FAQS Health



We present some of the FAQs we hear about our unique health insurance for afpop members. We are always happy to explain our benefits and costs, if there is something else you would like to clarify. If you can not find what you are looking for here, search with further detail in our document about FAQs or call our services.

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 the Allianz through the number of Assistance 210 049 378 and will cost € 20.
For the option B and C 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 receive the following amount: 
€85 - €35 (annual deductible)* 80% = 40 €.
The following expenses, you will receive 80% 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 within a maximum of 120 days for the Medal, towards our health department to analyze and verify if it is missing any document that is necessary to proceed with the claim.
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 to journeys over 60 days. It is very important to note that there is not any excluded countries and if you want you can extend the period of 60 days and you will have to pay an additional amount.

SEDE / HEADOFFICE:
R. Dr. Teófilo Braga, 3A - 1º
Apartado 948, 8501-919 Portimão
Tel.: +351 282 430 800
 
ESCRITÓRIO / OFFICE: 
Avª. José dos Santos Farias, Lt. 83, R/C Dto. 
8135-167 Almancil
Tel.: +351 289 351 000
 
ESCRITÓRIO / OFFICE:
Av. Sabóia, 487 C/D
2765-298 Monte do Estoril
Tel.: +351 210 523 130

 

Mediador de Seguros registado em 27.01.2007 na ASF-Autoridade de Supervisão de Seguros e Fundos de Pensões com a categoria de Agente de Seguros, sob nº 407154810/3, nos ramos Vida e Não Vida verificável em www.asf.com.pt Capital Social:150.000,00€. Em caso de litígios o reclamante pode recorrer ao Centro de Informação, Mediação e Provedoria de Seguros (CIMPAS), enquanto Entidade de Resolução Alternativa de Litígios (ERAL). Mais informações em www.cimpas.pt ou no Portal do Consumidor em www.consumidor.pt