Insurance phrases explained (in actual English)
This applies when you first take out health insurance. During your waiting period, you will be covered for accident and injury treatments, but not illness. Once the waiting period has passed, you’ll be able to claim all your scheme’s benefits.
The excess on your insurance is the amount of money that you pay towards medical bills before you can claim back from your insurer. For instance, when it comes to healthcare insurance, you might pay the first €150 of your everyday medical expenses (doctor’s visits and so on) before you can claim back money from laya healthcare.
Public vs private hospital accommodation
A private room is exactly that. It’s just you.
A semi-private room is a room with no more than five beds.
Public accommodation means you’d be on a ward with more than five beds.
A co-payment isn’t the same as an excess. Instead, it’s an arrangement by which the costs of certain treatments are split between you and laya healthcare.
Typically, we agree with you in your insurance scheme what cost of certain treatments you’ll pay. And we do, of course, set a limit.
You then make your share of the payment directly to the provider of the treatment.
Inpatient cover pays for treatment, procedures and accommodation in a hospital once you are admitted to a hospital. This may vary from being admitted for a few hours, a day, a night, or more.
Sometimes there is a gap between the charge for hospital treatment and how much your insurer covers. That gap is known as a ‘shortfall’. As you’ll be making up this difference, it’s worth comparing schemes to make sure you’re comfortable with the level of shortfall you’d be expected to pay.
Day-case treatment covers you when you have to be admitted into a hospital and occupy a bed during the day, but you don’t stay overnight.
This is cover that pays for hospital visits when you go home on the same day as the treatment or procedure.
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.
A rules booklet is a guide to your healthcare insurance scheme. It sets out your cover and benefits, along with all the applicable terms and conditions.
You’ll find a list of downloadable rules booklets here