Do you have an eligible Out-Patient Claim?

Hospital plans provide limited cover for out-patient medical expenses such as GP fees. Before you can qualify to make a claim, the total eligible expenses for each insured member must exceed the annual individual excess on your plan. The excess amounts are shown below.

Type of Policy Annual excess per member
Plans A, Plan B and Plan B Parents & Kids
€300
Plans A Option, Plan B Option and B Option Parents & Kids
€250
Plans C, D and E
€200

Calculating your eligible expenses
Illustration of a typical claim which does not reach the excess.

Plan B - Out-Patient Expenses Claim (one person) - for illustration purposes only
Expenses type Medical expenses incurred Number of visits Benefit per visit Eligible expenses
GP fees
€200
4
€13
€52
Consultant fees
€150
2
€39
€78
Physiotherapy
€200
5
€13
€65
Radiologists' & Pathologists fees'
€50
1
€20
€20
X-rays & Tests
€50
1
€25
€25
Sub-total
€650
€240
Less, annual excess
-€300
The money you get back
€0

Submitting your claim
  • There is no need to submit a claim to us if the total eligible expenses do not exceed the annual excess for each insured member. If you think you have exceeded the annual excess to make an eligible claim: Outpatient Claim form.
  • We can only pay benefits when we receive a completed and signed claim form.
  • Submit the original receipts along with your claim, as they are not returned it is advisable to retain a copy.
  • You must submit your claim within 3 months of the end of your (annual) contract.
  • We will pay benefits for eligible expenses listed in Section 9 of your Table of Benefits as a lump sum at the end of each year.

To determine the appropriate benefit per visit, refer to the table of benefits document issued to you at the start of the annual contract.

Tax relief
Medical expenses not covered by Vhi Healthcare may be eligible for income tax relief. To find out how you can benefit from this relief, please contact your local tax office for details.