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Laya Healthcare

Total Health Extra

Prices per Annum

Date current version of plan commenced

Info

Adult

Info
€1,644.80

Child 1

€442.59

Child 2

€442.59

Child 3

€442.59

Child 4

€442.59

Young Adult

€730.16

Newborn

€0.00

In Patient

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

Info

Covered

Public Hospital Private Room

Covered

Private Hospital Semi Private Room

Covered with €125 excess per claim.  No excess payable on the first 2 day case/inpatient claims; No excess applies to 5 orthopaedic procedures (hip and knee replacement) in 12 private hospitals

Private Hospital Private Room

Covered with €110 shortfall per night and €125 excess per claim.  No excess payable on the first 2 day case/inpatient claims. Full cover in Mater Private Cork with €125 excess per claim only; 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 €125 excess per claim.  Beacon has shortfall of €110 per night for private accommodation. No excess payable on the first 2 day case/inpatient claims. Blackrock Clinic and Mater Private covered with €125 excess per claim and a  €175 shortfall 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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Beacon covered with €125 excess per claim.  Beacon has shortfall of €110 per night for private accommodation. No excess payable on the first 2 day case/inpatient claims. Blackrock Clinic and Mater Private covered with €125 excess per claim and a  €175 shortfall per night

Day Case Private Hospitals

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Covered with €125 excess per claim. No excess payable on the first 2 day case/inpatient claims.

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

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Covered with €125 excess per claim. No excess payable on the first 2 day case/inpatient claims.

Convalescence

Up to €60 x 14 days

Cancer Support Benefit

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Up to €100 per day; 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

Covered

Home Births

Up to €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 (Not subject to €2,000 outpatient cap)

Post Natal Home Help

Not covered

Alternative Amount To Post Natal Home Help

Not covered

Post Natal Home Nursing

Up to €1,300 for 2 nights or up to €650 for 1 night if hospital stay is less than 3 nights (not subject to €2,000 outpatient cap)

Child Home Nursing

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

Pre Post Natal Care

Up to €275 for combined receipts for baby massage classes, midwifery service, optical, dental, breastfeeding consultations, GP, physiotherapy, complementary therapies, chiropody, nutritionist and counselling services (not subject to €2,000 outpatient cap)

Child Healthcare Benefit

Child Counselling 50% x 8 visits and 50% of 1 assessment up to €60; Up to €250 for combined receipts for GP, consultant, physiotherapy, radiology, pathology, child counselling, speech and language, dietitican and occupational therapy (not subject to €2,000 outpatient cap)

Parent Accompanying Child

Up to €105 x 14 nights (not subject to €2,000 outpatient cap)

Partner Benefit

Info

Not covered

Breastfeeding Consultancy

Not covered

Other Maternity Benefits

Infertility Benefit €1000 per lifetime towards IVF, IUI, ICSI (not subject to €2,000 outpatient cap)

Out-patient Benefits

Individual Excess

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€1; All benefits subject to €2,000 outpatient cap per member per year unless specified otherwise.

Family Excess

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€1; All benefits subject to €2,000 outpatient cap per member per year unless specified otherwise.

Consultant Fees

50%

GP Visits

50%; 3 consultations for online GPLive or Prescription Consultation Service

 

Physiotherapist

50% x 25 visits; Physioline

Emergency Dental Care

50% refund up to €510 per year

Non Emergency Dental

50% refund up to €300 per year

Home Nursing

50% refund up to €1,400 per year

A & E Charge

50% refund up to €50 per visit

Alternative Medicines Acupuncture Chiropractor Osteopath

50% refund x 12 visits per practitioner

Dietician Occupational Therapist Chiropodist Speech Therapist

50% refund x 5 visits for Dietician, Chiropodist/Podiatrist and Occupational Therapist. Occupational Therapist also 50% for 1 assessment up to €60; Speech Therapist 50% x 8 visits plus 1 assessment 50% refund up to €60.

Psycho Onchology Counselling

Not covered

Manual Lymph Drainage

Up to €500 per year (Not subject to €2,000 outpatient cap)

Hearing Test

50% up to €40 per year

Optical

50% up to €150 per year

Prescription Costs

Not covered

Employee assistance programme

Covered with 5 face to face counselling sessions

Other Day To Day Practitioners

Orthoptists, Physical Therapy and Reflexology 50% x 8 visits to each; Homeopath 50% x 12 visits; 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

Covered under Child Healthcare Benefit of Up to €250 for combined receipts for GP, consultant, physiotherapy, radiology, pathology, child counselling, speech and language, dietitican and occupational therapy (not subject to €1,000 outpatient cap)

Travel Vaccinations

50% up to €60 per year

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.

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 in certain centres; Full cover for 'HeartBeat' cardiac screening every 2 years; 50% refund per year for Women's and Men's cancer screening; Sports Health Screening and Executive Health Screening 50% refund every 2 years (not subject to €2,000 outpatient 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

Up to €100,000 per episode

Repatriation Expenses

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Up to €2,000,000

Companion Repatriation Expenses

Not covered

24 Hour Telephone Assistance

Covered

Expenses For Companion

Not covered

Psychiatric Cover

In Patient Psychiatric Non Alcohol Drug

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Up to 100 days

In Patient Psychiatric Alcohol Related

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91 days per 5 years

Out Patient Psychiatric Care

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Child Counselling 50% x 8 visits and 50% of 1 assessment up to €60; Clinical Psychologist 50% up to €40 x 8 visits; Dean Clinic outpatient mental health services 50% x 12 visits; Lois Bridges outpatient eating disorder consultations 50% x 12 visits