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Laya Healthcare

Simply Health Plus

Prices per Annum

Date current version of plan commenced

Info

Adult

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€1,426.93

Child 1

€449.02

Child 2

€449.02

Child 3

€392.98

Child 4

€392.98

Young Adult

€713.47

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/€125 excess per claim; 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 and €50/€125 excess per claim; 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 in the Beacon with €125 excess per claim; Blackrock Clinic and Mater Private €175 shortfall per night & €200 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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Covered in the Beacon (semi-private) with €125 excess per claim; Blackrock Clinic and Mater Private €175 shortfall per night & €200 excess per claim.

Day Case Private Hospitals

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Covered with €50/€125 excess per claim

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

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Covered in Beacon with €125 excess per claim; Blackrock Clinic and Mater Private covered with €200 excess per claim

Convalescence

€45 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.

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

Out Patient Maternity Consultant Care

Up to €400 per year

Post Natal Home Help

Not covered

Alternative Amount To Post Natal Home Help

Not covered

Post Natal Home Nursing

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

Child Home Nursing

50% up to €2,800 per year

Pre Post Natal Care

€275

Child Healthcare Benefit

€250 for outpatient expenses if child in hospital more than 3 nights

Parent Accompanying Child

€105 x 14 not incl. first 3 days

Partner Benefit

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Not covered

Breastfeeding Consultancy

€30 X 2

Other Maternity Benefits

€1000 per lifetime for IVF, IUI, ICSI in approved centres

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; 3 consultations for online GPLive or Prescription Consultation Service

Physiotherapist

50% X 25; Physioline

Emergency Dental Care

50% up to €510 when carried out within 5 days

Non Emergency Dental

50% up to €300

Home Nursing

50% up to €950 per year

A & E Charge

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

Alternative Medicines Acupuncture Chiropractor Osteopath

50% of costs for 12 visits for each therapy

Dietician Occupational Therapist Chiropodist Speech Therapist

50% X 5 per therapy; Speech Therapy 50% x 8 + 50% up to €60 x 1 consultation; Occupational therapy 50% X 5 + 50% up to €60 x 1 consultation

Psycho Onchology Counselling

Not covered

Manual Lymph Drainage

€500 - not subject to outpatient excess

Hearing Test

50% up to max of €40

Optical

50% up to €150

Prescription Costs

Not covered

Employee assistance programme

Covered

Other Day To Day Practitioners

Physical therapy 50% x 8; Reflexologist 50% x 8; Homeopathy 50% x 12; 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

Travel Vaccinations

50% up to €60

Out Patient 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. 50% refund every 2 years for sports health screening and executive health check; Men and Women's Cancer Screening 50%. Full cover for 'HeartBeat' cardiac screening, no excess

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

In Patient Psychiatric Non Alcohol Drug

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100 days

In Patient Psychiatric Alcohol Related

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91 days per 5 years

Out Patient Psychiatric Care

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50% x 12 Mental Health Consultations in Dean Clinic; Clinical Psychologist 50% up to €40 x 8; Child Counselling 8 visits up to €50 after 3 days in hospital-part of Child Healthcare Support Benefit; 50% x12 eating disorder consultations at Lois B