Health Insurance

In order to fulfil a growing need amongst our Clients for private Health Care, we have designed a Special Health Insurance for members of afpop.

This policy was specially designed to cover expensive emergency procedures such as surgery, inpatient and outpatient treatment due to illness or accidents. We provide four options with different capitals and covers to enable you to choose the most fitting health insurance for your needs.

Aware of the importance of this insurance in daily life of our Clients/members of afpop, and the importance in providing prompt and quality service, we provide through a team specifically and dedicated all the assistance and communication between the client, providers of clinical services and insurance.

Major Benefits

No age limit to stay insured

70 years age limit to join

No annual excess in the Insurer Network for outpatient services

Inpatient cover: only 15% excess, even outside the Network

Lower excess in outpatient services

(consultations, treatments and exams)

Lower excess in outpatient services

(consultations, treatments and exams)

Discover our range of health insurance plans

Get a personalised estimated quote, or chat to our experienced advisers to find a plan that best suits your needs. Whatever plan you decide, MEDAL gives you the freedom to choose when and where you are treated, within your area of cover.

Covers / LimitsOption Light**Option BOption AOption A PlusOption Premium
In-patient Hospitalisation/ Surgery / Oncology*65 000€ 15% copayment with max. of 1 500€*65 000€ 15% copayment with max. of 1 500€*150 000€ 15% max. 2 500€ of copayment*250 000€ 15% max. 2 500€ of copayment*500 000€ 0% copayment
Worldwide Hospitalisation / Surgery100 000€
Childbirth3 000€5 000€5 000€0% Copayment
Out-patient Consultation / Exams Treatments / Physiotherapy1 000€2 000€4 000€5 000€10 000€ 0% Copayment
Dental TreatmentDental CardDental Card300€500€1 000€ 0% Copayment
Medicines200€500€500€
Prostheses and orthoses

Ophthalmological orthoses
2 000€
300€
2 500€
500€
2 500€
500€
Daily Subsidy in case of Hospitalisation120 Days 75€ day120 Days 75€ day120 Days 75€ day120 Days 75€ day120 Days 75€ day
International medical coverage for serious illness1 000 000€1 000 000€1 000 000€1 000 000€
Second Medical Opinion
Travel Assistance Abroad
Portugal Assistance
Online Medical Assistance
Actions
* 15% with a max. of 10% of the sum insured for oncology surgery/hospitalization, and 15% for chemotherapy and radiotherapy. ** Subscription age limited to 65 years old.

Alternative Plans for 70+

Alternative plans for people over 70 years of age and/or wishing to include pre-existing conditions after one year of coverage.

Covers / LimitsEssencialIdealTotal
In-Patient Hospitalisation / Surgery / Oncology60 000€100 000€500 000€
Childbirth1 500€Included within the
In-Patient capital
(100 000€)
Included within the
In-Patient capital
(500 000€)
Out-patient Consultation / Exams
Treatments / Physiotherapy
1 000€2 500€5 000€
Dental TreatmentDental Card500€
(annual excess 50€)
1 000€
Medicines200€
(3,5€ of excess per prescrition)
500€
(3€ of excess per prescrition)
Prostheses and orthoses

Ophthalmological orthoses
1 000€2 000€
Daily Subsidy in case of Hospitalisation
International medical
coverage for serious illness
Second Medical Opinion
Actions
Note: On the 1st year of contract you will have a co-payment for hospitalization of 30% (minimum of 500€), except for childbirth. Total plan can only be taken out for two or more persons and is not available on an individual basis.

FAQs

Due to the unique conditions for afpop members the renewal date is on 01/01 of each year, and the payment is annual. You will receive our renewal letter with the payment invoice attached in order you can pay by bank transfer, cheque or cash. We also have the direct debit option. 

Bearing in mind this policy was designed for a group, afpop members, with similar needs and benefiting from significant advantages, the premium must have similarly increases, depending on the age group in all insured persons. In this way, we can ensure that if you have a serious claim your policy premium will not be increased in equal proportions because the claims ratio refers to the whole Group, thus enabling small increases that are common to all members of afpop. Our experience also tells us that the policies premium should be annually updated to avoid a large increases in the future.

For this issue, your insurance allows you to have two options. Which means that you can choose a doctor with agreement and pay the agreed value or visit a doctor without agreement and pay the totally amount and ask the reimbursement with presentation of the receipt. 

For consultations at home you must contact Allianz through the number of Assistance (+351) 213 108 321 (bilingual) and it will cost 18,50€.

For both Option Light and B there is an annual deductible of 35€ for first expenses submitted for reimbursement. For example, if your first expenses outside Allianz network are 85€ you will receive the following amount: 
85€ – 35€ (annual deductible) * 60% = 30€.

As for the following expenses, you will then receive 60% of the presented value.

The target date for pre-existing effect is the starting date of your policy. The date considered for pre-existing conditions is extremely important, because all medical conditions previous to this date, or related to them, are automatically excluded from your policy.

However, if you have been insured by another health insurance policy is possible that Allianz recognize, upon insurance certificate, the starting date of the previous policy for pre-existing conditions. This means that Allianz will transfer your clinical history for the new policy. The waiting period of 60 days will be also cancelled.

The use of the providers network is more dresser to the client not only because the insured will only have to shell out the amount to charge, and the party in charge of Allianz paid directly by Allianz to the provider, but also because the prices paid by Allianz are more advantageous, which means that the claims ratio will be better later in the year.

This, and the fact that, to the extent that there is an agreement with Allianz and pricing to our customers are lower than the prices from the general public, it is particularly beneficial in terms of claims ratio.

Reimbursement of expenses should always be sent  to MEDAL within a maximum of 90 (MGEN) or 180 days (Allianz), towards our health department to analyze and verify if it is missing any document that is necessary to proceed with the claim and send the request to the insurer.

To make this procedure easier and faster, we have a list of procedures and a refund form to guide you.
The refund will be made to your bank account within 15-20 business days. The amount not reimbursed for all expenses incurred each year, will be on the health expenditure statement made in this year, which will be sent to you for tax purposes (IRS) at the beginning of each year.

The territorial scope of the policy is Portugal and Spain and as such is only covered outside Portugal in case of sudden illness or accident, not for journeys over 90 days. It is very important to note that there are no excluded countries and if you want, you can extend the period of 90 days and you will have to pay an additional amount.

Add to your base plan:

  • Breach of Contract – If a project deadline is missed due to the illness or departure of a key team member, resulting in financial loss for the client, this policy provides coverage.

  • Professional Errors, Omissions, and Negligence – If the delivered work does not meet the client’s expectations, our policy ensures financial protection.

Ensure your business remains secure against unexpected claims and financial risks. Contact us today for a personalised quote.

Fill out the contact form or schedule a meeting today to tailor a policy to your needs.

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If you’re already a MEDAL Insurance customer, please access your Client Area and consult your broker’s contact information for personalised support.

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