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1 GloHealth Table of Contents GloHealth Table of Basic 2 GloHealth Table of Good 3 GloHealth Table of Better 4 GloHealth Table of Best 5 GloHealth Table of Ultra 6 GloHealth Table of Ultimate 7 GloHealth Table of Better Plan Ultra Cash 8 GloHealth Table of Best Plan Ultimate Cash 10 GloHealth Daily Care Good 12 GloHealth Daily Care Better 12 GloHealth Daily Care Best 12 Family & Kid s Health Package 13 Family Protection Package 13 Dental & Optical Package 13 Enhanced Package 14 International Health & Travel Package 14 Sports Cover Package 14 Women s & Men s Health Package 15 Complementary Therapy Package 15 GloHealth Financial Services Ltd trading as GloHealth is regulated by the Central Bank of Ireland. GloHealth health insurance policies are underwritten by Great Lakes Reinsurance (UK) Plc. Great Lakes Reinsurance (UK) Plc is authorised by the Financial Services Authority in the United Kingdom and is regulated by the Central Bank of Ireland for conduct of business rules. GloHealth has been appointed as an agent of Great Lakes (UK) Plc and at all times shall act solely on their behalf. GLO Rev 1 1

2 GloHealth Table of Basic Plan High-tech Hospital Semi-private room High-tech - Listed cardiac procedures High-tech - Listed special procedures semi-private rate 60% of semi-private rate 60% of semi-private rate Yes excess* 60% cover** 35% cover 35% of semi-private rate Yes excess* 60% cover** 35% cover 35% cover Public hospital cover 385 In-patient maternity consultant fees 296 Maximum amount of out-patient benefits per policy year 2,500 Consultant fees (non-maternity) 40 per visit 60 x 1 each year* 60 x 1 each year or 66% of the cost whichever is the lower** as per list available at Radiology cost of test MRI, CT and PET Scans approved centres - direct settlement* Yes in treatment centres; 60% cover in private hospitals.** MRI, CT and PET Scans non-approved centres up to 250 subject to out-patient excess and max benefit of 60% 100 days Convalescence benefits 26 x 14 Cancer Support Benefit - accommodation Not if medically necessary * Plans effective before 31st March 2013 ** Plans effective from 31st March 2013 Personalised Packages cannot be purchased on Basic Plan** Existing members, who have purchased Personalised Packages and wish to retain these, at their renewal, can migrate to our Good Plan. 2

3 GloHealth Table of Good Plan High-tech Hospital Semi-private room High-tech - Listed cardiac procedures High-tech - Listed special procedures 60% of semi-private rate 60% of semi-private rate - 75 excess 35% cover 35% of semi-private rate - 75 excess 35% cover 35% cover Public hospital cover - private room 3 nights In-patient maternity consultant fees 865 Maximum amount of out-patient benefits per policy year 2,500 Consultant fees (non-maternity) 60 per visit 60 x 1 each year as per list available at Radiology cost of test MRI, CT and PET Scans approved centres - direct settlement MRI, CT and PET Scans non-approved centres up to 250 subject to out-patient excess 100 days Convalescence benefits 26 x 14 Cancer support benefit - accommodation Not covered if transport is medically necessary 3

4 GloHealth Table of Better Plan High-tech Hospital - Semi-private room High-tech - Listed cardiac procedures High-tech - Listed special procedures subject to 100 excess per claim and a 2,000 co-payment on certain orthopaedic procedures subject to a 200 excess per night and a 2,000 co-payment on certain orthopaedic procedures - 50 excess - 50 excess 90% cover subject to a 150 excess per claim 90% cover subject to a 150 excess per claim and a 2,000 co-payment for certain orthopaedic procedures Public hospital cover - private room 3 nights In-patient maternity consultant fees 865 Maximum amount of out-patient benefits per policy year 4,000 Consultant fees (non-maternity) 60 per visit 60 x 1 each year as per list available at Radiology cost of test MRI, CT and PET Scans approved centres - direct settlement MRI, CT and PET Scans non-approved centres up to 250 subject to out-patient excess 100 days Convalescence benefits 26 x 14 Cancer support benefit 100 per day x 15 days (for accommodation expenses when traveling more than 50km) if medically necessary 4

5 GloHealth Table of Best Plan High-tech Hospital - Semi-private room High-tech - Listed cardiac procedures High-tech - Listed special procedures subject to a 2,000 co-payment on certain orthopaedic procedures subject to a 200 excess per night and 2,000 co-payment on certain orthopaedic procedures 90% cover subject to a 2,000 co-payment for certain orthopaedic procedures Public hospital cover - private room 3 nights In-patient maternity consultant fees 865 Maximum amount of out-patient benefits per policy year 5,000 Consultant fees (which leads to an elective procedure)* 100 per year (not subject to out-patient excess)* All other non-maternity Consultant fees 60 per visit 60 x 1 each year as per list available at Radiology cost of test MRI, CT and PET Scans approved centres - direct settlement MRI, CT and PET Scans non-approved centres up to 250 subject to out-patient excess 100 days Convalescence benefits 26 x 14 Cancer support benefit 100 per day x 15 days (for accommodation expenses when traveling more than 50km) if transport is medically necessary Companion Expenses* 25 x 2 *Policies effective from 31st March

