Laya Procedure Code and the period covered

[Leabharlanna]

Hi,
I have a query about procedure codes and the period for which you are covered under your health insurance. For example, if you need to go to the hospital to have a procedure carried out and your health insurer confirms that you are covered for X days for this procedure. What happens if due to a medical complication you need to stay in hospital longer? Will your health insurance continue to cover your hospital stay after the initial procedure period has expired? Does it matter if the procedure is being carried out in a private or public hospital?
Any help or advice would be gratefully received.
Many thanks.

 

[LS400]

I would hope they did cover the extra days.

The down side is you take out cover for a specific type of policy, not open ended, and so I would say its at the discretion of the company.

On a different scale, but still within the bounds of making an insurance claim, If I leave my car in to be repaired under an insurance claim, and my policy give me 5 days car replacement, but during the repair complications arise due to extra damage, non availability of parts etc, I still only get 5 days car replacement cover..but, most insurance companies would allow extra days grace when asked.

In your case, if the procedure costs more due to complications, I would have to assume this is covered, with the possibility of expecting a higher excess payment on your end

This is just a Laya persons opinion.

 

[Leabharlanna]

Thanks very much for your reply. I assumed that the PHI would cover any extra time as long as a doctor certified that it is required due to medical necessity. Any such time would be subject to any excess or shortfall attached to your plan. It's an ever changing landscape so I better check if that's correct.