Frequently Asked Questions

A : Most insurance companies exclude cover for all pre-existing conditions during the first two years of membership. After this period this exclusion may be removed provided the insured has been treatment, symptom and advice free for the continuous two year period since taking the medical cover. This has to be accepted and approved in writing.
Some plans can cover pre-existing conditions subject to loading and full underwriting/disclosure at application stage.

A : Claims are generally payable up to the annual maximum limit as specified in your policy schedule. Certain treatments have their own sub-limits.

A : Depending on the type of treatment which is required, claim procedures will differ as follows;
If an insured is hospitalized, they need to produce their medical scheme membership card to the hospital and can be admitted without paying a deposit. This is only applicable if the medical insurance company has a Direct Settlement agreement with that particular hospital.
In this case the hospital will liaise directly with the Insurance company and obtain the necessary payments.
Out-patient claims however normally require the insured to pay the treating doctor or medical facility and submit a claim form later to the insurance provider. This requires a signed claim form (doctor & insured) along with original receipts.
Should a member be hospitalized in a hospital where a Direct Settlement agreement is not in place, the member would be required to settle the bills and then make a claim later.

A : An insured is free to use a Hospital or Doctor/Medical practitioner of their choice provided adequate and suitable treatment can be provided.

A : Most medical providers only require you to complete the medical declaration on the application form. The only time a medical report may be required is when an existing condition has been declared about which the insurance company requires more information.

A : Most international insurers commence cover soon as your application is received by them. Some medical providers may also backdate the cover slightly to suit your needs and compensate for the time delay in receiving the application forms. However some benefits such as pregnancy cover usually have a waiting period, please check your policy terms and conditions for more details.

A : International medical insurance providers have very competitive insurance products which offer high limits and a wide range of benefits and options which may not be available locally. Members of such schemes are covered worldwide (excluding USA ) and do not have to inform the insurance company of their travels. An insured member can seek treatment at the best international medical facilities should they wish. Most providers also offer guaranteed renewal terms, which means no matter how sick the client gets, the provider does not refuse to renew that members cover, unless the client has not paid, mislead the insurance company or failed to observe the policy terms and conditions. International medical covers furthermore provide you with the option of visiting your choice of doctors and medical facilities worldwide.