Health Insurance

You cannot foresee what medical treatment you might require. Think ahead and protect
yourself and your loved ones. MAPFRE Middlesea’s Health policy ensures that
you and your family benefit from any
treatment you may need in a comfortable environment and that you are cared
for in an optimal manner.

You cannot foresee what medical treatment you might require. Think ahead and protect yourself and your loved ones. MAPFRE Middlesea’s Health policy ensures that you and your family benefit from any treatment you may need in a comfortable environment and that you are cared for in an optimal manner.

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Manufacturer of the product is: MAPFRE Middlesea

MAPFRE Middlesea p.l.c. (C-5553) is authorised by the Malta Financial Services Authority (MFSA) to carry on both Long Term and General Business under the Insurance Business Act. MAPFRE Middlesea p.l.c. is regulated by the MFSA.

   | Middlesea

The MAPFRE Middlesea Health Insurance Schemes offer customers the freedom to choose the level of cover that best suits their individual requirements and budget. They are more accessible, easier to understand, more comprehensive and above all more flexible.
  • Best medical care

    Whichever scheme customers choose, it will enable them to access the best medical care at times and locations that suit them most, whilst offering peace of mind for them and their loved ones.

  • Three levels of cover

    These schemes provide three levels of cover on an Inpatient and Outpatient basis as detailed below:

    • Basic Scheme
    • Hospital Scheme
    • International Scheme

    Cover is Worldwide for the Basic and Hospital Schemes subject to the limits contained in the respective Tables of Benefits. Under the International Scheme cover is Worldwide excluding USA and Canada although there is a limit for cover in this territory for emergency treatment only.

  • Cost-reducing options

    In order to make its schemes more accessible to a wider section of the public, MAPFRE Middlesea p.l.c. has a number of cost-reducing options whereby the applicable premium may be significantly improved when In-patient cover only variations are selected. A new option under this type of cover is the International Inpatient Only Scheme which has been added to the already established:.

    • Basic Inpatient Only Scheme
    • Hospital Inpatient Only Scheme

    These two variations provide insurance protection for hospitalisation as an in-patient. By opting not to be covered for out-patient treatment and consultations, a person could still have the peace of mind that he/she is covered for expensive in-patient treatment costs.

  • Further flexibility

    Further flexibility is provided by allowing customers to introduce a voluntary excess of 10% or 20% and enjoy a further reduction in their premium.

  • Second Medical Opinion

    We care for your health as if it were our own. Kindly refer to the detailed brochure found under the downloadable documents.

  • Routine and Preventive Care Cover

    Limited cover for routine visits for screening and monitoring which would usually not be covered under our standard policy. This can be purchased with all our Inpatient and Outpatient Schemes.

  • Dental Cover

    Limited Cover for Routine and restorative dental treatments such as scaling, polishing, x-rays, root canal treatments, crowns and bridges. This cover can be purchased with all our Inpatient and Outpatient Schemes.

  • Loss of income Extension

    If during the Policy Year, You or any Dependant/s, who are over 18 years of age and in Fixed Employment, are diagnosed with a long term Medical Condition then the Policy will pay You a Loss of Income benefit of Eur500 per week for three consecutive weeks subject to a maximum benefit limit of Eur1,500 per Policy year. This benefit will be paid after 12 weeks from Diagnosis provided the presence of the same Medical Condition of the Beneficiary is uninterrupted. This cover can be purchased at an additional premium with our Hospital Inpatient and Outpatient Scheme and is included in our International Inpatient and Outpatient Scheme at no additional charge.

  • Waiver of Standard Exclusions Extension

    At an additional Premium the Standard Exclusions relating to Clinic Fees, Allergies and Vaccinations can be waived from the cover. These charges would be paid from the Outpatient benefit (no 9) limits. This cover can be purchased with our Hospital and international Inpatient and Outpatient Schemes.

More information about our Health Insurance can be found here.

Your MAPFRE Middlesea Health Insurance policy includes a wide range of interesting benefits for you and your family:
With this insurance you can choose between 4 levels of coverage: Basic Scheme, Hospital Scheme, International Scheme and Family Health Scheme.

Options available are “Inpatient Only” Cover or “Inpatient and Outpatient” Cover. The Inpatient Only Cover is a cost reducing option providing insurance protection for hospitalisation. Cover is Worldwide for the Basic and Hospital Schemes subject to the limits contained in the respective Tables of Benefits. Under the International Scheme cover is Worldwide excluding USA and Canada although there is a limit for cover in this territory for emergency treatment only.

Basic Scheme covers essential health services, and refunds prearranged amounts for treatments. It includes in-patient services such as specialist consultations, pathology, radiology, diagnostic tests and physiotherapy; Reasonable Fees up to €325 per policy year

Hospital Scheme covers full refund of hospital accommodation, including intensive care and nursing care. It also comprises operating theatre charges, surgeons’ and anaesthetists’ fees for surgical operations, Computerised Tomography Scan (CT Scan), Magnetic Resonance Imaging (MRI) and PET Scans.

International Scheme provides in-patient and out-patient cover on a worldwide basis except USA and Canada. It offers full refund of osteopathy, homeopathy, acupuncture, and chiropractic treatments provided by qualified practitioners.

