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INFORMATION ON HEALTH INSURANCE PROGRAMS
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Health insurance programs are divided into classes „Standard”, „Comfort”, and „VIP”.
„Standard” class covers provision and payment to the Insured of medical care (service) in the volume specified by the treatment procedures approved by the Ministry of Health of Ukraine, the List of medical services and the limits of their costs provided in the Annex No.3 to the Rules and the corresponding Health insurance programs.
„Comfort” class in addition to the List of medical services and the limit of their cost of „Standard” class covers provision and payment to the Insured of medical care (services) of enhanced level and in the quantity as specified in the Annex No.4 to the Rules.
„VIP” class covers provision and payment to the Insured of medical care (services) through the network of private hospitals which satisfy the high level of medical standards, as specified in the Annex No.5 to the Rules.
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„А” program („HOSPITAL”)
The program covers provision and payment within the sum insured and the set treatment procedures approved by the Ministry of Health of Ukraine, the List of medical services and the limits of their costs provided in the Annexes No. 3,4,5 to the Rules, in-patient emergency in hospitals with which the Insurer has concluded the necessary contracts, in general and specialized departments.
Hospitalization is effected within 1-3 days since receipt of the appointment card or immediately in case of an acute illness or an accident. Payment for the medicine necessary for treatment, performance of manipulations with disposable instruments, and board is guaranteed.
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„В” program („POLYCLINIC”)
The program covers provision and payment within the sum insured and the set treatment procedures approved by the Ministry of Health of Ukraine, the List of medical services and the limits of their costs provided in the Annexes No. 3,4,5 to the Rules, out-patient treatment by qualified specialists of any profile in medical establishments with which the Insurer has concluded the necessary contracts, with repayment of the medicine cost after completion of the out-patient treatment.
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„С” program („MEDICINE”)
The program provides compensation of the cost of medicine complex used during out-patient or in-patient treatment of the Insured based on the prescriptions of the physician subject to agreement with the coordinating physician of the Insurer and availability of the payment documents: (cash-memo with the list of medicine with the seal of the pharmacy attached and the receipt), which confirms purchase of the prescribed medicine.
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„D” program („EMERGENCY”)
The program is intended for providing an all-day-round highly qualified medical assistance in emergency cases. Most important is that emergency hospitalization will be effected to the nearest medical establishment with high level of medical services according to the illness profile.
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„E” program („SURGICAL OPERATION”)
The program covers urgent surgical operations on the Insured, complex examination of the pre-operation and post-operation period, including:
- provision of treatment with medicine, but not exceeding five post-operation days;
- consulting with physicians-specialists;
- laboratory and instrumental diagnostics;
- anesthetic and reanimation measures;
- emergency operative surgical intervention;
- provision of post-operative period, but not exceeding five post-operation days.
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„F” program („FLUE”)
The program provides:
- performance and payment for vaccination of the Insured against the virus stamp which is of current importance and is expected at the moment of inoculation;
- in case of illness – compensation of medicine for flue treatment based on the prescriptions of the physician subject to agreement with the coordinating physician of the Insurer and availability of the payment documents: (cash-memo with the list of medicine with the seal of the pharmacy attached and the receipt), which confirms purchase of the prescribed medicine.
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„G” program („CHILDBIRTH”)
The program covers provision and payment for complex out-patient polyclinic and in-hospital assistance after the 36th week of pregnancy and during childbirth in case of the following complications:
- preterm delivery;
- bleeding during labor;
- placenta detachment;
- fetus displacement;
- puerperal sepsis;
- preeclampsia and eclampsia.
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„H” program („DENTISTRY”)
The program provides urgent dental aid, in particular:
- urgent therapeutic and surgical aid;
- teeth and fangs removal in case of acute purulent processes.
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„I” program („FAMILY DOCTOR”)
The program covers organizing and payment for urgent medical assistance provided to the Insured family members by a highly qualified physician with whom a contract is concluded.
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„J” program („OFFICE DOCTOR”)
The program covers organizing and payment for urgent medical assistance provided to natural persons who are permanent labor relations (hereinafter referred to as Names Insured) with a legal entity (hereinafter referred to as Insured), who has entered into the necessary contract of health insurance for its employees. Medical services are provided by a highly qualified physician with whom a contract is concluded.
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„К” program („SOCIAL”)
The program covers payment within the sum insured and the set treatment procedures approved by the Ministry of Health of Ukraine, the List of medical services and the limits of their costs specified in the Annex No. 3 to the Rules, medical assistance in medical establishments with which the Insurer has concluded the necessary contracts.
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