Plan Costs

Plan cost: €1097.83 per year

Cost per additional child: €299.26 per year

Cost per additional young adult:

Age Cost
Age 18-20 €484.52
Age 21 €573.73
Age 22 €678.04
Age 23 €782.35
Age 24 €904.66
Age 25 €1033.44

Hospital Cover (In-patient benefits)

What’s covered: 

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✅ A Multi-Occupancy or Semi-Private room in a Public Hospital and Day Case (Semi-private: Full cover; Day-case/Out-patient surgical: Full cover)
✅ Public Hospital Private Room and Day Case (Private: Full cover; Day-case/Out-patient surgical: Full cover)
✅ Private Hospital Semi-Private Room (Private hospital excess: €300 excess per claim ; Semi-private: Full cover, including Beacon Hospital; Specified Orthopaedic & Ophthalmic Procedures: 20% shortfall)
✅ Private Hospital Private Room (Private hospital excess: €300 excess per claim ; Private: €165 shortfall per night, including Beacon Hospital. Full cover in Mater Private Cork; Specified Orthopaedic & Ophthalmic Procedures: 20% shortfall)
✅ The Blackrock Clinic, the Mater Private and the Beacon Hospital, certain Cardiac Procedures (Full cover – no excess)
✅ The Blackrock Clinic, the Mater Private and the Beacon Hospital, certain Special Procedures (Hi-tech hospital excess: €300 excess per claim ; Day-case/Out-patient surgical: Full cover in Beacon Hospital only. No cover in Blackrock Clinic & Mater Private Dublin; Semi-private: Full cover in Beacon Hospital only. No cover in Blackrock Clinic & Mater Private Dublin; Private: €165 shortfall per night in the Beacon Hospital. No cover in the Blackrock Clinic or Mater Private Dublin; Specified Orthopaedic & Ophthalmic Procedures: 20% shortfall in Beacon Hospital. No cover in the Blackrock Clinic & Mater Private Dublin)
✅ The Blackrock Clinic, the Mater Private and the Beacon Hospital procedures other than Cardiac and Special (Hi-tech hospital excess: €300 excess per claim; Day-case/Out-patient surgical: Full cover in Beacon Hospital only. No cover in Blackrock Clinic & Mater Private Dublin; Semi-private: Full cover in Beacon Hospital only. No cover in Blackrock Clinic & Mater Private Dublin; Private: €165 shortfall per night in the Beacon Hospital. No cover in the Blackrock Clinic or Mater Private Dublin; Specified Orthopaedic & Ophthalmic Procedures: 20% shortfall in Beacon Hospital. No cover in the Blackrock Clinic & Mater Private Dublin)
✅ Day Case Private Hospitals (Private hospital excess: €300 excess per claim ; Day-case/Out-patient surgical: Full cover, including Beacon Hospital)
✅ Day Case The Blackrock Clinic, the Mater Private and the Beacon Hospital (Full cover in Beacon Hospital only. No cover in Blackrock Clinic & Mater Private Dublin, €300 excess per claim)
✅ Convalescence (Up to €50 per day for 14 days)
✅ Cancer Accommodation Support (Up to €100 per night. No limit)

Overseas Cover

What’s covered:

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✅ Benefit Abroad For Surgical Procedures Available In Ireland (Full cover for treatment in another country within the EU or UK, up to the amount payable in Ireland – subject to prior approval)
✅ Benefit Abroad For Surgical Procedures Not Available In Ireland (Full cover in the EU or UK- subject to prior approval)
✅ Hospital Bill (Up to €100,000 per episode of illness or injury)
✅ Repatriation Expenses (Up to €2 million towards the cost of medical evacuation. Up to €1,000 towards companion evacuation)
✅ Companion Repatriation Expenses (Up to €2 million towards the cost of medical evacuation. Up to €1,000 towards companion evacuation)
✅ 24 Hour Telephone Assistance (24 Hour GPLine and Nurseline cover from Ireland and abroad)
✅ Expenses For Companion (Up to €2 million towards the cost of medical evacuation. Up to €1,000 towards companion evacuation)
✅ Gender Affirmation (Gender affirmation surgery abroad: Cover up to €100,000 in the EU or UK – subject to prior approval; Gender affirmation
support: Cover up to €5,000 in Ireland or in the EU subject to prior approval)

