Here we are called to cover the expenses that will be needed if we cross the threshold of the hospital. Expenses for hospitalization, surgeries, medical fees of treating physicians, examinations performed within a hospital and emergency treatment. This category is also called Secondary Care.
The choices we have to make concern the annual coverage capital, the hospitalization position and the deductible amount of exemption. We can add additional coverages such as hospital allowance, surgery allowance, Medical Expenses from Accident, Exemption from Premium Payment etc.
Expenses incurred outside the hospital or otherwise Primary care is the object of insurance in this category.
Having this coverage we mainly cover expenses for medical visits in private clinics and diagnostic examinations in diagnostic centers and polyclinics.
Most programs on the market include Free annual check ups.
They mainly work with a selected contracted network, except for very few programs that allow you to go to your personal doctor.
Expenses incurred by accident (and not by illness) are covered by this category of insurance. Having a Personal Accident contract we buy some Death and Disability funds but also an Accident Medical Expenses (IFE) capital. This ensures the costs of medical fees, diagnostic tests, medications, physiotherapy, but also hospital care costs. It is usually not mandatory to use a network of doctors and diagnostic centers, they are given with small funds and are very economical. They can also be purchased on their own or included in a Primary or Secondary Care program.
Usually the diagnosis of a serious illness incurs additional costs, which are not covered by the Secondary Care programs.
Such could be:
The insurance capital agreed in the contract is paid as a bonus, regardless of whether hospitalization or treatment takes place.
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When I have an exception in my insurance plan, the cost is reduced. The higher the exemption, the lower the annual premiums. However, if another, mainly or not, insurance company is used (EOPYY or group program), my participation is reduced or zeroed! So, in fact, you pay a very small amount up to zero for your medical expenses.
The hospital program also covers – in addition to primary care needs – needs related to hospitalization and the entire hospitalization process. For example: Anesthesiologist Remuneration Surgeon Remuneration Hospital room costs Preoperative and postoperative expenses.
Most insurance companies do not provide hospital coverage if an insured person moves abroad permanently. This is mainly because the premiums cost by their actuaries are adjusted to the Greek medical cost data. In this case we may need to apply for your insurance to another company, possibly abroad. However, in case the time you will need to miss abroad is limited, then upon request some people either accept to give the coverage or keep your contract inactive (without paying premiums) until you return.
Usually not. The usual tactic is that the company requests the medical history of the candidate to be insured, as well as relevant medical opinions. Depending on the profile of the candidate to be insured, as well as the selected program, the company can request pre-insurance examinations. Pre-insurance check is usually requested at the age of 55-60 years.
The change in the cost of treatment due to a difference in the treatment room is borne by the insured. Example: If you have a B-double and the hospital puts you in an A-single, then you will have to pay the cost difference.
If the hospitalization takes place in a Collaborating hospital, you only have to pay the deductable (if any). If you hospitalized in a non-Collaborating hospital, you have to pay the entire treatment costs (in cash, credit etc) and then send the invoices to the insurance company for account compensation.
The supporting documents required are: Declaration of accident or illness. original invoices for services and original invoices of the special materials used for the operation, payment receipts and coupons of medicines that were charged in the invoice of the Hospital and the discharge of the Hospital. Additional supporting documents that can be requested depending on the incident: Information note of the Hospital (for treatment in a state hospital), official translations from the Ministry of Foreign Affairs (for treatment in a hospital abroad), medical history of the hospital, original Health booklet.
Outpatient Programs cover a wide range of health needs, not related to hospitalization / hospital stay. For example: Medical Visits, Medical Operations, Diagnostic Tests, General Preventive Tests.
Inpatient health program : The maximum usual entry age for most insurance companies in Greece is 65 years. There are few who have limit for the entry until 79 years. Foreign companies usually do not have any entry age limit.
Outpatient health program : There are programs in the insurance market without any entry age limit.
A congenital disease is a disease or illness that afflicts someone from the time he/she is born and not those that arise along the way. Some companies cover them normally after a certain waiting time, others cover them with a certain maximum coverage capital amound and some do not cover them at all.
Serious Diseases are diseases or serious accidents-disabilities that change our quality of life significantly. They affect it in such a way that they make our productivity zero and at the same time greatly increase our expenses in order to deal with it. Having a health Care program can cover a large part of the cost of survival, but not all and not always. A serious car accident or stroke in many cases needs rehabilitation in special centers, outside the hospital (and therefore not covered by the health Program). Diseases such as multiple sclerosis or Parkinson’s do not require hospitalization or surgery, but have incalculable costs at home. The reason you need coverage for Serious Illness is to cover financially all the expenses required in cases where you do not go to the hospital and the coverage capital is is given as an extra amount after the onset of the disease.
Yes. The given annual increase is due to the age adjustment, as every year the insurance company re-invoices your new age. After all, the older you are, the statistically more likely you are to get sick and get hospitalized. In addition to this increase, the insurance company can make an additional increase in the following cases: if there is an increase in medical inflation, if the total hospital and medical operation rates increase, as well as if there is an increase in the maximum coverage capital set by the insurance policy, where the relevant premium is additionally collected. The increase in insurance premiums is not affected by how often the insured uses the benefits of his insurance policy but is applied together in all insurance policies of all customers. Insurance companies do not want to make big increases, on the contrary I estimate that they prefer to be limited only to the age adjustment. The increase in premiums is one reason to lose healthy customers (as they will look for a cost-effective solution elsewhere) and many times fines are imposed after court decisions for huge increases.
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