Tailored Health Plans Lists of Medical Facilities - List B

A. Hospitals Hospital type Direct List B Cavan Cavan General Hospital Public Public Yes Covered Clare Mid Western Regional Hospital, Ennis Public Yes Covered Bantry General Hospital Public Yes Covered Bon Secours Hospital, Private Yes Covered University Hospital Public Yes Covered University Maternity Hospital Public Yes Covered Mallow General Hospital Public Yes Covered Mater Private Private Yes Covered Mercy University Hospital Public Yes Covered St. Patrick s (Marymount Hospice) Public Yes South Infirmary Victoria University Hospital Public Yes Covered Donegal Letterkenny General Hospital Public Yes Covered Beacon Cancer Centre, 18 Private Yes Covered Beacon Hospital, 18 - Cardiac procedures High Tech - Private Yes See Table of Cover Beacon Hospital, 18 High Tech - Private Yes See Table of Cover Beaumont Hospital, 9 Public Yes Covered Blackrock Clinic, Blackrock, Co High Tech - Private Yes Our Ladys Hospice Blackrock (part cover only), Co Public Yes Covered Bon Secours Hospital, Glasnevin, 9 Private Yes Covered Cappagh National Orthopaedic Hospital, 11 Public Yes Children's University Hospital, Temple St, 1 Public Yes Covered Connolly Hospital, 15 Public Yes Covered Coombe Women's and Infant's Hospital, 8 Public Yes Covered Hermitage Medical Clinic, 20 Private Yes Covered Highfield Private hospital, 9 Private Yes Covered Incorporated Orthopaedic Hospital of Ireland, 3 Public Yes La Ginesa, St John of God, Stillorgan, Co. Private Yes Covered Mater Misericordiae University Hospital, 7 Public Yes Covered Mater Private hospital, 7 High Tech - Private Yes See Table of Cover National Maternity Hospital, 2 Public Yes Covered Our Lady s Hospice (part only), Harold s Cross, 6W Public Yes Covered Our Lady's Hospital for Sick Children, 12 Public Yes Covered Peamount Hospital, Newcastle, Co. Public Yes Covered Rotunda Hospital, 1 Public Yes Covered Royal Victoria Eye and Ear Hospital, 2 Public Yes Covered Sports Surgery Clinic, Santry, 9 Private Yes Covered 1

A. Hospitals Hospital type Direct List B St. Columcille's Hospital, Co. Public Yes Covered St. Edmundsbury Hospital, Co. Private Yes St. James's Hospital, 8 Public Yes Covered St. John of God Hospital, Stillorgan, Co. Private Yes Covered St. Joseph's Hospital, Raheny, 5 Public Yes Covered St. Luke's Hospital, 6 Public Yes Covered St. Michael's Hospital, Co. Public Yes Covered St. Patrick's Hospital, 8 Private Yes St Vincent s Hospital, Fairview, 3 Public Yes Covered St Vincent s Private hospital, 4 Private Yes Covered St. Vincent s University Hospital, 4 Public Yes Covered Tallaght University Hospital, 24 Public Yes Covered Bon Secours Hospital, Private Yes Covered Clinic Private Yes Covered Portiuncula Hospital Public Yes Covered Regional Hospital, Merlin Park Public Yes Covered University College Hospital Public Yes Covered Bon Secours Hospital, Tralee Private Yes Covered University Hospital Public Yes Covered Clane General Hospital Private Yes Covered Naas General Hospital Public Yes Covered Kilkenny Aut Even Hospital Private Yes Covered Lourdes Orthopaedic Hospital, Kilcreene Public Yes St. Luke's General Hospital Public Yes Covered Laois Midland Regional Hospital, Portlaoise Public Yes Covered Leitrim Our Lady's Hospital, Manorhamilton Public Yes Covered Bon Secours Hospital at Barringtons Private Yes Covered Mid Western Radiation Oncology Unit Public Yes Mid Western Regional Hospital Public Yes Covered Mid Western Regional Maternity Hospital Public Yes Covered Mid Western Regional Orthopaedic Hospital Public Yes Milford Care Centre Public Yes St. John's Hospital Public Yes Covered Louth Louth County Hospital Public Yes Covered Our Lady of Lourdes Hospital Public Yes Covered 2