6 GloHealth Table of Ultra Plan High-tech Hospital Semi-private room High-tech - Listed Cardiac procedures High-tech - Listed Special procedures 65% cover 55% cover 90% cover Public hospital cover - private room 3 nights In-patient maternity consultant fees 865 Maximum amount of out-patient benefits per policy year 5,000 Consultant fees (non-maternity) 60 per visit 60 x 1 each year as per list available at Radiology cost of test MRI, CT and PET Scans approved centres - direct settlement MRI, CT and PET Scans- non-approved centres up to 300 subject to out-patient excess 180 days Convalescence benefits 50 x 14 Cancer support benefit 100 per day x 15 days (for accommodation expenses when travelling more than 50km) if medically necessary 6

7 GloHealth Table of Ultimate Plan High-tech Hospital Semi-private room High-tech - Listed cardiac procedures High-tech - Listed special procedures 200 per night excess* ** Public hospital cover - private room 3 nights In-patient maternity consultant fees 865 Maximum amount of out-patient benefits per policy year 5,000 Consultant fees (non-maternity) 60 per visit 60 x 1 each year as per list available at Radiology cost of test MRI, CT and PET Scans approved centres - direct settlement MRI, CT and PET Scans- non-approved centres up to 350 subject to out-patient excess 180 days Convalescence benefits 70 x 14 Cancer support benefit *Between 1st Dec to 30th March 2013 **Effective from 31st March per day x 15 days (for accommodation expenses when traveling more than 50km) if medically necessary 7

8 GloHealth Table of Better Plan Ultra Cash My cover. My way. High-tech Hospital - Semi-private room High-tech - Listed cardiac procedures High-tech - Listed special procedures subject to 100 excess per claim and a 2,000 co-payment on certain orthopaedic procedures subject to a 200 excess per night and a 2,000 co-payment on certain orthopaedic procedures - 50 excess - 50 excess 90% cover subject to a 150 excess per claim 90% Cover subject to a 150 excess per claim and a 2,000 co-payment for certain orthopaedic procedures Public hospital cover - private room 3 nights In-patient maternity consultant fees 865 Maximum amount of out-patient benefits per policy year 4,000 Consultant fees (non-maternity) 60 per visit 60 x 1 each year as per list available at Radiology cost of test MRI, CT and PET Scans - approved centres - direct settlement MRI, CT and PET Scans non-approved centres up to 250 subject to out-patient excess 100 days Convalescence benefits 26 x 14 Cancer Support Benefit 100 per day x 15 days (for accommodation expenses when traveling more than 50km) if medically necessary 8

9 GloHealth Table of Better Plan Ultra Cash My cover. My way. Daily Care Excess 1 GP Dental Optical Physiotherapy Alternative practitioners (reflexology, nutritionist, massage, acupuncture, osteopath, physical therapists, chiropractor, reiki, chiropodist, speech therapist, occupational therapist, orthoptists, homeopathy) Non-maternity consultant fees Public Hearing test Health screening & allergy testing 50% of each visit 50% up to 300 per year 50% up to 150 per year 50% x 25 visits 50% x 12 combined visits 50% of each visit 50% up to 50 per visit 50% to max. of 40 per annum Up to 200 per annum 9

10 GloHealth Table of Best Plan Ultimate Cash My cover. My way. High-tech Hospital - Semi-private room High-tech - Listed cardiac procedures High-tech - Listed special procedures subject to a 2,000 co-payment on certain orthopaedic procedures subject to a 200 excess per night and 2,000 co-payment on certain orthopaedic procedures 90% cover subject to a 2,000 co-payment for certain orthopaedic procedures Public hospital cover - private room 3 nights In-patient maternity consultant fees 865 Maximum amount of out-patient benefits per policy year 5,000 Consultant fees (which leads to an elective procedure)* 100 per year (not subject to out-patient excess)* Consultant fees (non-maternity) 60 per visit 60 x 1 each year as per list available at 50% per test 50% per consultant fee Radiology cost of test 50% per test 50% per consultant fee MRI, CT and PET Scans approved centres - direct settlement MRI, CT and PET Scans non-approved centres up to 250 subject to out-patient excess 100 days Convalescence benefits 26 x 14 Cancer Support Benefit 100 per day x 15 days (for accommodation expenses when travelling more than 50km) if medically necessary Companion expenses* 25 x 2* 10

11 GloHealth Table of Best Plan Ultimate Cash My cover. My way. Daily Care Excess 1 GP Dental Optical Physiotherapy Alternative practitioners (reflexology, nutritionist, massage, acupuncture, osteopath, physical therapists, chiropractor, reiki, chiropodist, speech therapist, occupational therapist, orthoptists, homeopathy) Prescriptions Non-maternity consultant fees Public Hearing Test Health screening & allergy testing *Policies effective from 22nd June % of each visit 50% up to 300 per year 50% up to 150 per year 50% x 25 visits 50% x 12 combined visits 20 x 5 prescriptions 75% of each visit 50% up to 50 per visit 50% to max. of 40 per annum Up to 200 per annum 11

