health2 the future of health 4D Health 2 Employee Plan Your Benefits at a Glance

Transcription

1 health2 the future of health 4D Health 2 Employee Plan Your Benefits at a Glance

2 Welcome to your 4D Health 2 Plan

3 Welcome to Irish Life Health For over 75 years, Irish Life Group has helped over 1m Irish people to look after their life assurance, pension and investment needs. Now, Irish Life Group has extended its remit to health insurance, through the acquisition of Ireland s two most innovative health insurers, to become Ireland s most progressive health insurer. With 4D Health Plans, we take a broader view of your health. Optimal health and wellbeing is about keeping you well before you fall ill and supporting you on your road back to full health. Wellbeing Diagnosis Treatment Recovery For further information on the 4D Health 2 Plan, call our Corporate Sales Team today on

4 Going Further to Support your Wellbeing 4D Health 2 covers you for Wellbeing, Treatment, Diagnosis and Recovery offering fast access to public and private hospitals and scan centres around the country and contributions towards medical expenses, like GP & Dental visits. With 4D Health 2 it doesn t just stop at great new benefits. We have designed a range of extra dimensions (Extras), which are your personalised packages reflecting a multi-dimensional approach to your health and the uniqueness of your personal health journey. With 4D Health 2, regardless of where your health journey starts, we have meaningful benefits to support that journey and support your recovery. 4D Health 2 Key Benefits at a Glance > GP Visits: 50% per visit x unlimited > Unlimited 24/7 Digital Doctor > Non Maternity Consultant Visits - 50% per visit x unlimited > Routine Dental: 50% up to 150 per year > Optical Visits : 50% up to 75 per policy year > Physiotherapy: Up to 30 x 7 visits > Back Up Programme (Back & Neck Pain Management Programme) > Private A&E: Cover as per consultant s benefit > Public A&E: 50% up to 50 per visit > International Second Opinion Service > 2 Extras available to personalise your cover

5 4D Health 2 Plan - Your Plan Explained This table of cover must be read in conjunction with your member certificate and Tailored Health Plans membership handbook effective from August The hospitals and treatment centres covered on this plan are set out in List A in Part 12 of your Tailored Health Plans membership handbook. Table of Cover effective from August 1st 2017 In-patient Benefits 4D Health 2 Plan Cover Preventative care Day to Day Preventative care Day to Day Other day to day benefits Diagnostic Other day to day benefits Scan Maternity cover Diagnostic Maternity Scan cover A&E abroad Maternity Elective A&E overseas abroad referral Psychiatric Elective treatment overseas referral Other benefits Psychiatric treatment Hospital Cover Consultants fees In-patient scans Public Hospital Semi-private room Personalisation Private room Employee Day case assistance Personalisation programme Private Hospital Semi-private room subject to 150 excess per claim subject to 2,000 Aco-payment on certain orthopaedic procedures 1 Private room Amazing Plus Employee Amazing Semi-private rate subject to 150 excess per claim subject to assistance Plus programme 2,000 co-payment on certain orthopaedic procedures 1 Day case subject to 75 excess per claim High-tech Hospital A Semi-private room Amazing Plus Partnership Amazing Plus (Beacon only) subject to 150 excess per claim. 50% cover in Blackrock Clinic and Mater Private Semi-private rate (Beacon only) subject to 150 excess per claim. Private room Out patient benefits 50% of semi-private rate in Blackrock Clinic and Mater Private Day case Seamless Partnership transition subject to 75 excess per claim Listed cardiac procedures 1 subject to 150 excess per claim Out patient 1 Listed special procedures benefits subject to 150 excess per claim subject to 2,000 co-payment on certain orthopaedic procedures 1 Private Maternity Room Public hospital cover for maternity 3 night s accommodation Out patient In-patient maternity benefitsconsultant fees As per schedule of benefits for professional fees 2 Outpatient Private maternity consultant fees Ongoing 400 Room support Home birth up to 4,000 Newborn free till next renewal Yes A&E Abroad A&E visit Private Room Hospital bill for in-patient treatment up to 100,000 Repatriation expenses up to 1 million Expenses for companion who remains International International up to 1,000 with you health & travel health A&E & visit travel Companion repatriation expenses up to 1, hour telephone assistance Yes Elective overseas referral International health & travel Benefit abroad for surgical procedures that are not available in Ireland Benefit abroad for surgical procedures that are available in Ireland International Second Opinion Service Seamless Ongoing transition support International Sports cover health & travel Yes up to the amount for the most similar surgical procedure to treat the same condition in Ireland Yes - subject to level of cover available in Ireland Complementary cover Sports cover refer to your Membership Handbook

