FAQ: Cover 

To be certain of your level of cover, you must always read your Table of Benefits in conjunction with your Benefit Guide, to find full details of the cover applicable to you, including definitions and/or exclusions applicable to your plan.

However, for your convenience, we list below some of the most common benefits available under our standard International Healthcare Plans.

Please check your Table of Benefits to confirm if any of the below benefits are included in your cover. Refer to your Benefit Guide to verify if the terms, definitions and exclusions related to your covered benefits are the same as described below, as cover differs depending on the plans available to you.

You can access your Table of Benefits and Benefit Guide via MyHealth Digital Services. Simply login via your browser or use the Allianz MyHealth app, click on “My Policy” and select the “Documents” tab.

Please refer to the specific question/answer below for more detail on the relevant benefit.

a. In-patient treatment

In-patient treatment refers to treatment received in a hospital where an overnight stay is medically necessary.

b. Day-care treatment    

Day-care treatment is planned treatment received in a hospital or day-care facility during the day, including a hospital room and nursing, that does not medically require the patient to stay overnight and where a discharge note is issued.

Please note that any endoscopic procedures such as gastroscopy or colonoscopy are covered under the “Day-care treatment” benefit, except if they are done for routine health check purposes – in that case, they will be covered under the relevant benefit included in your Out-patient Plan, if this is included in your policy. 

c. Out-patient treatment         

Out-patient treatment refers to treatment provided in the practice or surgery of a medical practitioner, therapist or specialist that does not require the patient to be admitted to hospital.

Any regular doctor visits and laboratory tests that do not require overnight stay in the hospital are considered out-patient treatment.

Your cover may be subject to a maximum plan benefit (which applies to certain plans). This is the maximum we will pay in total for all benefits included in the plan per member, per Insurance Year.

If your plan has a maximum plan benefit, it will apply even where:

• The term "Full refund" appears next to the benefit
  
• A specific benefit limit applies - this is when the benefit is capped to a specific amount (e.g. €10,000)

Benefit limits may be provided on a “per Insurance Year” basis, on a “per lifetime” basis or on a “per event” basis (such as per trip, per visit or per pregnancy). In some instances, in addition to the benefit limit, we will only pay a percentage of the costs for the specific benefit (e.g. 80% refund).

All limits are per member and per Insurance Year, unless your Table of Benefits states otherwise. Some plans and benefits may also be subject to a deductible or co-payments or both. Your Table of Benefits will show whether this applies to your plan.

Please note that the benefits “Routine maternity” and “Complications of pregnancy and childbirth” are paid on either a “per pregnancy” or “per Insurance Year” basis. For further information, please refer to the point “Which maternity-related expenses are covered under my plan?”

a. What's a deductible?

A deductible (also known in health insurance as an ‘excess’) is a fixed amount you need to pay towards your medical bills per period of cover before we begin to contribute. Your Table of Benefits will show whether this applies to your plan. 

b. What's a co-payment?

A co-payment is when you pay a percentage of the medical costs. E.g. if a benefit has a 80% refund, this means that a co-payment of 20% applies, therefore we will pay 80% of the costs of each eligible treatment per insured person, per Insurance Year. Some plans may include a maximum co-payment per insured person, per Insurance Year and, if so, the amount will be capped at the figure stated in your Table of Benefits. 

Please refer to your Table of Benefits and Benefit Guide for more information regarding your limits and contribution. You can access your Benefit Guide and Table of Benefits via MyHealth Digital Services. Simply login via browser or use the MyHealth app, click on “My Policy” and select the “Documents” tab.
 

Under the multiple plans we offer, we include a number of different maternity-related benefits. These could be “Routine maternity”, “Complications of pregnancy”, “Complications of childbirth”, “Home delivery”, etc. Depending on the plans available to you, you may be covered for some or all of these benefits. It is therefore important that you refer to your Table of Benefits to confirm which maternity-related benefits are available to you and whether any benefit limits and/or waiting periods apply.

Below we provide you with a generic explanation of the most common maternity-related benefits which you may be covered for, depending on your plan. Please note that the terms (e.g. definitions and exclusions) related to the below benefits may be slightly different depending on the plan you have, so please check your Benefit Guide to confirm your cover.

