since 7/2003
Bespoke health products / productos de salud a medida ... for / para:
boat and golf insurance in Spain
Commercial Premises insurance - Spain
Community Insurance 'Comunidad' - Spain
Company Platinum - health plan for employees in Latin America and the Caribbean
dental and medical insurance plans
English insurance agent in Spain
España - seguros médicos - pero ¿cuál?
health insurance Czech Republic
international health, medical and travel insurance cover
international travel insurance
Maritime plan - international health cover (crew only)
Oil and Gas Industry - health insurance
Patrocinadores - América Latina y el Caribe
'Residencia' (medical insurance)
Retirement? How about retiring to Spain?
Sanitas Accesible Síndrome de Down
Sanitas Accesible Down Syndrome
Sanitas Oro Reembolso / Reimbursement
Studying outside Spain for at least 6 months?
Teachers - international health cover (Spain)
traducciones juradas (sworn translations)
www.e-healthinsuranceservices.com
Lifeline membership guide (from 1.10.2006) (Membership Guide 2008)
2. What is covered?
This section contains your table of benefits and the accompanying notes. Before you look at these please read the important information below about the kind of costs that we cover.
2.1 Treatment that we cover
For us to cover any treatment that you receive, it must satisfy all of the following requirements:
- it is at least consistent with generally accepted standards of medical practice in the country in which treatment is being received
- it is clinically appropriate in terms of type, duration, location and frequency, and
- it is covered under the terms and conditions of the plan.
2.2 Conditions that we cover
Acute conditions
This plan covers you for treatment of acute conditions. Acute conditions are diseases, illnesses or injuries that respond to medical care without the need for long-term or prolonged treatment. The treatment that you receive should be likely to lead to a complete recovery, or restore you as closely as possible to your previous state of health.
Please note that this definition above means that you do not have cover for treatment for chronic conditions (please see Section 3 for more information about chronic conditions).
Acute and chronic conditions - how it works in practice
1. We will cover an acute condition until we become aware that it is chronic.
2. If you develop a condition which is known to be chronic, we will pay for treatment to
- diagnose your condition
- stabilise your condition
but, we will not pay for ongoing treatment or drugs to maintain your health or control the condition.
3. If you suffer from an acute flare-up of a chronic condition we will pay for treatment you receive during this period.
Example: a chronic condition such as angina is usually controlled by medication. We will not pay for drugs, consultations or other treatment to control this condition. However, angina could lead to severe chest pains and the need for a heart bypass; this is an acute flare-up of a chronic condition. In this situation we would pay costs associated with the heart by-pass according to the table of benefits (section 2.4) and the notes (section 2.5)
Please contact the customer services helpline if you have any questions about acute and chronic conditions.
2.3 Reasonable and customary charges
We only pay costs when the charges made by the provider of services are reasonable and customary. By this we mean that the charges are the same as those made to our members by the majority of other service providers in the same country: and also that they are not more than the provider would normally charge.
2.4 Table of benefits
The table of benefits shows the benefits and limits that apply to your plan. The notes that follow it in section 2.5 contain the detailed rules for each benefit. You also need to read 3. What is not covered? so that you understand the exclusions on your plan. A copy of the Table of benefits can be found on the fold-out cover of the guide.
How to read the Table of benefits
There are three levels of cover: Essential, Classic and Gold. You need to read the column in the table of benefits that applies to your level of cover, as shown on your Membership Certificate.
Benefit limits
There are two kinds of benefit shown in this table. The 'overall annual maximum' is the maximum we will pay for all benefits in total for each person, each membership year. Some benefits also have a limit applied to them separately: for example Home Nursing.
All benefit limits apply per member and per membership year; This means that once a benefit limit has been reached, that benefit will no longer be available until you renew your plan and start a new membership year.
Currencies
All the benefit limits in this table of benefits and notes are set out in three currencies: £ sterling, $ US dollars and € euros.
The currency in which you pay us your subscriptions is the currency that applies to your membership for the purpose of the benefit limits.
For example, if you pay your subscriptions in £ sterling then the benefit limits given in £ sterling apply to your membership and $ US dollar and € euro limits do not apply to you.
If you are unsure which level of cover you have, the currency that applies to your membership, or whether you have an annual deductible, you can check on our Membersworld website or contact the customer services helpline.
Lifeline:
* provides international private medical insurance for people living or working abroad for at least six months of the year
* for individuals and their families
* three different levels of cover to meet any client's needs:
| Product description (and limits) | |
| Essential | Essential |
| Classic | Classic |
| Gold | Gold |
Company Scheme ( Castellano Deutsch Français Português )
| For more information please contact me: | |
| davidharris@wanadoo.es / saniprof@mail.ddnet.es | |
| Fax: | (+ 34) 91 8032484 |
| 'phone: | (+ 34) 609 522 300 |
| Also more information on.. | www.e-healthinsuranceservices.com |