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In this description you can read about the Hungarian Private Health Insurance opportunities in English.

Health services

What does the insurance cover?

You can find examples of each benefit under the more information menu item.

Gynecologist talking to a woman during consultation in the office with a nurse

Outpatient benefits

One-off or occasional specialist healthcare provided by a specialist.

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Diagnostic tests

A distinction is made between diagnostic tests and low- and high-value diagnostic services.

Diverse group of male and female surgeons in operating theatre wearing face masks performing surgery. medicine, health and healthcare services during coronavirus covid 19 pandemic.

Same day surgery

Surgical intervention requiring a hospital stay of less than 24 hours.

Beds In Empty Hospital Ward

Hospital inpatient care

Medical care requiring a hospital stay of more than 24 hours.

The man doctor measures the wrist pulse, the heartbeat of the patient, and discusses health care closely. Medical and health care concepts.

Screening tests

A pre-planned medical examination that is carried out on a preventive basis.

Shot of a note reading Emergency against a jar filled with money on a hospital counter.

Sum insurances

Classic life and accident insurances, critical illness coverage.

The Insurance company therefore pays AND organizes your medical care at a private clinic. Incredible? - I believe it... But it's true!

Introduction

If you are just interested or if you already have health insurance based on service financing, then in this article we will show you how you can use your insurance in practice. In many cases, insurance packages may contain quite different services, but their practical use is roughly the same. In order to understand the process, it is important to clarify some concepts:

Insurance company: The customer concludes the insurance contract with the insurance company. The insurance company handles the preparation of the invoice, policy, and proof of coverage and other administrative matters. When concluding the contract, we accept what is written in the insurance conditions.

Service organizer: Each insurance company has a service organizer partner. The service organizing partner carries out the entire logistical tasks of the medical examinations requested by the Clients. They coordinate with Customers, communicate with Insurance companies, and are in direct contact with medical institutions. In short, they are the heart of our health insurance. This function is typically performed by three large companies in Hungary:

Teladoc Hungary Kft – Insurance partner of Aegon, Groupama, CIG, Uniqa

Medi 24 (Europe Assistance) – partner of Generali Insurance

ÉRTED Kft – Union Insurance Partner

What is the practical process?

Step 1: A health complaint occurs.

The first step in using the insurance is that you have a health complaint that makes you want to see a doctor. If you choose an insurance policy that includes a screening package, then by definition you do not have to wait for a complaint to appear, you can see a doctor immediately.

Step 2: You contact the Service Organizer

There are two possible ways to do this. According to the basic process, you call the service organization company on a pre-specified phone number. If you do not want to make a phone call, in the case of certain healthcare services, you have the option of booking an appointment online. In this case, you have to go to a website and you can book the service there immediately. It is important to emphasize that online appointment booking only applies to outpatient services, in the case of diagnostic, one-day surgery and screening services, the telephone number must be dialed.

Step 3: You tell us what kind of health complaint you have / you apply for a screening test.

After you have dialed the service organizer, the administrator will identify you based on some personal data (name, mother’s name, place and time of birth). It will check what benefits you are entitled to and if you have a limit package, it will inform you about the current status of the limits. You must tell the administrative staff why you are looking for them, as they will help organize your care in a private healthcare institution.

Step 4: The service organizer organizes the care.

Based on the information provided, the administrative staff will organize the care for you and inform you of the exact location and time. Of course, if there is an institution that you would like to go to, you can tell this to them, and you can also specify a preferred date.

Step 5: The care is provided, for which it is not needed to pay on the spot.

All that’s left is the examination. Care is provided at the institution. It is very important: you do not need to pay the cost of the care on the spot. The insurance company settles the cost of the care directly with the health care institution.

Step 6: If further medical examination is necessary, call the service organizer again

Depending on the test results, if you need further testing, call the service organizer again, who will help you organize the next care.

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Because he sacrifices his health in order to make money. Then he sacrifices money to recuperate his health.

– Dalai Lama

Just the numbers.

01.
Policy-holder
0 +
02.
Insurance company
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Where can you go to the doctor with the insurance? Partner clinics.

In general, it can be said that the health insurances we can sell you, can be used in many clinics of the country’s largest private healthcare institutions.

The insurance companies do not organize medical care directly, this task is carried out by the service organizing partners of the insurance companies. The country’s three largest service organization companies are Teladoc, Medi24 (Europe Assistance) and Érted.

Each service organization company works with its own partner list.