6 Elective overseas referral In-Patient Benefits International health & travel International health & travel 4D Health 2 Plan Cover Psychiatric treatment Other benefits Out patient & day to day benefits limits Psychiatric Treatment Not related to substance abuse Related to substance abuse Other In-Patient Benefits Oncotype DX Health in the Home Post-operative Recovery Benefit Convalescence benefits Child home nursing care Sports cover Complementary cover Radiology Parent accompanying child Point of Care: Day case procedure for Rheumatology & Chemotherapy Cancer Support Benefit (for accommodation expenses when travelling more than 50km) Medicall ambulance costs Stress management line Employee assistance programme Pathology MRI/CT/PET-CT scans 100 days 91 days per 5 years (Immediately following an in-patient stay) 120 cash benefit 50 x 15 days 100 x 14 days (following in-patient stay of minimum 5 days) 40 x 14 days (not payable for the first 3 days) Up to 100 per day for up to a maximum of 1,500 per calendar year (refer to Membership Handbook) 365 days stress line 6 face-to-face follow-up counselling sessions Outpatient Benefits - not subject to excess Nurse-on-call Digital Doctor Nutrition Recovery Benefit Out patient benefits Health screening & allergy testing Yes Unlimited. See irishlifehealth.ie for further information. Up to 200 per policy year Outpatient Scan Cover (in approved centres) PET-CT MRI CT Private Room Outpatient Benefits - subject to excess Individual excess 1 Maximum amount of outpatient benefits per member per policy year 4,000 Consultant fees 50% per visit, unlimited Public A&E cover 50% up to 50 per visit Psycho-oncology counseling 50% up to 25 x 8 visits Manual lymph drainage 50% up to 25 x 5 visits Home nursing 40 x 20 days Emergency dental care Up to 250 Medical and surgical appliances As per specified list 3 (subject to 200 per person excess) Pathology cost of test 50% covered Pathology consultant fees 50% as per schedule of benefits for professional fees 2 Radiology cost of test 50% covered Radiology consultant fees 50% as per schedule of benefits for professional fees 2

7 Day to Day Preventative care Day to Day Other day to day benefits Diagnostic Other day to day benefits Scan cover Diagnostic Maternity Scan cover A&E abroad Maternity Elective overseas referral A&E abroad Psychiatric treatment Elective overseas referral Other benefits Psychiatric treatment Out patient & day to day benefits limits Other benefits Out patient & day to day benefits limits Day to Day Benefits Individual day to day excess Employee 1 Day to Day Practitioners GP visits Dentist Visits Physiotherapy visits Practitioners Acupuncturist Chiropractor Out patient Homeopath benefits Massage therapist Osteopath Reflexologist Reiki practitioner Out patient Private benefits Room 4D Health 2 Plan Cover 50% of each visit 50% up to 150 per policy year 30 x 7 visits Other Day to Day Benefits Ongoing Chiropodist support Clinical Psychologist 25 x 10 visits Dietician A&E visit Hearing Private test Up to 25 x 1 Room Out patient Nutritionist benefits International International Occupational therapist health & travel health & travel Optical (eye test and/or glasses/lenses combined) A&E visit 50% up to 75 per policy year Orthoptist Physical therapist Sports cover Private Podiatrist Room International International Prescriptions health & travel health & travel 15 x 3 prescriptions Speech therapist Personalised Packages Choice of 2 Personalised Packages from range of 6 Member Benefits Allen Carr Smoking Cessation Laser Eye Surgery Amazing Plus Amazing Plus assistance programme A Personalisation Amazing Plus assistance programme A Partnership Amazing Plus Seamless transition Partnership Ongoing support Seamless transition Complementary cover Sports cover Radiology Complementary cover Pathology Radiology Back-Up Smiles Dental Access Package For full details on the above member MRI/CT/PET-CT benefits please visit the Member Benefits scans section on Pathology 1. All procedure lists are available on or available on request by calling Irish Life Health on MRI/CT/PET-CT 2. The schedule of benefits is available on scans or available on request by calling Irish Life Health on The medical and surgical appliances list is available on or available on request by calling Irish Life Health on

