How to claim
Making a claim
Traditionally, there are two types of costs that people need to claim money back for - these are either Out-patient (everyday medical expenses, e.g. GP visits) or In-patient (a day-case or overnight stay in hospital).
1. How To Claim For Your Out-patient or Everyday Medical Costs?
It's easy to claim for your everyday medical costs. For your convenience and for prompt payment of your out-patient claim, we can arrange to make payment directly, where possible, into your bank account. Please provide your bank account details on the 'Your Payment Details' section on the claim form. Below are some guidelines to help you make your out-patient claim.
Check that your original out-patient receipts are enclosed (photocopies, cash register receipts etc are not acceptable).
Please ensure that all receipts include the name of the patient, the cost incurred and the date of the visit.
Please note that out-patient receipts will not be returned following assessment.
The Revenue Commissioners will now accept your Statement of Claim (which we will send to you when your claim has been assessed) as evidence of medical expenses incurred.
Claims should be made at renewal date and only for out-patient costs incurred within the previous membership year.
Send your completed claim form to Laya Healthcare, PO Box 12679, Dublin 15.
What does my scheme allow me to claim on?
To find out what your scheme allows you to claim back on, simply log in to your Member Area and click on "Check cover".
2. How to claim for a visit to hospital?
The majority of these claims are settled directly between us and the hospital so you don't usually need to submit an In-patient claim form. However we have outlined some useful information below should you need it;
Step 1. If you are referred by your GP to a Consultant, let them know that you have private health insurance.
Step 2. Once you have the details of the hospital, Consultant and procedure code, please contact one of our customer service advisers on 1890 700 890 to check your cover.
Step 3. If you then need to go into hospital, remember to bring your membership card with you. Please note you will be asked to sign a claim form in hospital.
Step 4. The hospital then sends us the bill and in the majority of cases we settle these bills directly with the hospital. We will then send you a letter which will explain what has been paid on your behalf and to whom.
Tax relief may also be available for medical expenses.
Please note all claims are paid in accordance with our scheme rules and table of benefits.
Please note if your scheme has an excess, this will be applied to your claim. The amount of the excess deducted will depend on your scheme. You can log in to your Member Area to check if an excess applies to your scheme.