A. Hospitals Hospital type Direct List B Mayo Mayo University Hospital (Castlebar) Public Yes Covered Meath Our Lady's Hospital, Navan Public Yes Covered Monaghan Monaghan General Hospital Public Yes Covered Offaly Midland Regional Hospital, Tullamore Public Yes Covered Roscommon Roscommon County Hospital Public Yes Covered Sligo Sligo General Hospital Public Yes Covered Kingsbridge Private hospital, Sligo Private Yes Covered Tipperary Mid Western Regional Hospital, Nenagh Public Yes Covered South Tipperary General Hospital Public Yes Covered Regional Hospital Public Yes Covered Whitfield Cancer Centre Private Yes Covered Whitfield Clinic Private Yes Covered Westmeath Midland Regional Hospital, Mullingar Public Yes Covered St. Francis Hospital, Ballinderry Private Yes Covered Wexford Ely Hospital Public Yes Covered Wexford General Hospital Public Yes Covered Northern Ireland Antrim Royal Victoria Hospital, Belfast Private No Derry Altnagelvin Area Hospital Private Yes Fermanagh Southwest Acute Hospital, Enniskillen Private Yes 3

B. Treatment centres Hospital type Direct List B Clare Bushypark Treatment centre, Ennis Addiction Centre Yes Covered Clinic, Western Road Addiction Centre Yes (limited to hysteroscopy and cystoscopy only) Cuan Mhuire, Farnanes Addiction Centre Yes Covered Tabor Lodge, Belgooly Addiction Centre Yes Covered Donegal White Oaks Treatment centre Addiction Centre Yes Covered Eccles Clinic, 7 Treatment Centre Yes Covered MS Care Centre, Rathgar, 6 Treatment Centre Yes Park West Clinic, Nangor Road, 12 Treatment Centre Yes Rutland Centre, Templeogue, 16 Addiction Centre Yes Covered Cuan Mhuire, Coolarne Addiction Centre Yes Covered Talbot Grove, Castleisland Addiction Centre Yes Covered Cuan Mhuire, Athy Addiction Centre Yes Covered Kilkenny Aislinn Treatment centre, Ballyragget Addiction Centre Yes Covered Cuan Mhuire, Bruree Addiction Centre Yes Covered Mayo Hope House, Foxford Addiction Centre Yes Covered Tipperary Aiseiri Centre, Cahir Addiction Centre Yes Covered Wexford Aiseiri Centre, Roxborough Addiction Centre Yes Covered C. : Facility Type Direct Approved List B Approved MRI Cardiac Affidea, The Elysian centre Yes No Covered Alliance Medical at University Hospital Public hospital Yes Yes Covered Alliance Medical at Mercy University Hospital Public hospital Yes Yes Covered Alliance Medical, Mater Private centre Yes No Covered Bon Secours Hospital Private Hospital Yes No Trans Specialists at South Infirmary Victoria University Hospital Public hospital Yes No Covered Affidea Dundrum, Rockfield Medical Campus, Balally, 16 centre Yes No Covered Affidea Meath Primary, 8 centre Yes No Covered 4

C. : Facility Type Direct Approved List B Approved MRI Cardiac Affidea Northwood, Santry, 9 centre Yes No Covered Affidea Tallaght, 24 centre Yes No Covered Alliance Medical, Charter Medical, 7 centre Yes Yes Covered Beacon Hospital, Sandyford, 18 Private hospital Yes No Covered Blackrock Clinic, Co. Private hospital Yes Yes Covered Bon Secours Hospital (Glasnevin), 9 Private hospital Yes No Covered Hermitage Clinic Lucan, 20 Private hospital Yes Yes Covered Mater Private hospital, 7 Private hospital Yes No Covered Sports Sugery Clinic, 9 Private hospital Yes No Covered St. James s Hospital, 8 Public hospital Yes No Covered* Derry Alliance Medical at North West Independent Hospital Private hospital Yes No Covered Donegal Letterkenny General Hospital Public hospital Yes No Covered Affidea Letterkenny centre Yes No Covered Alliance Medical at Merlin Park centre Yes Yes Covered Alliance Medical Portiuncula centre Yes No Covered Bon Secours Hospital, Renmore Private hospital Yes No Covered Clinic Private hospital Yes No Covered Alliance Medical at Bon Secours Tralee centre Yes No Covered Affidea Vista Primary Care Centre centre Yes No Covered Alliance Medical, Clane Hospital centre Yes No Covered Kilkenny Affidea, Dean Street Clinic, Kilkenny centre Yes No Covered Aut Even Hospital Private hospital Yes No Covered Alliance Medical at Bon Secours Hospital at Barringtons centre Yes Yes Covered Clinic, City Gate House, Raheen Business Park centre Yes No Covered Louth Alliance Medical at Our Lady of Lourdes Hospital, Drogheda centre Yes Yes Covered Offaly Alliance Medical, Midland Regional Hospital, Tullamore centre Yes No Covered Sligo Affidea Sligo General Hospital centre Yes No Covered Tipperary Alliance Medical, South Tipperary General Hospital centre Yes No Covered 5