The Family Health Insurance Scheme covers all the health insurance needs of all family members, upon payment of a single premium only. This scheme protects family members in case of any injury or other medical contingencies such as hospitalisation, and medical and surgical expenses. This scheme offers out-patient benefits including refund for general practitioners’ fees, consultations with specialists, a dental benefit and a maternity cash benefit (€300 per pregnancy). If you become unemployed as a result of redundancy, and consequently not being able to pay for the Family Health insurance premium, MAPFRE Middlesea will cover the annual renewal premium for you.

The Hospital and International Schemes offer you the Second Medial Opinion Service if any member of your family is diagnosed with a severe illness and would like to get further confirmation, this service gives you access to a network of recognised international medical experts at no extra cost.

Under our policies a number of Extensions are available as shown below:

Extensions
Already included at no additional charges with the below Schemes:
Available at an additional premium with the below Schemes:
Second Medical Opinion
Hospital (incl. Family) and International Scheme
Basic Schemes
Mediphone
Hospital (incl. Family) and International Scheme
Basic Schemes
Routine and Preventive Care Cover
Not applicable
Only "Inpatient and Outpatient" Schemes
Dental Cover
Not applicable
Only "Inpatient and Outpatient" Schemes
Evacuation (to nearest country where treatment is available) and Repatriation to home country for medical treatment or of mortal remains
Not applicable
Only "Inpatient and Outpatient" Schemes
Loss of Income
International Scheme
Hospital "Inpatient and Outpatient" Scheme
Waiver of Standard Exclusions
Not applicable
Hospital (incl. Family) and International Schemes
This policy has certain requirements that shall be evaluated by the customer. It is very important to consider them in order to decide which insurance policy satisfies better the policyholder needs.

The aim of this policy is to provide cover for the reasonable fees of accredited treatments. This insurance is not planned to cover experimental or unproven treatments, but if such possibility occurs, we will discuss it with the policyholder specialist and decide if the cost of the suggested treatment will be covered.

For the full Policy exclusions please refer to your policy document. The following are some of the restrictions that apply to the policy, unless otherwise specified in Your Policy Schedule or Table of Benefits:

  • We will not pay for pre-existing medical conditions that, however, will be covered after five years of continuous insurance with us, provided that during that period policyholder has not consulted any doctor for treatment or advice, or taken any medication (including drugs, medicines, special diets and injections) for that condition.
  • We will only cover pre-existing cardiac or cancer conditions provided at the time when the condition reappears the beneficiary has been free from treatment, advice or medication for that condition during the previous ten years.
  • We will not pay for fees charged for providing medical reports and prescriptions.
  • We will not cover pregnancy or childbirth, other than for related complications arising at least ten months after the expectant mother contracted the policy. In the case of a caesarean section we will only pay the difference between the reasonable fee for the intervention, and the fee which would have been charged for a normal delivery.
  • We do not cover contraception, sterilisation, termination of pregnancy, infertility and/or any form of assisted reproduction, and treatment of sexual problems. Treatments arising from or related to a sex change are excluded.
  • The cost of vaccinations, routine or preventive medical examinations, medical screening including health check-ups, sight and hearing tests are excluded.
  • Treatments received in health hydros, spas, nature cure clinics or in any similar establishments, even if they are registered as a hospital, are not included.
  • We do not cover regular or long-term kidney dialysis or end stage renal failure.
  • We do not pay for treatments caused by a deliberate self-inflicted injury or attempted suicide.
  • Treatments given to relieve any allergic condition or disorder are excluded.
  • We do not pay for treatments arising in any way from alcohol, drug or substance abuse.

We recommend to the policyholder, in order to receive benefits of all the guarantees of the policy, to consider some relevant aspects before and after contracting the policy:

  • Premiums are payable to us in euros and must be paid on the date when they become due. If they are not paid by such date, we will have the right to cancel the policy with effect from the day when the premium or any instalment became due.
  • If we accept new members under your policy, you will pay an additional premium. This additional premium will be a pro-rata premium based on the number of days remaining between the date of the acceptance and the renewal date following the said date.
  • If you wish to pay your premium in instalments you may choose from Monthly, Quarterly or Half-yearly. A direct Debit mandate has to be completed for this to be set up with your bank. Frequency charges will apply.
  • If you wish to pay your premium in instalments you may choose from Monthly, Quarterly or Half-yearly. A direct Debit mandate has to be completed for this to be set up with your bank. Frequency charges will apply
  • If not in any member or his/her dependant wish to cancel the cover during the policy year, a pro-rata refund of premium will be made by us, provided that no claims, whether paid or not, shall have been made in connection with this policy during the period in which this cover is to be cancelled. The refund of the premium will be based on the number of days remaining between the cancellation date and the expiry date of the policy.
  • The policyholder must give us notice of any planned In-patient treatment. This will give us the opportunity to confirm whether or not your proposed treatment is covered under your policy and the level of cover you have. An infringement of this condition will prejudice the payment of the claim.
  • If you pay for appropriate overseas treatment in currency other than in euro, we will cover the equivalent in euro at the rate of exchange prevalent at the time of settlement of the claim.
  • To qualify for the nursing at home benefit, all home nursing must immediately follow a period of in-patient or day-case hospital treatment covered by the policy, and be approved by a specialist.
  • If you wish to pay your premium in instalments you may choose from Monthly, Quarterly or Half-yearly. A direct Debit mandate has to be completed for this to be set up with your bank. Frequency charges will apply.

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