Health insurance for a foreigner

The insurance premium is calculated according to the age of the insured person, taking into account their state of health. The state of health is assessed only before entering into an insurance contract, and for this, the insured person has to fill out a health questionnaire. The insurance contract is open-ended and there is no need to assess the state of health during the period of validity of the insurance period.

The insurance cover starts after the conclusion of the insurance contract and after the expiry of the waiting period specified in the insurance contract.

The family physician sees a valid contract for ERGO health insurance only if they are a partner of ERGO. In other cases, the family physician does not see the ERGO insurance contract.

Yes. Insured person first pays for the outpatient medical care themselves and then submits an application for indemnity to ERGO together with a document certifying payment and a medical certificate. In addition, the following documents have to be attached to the medical bill: 

• in the case of examinations and analyses, an extract from the medical history must also be submitted to ERGO;
• in the case of dental treatment, an invoice with a list of dental services issued in the name of the person who has received the treatment must be submitted.  

The insurer indemnifies the costs up to the indemnity limit specified in the insurance policy. The indemnity limit is determined for the insurance period, not for the insured event.

If the dental treatment indemnity limit is used during the current period, then this cover will no longer be available during this period. In the new period, the dental treatment indemnity limit will be restored to the extent of the amount specified in the policy. The indemnity limit will not be restored in the new period with additional cover for critical illnesses in the case of a critical illness diagnosis that has already been indemnified.

Doctors can only add to the family physician’s list those persons who have insurance from the National Health Insurance Fund. If a person does not have insurance from the National Health Insurance Fund, they can use the paid services of doctors, as well as attend a paid appointment with the same family physician of their choice.

Voluntary health insurance and private health insurance are two different names for a similar insurance product.