You can access your Benefit Guide via MyHealth Digital Services. Simply  login via your browser or use the Allianz MyHealth app, click on “My Policy” and select on the documents tab.

a. Routine maternity

Routine maternity refers to any medically necessary costs incurred during pregnancy and childbirth. This includes hospital charges, specialist fees, the mother's pre- and post-natal care, midwife fees (during labour only) as well as newborn care (read the definition of “Newborn care” to verify what we cover under this benefit and the in-patient treatment limits that apply to adopted and fostered children, all babies born by surrogacy and multiple birth babies born as a result of medically assisted reproduction).

We do not cover costs of complications of pregnancy and childbirth under the “Routine maternity” benefit. Caesarean sections that are not medically necessary are covered up to the cost of a routine delivery in the same hospital, subject to any benefit limits. Medically-necessary caesarean sections are paid for under the "Complications of childbirth" benefit (if included in your policy). 

In case of home deliveries, we will pay up to the amount specified in the Table of Benefits if your plan includes the ‘Home delivery’ benefit.

b. Pre-natal care

Pre-natal care includes common screening and follow-up tests as required during a pregnancy. For women aged 35 and over, this includes Triple/Bart’s, Quadruple or Spina Bifida tests, amniocentesis and, if directly linked to an eligible amniocentesis, DNA-analysis.

c. Post-natal

Post-natal care refers to the routine post-partum medical care received by the mother for up to six weeks after delivery.

d. Newborn care

Newborn care includes customary examinations required to assess the integrity and basic function of the child's organs and skeletal structures. These essential examinations are carried out immediately following birth. 

Cover doesn’t include further preventive diagnostic procedures, such as routine swabs, blood typing and hearing tests. However, if for medical reasons the child needs any follow-up investigations and treatment, these are covered under the newborn's own policy (if they have been added as a dependant).

For multiple birth babies born as a result of medically assisted reproduction, all babies born by surrogacy, adopted and fostered children, in-patient treatment is limited to a specified amount per child for the first three months following birth (please consult your Benefit Guide for full details). Out-patient treatment is paid within the terms of the Out-patient Plan (if included in your policy).

e. Complications of pregnancy

Complications of pregnancy relates to the health of the mother. We will cover only the following complications that arise during the pre-natal stages of pregnancy: ectopic pregnancy, gestational diabetes, pre-eclampsia, miscarriage, threatened miscarriage, stillbirth and hydatid form mole.

f. Complications of childbirth

Complications of childbirth refers only to post-partum haemorrhage and retained placental membrane. Where your plan also includes a routine maternity benefit, complications of childbirth includes medically necessary caesarean sections.

g. Maternity-related benefit limits

When a pregnancy spans two Insurance Years and the benefit limit changes at policy renewal, the following rules apply:

• In year one – the benefit limits apply to all eligible expenses.
• In year two – the updated benefit limits apply to all eligible expenses incurred in the second year, less the total benefit amount already reimbursed in year one.
• If the benefit limit decreases in year two and we have already paid up to or over this new amount for eligible costs incurred in year one, we will pay no additional benefit in year two.

Limit for multiple-birth babies, all babies born by surrogacy, adopted and fostered children
There is a limit for in-patient treatment that takes place in the first three months following birth if the baby:

• was born by surrogacy
• is adopted
• is fostered
•  is a multiple-birth baby born as a result of medically assisted reproduction

Check your Benefit Guide to confirm the limit that applies per child. Out-patient treatment is paid under the terms of the Out-patient Plan.
 

h. Maternity-related exclusions

•  Termination of pregnancy, except if the life of the pregnant woman is in danger.
• Treatment directly related to surrogacy, whether you are acting as a surrogate, or are the intended parent.
• Genetic testing, except:
  a) Where specific genetic tests are included within your plan.
  b) Where DNA tests are directly linked to an eligible amniocentesis i.e. in the case of women aged 35 or over.
  c) Where testing for genetic receptor of tumours is covered.
• Pre- and post-natal classes.
• Triple/Bart’s, Quadruple or Spina Bifida tests, except for women aged 35 or over.
• Infertility Treatment
  

Dermatologist consultations and treatments are covered if medically necessary under the “Specialist fees” benefit (if this is listed in your Table of Benefits and therefore included under your plan). If the skin condition is diagnosed by a general medical practitioner rather than by a specialist, then you will be covered under the “Medical Practitioner fees” benefit (if included under your plan).

