Contract
What’s the minimum contract duration?
The contract per insured person is concluded for 12 months and then automatically renews if not canceled. After the minimum duration of 12 months the contracted can be canceled monthly.
What happens if my team member leaves the company?
There are several options:
- In any case your team member will be offered the option to keep the health insurance coverage in their own name (means paying for it themselves). This way they don’t risk to loose their health insurance coverage just by leaving one employer.
- If the person leaves before the minimum duration of 12 months is reached and don’t want to keep the coverage we will grant an extraordinary termination right if you proof the ending of the employment (e.g. with a copy of the termination letter or in case it’s a board member with the note of the deletion from the company register).
Premium payment
Which payment methods do you offer?
As of now the payments are received by bank transfer to Dr. Walter. Credit card payments will be offered at a later stage.
Claims
How do I claim a reimbursement?
The expenses must be proven by the originals of the invoices or by copies of the invoices confirming the benefits provided by other
insurers or health insurers. Medical bills must include:
- name of the treated person,
- designation of all diseases,
- information about the individual medical services with clauses of the applied fee schedule,
- treatment data.
The evidence should be submitted no later than March 31 of the year following the medical treatment.
In what currency do I receive reimbursements?
All reimbursements are paid in Euro.
Costs incurred in a foreign currency are converted into euros at the current exchange rate on the day the receipts are received by
the insurer. The rate of the day is the official euro exchange rate of the European Central Bank. For non-traded currencies for which
no reference rates have been fixed, the rate according to “Exchange Rate Statistics”, published by the Deutsche Bundesbank,
Frankfurt/Main, shall apply according to the latest status, unless the insured person proves by bank receipt that he/she has acquired
the foreign currencies required for payment of the invoices at a less favorable rate.
What if the receipts and medical bills are in a foreign language?
Translation costs are not deducted from the benefits. Costs for transfer of insurance benefits will be deducted from the benefits only if they are incurred because the insurer makes bank transfers abroad at the policyholder’s request or chooses special forms of bank transfer.
Benefits
Which practitioners may I choose?
The insured person is free to choose among physicians and dentists who are licensed to provide medical treatment under the law applicable to the country of stay. The services of therapists who are licensed in the country of residence and practice recognized medical professions there (e.g., non-medical practitioners, chiropractors, physiotherapists, osteopaths) may also be used.
Which hospitals can I choose?
In the case of medically necessary inpatient treatment, the insured person is free to choose from among the hospitals generally recognized in the country of stay, which are under permanent medical supervision, have adequate diagnostic and therapeutic facilities, work according to generally accepted scientific methods, and keep medical records
Are there any waiting periods?
There is a 10-month waiting period for dentures, tooth and jaw adjustment (orthodontic treatment), childbirth, and psychotherapy. In the event of an accident, the waiting periods for dentures as well as tooth and jaw adjustment (orthodontic treatment) do not
apply. There is a 2-year waiting period for surgical measures to correct refractive errors (e.g., LASIK), including the necessary pre- and postoperative examinations
Waiting periods are calculated from the start of the insurance.
Accounting
How can I expense the premiums in my company?
Details depend on the accounting rules of your country. In general you can say that health insurance, agreed as a part of the compensation scheme with your team members, can be expensed just like salary.
Different rules may apply for family members who are not part of your business (e.g. fringe benefits tax in Estonia). Here it might make sense to reimburse the respective amount to the company to avoid taxation.
In any case: Consult your local accountant or tax advisor.