PROVIDENT AND INSURANCE GROUP OF INTERNATIONAL OFFICIALS
THE COMPLEMENTARY HEALTH INSURANCE FROM A TO Z
Benefits
The complementary health insurance provided
by GPAFI reimburses, in most of the
cases, 90% of expenses supported by the insured
person, after reimbursement from the
organization’s medical insurance.
Among the numerous benefits of the complementary health insurance, the most important are described below.
Concerning outpatient treatment, generally reimbursed at 80% from the organization’s medical insurance, the complementary health insurance reimburses 18% of expenses (90% of 20% supported by the insured person), so that the most common expenses are covered at 98%. It concerns doctors’ fees, pharmaceuticals, laboratory analyses and tests, injections, radiotherapy, medical imagery (X-rays, echographia, NMR, etc.).
In case of hospitalization, the organization’s medical insurance reimburses generally 90% of the expenses in a semi-privateward (room with two beds ormore). The complementary health insurance allows to cover the expenses for a private room and to have free choice of doctor, hospital and date of operation. For example, in case of hospitalization in a private room of a private clinic in Geneva, the insured person will have to support approximately 350 fr. per day, after reimbursement from the organization’s medical insurance. So, it represents 1,750 fr. for five days hospitalization, which is the average duration, that is more than one and a half years premiums for complementary health insurance! Hospital accommodation expenses incurred by one parent who must stay with his/her hospitalized child are reimbursed up to a maximum 3,000 fr. per year.
An annual amount of 2000 fr. per year is allocated for treatment by methods of natural medicine: acupuncture, lymphatic drainage, homoeopathy, osteopathy, herbal medicine, traditional Chinese medicine, shiatsu, neural therapy, etc.
Supplementary services
Supplementary services are at the disposal of
the insured persons:
Assistance whilst abroad. Thanks to the partnership with INTER PARTNER ASSISTANCE, the insured person can profit ofmore services, e.g., delivery ofmedicines wherever the personmay be, reimbursement of unlimited outpatient treatment costs, coverage of unlimited hospitalization fees during sixty days, appropriate transportation (air ambulance, ambulance, train, etc.) to the nearest suitable hospital, arrangements and payment for repatriation (with family members).
Access around the clock to the free medical advice from MEDGATE, the most important telemedical centre in Switzerland. A second medical opinion by a specialist whose position is neutral in the event of a surgical operation. The doctor consultation is free, there is no constraint and the insured person takes a decision without appeal. A legal protection in case of dispute with a healthcare provider if the patient didn’t get the benefits due from a doctor or a hospital, or to claim compensation for incompetent medical treatment.
Monthly premiums
There are two variants of the complementary
health insurance.
The standard variant has amonthly premium of 92 fr. for an insured person alone or for the 1st insured person of a family (degressive premiumfor the other familymembers: 70 fr., 55 fr. and 29 fr.; there is no charge from the 5th person).
With the additional dental care option, including benefits for dental treatment up to maximum 500 fr. par year, the monthly premium would be of an extra 14 fr. for an insured person alone or for the 1st insured person of a family (degreessive extra premium for the other family members: 11 fr., 9 fr. and Fr. 6 fr.; there is no charge from the 5th person).
Thanks to a large number of insured persons, actually more than 4,500, premiums have been stabilized over the last years.
Admission
An application form with a health questionnaire
has to be filled. International Officials
may fill a simplified health questionnaire
whereas family members have to fill a
complete health questionnaire. The age
limit is 65.
Children of International Officials may keep their complementary health insurance as long as they are insured by the organization’s medical insurance. For children living in Switzerland who are not anymore entitled to be covered through this insurance, GPAFI provides a group plan, including basic insurance according to the federal law on health insurance (LAMal) and supplementary insurance. They would be transferred in this plan without filling a new health questionnaire (medical history disregarded).
The prenatal insurance consists of applying for the complementary health insurance for the unborn child. The prenatal insurance allows the new-born child to be covered from the birth whatever the health condition.
Payment of benefits
Original bills have to be sent to the organization’s
medical insurance, according to its
rules, for reimbursement.
During the first year of affiliation, photocopies of bills and prescriptions have to be sent with the original reimbursement notice of the organisation’s medical insurance.
From the second year of affiliation, photocopies of bills for outpatient treatment are no more required. Only photocopies of bills for hospitalization and cures are required. If benefits are not payable by the organisation’s medical insurance but payable by the complementary health insurance (for example certain treatments by methods of natural medicine), the original bills are to be sent.
Quality service
For the complementary health insurance,
GPAFI has a partnership with INTRAS which
is a famous health insurer in Switzerland,
one of the companies of the CSS Group
which forms the country’s biggest insurer
with 1.6 million policyholders.
INTRAS dispose of a staff specially dedicate
to GPAFI’s members in order to guarantee
high quality of personalized services.
Information, enrolment, contact
For information about the complementary insurance
or other insurances provided by
GPAFI, for documentation or enrolment, you
can contact GPAFI or consult its website.
Address
GPAFI Palais des Nations
CH – 1211 Geneva 10
Reception
Palais des Nations
Room C.419 Door 6, lift no. 7, 4th floor
Open Monday to Friday from 10 am to 12 am
and from 2 pm to 4 pm
Tel. +41 (0)22 917 26 20 or 39 46
Fax +41 (0)22 917 05 25
Email
gpafi@unog.ch
