Higher reimbursement amounts at TU Zdrowie allow for more treatment freedom
TU Zdrowie increases the reimbursement amounts for medical services provided outside of its network of cooperating facilities. Due to this change, inflation and health care market increases will be felt by the TU Zdrowie insureds to a much lesser extent compared to others. They will thus enjoy much higher reimbursement limits for consultations, diagnostic tests or dental care appointments at any medical facility across the country..
- Price increases, afflicting many areas of the economy, have not spared the medical services market either. In response to this situation, we have updated the Health Policy and TeleRefund Policy, increasing the Upper Limit of Liability (ULL), i.e. the guaranteed maximum reimbursement amount for a doctor’s consultation, e.g. with an ENT specialist, up to PLN 240. This translates into 100% reimbursement in the vast majority of medical facilities in Poland and offers freedom in using private health care in the insured person’s closest vicinity - says Teresa Domańska, Director of Health Insurance Department at TU Zdrowie.
The increase of the Upper Limit of Liability applies not only to medical consultations, but also to other services included in the insurance scope, i.e. diagnostic tests, including laboratory, functional, endoscopic and imaging tests such as X-ray, ultrasound, computed tomography and magnetic resonance imaging, as well as extra options – prevention, rehabilitation or dentistry.
So far, under the basic option with the insurance amount of PLN 100,000 (ULL 1.0), any consultation with an ENT specialist was covered up to PLN 80 (ULL 1.0) or PLN 160 (ULL 2.0). In the new option, the reimbursement amount has been increased to PLN 200 (ULL 2.5) and even to PLN 240 (ULL 3.0) and thus the insured will receive a full reimbursement of such a consultation.
TU Health experts say that the increase in reimbursement amounts is particularly important for those insured who are employed or live in smaller towns without subscription-based providers.
- Health insurance with TU Zdrowie opens up access to all commercial doctor’s offices for patients in smaller towns. The insured decides which doctor they prefer and what amount they can afford to pay for a visit. With higher reimbursement amounts, it may turn out that the insurance cover will pay for the service even in one hundred percent. Importantly, the insured can benefit from the reimbursement with no need to inform TU Zdrowie about such intention beforehand. The insured must only complete an electronic request in the Insured Panel or via the mobile application, and attach a scan or a photo of the bill. TU Zdrowie will immediately consider such a request and will pay the due benefit to the account of the insured. Currently, the average time of reimbursement and refund by TU Zdrowie is up to 6 business days - says Dariusz Grądziel, Sales Director at TU Zdrowie.
The changes apply to both the Health Policy and the TeleRefund Policy for group customers, for groups with a minimum of 30 employees. The change is of special importance for the TeleRefund Policy with a two-pronged approach to service provision – via teleconsultations (e-consultations with specialist doctors) and as reimbursement of medical services incurred, in accordance with the amount indicated in the Catalogue of Medical Benefits. A higher reimbursement amount implies the Insured’s lower share in the costs of the services provided, which is particularly important for this product design.
