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Ziektekosten verzekering

Medical Safety

Good health is precious and priceless. To better protect your health as well as the health of your loved ones, Generali offers "Medical Safety". The following are included in the new version of health insurance, "Medical Safety".

Hospital Medical Care
arrow Before and after Medical Benefits
arrow Coverage of expenses for hospitalization abroad
arrow Coverage of expenses for exterior medical care
arrow Annual prevention medical check-up
arrow Hospitalization and surgical benefits
arrow Maternity benefits
arrow Generali Tele-Communication Centre
arrow Emergency Air Transport
arrow Medical Card
arrow Benefit of Good Use
arrow Law Protection Coverage

MEDICAL SAFETY

HOSPITAL COVERAGE
In case the insured client is admitted to hospital or a clinic or is treated by first-aid in an outside surgery because of an accident or illness, Generali will pay the expenses in full up to the limit of each accident or illness as written in the "List of Benefits" of the Insurance Policy and in general: hospital room and meals, doctor's bills (surgeon, anaesthetist) opening of the surgery, medicine, lab analysis, e-ray tests, nurse's fees, transportation to hospital or clinic by ambulance, blood transfusion, plain or cast bandage, brace or physical therapy during the hospital stay. Hospital fees are also those diagnoses made 30 days before and 60 days after the surgical operation done in hospital or clinic, and the expenses for lab tests, medicine or physical therapy which was applied up to 60 days after operation.

We also cover:
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Surgical operations without admission to hospital
On condition that the insurance company is informed of the operation before admission and is approved of the fee coverage. If the operations take place in the USA or Canada, 90 % coverage is available.
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Coverage of Air Transport
Full fee coverage of air transport is available in Greece and the European Union, provided that contact is made with the Doctor's Coordinate Centre.
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Hospitalization without Request of Compensation
In case our client requests to not receive compensation, Generali will pay 130.00 Euros daily for a limit of 15 days. In "Intensive Care" we will pay 190,00 Euros daily. In case of surgical operation, Generali will also give a benefit for surgical operations according to the nature of the operation and in general: A very small operation: 100,00 Euros, a small operation: 200,00 Euros, a medium operation: 350.00 Euros, a large operation: 500.00 Euros, a serious type of operation: 700,00 Euros, a very serious type of operation: 1.200,00 Euros and an exceptionally difficult operation our client will receive a benefit of 2.000,00 Euros.
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Private Nurse
A full coverage for the fee of a private nurse is covered if it is absolutely necessary.
arrow Room Accommodation and Meals
The insured has the possibility to select one of the below categories for room and meals:

Luxury -- A class -- B class -- C class

The insured can be hospitalized in a higher class than first chosen if he takes part in the expenses of hospitalization. The percentage of his share in expenses according to the chart:
arrow From 3rd class to 2nd class – 15 %
arrow From 3rd class to 1st class – 30 %
arrow From 3rd class to Luxury class – 50 %
arrow From 2nd class to 1st class – 15 %
arrow From 2nd class to Luxury class – 30 %
arrow From 1st class to Luxury class – 15 %
arrow Maternity Benefit
A time period of 24 months from the date of signature must pass to receive a benefit amount as an after birth allowance.
The amount given depends on the category appointed: Luxury – 2.000,00 Euros, 1st class – 1.600,00 Euros, 2nd class – 1.300,00 Euros and 3rd class – 1.000,00 Euros.
The benefit amount increases by 50 % after the first 5 years providing that the policy is still valid and in use.
arrow Check-ups
An annual check-up is fully covered by the doctors in our medical appointed program.
Tests covered are: General blood tests, T.K.E. , general urine tests, diabetics tests, uric acid tests, cholesterol, triglycerides, HDL, LDL, SFOT, SDPT, and cardiological tests.
arrow Law Protection
Provided are also law fees which cover up to 3.000,00 Euros for each situation. The program for legal coverage includes protesting for compensation against the hospital – clinic for:
1. Negligence during a surgical operation.
2. False diagnosis by a doctor of the hospital
3. Wrong type of medical treatment assigned to the patient which is the responsibility of doctors or nursing employees, and for cases which occurred from the insured's compensation claim from his insurance policy.
arrow Adjustment on sections of limited benefits
Adjustments can be made on high limitations.
a) on the highest amount of benefit
b) the limit of compensation of nursing or surgical operations
c) the amount that the insured is requested to pay
d) the fees for surgeons and anaesthetists,
e) benefit fee for maternity,
f) an amount to cover legal protection.