Maternity Cover

What’s covered:

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✅ Hospital Costs Up To 3 Nights (Full cover for 3 nights in a public hospital or up to €3,000 per year towards homebirth costs)
✅ Home Births (Full cover for 3 nights in a public hospital or up to €3,000 per year towards homebirth costs)
✅ Delivery Consultant Fees (Full cover for participating consultants)
✅ Outpatient Maternity Consultant Care (Up to €300 per pregnancy)
✅ Postnatal Home Nursing (Up to €1,200 for 2 nights home nursing & up to €600 for 1 night home nursing)
✅ Child Home Nursing (50% of costs up to €2,800 per year)
✅ Pre & Postnatal Care (Baby massage classes: Up to €100 per year; 3D/4D Scans: 50% of costs up to €50 per pregnancy; Antenatal classes/ midwifery services: Up to €75 per pregnancy; Car parking expenses: Up to €20 for car parking expenses incurred at hospital admission for delivery; Foetal screening (subject to annual out-patient excess): Up to €100 combined refund for NIPT & CVS tests & up to €40 refund for an early pregnancy scan; Maternity bra: Up to €40 per year; Maternity Yoga/Pilates: 50% of costs up to €50 per pregnancy; Midwife support service : Full cover for a phone consultation each trimester & one call within the first 3 months of your child’s birth (021 202 2824); New parents food allowance: Up to €20 per pregnancy; Paediatric First Aid Course: Unlimited access to online paediatric first aid course through member area & up to €40 for attending a course)
✅ Child Healthcare Benefit (Child counselling (subject to annual out-patient excess): 50% of costs – 8 visits & 50% of 1 assessment up to €60; Child healthcare support benefit (following in-patient treatment): Full refund up to €150 combined receipts on a range of benefits; Childhood development assessment : 50% of costs up to €150 once per lifetime; Play therapy: 75% of costs – 8 visits; Vaccinations (subject to annual out-patient excess): 50% of costs up to €20 per year)
✅ Parent Accompanying Child (Up to €Up to €30 per visit – 2 visits per year)
✅ Other Maternity Benefits (See Pre & Postnatal Care above)

What’s not covered: 

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❌ Postnatal Home Help
❌ Partner Benefit

Outpatient Benefits

What’s covered:

