What is a waiting period?
I am switching directly to Laya Healthcare from another Irish health insurer with no break in cover
If you have served all your waiting periods then there is no break in cover when you transfer to us. If you have not served all your waiting periods with your previous Irish health insurer you can serve the remainder of them with Laya Healthcare. We will fully recognise the length of time you’ve spent with your previous insurer.
I am taking out health insurance for the first time
If you are taking out health insurance for the first time or it has been 13 weeks since you last had private health insurance with an Irish health insurer, the following waiting periods may apply.
| Waiting Periods |
|---|
| Accident or Injury | Illnesses that develop after you join | Illnesses that develop before you join |
|---|
| None |
26 weeks |
5 years |
A 52 week waiting period applies to maternity/infertility benefits.
A 2 year waiting period applies if you want to avail of a higher level of cover/benefits for any disease, illness or injury which began or the symptoms of which began before you upgraded.
How many days treatment can you claim in a year?
Cover for in-patient hospital treatment is available for a maximum of 180 days per member in any calendar year.
Useful Definitions:
Prior to 01st May 2015: The definition of a pre-existing condition is when the symptoms of the illness or injury began before the original date of joining.
After 01st May 2015: The definition of a pre-existing condition will be an ailment, illness or condition where the signs or symptoms existed at any time in the period of 6 months prior to the insurance commencing.
Please Note: This information is issued as a guide only and does not form part of a contract. You will receive a copy of your rules booklet when you join or you can request one in advance.
What is the difference between public and private hospitals?
Public health services are provided by the hospitals run by the Health Service Executive (HSE) and public voluntary hospitals. They are run with little or no charge to the public as they are funded by taxes. Private and public patients can both use public hospitals.
The drawback is that being seen can take a while, and we are all familiar with the problem of hospital waiting lists. Private hospitals are quicker to access. They are also allowed to set their own patient charges, and they charge the patient directly.
What is a 'Hi-Tech Hospital'?
These are specialist hospitals that provide complex cardiac (heart), oncology (cancer) and orthopaedic treatment. They also provide other demanding care. There are three Hi-Tech Hospitals in Ireland, all of which are in Dublin: Beacon Hospital, Blackrock Clinic and Mater Private Dublin.
What is continuity of cover?
Continuity of cover means your cover continues seamlessly when you switch from one healthcare insurance provider to another. No waiting, no gaps, no hiccups. The only condition is that you’ve completed your waiting period with your previous provider.
If you still have some time left to go, no problem. We won’t start you all over again. We’ll take into account the waiting period you already served.
What is the 'excess'?
Everyday Medical Expenses Excess
The everyday medical expenses excess is the amount that must be reached per membership year before you can claim money back from laya healthcare. The amount you can claim back is the benefit amounts listed on your benefit table less amount shown as the out-patient excess. For example, if you have an everyday medical expense excess of €50 and the allowed amount shown on your benefit table for consultant visits is €40, you have not reached your excess yet. If you have 2 consultant visits worth up to €40 on your plan then €40 + €40 = €80 , less €50 excess, you would receive a refund of €30.
Inpatient Excess
Watch our video below to help you understand how an inpatient excess works;
Do I have to do anything before I go into hospital?
It’s best to contact us prior to your hospital stay with the name and location of the hospital you’ll attend, your consultant's name and details of the treatment you’ll undergo. If your scheme has a hospital-stay excess, you’ll need to pay this against of your hospital claim depending on the private hospital you choose. This should be paid directly to the hospital.
Do I need to complete a claim form in relation to my hospital stay?
Yes. The hospital will provide the form to you and request that you complete and sign it when you’re there. The hospital will then send the claim form to us. The only thing you have to remember is to bring your membership number along with you.
Do I need to pay the hospital directly?
In most cases, we pay the hospital directly; to enable us to do this quickly and efficiently, please remember to bring your membership card along with you. Depending on your level of cover, you may be required to pay the first €50, €125 or €200 of your hospital claim, depending on the private hospital you have chosen. You pay this directly to the hospital.
Do waiting periods apply to hospital stays?
You have immediate cover for accident, injury and out-patient costs incurred after you join Laya Healthcare. If you have served all your waiting periods with your previous insurer then waiting periods won’t apply when you switch to us. Alternatively, you can serve the remainder of your current waiting periods with Laya Healthcare because we fully recognise the length of time you have spent with your previous insurer.
Find out more about waiting periods.
Do waiting periods apply for maternity/infertility benefits?
A 52 week waiting period applies to maternity/infertility benefits.
Do I need to complete a maternity claim form to avail of my hospital benefit?
Yes. However, the hospital will provide the form to you and request that you complete it when you’re there. The hospital will then send the claim form to us. The only thing you have to remember is to bring your membership number along with you.
How can I cover my newborn baby?
You can add your newborn to your policy free of charge until your next renewal and enjoy the peace of mind that they are covered immediately. To add your newborn baby, simply login to the My login section of our website - click here for this.
Is travel insurance included with my overseas emergency cover?
No. Travel insurance must be purchased separately to your health cover. However, if you need travel insurance, just click here and we can help.
Is there tax relief for my health insurance subscription?
Under current Irish tax legislation, you are entitled to income tax relief in respect of your health insurance subscription. Relief is given at the applicable rate and refunded to you at source. This means that all our policy subscriptions are shown net of the applicable rate of income tax. Budget 2014 has had an impact on some of our schemes. For more information click here.
Hospitals covered 
Hospitals not covered