Post-Natal Home Help

Not covered

Post Natal Home Nursing

Up to €600 following a 2 night stay or €1200 following 1 night's stay (not subject to €1,000 outpatient cap)

Child Home Nursing

50% up to max of €2 800 per year (not subject to €1,000 outpatient cap)

Pre/Post-Natal Care

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Up to €385 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 (not subject to €1,000 outpatient cap)

Child Healthcare Benefit

Child Healthcare Support Benefit up to €250 for GP's, consultants, physiotherapy, radiology, pathology, child counselling, speech and language therapy, dietician and occupational therapy following 3 nights in hospital; ask laya for details (not subject to €1,000 outpatient cap)

Parent Accompanying Child

€105 x 14 not incl. first 3 days (not subject to €1,000 outpatient cap)

Partner Benefit

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Not covered

Breastfeeding Consultancy

Covered as part of pre/post natal care benefit

Other Maternity Benefits

Not covered

Fertility Benefits

€1,000 twice per lifetime for INF, IUI, ICSI (not subject to €1,000 out-patient cap)

Out-patient Benefits

Individual Excess

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€1 (all benefits combined are subject to a €1000 out-patient cap per member unless specified otherwise)

Family Excess

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€1 (all benefits combined are subject to a €1000 out-patient cap per member unless specified otherwise)

Consultant Fees

50% refund; Consultant Consultations-This benefit offers members with certain serious illnesses access to a review of their medical case by an international specialist. A list of serious illnesses considered for referral is available from Laya on request.

GP Visits

50% refund; GP Help line; 5 consultations for online GPLive or Prescription Consultation Service; HSE GP out of hours service X 2 visits (not subject to €1,000 outpatient cap)

 

Physiotherapist

50% refund; Physioline

Emergency Dental Care

50% refund

Non Emergency Dental

50% refund

Home Nursing

50% refund

A & E Charge

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

Alternative Medicines-Acupuncture, Chiropractor, Osteopath

50% refund

Dietician, Occupational Therapist, Chiropodist, Speech Therapist

50% refund

Psycho-Oncology Counselling

Not covered

Manual Lymph Drainage

€500 - not subject to €1,000 outpatient cap

Hearing Test

50% refund

Optical

50% refund

Prescription Costs

Not covered

Employee Assistance Programme

Covered

Other Day To Day Practitioners

50% refund for Reflexology, Homeopathy and Orthoptists; 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% refund

Vaccinations

Travel Vaccinations 50% refund

Outpatient Policy Limit

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All benefits combined are subject to a €1,000 out-patient cap per member unless specified otherwise

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. Covered up to 50% subject to outpatient excess in non direct payment centres.

Non-Approved Centres

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Not covered

Radiology Consultants' Fees

50% refund

Radiology Test Fees

50% refund

Health Screening

Full cover for Mammograms and Dexa scans and 'HeartBeat' cardiac screening in certain centres; 50% refund every 2 years for sports health screening & executive health check; Men and Women's Cancer Screening 50% covered (All not subject to €1,000 outpatient cap); Home testing kits, 50% up to €20 (subject to €1,000 outpatient refund cap)

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

Not covered

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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Dean Clinic and Lois Bridges 50% refund (subject to €1,000 out-patient cap); Clinical Psychologist 50% refund; Child Counselling 50% X 8 visits and 1 Assessment up to €60 (not subject to €1,000 outpatient cap); 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.