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✅ Individual Excess (€50 excess)
✅ Family Excess (€50 excess)
✅ Consultant Fees (50% of costs – 5 visits)
✅ GP Visits (GP Visits: 50% of costs-5visits. 100% cover for 2 HSE GP out of hours visits (2 HSE GP out of hours visits not subject to €500 out-patient cap); GPLive (online consultations): Unlimited consultations; 24 Hour GPLine cover from Ireland and abroad)
✅ Physiotherapist (50% of costs – 5 visits)
✅ Emergency Dental Care (50% of costs up to €300 per accident)
✅ Non Emergency Dental (50% of costs up to €300 per year)
✅ Home Nursing (50% of costs)
✅ A&E Charge (Hospital casualty charge: 50% of costs – 5 visits up to €50 per visit; QuickCare consultations & treatment: Up to €125 per visit in laya healthcare approved minor injuries & illness centres; Fracture Clinic: Up to €75 for a consultation & up to €50 for an x-ray in laya healthcare approved minor injuries & illness centres)
✅ Alternative Medicines-Acupuncture, Chiropractor, Osteopath (Acupuncture: 50% of costs – 5 visits; Chiropractor: 50% of costs – 5 visits; Osteopath: 50% of costs – 5 visit)
✅ Dietician, Occupational Therapist, Chiropodist, Speech Therapist (Dietician: 50% of costs – 5 visits; Occupational therapy: 50% of costs; Chiropody/Podiatry: 50% of costs – 5 visits; Speech & language therapy: 50% of costs)
✅ Other Day To Day Practitioners (Reflexology: 50% of costs – 5 visits; Homeopathy: 50% of costs – 5 visits; Chiropractor: 50% of costs – 5 visits; Menopause Support Package: Up to €200 per year; Intrauterine system (IUS) hormonal coil-device: 50% of costs up to €50 per year; Intrauterine system (IUS) hormonal coil-procedure: 50% of costs up to €75 per year; Vasectomy: 50% of costs up to €250 once per lifetime)
✅ Cancer Support Benefit (Breast prosthesis or hairpiece (following cancer treatment): Full cover for both; Sleeping caps: Full refund for 1 sleeping cap per membership year; Eyebrow tattooing (following cancer treatment): Full refund up to €300 once per membership year; Genetic screening for cancer risk: Full cover in the Mater Private Dublin ; Genetic testing consultation for cancer (subject to annual out-patient excess): 50% of costs for initial consultation)
✅ Psycho-Oncology Counselling (Adult Counselling-Counsellors and Therapists: 50% of costs – 5 visits up to €40 per visit; Adult Counselling-Psychologists : 50% of costs – 5 visits up to €40 per visit)
✅ Manual Lymph Drainage (Up to €500 per year)
✅ Hearing Test (50% of costs up to €40 per year)
✅ Optical (Optical: 50% of costs up to €150 per year; Orthoptist: 50% of costs – 5 visits; Laser Eye Surgery: Up to €100 per eye – payable once per lifetime)
✅ Employee Assistance Programme (24/7 Telephone Counselling: Full cover; Face to face/Video/Phone Counselling: Full cover for 6 visits per presenting issue)
✅ Child Speech And Language Therapy (50% of costs)
✅ Vaccinations (Vaccinations (subject to annual out-patient excess): 50% of costs up to €20 per year; Vaccinations-adults: 50% of costs up to €25 per year; Travel vaccinations: 50% of costs up to €60 per year)
✅ Outpatient Policy Limit (€7,650; the maximum refund is €500 per member for everyday medical expenses)
✅ Hormone Replacement Therapy for Gender Dysphoria (50% of costs up to €300 per lifetime)

What’s not covered: 

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❌ Prescription Costs

Outpatient Radiology

What’s covered:

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✅ Approved Centres (Direct payment MRI, CT & PET scans: Full cover in laya healthcare approved centres; Direct payment bone density/dexa scan: Full cover in approved direct payment density/dexa scan centres; Direct payment mammogram: Full cover in approved direct payment mammogram centres)
✅ Radiology Consultants’ Fees (50% of costs in laya healthcare approved hospitals or out-patient centres)
✅ Radiology Test Fees (50% of costs in laya healthcare approved hospitals or out-patient centres)
✅ Health Screening (HeartBeat cardiac screening: Full cover for 1 screen every 2 years for members over the age of 12 ; Executive health check (subject to annual out-patient excess): 50% refund for 1 visit every 2 years in approved centres; Sports health screening : Up to €200 every 2 years paid directly to centre; Women’s cancer screening (subject to annual out-patient excess): 50% refund of costs; Men’s cancer screening (subject to annual out-patient excess): 50% refund of costs)

What’s not covered: 

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❌ Non-Approved Centres

Fertility Benefits

What’s covered:

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✅ Infertility Benefit (First Steps fertility package: 50% of costs up to €1,500 per year. Please refer to rules for the list of eligible fertility tests and treatments; Pre Implantation Genetic Testing: 50% of costs up to €2,500 per lifetime)
✅ Fertility Preservation (€1,000 per lifetime for egg freezing, €1,000 per lifetime for embryo freezing, €150 per lifetime for sperm freezing, at approved
centres)
✅ Fertility Support Services (Full cover for 5 visits per presenting issue ( 5 visits are separate from 24/7 mental wellbeing support programme -0818 1000 30))