Health Insurance – FAQs

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

Can I have health insurance if I already suffer from an illness?
In some countries, it is mandatory to have health insurance, at least with minimum essential coverage. When shopping for health insurance, and considering incentives like skipping eternal waiting lists, or being assisted by qualified professionals, we also have to check the criteria we are requested to meet in order to be insured. That is, those requirements our insurance company may expect from us.

So what if we suffer from an illness before we buy the insurance? Will the insurance company reject us? The joining process is usually very simple as no medical tests are normally required following the completion of the proposal form; as long as the person applying for cover is under a certain age, for example, 65 years old.

On Proposal Forms, clients have to declare their conditions by answering questions like if they ever had surgery or if they ever had any broken bone. Pre-existing medical conditions will be excluded from the cover. This does not mean that we are not allowed to have health insurance if we suffer from a chronic medical condition or if we need hospitalization regularly. Only, our health insurance will be different, in order to fit our state of health.

What is the purpose of the MAPFRE Middlesea Health Insurance Policy?
The purpose of the policy is to provide cover for recognised treatment, which is medically necessary for acute medical conditions and injuries. This policy is not intended to cover experimental or unproven Treatment but should such situations arise we will discuss these with the beneficiary’s specialist and decide whether the cost of the proposed treatment is covered. Claims will be paid for those items specified in the policy benefits (up to the amounts stated, if applicable).
Does the MAPFRE Middlesea health policy offer cover for treatment in Malta only?

The MAPFRE Middlesea Insurance policy offers cover for everywhere in the world as explained below:

  1. Basic Scheme offers limited cover worldwide
  2. Hospital Scheme offers full cover of the reasonable fees locally and limited cover worldwide
  3. International Scheme offers full cover of the reasonable fees worldwide except in the USA and Canada, where a limit is offered.
Can I include my dependants in my policy?
Yes you may include your spouse or partner and children. Parents or siblings are not considered as dependants and will be sold a separate policy. The policyholder’s new born children can be included in the policy up to three months from their date of birth free of charge up to the next renewal upon presentation of their birth certificate.
Can I pay my policy by instalments?
Your premium is due at the start of the policy period in its entirety. However you may opt to pay your premium half yearly, quarterly or monthly. Charges will apply as follows: Half-Yearly – 2.5%, Quarterly – 5% and Monthly – 7.5%. When opting for any of these payments methods the premium plan must be arranged through a direct debit.

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