12 GloHealth Daily Care Good Daily Care Plan excess 1 GP Dental & optical Physiotherapy Alternative practitioners (reflexology, nutritionist, massage, acupuncture, osteopath, physical therapists, chiropractor, reiki, chiropodist, speech therapist, occupational therapist, orthoptists, homeopathy) Prescriptions Non-maternity consultant fees Public Health screening & allergy testing GloHealth Daily Care Better 8 x 5 visits 20 x 5 visits 10 x 5 visits 10 x 5 visits Not covered 30 x 3 visits 25 x 3 visits Up to 80 each year Daily Care Plan excess 1 GP 25 x 5 visits Dental & optical 25 x 5 visits Physiotherapy 25 x 5 visits Alternative practitioners (reflexology, nutritionist, massage, acupuncture, osteopath, physical therapists, chiropractor, reiki, chiropodist, speech therapist, occupational therapist, 25 x 5 visits orthoptists, homeopathy) Prescriptions Not Non-maternity consultant fees 60 x 3 visits Public 40 x 3 visits Health screening & allergy testing Up to 100 each year GloHealth Daily Care Best Daily Care Plan excess 1 GP 35 x 5 visits Dental & optical 35 x 5 visits Physiotherapy 35 x 5 visits Alternative practitioners (reflexology, nutritionist, massage, acupuncture, osteopath, physical therapists, chiropractor, reiki, chiropodist, speech therapist, occupational therapist, 30 x 5 visits orthoptists, homeopathy) Prescriptions 20 x 5 prescriptions Non-maternity consultant fees 75 x 3 visits Public 75 x 3 visits Health screening & allergy testing Up to 200 each year 12

13 Family & Kid s Health Package Family first aid course Child sports membership Parent accompanying child expenses Annual family flu vaccine Child nutritionist Child speech & language therapy Child developmental tests Baby massage course The Little Gym Baby swimming classes (Water Babies programme) Clap Handies play labs Fully covered - 1 day course 30 contribution each year 25 x 2 in-patient stays each year Fully covered - 1 each year 25 x 2 visits 25 x 2 visits 30 contribution and 30 point of sale discount 40 contribution each year minimum of 4 classes 67 contribution 10 week programme 20 contribution & 20 point of sale discount 20% discount Family Protection Package Flu vaccine Family first aid SADS Screening (Sudden Adult Death Syndrome) Fully covered - 1 each year Fully covered - 1 day course 50 x 1 each year Customers who choose this package will also get a free Family Protection plan from Irish Life, which will offer a level of protection against the financial uncertainty or hardship that comes with the following unfortunate events: Adult accidental death 10,000 Children s specified illness 10,000 Specified pregnancy complications 5,000 Children s life cover 5,000 Dental and Optical Package Emergency dental Retainers & fitted gum shields Cost of prescription glasses Contact lenses Designer sunglasses Laser eye surgery Eye exam 200 contribution 25 contribution 20% discount 20% discount 20% discount 20% discount 20 contribution 13

14 Enhanced Package Grant-in-aid for a private hospital/home birth 4,000 Pre/post natal maternity costs 200 Private ante-natal class 50 contribution Breastfeeding consultancy 25 x 2 visits Post natal depression counselling 20 x 2 visits expenses (partner expenses) 40 per birth Baby Sleep Academy 40 contribution - 1 day course 3&4D ultrasound scan 50 contribution with Baby Scan 3&4D ultrasound scan 75 contribution with InnerVision Clap Handies play labs 20% discount Early pregnancy scan 30 contribution with Baby Scan Pre & post natal Yoga & Pilates 20 x 2 visits International Health & Travel Package A&E abroad 100,000 Companion expenses 1,000 Repatriation cover 1,000,000 Travel vaccine Treatment abroad up to the amount that would have been paid in Ireland International nurse line 10% discount from the Tropical Medical Bureau - subject to pre-approval Sports Cover Package Physiotherapist Health screen 50 x 1 each year Sports massage 25 x 2 Metabolic testing Fully covered for a standard test Sports psychologist 25 x 2 SADS Screening (Sudden Adult Death Syndrome) 50 x 1 each year (including private) 30 x 1 visit each year V02 Testing 30 contribution 14

15 Women s & Men s Health Package Nutritionist Acupuncture Prostate check/screen Testicular check/screen Smear testing Flu vaccine Health screen Dexa scan Mammogram Slimming club membership* 25 x 2 visits 25 x 2 visits 40 contribution 40 contribution 40 contribution Fully covered 30 contribution 40 contribution 40 contribution 20 contribution and 20 (including 10 once off joining fee) point of sale discount on 6 week in-class membership with Unislim or, 20 contribution & 20 point of sale discount on 6 month on-line membership with Unislim* *Policies effective from 22nd June 2013 Complementary Therapy Package Reflexology Nutritionist Massage Acupuncture Osteopathy Physical therapists Chiropractor Reiki 15

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