Dermatology-related exclusions

Please note that normally, depending on the plan available to you, exclusions may be related to dermatological treatments. Please check you Benefit Guide to confirm what exclusions apply to your policy.

You can access your Benefit Guide via  MyHealth Digital Services. Simply login via your browser or use the Allianz MyHealth app, click on “My Policy” and select the “Documents” tab.

For your convenience, we indicate below the exclusions related to dermatology that normally apply to our standard International Healthcare Plans: 

Plastic surgery

Any treatment carried out by a plastic surgeon, whether or not for medical/psychological purposes and any cosmetic or aesthetic treatment to enhance your appearance, even when medically prescribed. The only exceptions are approved gender dysphoria and reconstructive surgery necessary to restore function or appearance after a disfiguring accident, or as a result of surgery for cancer, if the accident or surgery occurs during your membership of the scheme.

Loss of hair and hair replacement
Investigations into, and treatment of, loss of hair and any hair replacement unless the loss of hair is due to cancer treatment.

This cover is available to you if the “Psychiatry and psychotherapy” benefit is listed in your Table of Benefits, either under the Core Plan or under the Out-patient Plan (or in both), depending on the plans available to you. Where covered, your Table of Benefits will also state any benefit limits and/or waiting periods which apply to the cover for psychiatry and psychotherapy.

Our standard definition of the “Psychiatry and psychotherapy” benefit and related exclusions are as follows, although they may vary slightly depending on the plans available to you – please refer to your Benefit Guide for the definition and any exclusions applicable to your plan.

You can access your Table of Benefits and Benefit Guide via MyHealth Digital Services. Simply login via browser or use the Allianz MyHealth app, click on “My Policy” and select the “Documents” tab.

Related definition

Psychiatry and psychotherapy refers to the treatment of mental, behavioural and personality disorders, including autism spectrum and eating disorder. Treatment must be carried out by a psychiatrist, clinical psychologist or licensed psychotherapist. The condition must be clinically significant and the treatment medically necessary. All day-care or in-patient admissions must include prescription medication related to the condition. Out-patient psychotherapy treatment (where covered) requires referral by a doctor and is limited for 10 sessions per condition initially. After every 10 sessions, a psychiatrist must review the treatment. If you need more sessions, you must send us a progress report that indicates the diagnosis and the medical necessity for further treatment.

Counselling is available through our Employee Assistance Programme (EAP) and refers to short-term, solution-focused interventions, and typically deals with current issues that are easily resolved on the conscious level.  This is not meant for longer-term situations or the treatment of clinical disorders. EAP can help you and your immediate family deal with challenging situations that may arise in life, such as stress, anxiety, bereavement, workplace challenges, relationship issues, cross-cultural transition, coping with isolation and loneliness. For more information click here.

Related exclusions

• Family therapy and counselling

Costs in respect of a family therapist or counsellor for out-patient psychotherapy treatment (regardless if your plan includes a benefit for psychiatry and psychotherapy).

If you would like us to confirm cover of the psychiatry or psychotherapy benefit before commencing treatment, please forward us (using the email address below) a detailed medical report from the referring psychiatrist that includes the DSM-IV or ICD-10 code and that indicates the causes or reason of your condition. Our medical team will promptly review the report and will be able to advise you about your cover.

Please note that any psychiatry or psychotherapy treatment due to take place on an in-patient or day-care basis requires submission of a completed Treatment Guarantee Form and approval in advance of treatment.

Find out more about the Treatment Guarantee Process here.

Email:  medical.services@e.allianz.com

If dental benefits form part of your cover, under most of our plans you can simply pay for your treatment and then claim back any eligible expenses via our MyHealth Digital Services.

Any dental benefits available to you are shown on your Table of Benefits along with any deductibles, co-payments, benefit limits, waiting periods or age restrictions which apply. Your Table of Benefits must be read in conjunction with your Benefit Guide for full details of your dental benefits, including definitions and/or exclusions.

For your convenience, below we list the definitions and the exclusions related to dental benefits that apply to our standard International Healthcare Plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm your applicable definitions and exclusions.

You can access your Benefit Guide and Table of Benefits via MyHealth Digital Services. Simply login via browser or use the Allianz MyHealth app, click on “My Policy” and select the “Documents” tab.

Dental-related definitions

01. Dental treatment

Dental treatment includes an annual check-up, simple fillings related to cavities or decay, root canal treatment and dental prescription drugs.
 

