Since 2008, the two hi-tech hospitals Mater Private and Blackrock Clinic are not collecting shortfalls for a wide range of surgery - including the special procedures surgery list. These waivers apply to all providers including Laya.
I'm afraid Macdo is correct Snowyb. Laya will always have shortfalls on Special Procedures in High Tech Hospitals except on their highest levels of cover.
Firstly you state that Aviva & GloHealth have a €2,000 shortfall and that Vhi have a 20% shortfall on Special Procedures which is largely incorrect. It also suggests to me that you don't yet understand what the term 'Special Procedure' refers to.
There are almost 240 Special Procedures available in High Tech Hospitals.
Of these:
GloHealth has a €2,000 excess on only 11 of them.
Aviva Health has a €2,000 excess on 10 of them.
Vhi has a 20% shortfall on 22 of them.
Vhi's restrictions only relate to
certain Orthopaedic & Ophthalmic procedures only, and only in Private & High Tech Hospitals.
Aviva and GloHealth's restrictions relate to
certain Orthopaedic procedures only and again only in Private & High Tech Hopsitals.
Laya Healthcare however have shortfalls that relate to
all 200 plus Special Procedures in High Tech Hospitals. I will explain this in more detail further on.
Secondly you go on to state that the Mater Private is waiving the Aviva's & GloHealth’s €2,000 shortfall on orthopaedic procedures. I’m afraid that this is not correct either. The Mater Private do waive the Vhi shortfall of 20% on orthopaedic procedures but they certainly do not waive the Aviva shortfall.
Thirdly when mentioning the shortfalls in Private Hospitals as distinct from High Tech's you don’t make any reference at all to the fact that many of these Private Hospitals are also waiving the shortfalls, when indeed they are, and in greater numbers than the High Techs.
Fourthly you state that Laya Healthcare cover all these procedures with no shortfalls. Again this is incorrect. Laya Healthcare
do have plans that have
specific shortfalls for specific orthopaedic procedures in Private Hospitals.
Beyond that Laya Healthcare
also have general shortfalls which apply on all Special Procedures in High Tech Hospitals, which means that an additional 220 odd procedures are subject to shortfalls. The level shortfall depends on how long you spend in hospital but can range from Zero to up to €510 per night. There are also a good deal of plans with Laya Healthcare that are pitched at mid-range (to use your phrase) that have NO cover for special listed procedures in High Tech Hospitals.
What is important here is that these things are subject to change and when it comes to Schedules of Benefits changes can happen at any time!