C. : Facility Type Direct Approved List B Approved MRI Cardiac Affidea Dunmore Road, centre Yes No Covered Whitfield Clinic, Butlerstown North Private hospital Yes No Covered Westmeath St. Francis Private Hospital (Mullingar) Private hospital Yes No Covered C. : Facility Type Direct Approved List B Approved CT Cardiac Affidea, The Elysian centre Yes No Covered Alliance Medical, Mater Private centre Yes Yes Covered Bon Secours Hospital (Oncology CT only) Private hospital Yes No Covered Affidea Dundrum, Rockfield Medical Campus, Balally, 16 centre Yes No Covered Affidea Tallaght, 24 centre Yes No Covered Alliance Medical, Charter Medical, 7 centre Yes No Covered Beacon Hospital, Sandyford, 18 Private hospital Yes Yes Covered Beaumont Consultants Private Clinic, Santry, 9 Private hospital Yes Yes Blackrock Clinic, Co. Private hospital Yes Yes Covered Bon Secours Hospital (Glasnevin), 9 Private hospital Yes No Covered Hermitage Clinic Lucan, 20 Private hospital Yes Yes Covered Mater Private hospital, 7 Private hospital Yes No Covered St. James s Hospital, 8 Public hospital Yes No Covered* St. Vincent s Private hospital, 4 Private hospital Yes No Covered Alliance Medical at Merlin Park centre Yes Yes Covered Bon Secours Hospital, Renmore Private hospital Yes No Covered Clinic Private hospital Yes Yes Covered Alliance Medical at Bon Secours Tralee centre Yes No Covered Alliance Medical, Clane Hospital centre Yes No Covered Affidea at Vista Primary Care Centre centre Yes No Covered Bon Secours Hospital at Barringtons Private hospital Yes No UPMC Whitfield, Butlerstown (Oncology CT only) Private hospital Yes No Covered 6

C. : Hospital type Direct List B Approved PET-CT Alliance Medical at University Hospital Public hospital Yes Covered Beacon Hospital, Sandyford, 18 Private hospital Yes Covered Blackrock Clinic, Co. Private hospital Yes Covered Hermitage Clinic Lucan, 20 Private hospital Yes Covered Mater Private hospital, 7 Private hospital Yes Covered St. James s Hospital, 8 Public hospital Yes Covered Clinic Private hospital Yes Covered UPMC Whitfield, Butlerstown Private hospital Yes Covered D. Minor Injury Clinic Facility Type Direct List B Approved Minor Injury Clinics Affidea Expresscare Clinic, The Elysian, Minor Injury Clinic Yes Covered Affidea Expresscare Clinic, Tallaght, 24 Minor Injury Clinic Yes Covered MyMedical, Cherrywood Business Park, 18 Minor Injury Clinic Yes Covered Please refer to your Table of Cover to check whether list A, B, C or D applies to your plan. *Referrals must be made by an oncologist or other clinician at St. James Hospital and must be related to the diagnosis, treatment or staging of a cancer. Cover may be limited to specific treatment programmes only. Length of stay covered under your plan will be determined by the specific programme or evidence based model employed by the treatment centre based on what is deemed medically necessary and clinically appropriate for the member s presenting condition. These lists are subject to change and are correct as at 18 May 2018. For the most up-to-date lists, visit www.irishlifehealth.ie Irish Life Health, P.O. Box 764, Togher, 1890 717 717 www.irishlifehealth.ie Irish Life Health dac is regulated by the Central Bank of Ireland. Terms and Conditions apply. Registered in Ireland No. 376607. Registered Office: Irish Life Centre, Lower Abbey Street, 1 ILH_10015-18-05_List B 7