We strongly encourage our members to print out the overall Benefits Table (also referred to as Annex III) and always keep a copy at hand. This table follows a strict numeric sequence to which other parts of the Internal Rules often refer to.
However for your ease of perusal and for quicker access you will also find that the website lists the various Benefits according to their general classification, and then goes into further detail. This will help you quickly access the information you need.
Please remember that medical treatments must always be carried out by a medical doctor recognised as such by the competent health authorites. Treatment that need not be delivered by a medical doctor, must still be done by professionals recognised as such in their field of practice. (i.e. physiotherapy, psychotherapy, etc...)
We urge all members to ALWAYS remember that for certain medical benefits;
- prior authorization, by the Medical Adviser of the Society, in writing must be requested in accordance with rule VIII.4 (b) of the Internal rules. The member must attache the written authorization to their claim. Such authorizations are only valid for a period of six months from the date on which they are granted.
- The Medical Adviser shall determine the categories in which therapeutic treatments not listed in this annex may be classified for purposes of reimbursement.
- Expenses incurred in respect of any of the acts listed in the following table, shall be reimbursed at ta rate of 80 per cent unless otherwise stated.
- Supplementary Plan benefits may be paid depending on the type of medical treatment received. The various pages of this website dealing with the Benefits of the plan will specify so. Alternatively you may also find such information in Annex III of the Internal Rules.
Reimbursement is subject to the procedures and conditions set forth in Annex II. For the sake of clarification please do note that as a worldwide plan we cannot possibly have an exhaustive list of every single item that is excluded. The below points provide some guidance on the main issues of contention, and are not to be considered an exhaustive list.
- As a general rule of thumb we reimburse services by a Medical Doctor (MD) and medical drugs approved by the local competent authorities of the country concerned.
- For liability purposes cross border purchases of prescription drugs are not reimbursable. Not all prescribed medicaments are necessarily reimbursable.
- All reference to a "session" (for example physiotherapy and psychotherapy) is to be intended as one session per day, irrespective of duration. Multiple sessions per day will be considered as a single session and the monetary limit of one session will be applied for reimbursement.
- Alternative medicine treatment can be considered for reimbursement only if recognized as a "medical treatment" and carried out by a MD in the country conerned. Essentially some treatments may be reimbursable depending in which country they are undertaken.
- Eye tests are reimbursable only if carried by an ophtamologist. Eye tests carried out by an optician when purchasing glasses/lenses are not reimbursable.
- Acupunture must be carried out by a Medical Doctor
- Prescriptions are normally valid 6 months, unless otherwise stated by the doctor.
Do not hesitate to contact at firstname.lastname@example.org for any queries, doubts or explanations.