- The proposed treatment must be medically necessary and satisfy the criteria in our schedule of benefits for conditions of payment, including clinical indicators.
- 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.
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".
- All outpatient receipts are assessed in date order received and treatment date, as per your laya healthcare scheme rules and table of benefits.
- Outpatient claims must be submitted within 12 months of the treatment date on your receipt.
Making a Claim
Traditionally, there are two types of costs that people need to claim money back for:
- Out-patient (everyday medical expenses, e.g. GP visits)
- In-patient (a day-case or overnight stay in hospital)
1. How To Claim For Your Everyday Medical Expenses (or Out-Patient)
Claiming has never been easier with our new Laya Healthcare Member App. You can now submit your claims for everyday medical expenses through the app at any point during the year - 24 hours a day, 7 days a week. Welcome to Digital Customer Care from Laya Healthcare.
The app is really easy to use. It works by allowing the main member on your policy to take a photo of your receipt using a phone and submitting it through the App.
Follow these simple steps to make a claim using the Member App:
- Download the Member App
- Log in using your Member Area log in details. New to Member Area? Register here
- Tap "Submit a Claim"
- Take a photo of your receipt or else choose a photo from your gallery and click "next"
- Fill in a few details about what the receipt is for and submit your claim.
Please Note: Claims must be submitted within 12 months of the treatment date on your receipt.
For your convenience and for prompt payment, we can also arrange to make payment directly into your bank account, simply update your bank details on the app or on your personalised Member Area.
Simply download the App by searching for laya healthcare on the iTunes App Store or Google Play. If you have already registered for your personalised Member Area, you can use the same log in details for your Membera App too.
If you prefer to submit your claims by post, you can find our everyday medical expenses claim form here. Please note you can only claim at your renewal if you choose to claim in this way.
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, please have your membership number with you - this can be found on your digital membership card on the laya healthcare Member App. 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.
Did you know you may be entitled to tax relief?
Tax relief may also be available for medical expenses. You can claim this directly from the Office of the Revenue Commissioners under health expenses. Check out our handy guide on how to claim How to claim from revenue
Please note all claims are paid in accordance with our scheme rules and table of benefits.