8 4D Health 2 Extras With Irish Life Health, you tailor your plan to suit your individual needs and lifestyle with our new Extras. Each member selects 2 Extras from the range of 6, offering the freedom to personalise the health plan for each and every family member. Travel Extra The world gets smaller every day, with more and more people working abroad, so travel insurance is a must for many! So, if travel is your thing, Travel Extra has you covered. Travel Extra Travel consultation Travel vaccine Prescriptions abroad 4D Health 2 Plan * plus 10% point of sale discount* 20 x 1 prescription Travel insurance cover: Irish Life Health gives you a free travel insurance policy** when you choose the Travel Extra. For full details of what s covered under the travel insurance benefit, please visit **Provided by Allianz Global Assistance Sports Extra There are few better ways to stay physically and mentally healthy than engaging in sporting activity. Sports Extra ensures that you re covered for sporting activity with benefits that support you in peak fitness and also in recovery, following a sports injury. Sports Extra Sports psychologist visits Physiotherapy visits Adult sports Club/gym membership VO2 max testing Metabolic testing Sports massage / personal training sessions Wearable trackers 4D Health 2 Plan 30 x 2 visits 30 x 2 visits 30 contribution* Standard test fully covered* 30 x 2 sessions 30 contribution Fitted gum shield / protective sports gear 50% back up to 30 Foam roller 50% back up to 30 SADS screening

9 You Extra Once you re feeling good we want to keep you there. You Extra recognises that even if you are generally well, you may desire to feel even better. So whether you re a fitness fanatic or couch potato, we know everyone aspires to a healthier life, so we have created a range of booster benefits to support your journey to a healthier lifestyle. You Extra Mindfulness course Nutritionist or dietician Adult sports club / gym membership Sexual health screening - Simple 2 Test 4D Health 2 Plan 50 cash back 30 x 2 visits 30 contribution * Vasectomy (GP only) up to 360 Flu vaccine Fully covered* Fertility Extra The gift of life is not always straight forward. With Fertility Extra, you get enhanced cover to take the steps you need for your families journey. With more professionals now seeking greater options regarding family planning there is demand for more comprehensive fertility cover. Fertility Extra enhances your plan with a number of practical benefits to support you along your journey to family life. Fertility Extra Infertility benefit - IVF, IUI, ICSI Fertility treatment at Beacon CARE fertility AMH tertility test His & hers fertility screening Fertility counselling Miscarriage counselling Nutritionist, dietician or acupuncturist 4D Health 2 Plan 50% cover up to a max of 750, twice per lifetime 10% discount** 50 x 2 visits 50 x 2 visits 25 x 2 visits **Fertility discount is available on one cycle of treatment per lifetime

10 Maternity Extra Maternity Extra enables females to flex up their cover to suit their lifestyle. Our generous range of comprehensive extras includes early pregnancy scanning, antenatal care and unique post-natal recovery benefits. Maternity Extra 3D/4D & early pregnancy scans Private antenatal class Zika screening Flu vaccine Paediatrician consultation Breastfeeding consultancy Post-natal depression or miscarriage counselling Post-natal home help Pre/Post-natal yoga & pilates Partner benefit Baby massage First aid course for mums and dads 4D Health 2 Plan plus 10 point of sale discount* Fully covered* 100 x 1 visit 25 x 2 visits 50 x 3 visits 2 x 3 hour sessions* 20 x 3 classes 50 x 1 day 40 for course of 4 classes Fully covered* Children Extra The only thing more precious than your own health, is that of your children. Children Extra includes benefits for younger (such as paediatric consultants visits), through to maturing families, all facing their own unique stresses and challenges. Children Extra Parenting course Kids sports clubs Child/teen counselling Child/teen orthodontics SADS screening Child speech & language therapist Meningitis B / chicken pox vaccines 4D Health 2 Plan to 1 course 30 contribution 50% up to 40 x 8 visits 100 cash benefit 50% up to 30 x 8 visits *For some benefits in the Irish Life Health Extras, we have a preferred provider. For full details of all our benefits and preferred providers please see the relevant Table of Cover at **This discount applies to certain procedures and one cycle of treatment per lifetime. To see the procedures covered, please see the List of Discounted Treatments from Beacon CARE Fertility available at

11 How do I make a claim on my 4D Health 2 Plan? With Irish Life Health Online Claiming, you can claim for your day-to-day and outpatient expenses online anytime and we ll pay you directly into your bank account. Log into our member secure site, upload a photo of your receipt and submit your details it s that simple. LOG IN UPLOAD SUBMIT For more information on Online Claiming visit

12 Please note each Irish Life Health plan provides different levels of cover which may or may not suit your needs. Information relating to benefits, cover and member benefits contained in tables within this document is not conclusive. For full details on what s covered and what s not covered see the relevant Table of Cover and Health Plans Member Handbook at or call us. Information correct as of July Irish Life Health dac is regulated by the Central Bank of Ireland. C