Advantages of health insurance
Health insurance
Health is a precious commodity.
For you, who are concerned about your well-being and above all want quality service in the field of medical assistance, we have specialists at your disposal to explain the insurance solutions offered by the Insurers.
There are two types of Health Insurance:
- Reimbursement Insurance - The insured person pays his expenses and the Company reimburses him, afterwards.
- Conventional Network Insurance - The insured person uses the services in the agreed Hospitals, Clinics and Doctors, having only to pay the appropriate co-payment (e.g. Médis, Multicare, etc.)
Health Insurance can cover medical expenses, consultations, treatment, medication, hospitalisation, etc., both in Portugal and abroad.
Covers
Hospitalisation
Covers expenses associated with an admission to a hospital or clinic for a period of more than 24 hours. Present at the base of all policies, it includes the payment of the hospital daily charge, room rental, doctors', nurses' and anaesthetists' fees and auxiliary diagnostic elements (tests and examinations necessary for diagnosis).
Ambulatory
It pays for general or specialty medical consultations, auxiliary diagnostic exams and outpatient treatments. It guarantees outpatient hospital care: expenses for minor surgery without hospitalisation, surgeon and assistant's fees, equipment, operating theatre and, in some cases, ambulance transport.
Childbirth
Covers expenses related to pregnancy and childbirth. Apart from natural childbirth, caesarean sections and spontaneous termination of pregnancy are covered. The insurer pays the mother and newborn's hospital stay, the obstetrician and paediatrician's fees, the operating theatre and the medicines administered. In many cases, this coverage is integrated in the hospitalisation, having a capital limit of its own.
Stomatology
It pays for the cost of dental consultations and treatment. In some composite insurance policies, expenses under stomatology cover are only covered when they are covered by the insurer's network of service providers.
Prostheses and orthotics
It covers the purchase of appliances which replace a limb or organ (prostheses) and assist a function (orthotics) if prescribed by a doctor: e.g. wheelchairs, articulated beds, spectacles and graded contact lenses, hearing aids, crutches and orthopaedic prostheses.
Medicines
Covers expenses for medicines. Normally only medicines subsidised by the NHS are covered.
Second medical opinion
In the event of a serious illness (cancer, cardiovascular disease, organ transplants or stroke, for example), the insurer obtains a second medical opinion on the diagnosis or treatment to be followed from specialists worldwide.
International medical cover for serious illness
If the insured person with a serious illness chooses to be treated abroad, this cover pays the costs of hospital care, such as hospitalisation, surgical intervention, examinations and treatment, medicines or surgical prostheses.
Advantages
- Speed - In the National Health Service, access to routine consultations and emergencies may not be immediate, health insurance allows you access to health care more quickly.
- Freedom - How many times have you thought it would be better to change doctors? Health insurance allows you to choose the doctor that suits you best and in the place that is most favourable for you.
- Flexibility - Health insurance gives you the opportunity to use medical care through a network of providers. However, you can always go to a provider that is not part of the agreed network and, in this case, your health insurance will cover part of the health costs. In this way, you always have access to the best medical care at very attractive prices, regardless of the time, place and practitioner.
- Always by your side - Health insurance is not only a resource in emergency situations. Health insurance is a product that allows you to maintain the desired health, investing in prevention and in regular consultations that allow you to monitor your state of health providing the maintenance of a healthy lifestyle.
- For the whole family - Health insurance can be taken out for all family members, supporting and protecting your children from the first day of their life.
Care to be taken
There are several aspects to take into account when choosing to take out a health insurance policy, here are some points that you should consider:
- Illnesses existing at the time the insurance is taken out are, as a rule, always excluded
- Pre-existing illnesses may not be manifested at the date of taking out insurance, which does not mean that they are covered.
- occupational diseases and accidents at work
- nervous disorders and psychiatric illnesses
- accidents or illnesses resulting from participation in sporting competitions
- aesthetic, plastic or reconstructive treatment or surgery and their consequences (unless they result from illness or accidents covered by the insurance)
- weight loss treatments and/or surgery
- check ups and comprehensive health exams
- organ or marrow transplantation
Os designados “co-pagamentos”, ou seja, o valor que cabe a cada Pessoa Segura pagar quando recorre aos prestadores de cuidados de saúde aderentes à rede convencionada, são estipulados por tipo de garantia e por cada utilização, podendo ser um valor fixo ou corresponder a uma percentagem do custo do ato médico.
Period from which the contracted guarantees start to take effect. For example, in the case of out-patient cover, the Insured Persons only start taking advantage of the insurance, normally after 90 days have elapsed. In the case of Childbirth the waiting period is normally 365 days. In case of an accident no waiting period normally applies.
Recently, in order not to increase insurance premiums, insurers have opted to introduce an annual excess for outpatient cover (consultations). They set an amount of expenses (usually between €25.00 and €50.00) up to which the insurance does not cover the expenses incurred. In practice, as a result of the existence of this deductible, the 1st consultation will have to be paid in full by the Insured Person
The information contained in this website is merely indicative. The rights and obligations of the parties are defined in the Proposals, Conditions Special and General applicable terms of the respective insurance policies contracted.