The following plans are only available for corporate groups of three employees or more. Out-patient Plans can be purchased with any of our Core Plans. They cannot be bought separately. These plans are valid from 1st November 2012.
Maximum plan benefit
Out-patient Plan Benefits
Medical practitioner fees and prescription drugs
Chiropractic treatment, osteopathy, homeopathy, Chinese herbal medicine and acupuncture
(max. 12 sessions per condition for chiropractic treatment and max. 12 sessions per condition for osteopathic treatment, subject to the benefit limit)
Prescribed physiotherapy, speech therapy, oculomotor therapy and occupational therapy 
Routine health checks including screening for early detection of illness or disease
- Annual pap smear
- Mammogram (for women aged 50+, or earlier where a family history exists)
- Prostate screening (for men aged 50+, or earlier where a family history exists)
Well child test (for children up to the age of six years, up to a maximum of 15 visits per lifetime)
(18 month waiting period applies)
€12,000 per lifetime
€12,000 per lifetime
Psychiatry and psychotherapy
(18 month waiting period applies)
Prescribed medical aids
Prescribed glasses and contact lenses
Out-patient Plan Deductibles
The following are the optional Out-Patient Plan deductibles payable per person, per Insurance Year. To reduce your Out-patient Plan premium, simply select a deductible from the list below and read across to find the relevant premium discount. Our premiums are expressed in whole numbers (i.e. without any cents or pence etc.), therefore, percentages may be slightly higher or lower than those stated below.
0% out-patient premium discount
10% out-patient premium discount
20% out-patient premium discount
45% out-patient premium discount
70% out-patient premium discount
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.
2. Treatment Guarantee
Certain treatments and costs require submission of 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:
All in-patient benefits as listed .
Day-care treatment .
Out-patient surgery .
MRI (Magnetic Resonance Imaging) scan. Treatment Guarantee may be required for this test if you would like us to settle the bill directly with the medical provider.
PET (Positron Emission Tomography) and CT-PET scans.
Nursing at home or in a convalescent home .
Routine maternity and complications of pregnancy and childbirth (in-patient treatment only)
Oncology (in-patient and day-care treatment only).
Medical evacuation (or repatriation where covered).
Travel costs of insured family members in the event of an evacuation/repatriation .
Repatriation of mortal remains .
Travel costs of insured family members in the event of the repatriation of mortal remains .
Expenses for one person accompanying an evacuated/repatriated person .
Palliative care and long term care .
We should be contacted at least five working days before receiving treatment, so that we can ensure that there will be no delays at the time of admission. This will ensure that members benefit from cashless access to hospitals for in-patient treatment, where possible, and have their treatment overseen by our team of medical professionals.
In the case of an emergency, we should be informed within 48 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 claims 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 48 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 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, 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 £4,150/€5,000/$7,100/CHF6,500”. Where a specific benefit limit applies or where the term ”Full refund” appears next to certain benefits, the refund is subject to the maximum plan benefit, if one applies to your plan(s). All limits are per member, per Insurance Year, unless otherwise stated in your Table of Benefits.
5. Policy terms and conditions
Please note that cover for smaller groups is subject to underwriting i.e. cover may be excluded for pre-existing conditions, or a higher premium rate may apply to reflect the higher risk due to pre-existing medical conditions or additional risk factors. Cover is conditional upon acceptance of your application, which is only confirmed when an Insurance Certificate is provided. This Table of Benefits provides an outline of the cover we provide under each plan. Cover is subject to our policy terms and conditions, as 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.