Compare our Core Plans for Individuals

The different geographical areas of cover are:

• Worldwide which provides cover anywhere in the world
• Worldwide excluding the USA
• Africa only

Certain treatments and costs require the member to submit a Treatment Guarantee Form in advance. Following approval by Allianz Worldwide Care, cover for these required treatments or costs can then be guaranteed. In the Table of Benefits, benefits which require pre-approval through submission of a Treatment Guarantee Form are indicated by either a or a . These benefits are listed below, along with further important details on the Treatment Guarantee process:

• All in-patient benefits as listed 
• Day-care treatment 
• Out-patient surgery 
• MRI  (Magnetic Resonance Imaging) and PET  (Positron Emission Tomography) and CT/PET  scans
• Nursing at home or in a convalescent home 
• Complications of pregnancy 
• Routine maternity including complications of childbirth  (in-patient treatment only)
• Oncology  (in-patient and day-care treatment only)
• Occupational therapy  (out-patient treatment only)
• Rehabilitation treatment 
• Medical evacuation  (or repatriation  where covered)
• Repatriation of mortal remains 
• Expenses for one person accompanying an evacuated/repatriated person 
• Palliative care and long term care 

For benefits marked with a or a in the Table of Benefits, the member and their physician will need to complete the relevant sections of a Treatment Guarantee Form and send it to us for approval prior to commencement of treatment. We should be contacted at least 5 working days before receiving treatment, so that we can ensure that there will be no delays at the time of admission.

In the case of an emergency, we should be informed within 24 hours of the event to ensure that no Treatment Guarantee penalty will apply to the claim.

If Treatment Guarantee is not obtained for the benefits listed with a , we reserve the right to decline a claim. If the respective treatment is subsequently proven to be medically necessary, we will pay only 80% of the eligible benefits.

If Treatment Guarantee is not obtained for the benefits listed with a , we reserve the right to decline a claim. If the respective treatment is subsequently proven to be medically necessary, we will pay only 50% ofthe eligible benefits.

Allianz Worldwide Care has a simple claiming process in place to ensure that members can seek reimbursement for medical expenses.

Fully completed Claim Forms are processed and payment instructions issued to the member’s bank within 48 hours. Where further information is required to complete the claim, the member/medical practitioner will automatically be notified by email or mail within 24 hours of receipt of the Claim Form. An email is sent automatically to the member (where email addresses are provided to us) to advise them when the claim is received and when it is processed.

This swift claims processing policy ensures that our members receive their claims payment in the most effective and efficient manner.

Both the Claim Form and Treatment Guarantee Form are available to download here.

There are two kinds of benefit limits shown in the Table of Benefits: The maximum plan benefit, which applies to certain plans, is the maximum we will pay for all benefits in total, per member, per Insurance Year, under that particular plan. Some benefits also have a specific benefit limit which is applied separately, for example 'Nursing at home or in a convalescent home'. Specific benefit limits may be provided on a 'per Insurance Year' basis, a 'per lifetime' basis or on a 'per event' basis, such as per trip, per visit or per pregnancy. In some instances we will pay a percentage of the costs for the specific benefit e.g. '65% refund, up to £3,650/€5,000/$7,100'. Where the term 'Full refund' appears next to certain benefits, please note that this refund is subject to the maximum plan benefit, if one applies to your plan(s).

The Table of Benefits provides an outline of the cover we provide under each plan. However, please note that this cover is subject to our policy terms and conditions. These are detailed in our Individual Benefit Guide, which is issued to members upon policy inception. If you have any queries, please do not hesitate to contact us.