VHI Healthcare medical plan

What you need to know

VHI Healthcare administers the PMI 26 12 medical plan, which is 100% company paid. This means PayPal pays the cost of the policy, but you pay tax on the medical policy amount.

Extensive cover

The PMI 26 12 provides cover for public and private hospitals nationwide, with comprehensive benefits for day-to-day medical and maternity expenses. The plan also includes dental and vision cover. For plan details, refer to the 2021 Table of Benefits.

We’re able to keep this plan affordable by including an excess for private hospital treatment. Hospital cover includes direct payment to hospitals and access to more than 2,100 consultants.

Sign up today!

To enrol in the PMI 26 12 medical plan: 

  1. Go to vhi.ie.
  2. Click on JOIN VHI.
  3. Follow the prompts. 
     

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Plan at a glance

Public hospitals

Day care, side room, semi-private, and private room Full cover

Private hospitals (excludes Mater Private Hospital, Dublin)

Day care, side room, and semi-private room Full cover – €75 excess per claim
Private room Semi-private room rate – €75 excess per claim
Specified orthopaedic replacement and ophthalmic procedures Up to 80% cover – €75 excess per claim

Mater Private Hospital, Dublin

Day care and side room Full cover
Specified orthopaedic replacement and ophthalmic procedures Up to 80% cover – €75 excess per claim

Beacon Hospital, Hermitage Medical Clinic, and Mater Private Hospital, Dublin

Major cardiac procedures and a list of specialised procedures Full cover – €75 excess per claim

Vhi fertility benefits

Initial consultation €100
Fertility tests €100
Egg freezing/sperm freezing €1,000 per lifetime/€125 per lifetime
IUI, IVF, or ICSI—2 treatments per lifetime 50%, up to €1,000 per treatment

Maternity and baby cover1,2 – Hospital charges

Public maternity hospitals Full cover – 3 days
Home birth benefit €3,400
Pre- and post-natal visits (GP/consult/midwife) Up to €500 in the year of the birth
Child home nursing Up to €100 per day, max of 28 days per calendar year
Post-natal home nursing Up to €1,200 following 1 nights' stay and €600 following a 2nd nights' stay
Paediatrician benefit Up to €75 per 1 visit within 1 year of birth
Maternity & baby bundle (maternity yoga and pilates classes, 1 maternity scan, breastfeeding consultations, baby massage and swim classes, and ante-natal day course) 75% cover, up to a combined limit of €500/no excess
Parent accompanying child Up to €100 per day, max of 14 days

Day-to-day cover for medical expenses—Annual excess of €1 per member per year (an excess is the amount you pay before any benefit is payable )

GP visits  €30 per visit per member, max of 30 per year
Physiotherapy visits €30 per visit per member, max of 25 per year
Consultant consultations €75 per visit per member, max of 25 per year
A&E levy €75 per visit, max of 2 per year
Alternative3 and complementary4 therapies €30 per visit per member, max of 30 combined visits
Consultant pathologist/radiologist €75 per referral/procedure
Radiology and pathology and other diagnostics 50% of agreed charges, up to max €850 per year
Clinical psychologist visit €30 per visit per member, max of 12 per year
Dental visits €30 per visit per member, max of 25 per year
Optical (eye test and glasses/lenses) €30 in 24-month period, €150 in 24-month period
Hearing tests €40 per member, every 2 years

1 Free cover for newborns until the next renewal date 
2 Fourth and all subsequent children are free
3 Includes acupuncture, chiropractor, osteopath, physiotherapy, and reflexology visits
4 Includes chiropodist/podiatrist, dietician, occupational therapist, speech therapist, and orthoptist visits

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Additional benefits

Outpatient cover

In addition to the benefits listed in the chart above, you’re also eligible for the following outpatient cover:

  • Convalescent care up to €30 per night for a maximum of 14 nights per year 
  • Cancer care support up to €100 for one night accommodation per treatment
  • VHI SwiftCare appointment services
    • Consultant consultation covered at 75%
    • Dental—€30 per visit, up to 25 visits
    • Physiotherapist—€30 per visit, up to 25 visits
  • Full cover for VHI Hospital@Home with prior approval 
  • VHI LifeStage screening up to €200 per screening at a VHI Healthcare Screening Centre 
  • Full cover for mammograms covered up to 50% performed in an approved centre every 2 years
  • Screenings (services on hold until after the pandemic)
    • DEXA scans covered at 50% when performed at an approved DEXA scan centre (contact VHI for details)
    • Health screenings covered at 50%, once every 24-months, when performed at a VHI screening facility
    • STI screening up to €100
    • Fitness screenings carried out in the Sports Surgery Clinic, Santry—full cover (1 visit per 3 year period)

Stress-related cover

Members who are experiencing stress-related illnesses are eligible for the following cover:

  • 100 days cover per year for stress-related conditions, including eating disorders such as bulimia and anorexia, and for psychiatric hospitals
  • 91 days inpatient treatment for alcoholism, drug abuse, and other substance abuse within any 5-year period 
  • Counselling for children—€30 per visit with a maximum 8 visits per member per year 
  • Counseling for adults—€75 per visit with a maximum of 12 visits per member per year in approved outpatient centres 

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Travelling abroad

Your medical plan provides the following cover to you and your eligible dependants when travelling outside of Ireland:

  • Travel vaccinations, up to €100 per person per year 
  • Emergency treatment while abroad on holiday for less than 180 days, up to €100,000
  • Elective treatment abroad (when surgical treatment is available in Ireland) or treatment NOT available in Ireland, up to €100,000 (subject to prior approval and meeting specified criteria in full)
  • Access to 24-hour phone service staffed by an English-speaking medical expert 
  • Assistance finding a local GP, hospital, or clinic

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Filing a claim

You can file a claim online or through the post.

Online

File your claim quickly and easily through Snap & Send on the VHI Mobile Health Assistant.

Post

Download the VHI Day-to-Day Medical Expenses Claim form.

Follow the guidelines on the form and submit it to:
VHI Healthcare
P.O. Box 11530
Dublin 18

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Making changes to your plan

Your medical plan is in effect for a 1-year period. You can add and remove dependants or make changes to your cover during the renewal period in February without penalty. Early termination or changes 14 days after your policy has gone into effect is considered a breach of contract, and a fee will be assessed for any changes you make.

If you’re leaving the company, you will not incur any fees for terminating your policy.

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Contributions

The company pays the full cost of the medical plan. However, it is a taxable benefit. This means we pay the cost of the policy, but you’re responsible for paying the taxable amount.

The cost of this benefit to the company is:

  • Adult: €1,467.51
  • Child under age 18: €438.34
  • Dependant age 18–20: €508.90

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MyVHI

MyVHI allows you to view your policy details anytime, day or night: 

  • Access all your policy documents. 
  • Review your claims statements online. 
  • Check out exclusive member offers.
  • Receive online support from our health experts in one place.

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Provider contact information