General Practitioners

A general practitioner or GP is a medical practitioner who provides primary care and specialises in family medicine. A general practitioner treats acute and chronic illnesses and provides preventive care and health education. They have particular skills in treating people with multiple health issues.

On the LA Focus, LA Active, LA Core and LA Comprehensive Options any General Practitioner who participates in the Discovery GP Network is the Designated Service Provider for all GP visits. There are more than 3 000 GPs in this ‘willing provider network’ and you will be able to see whether your GP is participating in this network, by following this link, or find out more by calling 0860 103 933.

If you use one of these providers, you will not be liable for any co-payments as claims would be paid at the Scheme Rate, directly to the Network provider. If applicable, the specific limits in your Benefit Option will apply. If you do not use the services of a Network GP, your claim will be paid at the Scheme Rate only and we will make the payment to you. You will have to settle the full account with the GP.

On the LA KeyPlus Option, any GP in the KeyCare GP Network is the Scheme’s Designated Service Provider. If you do not use the services of one of the KeyCare GPs for in- and out-of-hospital consultations, benefits will be limited or you will have to pay for the treatment. You will be able to see whether your GP is participating in this network, by following this link, or find out more by calling 0860 103 933.

Cover for GPs is dependent on the benefits offered by your Option.

 In hospitalOut of hospital
LA Comprehensive

Consultations are covered in full at the Scheme’s network providers.

Consultations at non-network providers will be covered up to the Scheme Rate.  

Consultations are covered in full from available funds in MSA or Above Threshold benefit at the Scheme’s network providers.

Consultations at non-network providers will be covered up to the Scheme Rate

LA Core

Consultations are covered in full at the Scheme’s network providers. 

Consultations at non-network providers will be covered up to the Scheme Rate.

Consultations are covered in full from available funds in MSA or Extended Day-to-Day Benefit at the Scheme’s network providers.

Consultations at non-network providers will be covered up to the Scheme Rate

 

LA Active

Consultations are covered in full at the Scheme’s network providers.

Consultations at non-network providers will be covered up to the Scheme Rate.

Consultations are covered in full from available funds in MSA or Extended Day-to-Day Benefit at the Scheme’s network providers.


Consultations at non-network providers will be covered up to the Scheme Rate

 

LA Focus

Consultations are covered in full at the Scheme’s network providers.

Consultations at non-network providers are covered up to 100% of the Scheme Rate.

Consultations are covered in full from available funds in MSA at the Scheme’s network providers.

Consultations at non-network providers will be covered up to the Scheme Rate

 

LA KeyPlus

Consultations are covered in full if a KeyCare GP is used

Consultations at non-KeyCare GPs will be for the members own account

No overall limit for consultations - provided that the member’s chosen GP within the Scheme’s DSP network or KeyCare network is used.

For members travelling or on holiday - one (1) out-of-network GP visit is allowed per person per year