INSURANCE CHARGES

Payment Settlement Charge
You can charge the monthly payment to your credit card or pay by bank order, without paying an extra charge. When the payment is every six months, you are charged with an extra fee of 2% on the net amount of the insurance policy.

Insurance Policy Rights
Upon the payment of the first receipt, there is a right of policy in the amount of 30.00 Euros. This amount is charged with a tax policy of 10% and the legal fee of 2.4%.


HOSPITALIZATION – EXTERNAL MEDICAL CARE

Medical Card
A card for medical care is issued stating hospitals that are in our medical policy.

Coverage for Hospital abroad
After the removal of the participating amount which has been chosen beforehand, the insured is covered:
arrow 100 % for situations that need hospitalization abroad except for the USA or Canada
arrow 90 % for situations that need hospitalization in the USA and Canada.

Participation Exemption
The insured can choose one of the following programs:
Plan 1
Plan 2
Plan 3
Plan 4
Plan 5
0
1.000,00
2.500,00
5.000,00
10.000,00
These are exemptions in Euros.

Exemption is when the insured is hospitalized or in a private clinic and he pays the first amount of the bill according to the agreed plan above and the rest is paid in full by the insurance company. In the exemption paying program, the insured can also use another insurance coverage such as IKA, TEBE or some other policy.

Coverage of 100 %
After the removal of the exemption which the insured has already chosen, and upon informing the Medical Coordinating Centre, the insurance company will cover 100 % of all expenses made.

Waiting period for illnesses
arrow One month in Greece
arrow 6 months outside of Greece.

Contract Rights
When the benefit is given without Stand Alone the net insurance fee is charged with an extra 15 % for the rights of contract.

Highest annual limit coverage
150.000 Euros
300.000 Euros
500.000 Euros
1.000.000 Euros

Highest age limit
Up the 60 years old is eligible for insurance.

Highest age limit for expiring policies
When a Basic Life Coverage is requested for life or in an independent policy the same, then it is life time coverage of the insured.

Members included in the policy
Coverage is applied to the husband/wife of the insured as also the children up to the age of 18 or 25 if they are still in school studying. There is a discount of 40 % for each child.

Members between 46 – 60 years old
Those who want to be insured between the ages of 46 to 60 years old are request to have a full check-up before the policy is signed. All expenses here are also fully covered by the company.
Note: If there are already some health problems such as Diabetes, Cancer, HIV (AIDS) or any other serious illnesses or injury from an accident which has caused a serious problem in health, the insurance company does not cover such situations.

HOSPITALIZATION – EXTERNAL MEDICAL CARE
ACCIDENT OR ILLNESS MEDICAL CARE

External Medical Care
Medical Coordinating Centre
The Medical Centre is open 24 hours a day and gives medical advice by phone. It is responsible for acting upon services and benefits of hospitalization and external medical care.
Medical appointments from doctors of the Centre
Once the patient has contacted the Medical Coordinating Centre where he books an appointment, the centre will cover all expenses. These appointments are made at the co-operating doctor's offices. This is valid for the whole Greek State and for numerous visits throughout the year. (There is a small participating fee after the first five visits – 10 Euros per visit.)

Medical visits home from the participating doctors
In emergency cases and after contacting and arranging by telephone with the Medical Coordinating Centre, the company will cover all expenses of the house-call made by the doctor. This is valid for the whole Greek State and for numerous house-calls throughout the year with a small participating fee.

Coverage of medical visits to personal doctors
Visits to personal doctors are covered by 50 % of the expenses and up to a limit of Euros 40.00 for every appointment with a limit of 5 visits per year.

Diagnosis for Tests
All diagnosis tests in participating labs of the company are covered up to 85% of the amount. The first 15% is the insured. They must have been requested by a participating doctor or personal doctor as necessary.

Pre-natal Check-ups
Coverage is provided of the insured to take any pre-natal check-ups after a period of 15 (fifteen) months since the beginning of the policy or after a renewal. This provides the possibility to repeat tests because of abnormal results one more time during the period of pregnancy.

Child-care
All coverage of expenses for children of the insured to carry out customary preventative vaccinations done by participating doctors of the Medical Coordinating Centre.

For more information please contact your Insurance Agent at insurance@ktimatoemporiki.gr
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