Laya Laya simplicity slight changes over last few months

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ajapale

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im on laya simplicity since October and took Brendan’s advice and checked cover. The HIA site is good as far as it goes but it does not hold old “retired” schemes or older revisions of current schemes. This makes it impossible to determine what cover if any has dropped following a revision.

I noticed the following change in Simplicity private hospital cover. It may actually be an improvement in cover but it is difficult to say. Confusopoly seems to be the tactic.

“Covered with €100 excess per claim on the first two claims per year only; No excess applies to 5 orthopaedic procedures (hip and knee replacement) in 12 private hospitals”

What are the 12 hospitals and what are the 5 procedures?
 
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Mexicola said:
There has been no change to the cover, the only thing changed is the wording.
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Thanks mexicola , that’s somewhat reassuring.

I’m not an insurance professional but I would imagine that insurance policies are all about the words!

I’m wondering why 12 hospitals and 5 procedures are being introduced into a revised plan?
 
I'm with Simplicity ( I shop around every year) and have to say I find the cover excellent. The price went up a wee bit this year, but despite looking around Icouldn't find a comparable plan ( with similar outpatient benefits) as good, or even close. I really like the way Laya have introduced the 'app' where you can claim as you go throughout the year. It makes the whole process very straightforward.
 
Yes, I have been with Laya for years now and I like the simplicity product, and the flex product before that and the other product before that. But Laya keep retiring, chopping and changing offerings making it very difficult for consumers.

Anyone any idea in the “12 hospitals and 5 procedures” and why they are introducing this complexity at this stage?
 
ajapale said:
Thanks mexicola , that’s somewhat reassuring.

I’m not an insurance professional but I would imagine that insurance policies are all about the words!

I’m wondering why 12 hospitals and 5 procedures are being introduced into a revised plan?
Click to expand...

it's to clarify the exact procedures and also the hospitals with no excess/shortfalls

procedures:
3660
Arthroplasty of hip using prosthesis, unilateral

3666
Metal on Metal hip resurfacing arthroplasty, unilateral

3661
Revision of total hip arthroplasty, acetabular and femoral components with or without autograft or allograft

3910
Prosthetic replacement (total) of knee joint, unilateral

3911
Revision of arthroplasty of knee joint, with or without allograft, one or more components

I'll dig out the hospitals over the weekend
 
I rang up today and the woman I spoke to was adamant that there is no reduction in cover what so ever. The only change is a few small slight enhancements like 3 free online GP consults.
 
Hi AJ

If you go onto this page https://www.layahealthcare.ie/productsandservices/plan/scheme/simplicity you will see a map in the top right hand side. You can select a county - I have selected Dublin.

upload_2018-1-27_10-43-15.png


It would be useful if they just gave a simple list of hospitals covered and hospitals not covered.

Brendan
 
Hi Bazza
That's great. Thanks for that.

I liked the look of this policy. And had assumed from the map that it covered the Blackrock Clinic - but it appears that it doesn't.

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Now I see that I misread the main page
Hospital cover
  • Private room in public hospitals.
  • Private room in private hospitals including the Beacon.
  • Day-case cover in hi-tech hospitals.
I think that the insurance companies should publish a special box highlighting what is not covered - that is much easier to follow.


Brendan
 
Brendan, never rely on Laya's maps, it's quite confusing.

The tob states full cardiac and day cover in Blackrock and Mater Pr, shortfalls for anything else. Full cover in the Beacon for everthing.
 
Thanks Brendan, the page has an interesting feature in that it prompts for the date you took out your policy and presumably it is possible to see “changes, enhancements, clarifications and reductions” in cover over time.

The original question does not relate to the list of hospitals covered but rather to the introduction of some rather odd phraseology relating to 5 procedures and 12 hospitals. This phraseology is reproduced in the hia comparison website.

Aj
 
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