Free choice of doctor

In the event that you cannot find an institution where you would like to see a doctor among the partners of the service organizer, you have the option of going to an institution with the insurance that is not a contracted partner of the insurance company. You can therefore use the insurance ANYWHERE where medical care can be provided according to legal considerations.

In this case, unlike the (LINK) process described in our previous article, the insurance company will pay you the cost of the service afterwards, against the invoice issued in your name.

Let’s look at one or two concrete examples!

CMC SOUTH CLINIC

CMC DÉLI KLINIKA, located near the Southern Railway Station (Déli Pályaudvar), with an exclusive interior design, is one of the most advanced private institutions in the country. The implementation of precision medicine in the clinic is made even more effective and convenient with various bioinformatics solutions and decision-making support based on artificial intelligence.

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Swiss Clinic

All medical professions are available in the Swiss Premium Health Centers. There are 12 clinics in the country, including three priority health centers located in Pest, Buda and Újbuda. In addition to outpatient care, the clinic places great emphasis on same-day surgical care and screening tests.

Doktor24

Doktor 24 is Hungary’s leading healthcare provider. Patients are welcomed at 11 locations in 7 cities and with an institutional network of more than 100 clinics. With a medical staff of roughly 1,000 people, they provide health care for both adults and children in nearly 50 specialties.

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Ajánlatkérés - ingyenes tanácsadás

Írj nekünk és gondoskodjunk együtt a te és munkavállalóid egészségéről!

Outpatient benefits

What specialist medical services can you use?

Internal medicine, otolaryngology, ophthalmology, gynecology, urology, dermatology, allergology, cardiology, orthopedics, rheumatology, electrotherapy, pulmonary medicine, neurology, oncology, gastroenterology, dietetics, etc. General definition that the insurance covers outpatient services , which care is approved on medical grounds. Therefore, alternative medical procedures that are not medically interpretable are not included in the insurance.

Diagnostic tests

What diagnostic tests can you use?

Among the diagnostic services, we distinguish between low- and high-value diagnostic examinations.

Typically, low-value diagnostics include ultrasound examination, X-ray examination, blood and urine examination.

The group of high-value diagnostic tests includes MRI, PET CT and Cardio-CT.

Same day surgery

What same-day surgical services can you use?

In the case of same-day surgical services, the offers of insurance companies differ quite a bit. There are insurance companies that cover all care that is medically justified, while there are insurance companies that only cover one-day surgical care from a predetermined list. Some examples of these, without claiming to be complete:

  • Gynecology: Laparoscopic uterine, tubal and ovarian surgeries, therapeutic curettage, cervical surgeries, vaginoplasty and other minor gynecological surgeries
  • Surgery: Inguinal and umbilical hernia operations, treatment of hemorrhoids and rectal fistulas.

  • Gastroenterology: Endoscopic oesophagus, stomach, horseshoe intestine, bile and colon irrigations.

Additional services: Otorhinolaryngology, Orthopedics, Traumatology, Neurosurgery.

Hospital inpatient care

What inpatient services can you use?

The packages typically include a hotel room and related services (food and drink), as well as reimbursement for surgery required due to hospitalization.

Screening tests

What screening tests can you use?

If you don’t have any health complaints, but still want to get a detailed picture of your current state of health, you can go for screening tests.

These are typically the following: Internal medicine examination, ophthalmology, gynecology, urology, laboratory diagnostics, cardiology, abdominal and pelvic ultrasound, chest X-ray, resting ECG. Upon request, additional specialist screenings are also available.

There are insurance companies that do not determine in advance which specialist services can be used for screening, but reimburse the screening services used up to a limit.

Sum insurances

What insurance policies are available?

Reimbursement of critical illnesses: If an illness is diagnosed that is on the list of the given insurance company as „critical illness” – the insurance company transfers a predetermined amount to the insured. This amount can be spent on anything. Here, the insurance company not only pays the fee for the medical care, but also reimburses the insured an additional amount.

Accident insurance: This may be familiar to many. The insurance company reimburses a predetermined amount in the event of a predetermined insured event. Typical covers: Accidental death, accidental permanent damage to health, broken bones, burns, hospital daily allowance, inability to earn.

Life insurance: Similar to accident insurance, the insurance company reimburses a predetermined amount in the event of a predetermined insured event. It is important that here, the insurance company pays not only for events resulting from the accident, but also for health reasons: death, hospital daily allowance, incapacity for work.