02.  Dental prescription drugs

Dental prescription drugs are those prescribed by a dentist for the treatment of a dental inflammation or infection. The prescription drugs must be proven to be effective for the condition and recognised by the pharmaceutical regulator in a given country. They do not include mouthwashes, fluoride products, antiseptic gels and toothpastes.

03. Dental surgery

Dental surgery includes the surgical extraction of teeth, as well as other tooth related surgical procedures such as apicoectomy and dental prescription drugs. All investigative procedures that establish the need for dental surgery such as laboratory tests, X-rays, CT scans and MRI(s) are included under this benefit. Dental surgery does not cover surgical treatment that relates to dental implants.

04. Periodontics

Periodontics refers to dental treatment related to gum disease.

05. Orthodontics

Orthodontics is the use of devices to correct malocclusion (misalignment of your teeth and bite). We only cover orthodontic treatment that meets the medical necessity criteria described below. As the criteria is very technical, please contact us before starting  treatment so we can verify if your treatment meets the criteria.

Medical Necessity Criteria:

a Increased overjet > 6mm but <= 9 mm
b Reverse overjet > 3.5 mm with no masticatory or speech difficulties
c Anterior or posterior crossbites with > 2 mm discrepancy between the retruded contact position and intercuspal position
d Severe displacements of teeth > 4
e Extreme lateral or anterior open bites > 4 mm
f Increased and complete overbite with gingival or palatal trauma
g Less extensive hypodontia requiring pre-restorative orthodontics or orthodontic space closure to obviate the need for a prosthesis
h Posterior lingual crossbite with no functional occlusal contact in one or more buccal segments
i Reverse overjet > 1 mm but < 3.5 mm with recorded masticatory and speech difficulties
j Partially erupted teeth, tipped and impacted against adjacent teeth
k Existing supernumerary teeth

You will need to send us some supporting information to show that your treatment is medically necessary and therefore covered by your plan. The information we ask for may include, but is not limited to:
 

• A medical report issued by the specialist, stating the diagnosis (type of malocclusion) and a description of your symptoms caused by the orthodontic problem.
• A treatment plan showing the estimated duration and cost of the treatment and the type/material of the appliance used.
  
•  The payment arrangement agreed with the medical provider.
• Proof of payment for orthodontic treatment.
• Photographs of both jaws clearly showing dentition before the treatment.
• Clinical photographs of the jaws in central occlusion from frontal and lateral views.
• Orthopantomogram (panoramic x-ray).
• Profile x-ray (cephalometric x-ray).
• Any other document we may need to assess the claim.
   
   We will only cover the cost of standard metallic braces and/or standard removable appliances. However, we’ll cover cosmetic appliances such as lingual braces and invisible aligners up to the cost of metallic braces, subject to the “Orthodontic treatment” benefit limit.
  
  

In summary, the “Orthodontics” benefit covers:

• Braces
• Brackets
• Orthodontist's fees
• Other related treatment such as x-rays or photographs of jaws

Orthodontic treatments take place on an Out-Patient basis. They are usually carried out over the course of several years: however, you do not need to wait until the end of your treatment to be reimbursed. You might submit invoices throughout the duration of your treatment (e.g. quarterly), but only once the part of the treatment relating to the invoice you submit has all taken place. For example, you could submit an invoice at the end of every quarter for the treatment that has taken place in that quarter.


06. Dental prostheses

Dental prostheses include crowns, inlays, onlays, adhesive reconstructions/restorations, bridges, dentures and implants as well as all necessary and ancillary treatment required.


07. Emergency Out-Patient Dental treatment

Emergency out-patient dental treatment is treatment received in a dental surgery/hospital emergency room for the immediate relief of dental pain caused by an accident or an injury to a sound natural tooth. Treatment may include pulpotomy or pulpectomy and the subsequent temporary fillings, limited to three fillings per Insurance Year. Treatment must take place within 24 hours of the emergency event. It does not include any form of dental prostheses, permanent restorations or the continuation of root canal treatment. However, if your policy also includes a Dental Plan, it will cover dental treatment in excess of the (Core Plan) limit on emergency out-patient dental treatment benefit. In that case, the Dental plan terms will apply.

Dental-related exclusions

Dental veneers and related procedures are not covered.

Below you will find the definition related to “Complementary treatment” that apply to our standard International Healthcare Plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions that apply to your policy.

