What is this insurance?
We reimburse medical expenses for health goods and services in the conditions of Outpatient and Hospital medical care, as a result of illness or accident of your employees and members of their families.
What does the insurance cover?
Basic coverage
Services and goods in a certain volume and limit are grouped into Packages:
- Outpatient medical care;
- Combined medical care - includes hospital and outpatient medical care;
- Reimbursement of expenses.
Ways of using the coverage:
- Reimbursement of expenses - you pay the expenses for the used health goods and services in a medical facility of your choice, after which they are reimbursed from your indurance;
- Subscription service - We pay the costs for health services you use in a medical facility which has a contract with EUROINS JSC.
- A combination of both ways.
Clause Standard- basic coverage
Outpatient medical care
- medical examinations and services; .
- emergency medical care;
- clinical and laboratory tests in volume for diagnosing the health problem - by doctor's appointment;
- clinical-instrumental studies in volume for diagnosis and follow-up of the health problem - by doctor's appointment;
- imaging diagnostics;
- functional studies;
- treatment in outpatient settings - by doctor's appointment;
- physical therapy;
- ambulatory surgical operations, the subject of activity of outpatient medical care;
- day hospital;
- preparation for hospitalization of a sick person and others.
Hospital medical care
- hospitalization with a total duration of up to 30 days in one insurance year, but no more than 7 days;
- medical examination and appointment of treatment;
- clinical and laboratory tests - by doctor's appointment;
- clinical-instrumental examinations - by doctor's appointment;
- operations of small and medium volume and complexity;
- selection of doctor/team in operative studies;
- medical consumables and/or implants during operative interventions;
- rehabilitation, physiotherapy;
- sanitary transport and others.
Reimbursement of health care products
- medicines for outpatient and hospital care - as prescribed by a doctor;
- medical consumables for outpatient and hospital care;
- aids in outpatient care;
- aids in hospital care;
- dioptric lenses for spectacles or lenses for vision correction
Clause Premium – extended coverage by volume and type
Outpatient medical care
- medical examinations and services;
- emergency medical care;
- clinical laboratory tests in volume for diagnosing the health problem - by doctor's appointment, including tumor markers and genetic tests;
- clinical-instrumental studies in volume for diagnosis and follow-up of the health problem - by doctor's appointment, including osteodensitometry;
- imaging diagnostics;
- functional studies;
- treatment in outpatient settings - by doctor's appointment;
- examination for diagnosis and removal of benign skin formations by cryotherapy, laser therapy or electrocoagulation;
- medical examination and certification.
Hospital medical care
- hospitalization with a total duration of up to 30 days in one insurance year, but no more than 7 days, including in a private room;
- medical examination and appointment of treatment;
- clinical and laboratory tests - by doctor's appointment;
- clinical-instrumental examinations - by doctor's appointment;
- operations of large and very large volume and complexity;
- selection of doctor/team in operative studies;
- medical consumables and/or implants during operative interventions;
- rehabilitation, physiotherapy;
- psychotherapeutic treatment;
- sanitary transport and others.
Reimbursement of health care products
- medicines for outpatient and hospital care - as prescribed by a doctor, including vitamins and nutritional supplements;
- medical consumables for outpatient and hospital care;
- out-of-hospital aids, including a hearing aid.
- aids in hospital care;
- dioptric lenses for spectacles or lenses for vision correction.
Additional covers
We recommend that you extend your coverage with one or more additional Packages.
Each additional cover is selected only in combination with one of the basic packages.
Improving health and preventing disease - Organized prevention
- includes agreed preventive examinations and tests, which are provided once for one insurance year and are organized by Euroins JSC.
Health services for pregnant women
- pregnancy monitoring;
- childbirth - in case the Combined health care package is selected.
Outpatient dental care
- preventive, therapeutic, surgical, orthopedic dental care;
- x-ray diagnostics;
- emergency medical care.
Where does the insurance apply?
On the territory of the Republic of Bulgaria.
Insurance conditions
What is the duration of the Insurance cover?
For a period of one year.
What are the limits of liability?
The scope of services and liability limits are agreed in the insurance package.
Necessary documents for taking out insurance:
- Questionnaire
- List of insured persons (for family and group insurance)
- Personal health declaration (only for individual, family and group policies for up to 50 persons)
- Other documents - additional documents requested in connection with the issuance of a policy or an addendum to it cat.
Documents
- Информационен документ за групова медицинска застраховка
- Общи условия Медицинска застраховка
- Въпросник-предложение Групова Медицинска застраховка
- Бланка Искане за завеждане на претенция за възстановяване на разходи за здравни стоки/или услуги по медицинска застраховка
- Декларация за изплащане на обезщетение на дете
- Декларация за трето лице
- Обичайни и разумни разходи, в сила от 01.04.2024 г.
- Обичайни и разумни разходи, в сила от 16.01.2024 г. до 31.03.2024 г.
- Информация за всички лечебни заведения от групата на Аджибадем Сити Клиник
Често задавани въпроси
Where can I buy insurance?
You can also buy insurance at any office of Euroins Insurance JSC, as well as through insurance intermediaries who have a valid contract with the company.
How can I pay the insurance policy premium?
or on-site at any Agency of Euroins Insurance JSC, as well as by bank transfer to the account specified in your insurance policy.
When paying by bank transfer, it is necessary to quote the number of your insurance policy in the payment order.
When does the insurance contract come into force?
In the case of motor CASCO insurance, the policy comes into effect after an inspection of the vehicle and installation of a GPS in cases where it is necessary.