| Out-patient Plans |
| The following plans can only be purchased with a Core Plan, they cannot be purchased separately. These plans are valid from 1st November 2008. To change currency, please use the dropdown menu above. |
| Gold | Silver | Bronze | Crystal | ||
Maximum plan benefit | No Limit | €9,000 | €4,500 | €2,500 | |
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Out-patient Benefits | ||||
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Medical practitioner fees and prescription drugs * This amount is payable in addition to the overall maximum benefit amount. | Full refund | Full refund | €1,000 * | €1,000 |
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Specialist fees | Full refund | Full refund | Full refund | Full refund |
Diagnostic tests | Full refund | Full refund | Full refund | Full refund | |
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Vaccinations | Full refund | Full refund | Full refund | N/A |
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Chiropractic treatment, osteopathy, homeopathy, Chinese herbal medicine and acupuncture | Full refund | Full refund | €1,125 | €500 |
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Prescribed physiotherapy, speech therapy, oculomotor therapy and [occupational therapy ] | Full refund | Full refund | €1,125 | €500 |
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Routine health checks | €800 | €600 | N/A | N/A |
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Infertility treatment (18 month waiting period applies) | €12,000 per lifetime | €12,000 per lifetime | N/A | N/A |
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Psychiatry and psychotherapy (18 month waiting period applies) | 30 visits | 20 visits | N/A | N/A |
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Prescribed medical aids | Full refund | €2,500 | N/A | N/A |
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Prescribed glasses and contact lenses | €200 | €180 | N/A | N/A |
| Out-patient deductibles |
| The following are the optional Out-Patient Plan Deductibles payable per person per Insurance Year. To reduce your Out-patient Plan premium, select a deductible from the list below and read across to find the relevant Out-patient premium discount. |
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No deductible: | 0% Out-patient premium discount | ||||
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€100 deductible: | 10% Out-patient premium discount | ||||
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€200 deductible: | 20% Out-patient premium discount | ||||
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€500 deductible: | 45% Out-patient premium discount | ||||
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€1,000 deductible: | 70% Out-patient premium discount |
Notes |
1. Area of cover |
Allianz Worldwide Care offers a range of options in relation to geographical cover. The chosen area of cover will be specified in the Insurance Certificate. |
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:
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. |
3. Claims process and turnaround |
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. |
4. Benefit limits. |
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). |
5. Policy terms and conditions. |
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 Employee Benefit Guide, which is issued to members upon policy inception. If you have any queries, please do not hesitate to contact us. |