You can access your Benefit Guide and Table of Benefits via MyHealth Digital Services. Simply login via your browser or use the Allianz MyHealth app, click on “My Policy” and select the “Documents” tab.

Complementary treatment 

Complementary treatment refers to therapeutic and diagnostic treatment that exists outside of traditional Western medicine. Please refer to your Table of Benefits to confirm whether any of the following complementary treatment methods are covered: chiropractic treatment, osteopathy, Chinese herbal medicine, homeopathy, acupuncture and podiatry as practised by approved therapists.

Where covered, this benefit does not require pre-approval, therefore you can simply pay for your treatment and then claim back any eligible expenses via our MyHealth Digital Services.

Below you will find the definition related to “Prescribed glasses and contact lenses including eye examination” that apply to our standard International Healthcare Plans. It may vary slightly depending on the plans you have, therefore please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions that apply to your policy.

Prescribed glasses and contact lenses including eye examination provides cover for a routine eye examination carried out by an optometrist or ophthalmologist (one check-up per Insurance Year) and for lenses and glasses to correct vision.

Pre-approval is not required to avail of this benefit but you will need to submit your prescription (stating your dioptre) together with your invoice when claiming your expenses.

You can access your Benefit Guide and Table of Benefits via  your MyHealth Digital Services. Simply login via your browser or use the Allianz MyHealth app, click on “My Policy” and select the “Documents” tab.

Below you will find the definition related to “Diagnostic tests” that apply to our standard International Healthcare Plans. It may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions that apply to your policy.

Diagnostic tests are investigations such as x-rays or blood tests, carried out for diagnostic purposes. These test are covered when you are already displaying symptoms or when needed following other medical test results. This benefit does not cover annual check-ups or routine screenings.

Usually these tests do not require pre-approval, however please be aware that some more invasive tests will need to be pre-approved via submission of a Treatment Guarantee/Pre-authorization Form. Please refer to your Table of Benefits to confirm this.

You can find more information on pre-approval here. 

You can access your Benefit Guide and Table of Benefits via your MyHealth Digital Services. Simply login via your browser or use the Allianz MyHealth app, click on “My Policy” and select the “Documents” tab.

Below you will find the definition related to “Health and wellbeing checks” that apply to our standard International Healthcare Plans. It may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions that apply to you.

You can access your Benefit Guide and Table of Benefits via MyHealth Digital Services. Simply login via your browser or use the Allianz MyHealth app, click on “My Policy” and select the “Documents” tab.

Health and wellbeing checks

Health and wellbeing checks including screening for the early detection of illness or disease are health checks, tests and examinations, performed at appropriate age intervals, that are undertaken without any clinical symptoms being present. Please refer to your Table of Benefits to confirm what tests and checks are covered under this benefit.

Below you will find the definitions related to “Medical practitioner fees” that apply to our standard International Healthcare Plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions that apply to you.

You can access your Benefit Guide and Table of Benefits via  your MyHealth Digital Services. Simply login via browser or use the Allianz MyHealth app, click on “My Policy” and select the “Documents” tab.

Medical practitioner

Medical practitioners are doctors who are licensed to practise medicine under the law of the country in which treatment is given and where they are practising within the limits of their licence.

Medical practitioner fees

Medical practitioner fees refers to non-surgical treatment performed or administered by a medical practitioner. 

Below you will find the definitions related to “Specialist fees” that apply to our standard International Healthcare Plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions that apply to you.

You can access your Benefit Guide and Table of Benefits via MyHealth Digital Services. Simply login via your browser or use the Allianz MyHealth app, click on “My Policy” and select the “Documents” tab.

Specialist

Specialist is a licensed doctor possessing the additional qualifications and expertise necessary to practise as a recognised specialist in diagnostic techniques, treatment and prevention in a particular field of medicine.

Specialist fees

Specialist fees refers to non-surgical treatment performed or administered by a doctor. 

This benefit does not include cover for psychiatrist, psychologist fees or any treatment that is already covered by another benefit under your Table of Benefits. We don't cover specialist treatment that is excluded under your policy.

Any fee applied for an eligible consultation or treatment provided by a qualified specialist, i.e. ENT, endocrinologist, gynaecologist, cardiologist, etc. will be covered under the “Specialist fees” benefit.

 If the “Specialist fees” benefit is listed in your Table of Benefits, cover will be provided in line with the terms and conditions of your policy without the need for pre-approval, i.e. on a pay and claim basis.

