Frequently asked questions (FAQs).
A. Existing conditions may be specifically excluded and the terms of any exclusion will be noted on your insurance certificate. These will be assessed at the time of application based on the information you declare to us. Undeclared conditions will be excluded and will invalidate your cover. If your underwriting terms are moratorium, cover for all pre-existing conditions (and related conditions), with the exception of congenital conditions, is excluded during the first two years of membership. After this period, should an eligible condition recur, provided you have been treatment, symptom and advice free for a continuous period of two years since joining the plan, then the future costs will be covered which have been declared and accepted by us in writing.
If you prefer, our Full Medical Underwriting (FMU) option covers pre-existing medical conditions provided you submit a full medical declaration for us to assess. We will agree to either accept all or some of your pre-existing
medical conditions and may charge an increased premium, exclude all of your pre-existing medical conditions, or decline cover altogether
A. You are able to claim up to an annual maximum of U.S.$1,600,000 under Major Medical and Major Medical Plus plans, $2,500,000 under Foundation plan and $5,000,000 under Lifestyle options. Additionally, certain benefits have sub-limits. You will only be required to pay an deductible if you have specifically chosen this option.
A. Three geographic coverage options are available for accessing emergency and elective treatment. These include Africa plus India, Pakistan, Bangladesh and Sri Lanka, Worldwide excluding USA; and Worldwide.
A. You are able to claim up to an annual maximum of U.S.$1,600,000 under Major Medical and Major Medical Plus plans, $2,500,000 under Foundation plan and $5,000,000 under Lifestyle options. Additionally, certain benefits have sub-limits. You will only be required to pay an deductible if you have specifically chosen this option.
A. Three geographic coverage options are available for accessing emergency and elective treatment. These include Africa plus India, Pakistan, Bangladesh and Sri Lanka, Worldwide excluding USA; and Worldwide.
A. You are covered for Accident and Emergency treatment outside of your selected geographic coverage area for business trips or holidays. Specifically, this benefit is provided for up to 90 days during the period of cover and limited to a maximum of 60 days of treatment per event.
A. No. In the rare instance that we require additional information for fair and accurate underwriting purposes, we will ask you to submit a medical report from your doctor.
A. As soon as we receive a completed application form (email or original), we can confirm immediate cover for 15 days, subject to underwriter’s acceptance and pending receipt of the premium. If you wish to be covered immediately, please contact Executive Healthcare Solutions on (254) 20 291 0000 or (254) 709 337 000. You may also reach us via email at info@ehsmicpresentations.com.
A. Yes. Your spouse or adult partner, who is permanently living with you, can be included as a dependant. Also eligible for cover are unmarried children not more than 18 years old and living with you, or not more than 26 years
old and in full-time education. Again, this is subject to a completed Application form.
A. You have 15 days from the commencement date of your cover to review your benefits. If you decide to cancel and no claims have been made, we will arrange a full refund of any premium paid, provided we receive a written request to cancel your cover.
A. Unlike some insurers, EHS and Allianz Care do not have a Hospital Bed Directory and therefore your employees are free, with a few exceptions, to use any hospital that they may choose, so long as adequate facilities and suitable treatment is provided.
A. Yes, Accident and Emergency treatment are covered, unless they are pre-existing Medical Conditions or where symptoms existed prior to the first date of travel, outside of your selected area of coverage for a maximum of 90 days during the Period of Cover and limited to 60 days of travel per event.
A. Your account executive or broker can email the form to you, alternatively, claim forms can be downloaded from www.executive-healthcare.com
A. There are no limits to the number of times a member can make a claim, however some benefits do have sub-limits to the overall monetary amount of cover provided.
A. Whilst we normally ask that any in-patient treatment is pre-approved prior to the commencement of any treatment, in a medical emergency it is important to get treatment as soon as possible. All we ask is that either the patient or a family member/colleague contacts our 24-hour emergency assistance centre as soon as reasonably possible so that we can provide any additional assistance that may be required.
A. With all EHP plans, you can choose whether or not to have a deductible against your policy. You will be required to pay for covered services before the insurer will begin to pay. Considerable savings can be made on your premium by selecting a deductible.