However, if the specialist fees you need to pay are related to an in-patient treatment (or to any treatment which require pre-approval, as stated in your Table of Benefits) you will need to complete and send us a Treatment Guarantee/Pre-authorization Form, to enable us to organise the settlement of your bill directly with the hospital (where possible).

Please be aware that in some countries you might have to visit your doctor/ general practitioner to obtain a referral for a specialist consultation.

Below you will find the definitions related to physiotherapy that apply to our standard International Healthcare Plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions and exclusions that apply to you.

You can access your Benefit Guide and Table of Benefits via MyHealth Digital Services. Simply log via browser or use the app, click on “My Policy” and select the “Documents” tab.

Non-prescribed physiotherapy

Non-prescribed physiotherapy refers to treatment provided by a registered physiotherapist without being referred by a doctor in advance. Where this benefit applies, cover is limited to the number of sessions indicated in your Table of Benefits. A doctor must prescribe any additional sessions over this limit, which will be covered under the prescribed physiotherapy benefit. Physiotherapy does not include therapies such as Rolfing, Massage, Pilates, Fango and Milta.

Prescribed physiotherapy

Prescribed physiotherapy refers to treatment provided by a registered physiotherapist following referral by a doctor. Physiotherapy (either prescribed, or a combination of nonprescribed and prescribed treatment) is initially restricted to 12 sessions per condition, after which treatment must be reviewed by the doctor who referred you. If you need further sessions, you must send us a new progress report after every set of 12 sessions, indicating the medical necessity for more treatment. Physiotherapy does not include therapies such as Rolfing, massage, Pilates, Fango and Milta.

If the “Prescribed physiotherapy” benefit is included in your cover, it doesn’t require pre-authorization, therefore you must pay for the sessions received and submit the bills for reimbursement to us, together with the referral or prescription from your treating doctor. Please note that if you are claiming for multiple sessions, you will need to provide the breakdown of costs and dates of each individual session.

We cover treatment for medical expenses arising from injuries sustained while both on- and off-piste skiing or while trekking as part of a leisure activity, if medically necessary. The treatment is covered within the limits of your plan and your geographical area of cover.

However, please note that treatment or diagnostic procedures for injuries arising from an engagement in professional sports are not covered at any circumstances.

If you need to be transported to a hospital and you can be reached by a ground ambulance, the costs for the ambulance is covered under the benefit "Local ambulance" listed in your Table of Benefits under your Core Plan. However, if you cannot be reached by ground ambulance due to being in a remote location, you may need to be transported off the mountain by the Army, Emergency Services, a specialist rescue company or similar and these costs are not covered under your plan.

If you need to be evacuated/repatriated following admission to hospital due to the required medical treatment is not available locally, costs for this will be covered under the “Medical evacuation” or “Medical repatriation” benefits, if included under your plan and if all conditions for eligibility under these benefits are met.

Please refer to your Table of Benefits and Benefit Guide for more information regarding your level of cover and specific benefit information.

You can access your Benefit Guide and Table of Benefits via MyHealth Digital Services. Simply login via browser or use the app, click on “My Policy” and select the “Documents” tab.

We cover treatment for medical expenses arising from injuries sustained while practicing any water sports if medically necessary. The treatment is covered within the limits of your plan and your geographical area of cover.

However, please note that treatment or diagnostic procedures for injuries arising from an engagement in professional sports are not covered at any circumstances.

If you need to be transported to a hospital and you can be reached by a ground ambulance, i.e. in-shore, the costs for the ambulance is covered under the benefit "Local ambulance" listed on your Table of Benefits under your Core Plan. However, if you cannot be reached by ground ambulance due to being off-shore or in a remote location, you may need to be transported by the Army, Emergency Services, a specialist rescue company or similar and these costs are not covered under your plan.

If you need to be evacuated/repatriated following admission to hospital because the required medical treatment is not available locally, costs for this will be covered under the “Medical evacuation” or “Medical repatriation” benefits, if included under your plan and if all conditions for eligibility under this benefit are met.

Please refer to your Table of Benefits and Benefit Guide for more information regarding your level of cover and specific benefit information. 

You can access your Benefit Guide and Table of Benefits via MyHealth Digital Services. Simply login via browser or use the app, click on “My Policy” and select the “Documents” tab.